Dr. Link on Nelarabine in Newly Diagnosed T-Cell Malignancies

Michael Link, MD, Lydia J. Lee Professor in Pediatric Cancer, professor, Pediatrics, Stanford Cancer Institute, and a 2018 Giant of Cancer Care in Pediatric Oncology, discusses the randomized trial testing nelarabine in patients with T-cell malignancies.

One of the practice changing abstracts presented at the 2018 ASCO Annual Meeting plenary session was the addition of nelarabine to treatment for the management of T-cell leukemia, says Link. T-cell leukemia used to be a disease that was very difficult to treat, and Link says that cure rates plateaued at around 30% to 40%. However, physicians were able to increase those rates with the drugs that were available to them. Link says that these cure rates are now comparable to other pediatric leukemias.

The study showed that adding nelarabine, which is a relatively new drug for the management of leukemia, to escalating-dose methotrexate is a feasible approach in an already intensive treatment regimen. The trial also showed that the addition of nelarabine resulted in a further incremental improvement in outcome. This series of incremental benefit has ultimately characterized the narrative of pediatric oncology, explains Link.