Dr Michael Thompson Highlights Novel Therapies Being Used in Hematologic Malignancies
Michael Thompson, MD, PhD, FASCO, Aurora Advanced Healthcare, outlines novel therapies being used in the treatment of hematologic malignancies and identified biomarkers for deciding on a treatment approach.
What are some novel therapies being used in the treatment of hematologic malignancies?
So, there are many examples of this. BCR-ABL is the prototypic example of precision medicine used for chronic myeloid leukemia (CML) with tyrosine kinase inhibitors, or TKIs. Acute myeloid leukemia (AML), which had not seen a lot of new therapies for decades, now has targeted therapies versus Flt3, versus IDH2, and we’re developing therapies for acute lymphoblastic leukemia (ALL), including Philadelphia-positive, just like CML.
And then in multiple myeloma, there have been limited reports of BRAF inhibition in myeloma. T(11;14) appears to be a marker for BCL-2 inhibition with venetoclax.
What biomarkers have you identified for deciding on a treatment approach for hematologic malignancies?
The biomarkers for treatment can either be prognostic, which we have a lot of biomarkers, or they can be predictive, which actually tells us that a drug is more likely to work in that area. My colleague has studied t(11;14) as a predictive biomarker in myeloma for effective venetoclax, and then we talked about BCR-ABL for Philadelphia-positive ALL for CML, and there are other emerging ones, so IDH2, Flt3 in AML.
Increasingly, people are trying to find other markers, which may be targets, and it’s somewhat theoretical sometimes, so FGFR in various hematologic malignancies. There’s JAK2 inhibition, but other JAK related pathways, so there’s a lot of emerging information. Some of these are in standard of practice. Some are almost becoming standard, and then others are still in the research category of trying to discover and implement new targeted therapies.