Expert Point of View: Bruno C. Medeiros, MD

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Bruno C. Medeiros, MD, of Stanford University School of Medicine, Palo Alto, commented, “It’s clear to say that new treatment strategies are needed for adults with [acute lymphocytic leukemia (ALL)] to improve outcomes of relapsed disease and to prevent relapses to begin with.”

He noted that while 90% of ALL patients achieve a first remission, approximately 50% relapse, where 80% of these relapses occur within 2 years of diagnosis. Median overall survival for relapsed ALL ranges from 4 to 6 months and is minimally impacted by sex, age, time from diagnosis, or site of relapse, he said.

Blinatumomab and inotuzumab ozogamycin both showed impressive single-agent activity in relapsed/refractory ALL, and both appear safe in the setting of prior stem cell transplant, according to Dr. Medeiros. What needs to be determined now is whether these monoclonal antibodies can be combined with chemotherapy or other monoclonal antibodies, and whether they have single-agent activity in the front-line setting. ■

Disclosure: Dr. Medeiros has served in a consulting or advisory role for Millennium, has received honoraria from Celgene and Millennium, and has received research funding from Celgene, Millennium, and Novartis.

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