Recent Advances in Hematologic Oncology: A 4-Part Live ...
Transcript of Recent Advances in Hematologic Oncology: A 4-Part Live ...
Recent Advances in Hematologic Oncology: A 4-Part Live Webinar Series Reviewing Key Data and
Presentations from the 62nd ASH Annual Meeting Part 2 — Hodgkin and Non-Hodgkin Lymphoma
Wednesday, February 3, 20215:00 PM – 6:00 PM ET
John Kuruvilla, MDJohn P Leonard, MD
Michael E Williams, MD, ScMModerator
Neil Love, MD
Faculty
Faculty
John Kuruvilla, MDHematologist, Princess Margaret Cancer CentreAssociate Professor, University of TorontoToronto, Ontario, Canada
John P Leonard, MDRichard T Silver Distinguished Professor of Hematology and Medical OncologyAssociate Dean for Clinical ResearchExecutive Vice Chair, Joan and Sanford I Weill Department of MedicineWeill Cornell MedicineNew York, New York
Michael E Williams, MD, ScMByrd S Leavell Professor of MedicineChief, Hematology/Oncology DivisionPhysician Lead, Cancer Service LineUniversity of Virginia School of MedicineCharlottesville, Virginia
Commercial Support
This activity is supported by educational grants from AstraZeneca Pharmaceuticals LP, Bristol-Myers Squibb Company, Genentech, a member of the Roche Group, Incyte Corporation, KaryopharmTherapeutics and Seagen Inc.
Dr Love — Disclosures
Dr Love is president and CEO of Research To Practice. Research To Practice receives funds in the form of educational grants to develop CME activities from the following commercial interests: AbbVie Inc,Acerta Pharma — A member of the AstraZeneca Group, Adaptive Biotechnologies Corporation, Agendia Inc, Agios Pharmaceuticals Inc, Amgen Inc, Array BioPharma Inc, a subsidiary of Pfizer Inc, Astellas, AstraZeneca Pharmaceuticals LP, Bayer HealthCare Pharmaceuticals, Biodesix Inc, bioTheranostics Inc, Blueprint Medicines, Boehringer Ingelheim Pharmaceuticals Inc, Bristol-Myers Squibb Company, Celgene Corporation, Clovis Oncology, Daiichi Sankyo Inc, Dendreon Pharmaceuticals Inc, Eisai Inc, EMD Serono Inc, Epizyme Inc, Exact Sciences Inc, Exelixis Inc, Foundation Medicine, Genentech, a member of the Roche Group, Genmab, Gilead Sciences Inc, GlaxoSmithKline, Grail Inc, Guardant Health, Halozyme Inc, Helsinn Healthcare SA, ImmunoGen Inc, Incyte Corporation, Infinity Pharmaceuticals Inc, Ipsen Biopharmaceuticals Inc, Janssen Biotech Inc, administered by Janssen Scientific Affairs LLC, Jazz Pharmaceuticals Inc, Karyopharm Therapeutics, Kite, A Gilead Company, Lexicon Pharmaceuticals Inc, Lilly, Loxo Oncology Inc, a wholly owned subsidiary of Eli Lilly & Company, Merck, Merrimack Pharmaceuticals Inc, Myriad Genetic Laboratories Inc, Natera Inc, Novartis, Novocure Inc,Oncopeptides, Pfizer Inc, Pharmacyclics LLC, an AbbVie Company, Prometheus Laboratories Inc, Puma Biotechnology Inc, Regeneron Pharmaceuticals Inc, Sandoz Inc, a Novartis Division, Sanofi Genzyme,Seagen Inc, Sirtex Medical Ltd, Spectrum Pharmaceuticals Inc, Sumitomo Dainippon Pharma Oncology Inc, Taiho Oncology Inc, Takeda Oncology, Tesaro, A GSK Company, Teva Oncology, Tokai Pharmaceuticals Inc and Verastem Inc.
Research To Practice CME Planning Committee Members, Staff and Reviewers
Planners, scientific staff and independent reviewers for Research To Practice have no relevant conflicts of interest to disclose.
