NEW YORKWorld-renowned thought leaders discussed important clinical advances and new guidelines in the diagnosis and treatment of hematologic malignancies, at the first annual National Comprehensive Cancer Network (NCCN) Hematologic Malignancies Congress. Highlights were presented in a media briefing.
Key changes, which have been included in updated NCCN Clinical Practice Guidelines in Oncology, include incorporation of recently FDA-approved dasatinib (Sprycel) into treatment of chronic myelogenous leukemia (CML), of lenalidomide (Revlimid) into treatment of multiple myeloma and myelo-dysplastic syndromes (MDS), and of 5-azacitidine (Vidaza) or decitabine (Dacogen) into treatment of MDS.
Hematologic cancer is not uncommon, NCCN noted in a news release, with more than 100,000 new cases diagnosed in the United States in 2006 alone. Indeed, commented media briefing moderator Christopher E. Desch, MD, national medical director of NCCN, "In addition to my position with NCCN, I care for patients in rural Virginia, and many of them have chronic leukemias, myeloma, or MDS."
Panelists at the briefing included Steven D. Gore, MD, of Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins; Paul G. Richardson, MD, of Dana-Farber Cancer Institute; and Stephen D. Nimer, MD, of Memorial Sloan-Kettering Cancer Center, all of whom have worked on developing NCCN guidelines for hematologic cancers.
"Now that we've started recognizing that many people with chronic anemia actually have chronic leukemia, it is thought that MDS may represent the most common hematologic malignancy," with some patients developing MDS secondarily as a result of effective chemotherapy for more common cancers such as breast cancer, lymphoma, or multiple myeloma, Dr. Gore commented.
Critical advances in MDS began in 1993, he said, when a team of oncologists led by Peter L. Greenberg, MD, of Stanford University, developed a prognostic scoring system for stratifying risk levels in MDS, which improved clinicians' ability to evaluate the benefit of various treatment regimens. In 2000, Bruce Cheson, MD, then with the Cancer Therapy Evaluation Program (CTEP) at NCI, spearheaded development of uniform clinical response criteria in MDS, he added.
These key changes, combined with technological advances such as polymerase chain reaction (PCR) and research into bone marrow physiology in MDS, fueled significant advances in the quality and validity of clinical research in MDS, Dr. Gore said.