Dr. Mauro on Selecting Therapies for Patients With CML

Michael J. Mauro, MD, hematologist, leader of the Myeloproliferative Neoplasms Program, Leukemia Service at Memorial Sloan Kettering Cancer Center, discusses how to best select therapies for patients with chronic myeloid leukemia (CML).

With five oral tyrosine kinase inhibitors and three agents available for patients in the frontline setting, Mauro says the challenge with selecting therapies is a good problem for oncologists to have. He advises them to have an understanding of side effects associated with each agent, as well as to take an individualized approach with patients. Promising therapies include nilotinib, dasatinib, and imatinib.

The next step after selecting an upfront therapy involves evaluating early responses in case switching treatments is necessary. In second-, third-, and fourth-line settings, treatment options remain broad. Disease stage, prior exposure, and genetic mutations are all factors that can be used to select therapies in these settings.

In the next few years, Mauro predicts researchers will have more data on side effects, cardiovascular risk, and using aggressive therapy as an upfront approach.