In this episode of Med News Week, presented in partnership with OncoDaily TV, Dr. Jorge Cortes, a globally recognized leader in leukemia research and incoming Chief of Hematology at the University of Alabama at Birmingham and Associate Director for Translation at the UAB O’Neal Comprehensive Cancer Center, discusses the rapidly evolving treatment landscape of chronic myeloid leukemia (CML).
Dr. Cortes reflects on the remarkable transformation of CML management, from historical approaches such as busulfan, hydroxyurea, interferon, and stem cell transplantation to the current era of tyrosine kinase inhibitors (TKIs) and increasingly sophisticated molecular monitoring. He explains how the goals of treatment have evolved from controlling symptoms and prolonging survival to achieving deep molecular responses, treatment-free remission, improved quality of life, and ultimately the possibility of cure.
The conversation also examines the importance of molecular monitoring in modern CML management. Dr. Cortes explains the progression from conventional blood counts and cytogenetic assessments to quantitative PCR and increasingly sensitive molecular techniques. He highlights the significance of early molecular responses in predicting deeper responses later in treatment and discusses the technical considerations involved in interpreting very deep molecular responses, including the importance of control-gene transcript levels when assessing MR4.5 and MR5.
The conversation also expands beyond individual treatment decisions to the global hematology landscape. Dr. Cortes discusses the importance of creating opportunities for researchers from low- and middle-income countries to share their work. He emphasizes that differences in patient populations, genetics, healthcare systems, treatment access, nutrition, and available resources can influence how diseases are managed and how therapies perform. Learning from these diverse experiences, he notes, can strengthen the broader hematology community.
Finally, Dr. Cortes reflects on the future definition of cure in CML. While treatment-free remission has become an achievable goal for many patients, he notes that defining cure remains challenging because disease recurrence can occur many years after treatment. Future advances in molecular testing may eventually allow clinicians to identify more precisely which residual cells are clinically meaningful and determine whether a patient has truly eradicated the disease.