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Modeling Chemotherapy Resistant Leukemia In Vitro
Published on: February 9, 2016
Speed bumps on the road to a chemotherapy-free world for lymphoma patients
1Lombardi Comprehensive Cancer Center, Medstar Georgetown University Hospital, Washington, DC.
Abstract:
With the increasing number of targeted agents for the treatment of patients with lymphoid malignancies comes the promise of safe and effective chemotherapy-free treatment strategies. A number of single agents, such as ibrutinib and idelalisib, have demonstrated impressive efficacy with a favorable toxicity profile. The observations that most responses are, however, partial and treatment duration is indefinite have stimulated interest in combinations of these agents with chemotherapy as well as with each other. Despite the promise of this approach, several recent trials of combinations of agents have been terminated as the result of life-threatening and fatal complications. Such outcomes have generated a cautionary note of the potential for unforeseen adverse effects that challenge drug development and mitigate against the empiric combination of such drugs outside of a clinical trial setting.
Insights
Targeted agents offer chemotherapy-free options for lymphoid malignancies, but combining them, even with chemotherapy, carries risks. Careful clinical trials are essential due to potential fatal complications from drug combinations.
Area of Science:
- Oncology
- Hematology
- Pharmacology
Background:
- Targeted agents like ibrutinib and idelalisib show promise for lymphoid malignancies.
- Current single-agent therapies often result in partial responses and require indefinite treatment.
Purpose of the Study:
- To evaluate the safety and efficacy of combining targeted agents in lymphoid malignancy treatment.
- To explore combinations of targeted agents with chemotherapy.
Main Methods:
- Review of recent clinical trials investigating targeted agent combinations.
- Analysis of reported efficacy and toxicity profiles.
Main Results:
- Single targeted agents demonstrate efficacy but often yield partial responses.
- Combinations of targeted agents, and with chemotherapy, have led to life-threatening complications and trial terminations.
Conclusions:
- While targeted agents offer potential chemotherapy-free strategies, combining them requires extreme caution.
- Empiric drug combinations outside clinical trials are strongly discouraged due to unforeseen fatal adverse events.
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