Mims Discusses Updates to NCCN Guidelines on AML

Alice S. Mims, MD, Acute Leukemia Clinical Research director and associate professor in the Division of Hematology at Ohio State University Comprehensive Cancer Center, discusses key updates to the National Comprehensive Cancer Network (NCCN) guidelines on newly-diagnosed acute myeloid leukemia (AML).

According to Mims, the management of AML has gotten a lot more complicated due to the increase in available therapies. Mainly, things have become divided based on certain patient characteristics such as age and outcomes.

Additionally, a greater emphasis has been put on genomic testing for decision making. Genomic testing helps to determine which patients are able to wait for certain types of therapy. According to Mims, this helps to target actionable mutations that weren’t initially an option in the frontline setting.

0:08 | With the NCCN guidelines, and some of the updates for the management, things have become a lot more complicated, because we have more available therapies than the prior 7 + 3 or hypomethylating agents. I think a lot of the changes have been dividing things up based on age and outcomes. Then looking at that genomic testing and making decisions based on those results for patients who are able to wait. I also think, there have been a lot more recommendations for older patients, who haven't been induction candidates before. The recommendations talking about repeating genomic testing at time of relapse disease, as patients could develop clonal evolution where they may have gain or targetable mutations that may be new options for them that necessarily weren't options in the upfront setting. So, I think those are a lot of the things that have come about in the NCCN guideline changes.