Dr. Tasian on Frontline Therapy for Pediatric Patients With Ph-Like ALL

Sarah K. Tasian, MD, an attending physician and assistant professor of pediatrics in the Division of Oncology at Children’s Hospital of Philadelphia (CHOP), discusses frontline therapy for pediatric patients with Ph-like acute lymphoblastic leukemia (ALL).

In pediatric oncology, physicians tend to enroll most patients on trials, explains Tasian. Patients who have Ph-like ALL with ABL-class lesions are assigned to dasatinib (Sprycel) on a separate arm of the frontline phase III trial at CHOP because they have a high risk of relapse and poor survival on regular chemotherapy, states Tasian.

For patients who have CRLF2 or JAK pathway alterations, physicians have a separate phase II clinical trial that is testing ruxolitinib (Jakafi) for second-line treatment of these patients. Physicians do not yet know whether this targeted agent is going to be effective in that patient subset, though. In the adult arena, there are ongoing clinical trials and FDA-approved medications, notes Tasian.