Investigational strategies in chronic myelogenous leukemia

Imatinib is the cornerstone of therapy in CML and a model for the development of novel agents directed at specific targets. The results of therapy with imatinib continue to improve with approaches such as higher doses of imatinib and, possibly, combinations of imatinib and IFN-α with or without ara-C. There are multiple targets with agents directed to them that may prove to be synergistic with imatinib. These approaches are attractive, particularly when dealing with imatinib-resistant CML, to prevent resistance and improve the probability of cure. The continued understanding of the biology of CML and mechanisms of resistance to imatinib and the ability to develop target-specific therapies should lead to the increased probability of cure for most patients who have CML.