Jeffrey E. Lancet, MD
Following the April 2017 FDA approval of the FLT3 inhibitor midostaurin (Rydapt) for patients with acute myeloid leukemia (AML), additional antibodies have emerged that are expected to advance the field.
The biggest challenges are going to be understanding how to best utilize targeted therapies earlier on and how to combine those therapies in the most effective way. As single agents, these drugs are active, but they are still relatively limited. The real potential is the ability to combine agents and to get the maximum effect out of inhibiting multiple pathways.
Being able, for the first time, to target minimal residual disease is another such challenge. That's clearly an unmet need in this disease when it comes to dealing with patients with leftover leukemia. There is very little that we can do that is effective, and we’re waiting for the other shoe to drop in most cases. If we have a targeted agent that may be able to impact minimal residual disease, that’s going to be a very important step forward. I know a lot of studies right now are focusing on the use of these targeted therapies in the MRD setting and in maintenance in general.
What do you hope community oncologists took away from your lecture that they can apply to clinical practice?
We’re still striking the tip of the iceberg. What we are doing right now and the new drugs that are out there are still so new that there’s a lot to learn. We need to focus on the continuation of clinical trials to advance the field because that’s where the progress is made.
Now that we have the onslaught of new treatments, it changes the way we approach patient care. In the past, we might have told patients that there is very little to offer. Now, we have to give the message to patients that there is more to offer. We should be looking more deeply and carefully at any 1 individual patient’s profile, both at the clinical level and at the molecular genetic level, to better understand that patient’s disease so that we can give the appropriate therapy based upon whatever target may be present.
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