For many pediatric patients with acute lymphocytic leukemia (ALL), the therapies they need are mainly be tested in the relapse/refractory settings. Which is why experts like Nirali N. Shah, MD, MHSc, head of the pediatric hematologic malignancies section of the Pediatric Oncology Branch at the National Cancer Institute, are looking to see how they can move these therapies into the frontline setting and address ALL head-on.  

One of the things we're trying to do globally in pediatric oncology is trying to see if we can move some of these therapies into frontline. Right now, everything that's being tested you sort of put into the relapse/refractory setting, and then it's sort of based on patients’ availability, suitability, what their antigen expression is, what prior therapies they've had and what we think they'll be able to tolerate in terms of toxicity. But the idea is that if you bring in some of these therapies upfront perhaps it can even prevent relapse overall and improve overall outcomes, so you don't have to have these patients relapse and become multiple refractory. 

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Pediatric patients with ALL can expect therapies to help target their disease after they relapse, but experts are looking to combat the disease in the frontline before that. 

Nirali N. Shah, MD, MHSc

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Moving Therapies From the Relapse/Refractory Setting to the Frontline