Dr Kuruvilla — Disclosures
Consulting Agreements AbbVie Inc, Bristol-Myers Squibb Company, Gilead Sciences Inc, KaryopharmTherapeutics, Merck, Roche Laboratories Inc, Seagen Inc
Contracted ResearchAstraZeneca Pharmaceuticals LP, Bristol-Myers Squibb Company, Celgene Corporation, Gilead Sciences Inc, Janssen Biotech Inc, KaryopharmTherapeutics, Merck, Novartis, Roche Laboratories Inc, Seagen Inc
HonorariaAmgen Inc, Antengene, AstraZeneca Pharmaceuticals LP, Celgene Corporation, Gilead Sciences Inc, Janssen Biotech Inc, Karyopharm Therapeutics, Merck, Novartis, Pfizer Inc, Roche Laboratories Inc, Seagen Inc, TG Therapeutics Inc
Dr Leonard — Disclosures
Consulting Agreements
ADC Therapeutics SA, AstraZeneca Pharmaceuticals LP, Bayer HealthCare Pharmaceuticals, BeiGene, Celgene Corporation, Genentech, a member of the Roche Group, Gilead Sciences Inc, Karyopharm Therapeutics, MEI Pharma Inc, MorphoSys, Nordic Nanovector, Novartis, Roche Laboratories Inc, Sutro Biopharma
Data and Safety Monitoring Board/Committee Biotest Pharmaceuticals Corporation, Bristol-Myers Squibb Company
Dr Williams — Disclosures
Advisory Committee AbbVie Inc
Consulting Agreements Celgene Corporation, Gilead Sciences Inc, TG Therapeutics Inc
Contracted Research Allos Therapeutics, Celgene Corporation, Gilead Sciences Inc, Janssen Biotech Inc, Pharmacyclics LLC, an AbbVie Company, TG Therapeutics Inc
Speakers Bureau Xian Janssen Pharmaceutical Ltd
We Encourage Clinicians in Practice to Submit Questions
Feel free to submit questions now before the program begins and throughout the program.
Familiarizing Yourself with the Zoom InterfaceHow to answer poll questions
When a poll question pops up, click your answer choice from the available options. Results will be shown after everyone has answered.
Cases from the Community: Investigators Discuss Emerging Research and Actual Patients
with Gastroesophageal Cancers (Part 2 of a 3-Part Series)
Thursday, February 4, 20215:00 PM – 6:30 PM ET
Daniel Catenacci, MDYelena Y Janjigian, MD
Rutika Mehta, MD, MPHZev Wainberg, MD, MSc
ModeratorNeil Love, MD
Faculty
Year in Review — Clinical Investigators Provide Perspectives on the Most Relevant New
Publications, Data Sets and Advances in Oncology:Breast Cancer
Tuesday, February 9, 20215:00 PM – 6:00 PM ET
Harold Burstein, MDLisa Carey, MD
ModeratorNeil Love, MD
Faculty
Recent Advances in Hematologic Oncology: A 4-Part Live Webinar Series Reviewing Key Data and
Presentations from the 62nd ASH Annual Meeting Part 3 — Multiple Myeloma
Wednesday, February 10, 20215:00 PM – 6:00 PM ET
Rafael Fonseca, MDRobert Z Orlowski, MD, PhDEdward A Stadtmauer, MD
ModeratorNeil Love, MD
Faculty
Cases from the Community: Investigators Discuss Emerging Research and Actual Patients with Colorectal Cancer (Part 3 of a 3-Part Series)
Thursday, February 11, 20215:00 PM – 6:00 PM ET
Kristen K Ciombor, MD, MSCIEric Van Cutsem, MD, PhD
ModeratorNeil Love, MD
Faculty
Current Concepts and Recent Advances in Oncology: A Daylong Clinical Summit Hosted in Partnership with
North Carolina Oncology Association (NCOA) and South Carolina Oncology Society (SCOS)
Saturday, February 13, 20218:30 AM – 4:30 PM ET
ModeratorNeil Love, MD
FacultyCourtney D DiNardo, MD, MSCE
Robert Dreicer, MD, MSJustin F Gainor, MD
Sara Hurvitz, MDIan E Krop, MD, PhD
John M Pagel, MD, PhDAlexander Perl, MD
Daniel P Petrylak, MDPhilip A Philip, MD, PhD, FRCP
Paul G Richardson, MD
Mitchell R Smith, MD, PhDEric Van Cutsem, MD, PhD
Peter Voorhees, MDHeather Wakelee, MD
Saturday, February 13, 2021 — 8:30 AM – 4:30 PM
Chronic Lymphocytic Leukemia and Lymphomas: John Pagel, Mitchell Smith
Multiple Myeloma: Paul Richardson, Peter Voorhees
Genitourinary Cancers: Robert Dreicer, Daniel Petrylak
Lung Cancer: Justin Gainor, Heather Wakelee
Gastrointestinal Cancers: Philip Philip, Eric Van Cutsem
Breast Cancer: Sara Hurvitz, Ian Krop
Acute Myeloid Leukemia and Myelodysplastic Syndromes: Courtney DiNardo, Alexander Perl
Thank you for joining us!
