20th Annual John Goldman Conference on Chronic Myeloid Leukemia: Biology and Therapy
Improved knowledge of the biology underlying CML has revolutionized the clinical management of the disease and introduced new therapeutic perspectives. Imatinib a direct Bcr-Abl kinase inhibitor leads to durable cytogenetic remissions and improved survival. However, many patients with CML are slow responders or develop resistance. Although monitoring is recognized as necessary, when and how to do it and the proper interpretation of the results remain in many ways controversial, and adherence to guidelines deficient. Treatment goals and the significance of deeper molecular response are still being debated. Second-generation TKIs including 2 FDA approved agents are available to overcome Bcr-Abl1 kinase domain mutations. Even so many patients fail subsequent treatment with these agents, as they can develop highly resistant mutations such as T315I. Newer data on the upfront use of second generation TKIs is changing the paradigm of CML therapy further and creating the need for new modalities that can address resistance to these agents. The TKI revolution has introduced new questions that are now being addressed in clinical trials. This information is important to shed light on optimal monitoring and treatment modalities in the setting of the pregnant CML patient. In view of long-term adverse events of TKIs that are now arising, there is also growing interest in the feasibility of treatment discontinuation and eventual restart, and in the monitoring procedures that can provide essential information for clinical decision-making in this context.
Speakers at this meeting will present the newest and often unpublished data that relate to the (1) Biology of CML including the origin of BCR-ABL1, signal transduction, basis of disease progression, action of tyrosine kinase inhibitors and mechanisms underlying resistance to TKI, and (2) Aspects of treatment including prediction and definition of responses, drugs used in combination, targeting residual stem cells, modern diagnostics and molecular monitoring treatment-free remission and approaches to cure.
Physicians & Allied Health Care Professionals
Upon completion of this CME activity, participants should be able to:
1. Understand something of the origin of the BCR-ABL fusion gene, the signal transduction pathways involved in producing the clinical picture of chronic myeloid leukemia (CML) and the mechanisms of action of tyrosine kinase inhibitors.
2. Have some insight into the possible mechanisms of genomic instability that predisposes to formation of the BCR-ABL fusion gene and predisposes also to disease progression.
3. Define a leukemia stem cell and its relationship to disease kinetics in so far as current knowledge permits.
4. Discuss the role of the microenvironment and epigenetic mechanisms in the genesis and progression of CML.
5. Evaluate the merits of various management decisions, eg., how to start treatment for patients in the different phases of CML, how to assess success or failure of initial treatment, what approaches to consider for patients who have failed to respond well to initial treatment, including assessing the precise role of second generation TKIs and other non-molecular therapeutic approaches.
6. Review new modalities of monitoring and mutation assessment and update the current understanding of proper monitoring, clinical significance of monitoring results at different time points, and the importance of timely assessments in the proper management of CML.
7. Assess the role of allogeneic stem cell transplantation in the management of CML in 2018.
8. Critically evaluate the current understanding of treatment discontinuation and approaches to improve the eligibility and outcome for treatment discontinuation.
9. Review current understanding of mechanisms of resistance to tyrosine kinase inhibitors and ways to overcome it.
* Disclosure information provided in handouts on-site at meeting.
ACCME Accreditation Statement:
This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education through the joint providership of the Medical College of Wisconsin and European School of Hematology. The Medical College of Wisconsin is accredited by the ACCME to provide continuing medical education for physicians.
AMA Credit Designation Statement:
The Medical College of Wisconsin designates this live activity for a maximum of 21.0 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
Hours of Participation for Allied Health Care Professionals:The Medical College of Wisconsin designates this activity for up to 21.0 hours of participation for continuing education for allied health care professionals.
- 21.00 AMA PRA Category 1 Credit(s)™AMA PRA Category 1 Credit(s)™
- 21.00 Hours of ParticipationHours of Participation credit.