Dr. Coutre Discusses Combination Strategies in ALL

Steven Coutre, MD, professor of medicine at Stanford University Medical Center, discusses combination strategies for the treatment of patients with acute lymphoblastic leukemia (ALL).

For patients with ALL, the backbone is multi-agent chemotherapy, says Coutre. The concept of using non-cross resistant agents was one of the advances shown in ALL. Newer drugs are not being used except blinatumumab (Blincyto) post induction, which is being investigated in a trial for patients age 40 and older. There is another trial for younger patients using a chemotherapy backbone and randomizing patients post remission to inotuzumab ozogamicin (Besponsa). However, physicians are unsure if using these newer agents earlier in treatment will change the natural history of disease and cause fewer patients to relapse, Coutre adds.

According to Coutre, there are still remaining questions involving minimal residual disease-assessment and if that can be used to identify patients very early who are at higher risk of relapse, as well as better identify their therapy.