Everyone is focused on precision medicine as a potential way to improve cure rates, as well as reduce therapy-induced toxicity. We all dream of being able to cure all of our patients with a minimum of side effects, which is often not the current reality with intensive multi-agent chemotherapy. If we can understand the alterations that drive specific leukemias and if we can find an effective way to target those mutations or target proteins the first time—such that we might prevent relapse or minimize time that a patient needs toxic chemotherapy—that is a "holy grail" of cancer medicine.
Supportive care is obviously critically important. Our patients are at high risk for life-threatening infections, which are major sources of morbidity or mortality. Preventing or minimizing those infections in children with acute leukemias is imperative. Knowing when to intervene with an alternative treatment when a patient isn't responding is also important, which is often guided by our knowledge of cancer biology and genetics and our ability to push the envelope safely and effectively in precision medicine.
Stay in touch with the literature. Listening to new developments will benefit the physician, and, of course, the patient.