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Review

Molecular monitoring of chronic myeloid leukemia: a personalized approach to optimizing treatment response

    Linda Nichols

    * Author for correspondence

    Department of Clinical Practices & Therapeutics, Express Scripts, 100 Parsons Pond Drive, B3-MS2, Franklin Lakes, NJ 07417, USA.

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    Email the corresponding author at linda@nicholsnet.com

    ,
    Julie Pippins

    Department of Clinical Practices & Therapeutics, Express Scripts, 100 Parsons Pond Drive, B3-MS2, Franklin Lakes, NJ 07417, USA

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    ,
    Lon Castle

    Department of Clinical Innovations, Express Scripts, 100 Parsons Pond Drive, Franklin Lakes, NJ 07417, USA

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    ,
    Mary Cassler

    Department of Clinical Innovations, Express Scripts, 100 Parsons Pond Drive, Franklin Lakes, NJ 07417, USA

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    &
    Courtney Fuller

    MolecularMD, 1341 SW Custer Drive, Portland, OR 97219, USA

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    Published Online:13 Sep 2012https://doi.org/10.2217/pme.12.81

    Abstract

    Personalized medicine is rapidly developing a purposeful niche in the field of oncology. Monitoring the activity of the oncogenic fusion gene BCR–ABL1 in chronic myeloid leukemia (CML) is a good example of individualizing CML treatment for patients using patient-specific genetic information. However, the frequency at which molecular monitoring for BCR–ABL1 transcripts occurs during treatment with tyrosine kinase inhibitors (TKIs) for CML in clinical practice is much lower than that recommended by either the National Cancer Center Network or the European LeukemiaNet guidelines. Adherence, one of the most critical factors affecting response to TKIs, is often less than desirable and rarely communicated to physicians by patients or managed by care providers. Less than optimal molecular monitoring and low adherence to TKI treatment can lead to rising transcripts levels, that when not detected, have been shown to contribute to poor outcomes. This review reports the basis for and describes the design of a state-of-the-art program intended to improve communication with physicians through real-time messaging about sequential test results for BCR–ABL1 and patients’ adherence to TKI therapy.

    Papers of special note have been highlighted as: ▪ of interest

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