Treatment failure from drug resistance is the primary reason for relapse in acute lymphoblastic leukemia (ALL). Burke and colleagues conducted a pilot clinical trial in patients with ALL using two classes of epigenetic modifying agents (decitabine and vorinostat) with the goal of synergistically targeting epigenetic alterations before and during chemotherap. that included UK ALLR3 re-induction. On this regimen, nine subjects (39%) achieved a complete response and five had stable disease (22%). Modulation of epigenetic marks was observed. However, the toxicity profile of the combination assessed was not acceptable. Therefore, future studies are necessary to determine if epigenetic modifying therapies can be successfully combined with chemotherapeutics for children with relapsed leukemia.

Metastatic pancreatic ductal adenocarcinoma (PDAC) carries a dismal prognosis and is refractory to conventional chemotherapy. Although immunotherapy has been safe and effective in multiple tumor types, the utility of immunotherapy is limited in PDAC. In a phase I study of...

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