Overview
Program Overview
The introduction of imatinib dramatically changed the management of chronic myeloid leukemia (CML). The International Randomized Study of Interferon versus STI571 (IRIS) trial—a comparison of imatinib versus interferon-α in combination with low-dose cytosine arabinoside—demonstrated that the vast majority of patients treated with imatinib achieve a complete cytogenetic response. Patients who achieve this level of response have a low risk of progression over the next 24 months. However, these and other results that show generally excellent and stable responses to imatinib have led some clinicians to become less vigilant regarding the need for routine monitoring. There is a significant subpopulation of patients with CML whose disease is refractory to imatinib therapy. Indeed, mutations in the kinase domain (KD) of BCR-ABL have been detected in up to 90% of patients who relapse after an initial response, which suggests a potential for the development of resistance over the long term. Moreover, in the IRIS study, approximately 30% of newly diagnosed patients in chronic-phase CML who were treated with imatinib had to discontinue therapy because of unsatisfactory therapeutic effects or toxicity.
Monitoring methods used to assess response to therapy and establish mutational status are critical to guide treatment strategies, especially for those patients with CML who achieve only a suboptimal response or experience imatinib failure. Although the novel tyrosine kinase inhibitors (TKIs) dasatinib and nilotinib are active against many of the BCR-ABL mutations implicated in imatinib resistance, neither of these drugs has activity against the T315I mutation. Consequently, investigational agents with activity against T315I are in clinical development. Given the rapidly changing environment of CML management, this program highlights proper monitoring techniques, the reliability and specificity of laboratory tests, the proper timing for ordering tests, current and emerging agents for treating CML, as well as insight into patients’ perceptions of their current role in therapy selection, treatment-related adverse events, and monitoring.
Educational Objectives
After attending this symposium, participants should be better able to:
- Describe mechanisms of primary and secondary TKI resistance in CML
- Examine the transformation potency and clinical impact of different ABL KD mutations in patients with CML
- Evaluate contemporary monitoring strategies, instruments, and assays utilized to assess disease progression in patients with CML
- Assess the growing body of clinical evidence regarding second-generation TKIs, and the emerging data on investigational agents that have overcome T315I and other KD mutations
Target Audience
This activity has been designed to meet the educational needs of medical oncologists, hematologist/oncologists, hematologists, oncology nurses, and other health care professionals involved in the management of patients with CML.
Agenda
12:30 PM – 1:15 PM Luncheon Reception and Registration
1:15 PM – 1:25 PM Keynote Address: The Convergence of Technology and Clinical Care
Jane F. Apperley, MD
1:25 PM – 1:50 PM Tyrosine Kinase Inhibitors for the Treatment of Ph+ CML
Franck E. Nicolini, MD, PhD
1:50 PM – 2:10 PM The Patient Perspective on Treatment Outcomes and Quality of Life
Cheryl-Anne Simoneau
2:10 PM – 2:35 PM Tools, Techniques, and Strategies for Monitoring Treatment Response in Your CML Patients
Luke P. Akard, MD
2:35 PM – 2:50 PM Case Review: Monitoring Patients With a Suboptimal Response to Imatinib
Jane F. Apperley, MD, and Luke P. Akard, MD
2:50 PM – 3:15 PM Drug Resistance in CML: Impact on Patient Prognosis and Treatment Selection
Andreas Hochhaus, MD
3:15 PM – 3:30 PM Case Review: How and When to Utilize Mutational Analysis in Patients With CML
Jane F. Apperley, MD, and Andreas Hochhaus, MD
3:30 PM – 3:55 PM Overcoming T315I and Other TKI-Resistant Mutations in CML
Alfonso Quintás-Cardama, MD
3:55 PM – 4:10 PM Case Review: Treatment Options for Patients With BCR-ABL Mutations
Jane F. Apperley, MD, and Alfonso Quintás-Cardama, MD
4:10 PM – 4:30 PM Question and Answer Session
Jane F. Apperley, MD
Faculty
Activity Chairperson
Jane F. Apperley, MD
Professor of Medicine
Chair, Department of Haematology
Division of Investigative Science
Imperial College School of Medicine
Hammersmith Hospital
London, United Kingdom
Faculty
Luke P. Akard, MD
Medical Co-Director
Bone Marrow Transplant Program
Indiana Bone and Marrow Transplantation
Indianapolis, Indiana
Andreas Hochhaus, MD
Professor of Medicine
Medizinische Fakultät Mannheim
Ruprecht-Karls-Universität Heidelberg
Mannheim, Germany
Franck E. Nicolini, MD, PhD
Professor of Medicine
Department of Hematology
E Pavilion, Hôpital Edouard Herriot
Lyon, France
Alfonso Quintás-Cardama, MD
Hematology/Oncology Fellow
Division of Cancer Medicine
The University of Texas M. D. Anderson Cancer Center
Houston, Texas
Guest Speaker
Cheryl-Anne Simoneau
President and Chief Executive Officer
The CML Society of Canada
Montreal, Quebec, Canada
