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Cancer Current Topics in Cancer

New Strategies for Hard to Treat CML

Summary & Participants

Standard treatment for chronic myeloid leukemia can occasionally fail. New studies show an increasing number of alternative treatments may be available.

Medically Reviewed On: July 10, 2008

Webcast Transcript

ANNOUNCER: Doctors treating chronic myeloid leukemia now have 54 months of experience with imatinib. The drug, also known as Gleevec, is the standard of care for treating most people with the disease.

BRIAN DRUKER, MD: The most recent updates on Gleevec are showing that for newly diagnosed patients with chronic phase CML, they're doing extraordinarily well. Overall survival at four and a half years is 90 percent. What's really interesting about the most recent data is that the rate of relapse, in other words, the percent of patients or the numbers of patients relapsing per year, actually may be decreasing a little bit. And if that trend holds, there could even be a plateau on the survival curve, meaning that patients could live for decades, potentially. I certainly don't want to make too much of that, because it's early data, but at least there's a hint that we're headed in that direction.

ANNOUNCER: Effectiveness in treating CML can be measured by checking whether a sample of white blood cells, when viewed under the microscope, harbors the abnormal chromosome responsible for the disease. This is a test for what's called the "chromosomal response."

A major chromosomal response is good. A complete chromosomal response is better. The latest data, also from the so-called IRIS trial, shows improving responses by these measures.

MICHAEL DEININGER, MD, PhD: The rate of complete chromosomal [cytogenetic] responses in the latest update of the IRIS trial was 86 percent. So this is still improving, compared to last year, and the major chromosomal response rate is at over 90 percent .

ANNOUNCER: Doctors also monitor CML with more sensitive testing, called molecular testing, or PCR. When patients quickly achieve a significant reduction in their disease at one year, as measured by PCR, new data shows their prognosis may be very good.

MICHAEL DEININGER, MD, PhD: The patients who achieve very substantial reduction of their disease burden at 12 months continue to do extremely well with almost nobody going to blast crisis or accelerated phase. So it seems, for the majority of patients that are newly diagnosed, standard dose imatinib treatment is highly efficacious and relapse is the exception if not the rule.

ANNOUNCER: Scientists are also reporting on early, small-scale studies with new drugs that may prove valuable for the patients whose disease shows resistance to Gleevec. Data from a phase I study of dasatinib shows a significant response in many patients.

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