Expanding Horizons for Immunotherapy in Pediatric Leukemia
While more than 85 percent of children with acute lymphoblastic leukemia (ALL) and 60 percent of children with acute myeloid leukemia (AML) are cured with frontline therapies, relapse and chemotherapy resistance remain major challenges that limit long-term survival. New immunotherapy approaches provide a major paradigm shift in pediatric oncology, often curing previously incurable children. This session will focus upon current clinical strategies to treat children with high-risk ALL and AML with antibody-based and cellular immunotherapies, as well as delineate critical lessons learned from patients who experience immunotherapeutic resistance.
Dr. Lia Gore will summarize successful uses of the bispecific T cell engager blinatumomab, antibody-drug conjugate inotuzumab ozogamicin, and CD19- and CD22-redirected chimeric antigen receptor (CAR) T cells in children with relapsed/refractory B-ALL. She will then discuss current approaches incorporating these immunotherapies into treatment of newly diagnosed children with goals of minimizing relapse and/or decreasing traditional chemotherapy-associated toxicities.
Dr. Sarah Tasian will review current suboptimal outcomes of children with AML treated with conventional therapies and highlight the need for new immunotherapeutic strategies to overcome chemoresistance. She will then discuss the landscape of current and soon-to-open phase i trials of antibody-based and cellular immunotherapies for children with relapsed/refractory AML, as well as the unique potential challenges of these approaches.
Dr. Rebecca Gardner will discuss predictive clinical biomarkers of response and resistance in children with B-ALL treated with antibody-based or cellular immunotherapies. She will then describe new approaches to overcome immunotherapeutic resistance via enhanced CAR constructs, bispecific antigen targeting, combination therapies, and the role of subsequent hematopoietic stem cell transplantation.
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