CME credit information will be emailed to each participant within 3 business days.
Recent Advances in Hematologic Oncology: A 4-Part Live Webinar Series Reviewing Key Data and
Presentations from the 62nd ASH Annual Meeting Part 2 — Hodgkin and Non-Hodgkin Lymphoma
Wednesday, February 3, 20215:00 PM – 6:00 PM ET
John Kuruvilla, MDJohn P Leonard, MD
Michael E Williams, MD, ScMModerator
Neil Love, MD
Faculty
Faculty
John Kuruvilla, MDHematologist, Princess Margaret Cancer CentreAssociate Professor, University of TorontoToronto, Ontario, Canada
John P Leonard, MDRichard T Silver Distinguished Professor of Hematology and Medical OncologyAssociate Dean for Clinical ResearchExecutive Vice Chair, Joan and Sanford I Weill Department of MedicineWeill Cornell MedicineNew York, New York
Michael E Williams, MD, ScMByrd S Leavell Professor of MedicineChief, Hematology/Oncology DivisionPhysician Lead, Cancer Service LineUniversity of Virginia School of MedicineCharlottesville, Virginia
We Encourage Clinicians in Practice to Submit Questions
Feel free to submit questions now before the program begins and throughout the program.
Familiarizing Yourself with the Zoom InterfaceHow to answer poll questions
When a poll question pops up, click your answer choice from the available options. Results will be shown after everyone has answered.
Cases from the Community: Investigators Discuss Emerging Research and Actual Patients
with Gastroesophageal Cancers (Part 2 of a 3-Part Series)
Thursday, February 4, 20215:00 PM – 6:30 PM ET
Daniel Catenacci, MDYelena Y Janjigian, MD
Rutika Mehta, MD, MPHZev Wainberg, MD, MSc
ModeratorNeil Love, MD
Faculty
Meet The ProfessorManagement of Lung Cancer
Friday, February 5, 202112:00 PM – 1:00 PM ET
Joshua Bauml, MD
ModeratorNeil Love, MD
Faculty
Year in Review — Clinical Investigators Provide Perspectives on the Most Relevant New
Publications, Data Sets and Advances in Oncology:Breast Cancer
Tuesday, February 9, 20215:00 PM – 6:00 PM ET
Harold Burstein, MDLisa Carey, MD
ModeratorNeil Love, MD
Faculty
Recent Advances in Hematologic Oncology: A 4-Part Live Webinar Series Reviewing Key Data and
Presentations from the 62nd ASH Annual Meeting Part 3 — Multiple Myeloma
Wednesday, February 10, 20215:00 PM – 6:00 PM ET
Rafael Fonseca, MDRobert Z Orlowski, MD, PhDEdward A Stadtmauer, MD
ModeratorNeil Love, MD
Faculty
Cases from the Community: Investigators Discuss Emerging Research and Actual Patients with Colorectal Cancer (Part 3 of a 3-Part Series)
Thursday, February 11, 20215:00 PM – 6:00 PM ET
Kristen K Ciombor, MD, MSCIEric Van Cutsem, MD, PhD
ModeratorNeil Love, MD
Faculty
Current Concepts and Recent Advances in Oncology: A Daylong Clinical Summit Hosted in Partnership with
North Carolina Oncology Association (NCOA) and South Carolina Oncology Society (SCOS)
Saturday, February 13, 20218:30 AM – 4:30 PM ET
ModeratorNeil Love, MD
FacultyCourtney D DiNardo, MD, MSCE
Robert Dreicer, MD, MSJustin F Gainor, MD
Sara Hurvitz, MDIan E Krop, MD, PhD
John M Pagel, MD, PhDAlexander Perl, MD
Daniel P Petrylak, MDPhilip A Philip, MD, PhD, FRCP
Paul G Richardson, MD
Mitchell R Smith, MD, PhDEric Van Cutsem, MD, PhD
Peter Voorhees, MDHeather Wakelee, MD
Saturday, February 13, 2021 — 8:30 AM – 4:30 PM
Chronic Lymphocytic Leukemia and Lymphomas: John Pagel, Mitchell Smith
Multiple Myeloma: Paul Richardson, Peter Voorhees
Genitourinary Cancers: Robert Dreicer, Daniel Petrylak
Lung Cancer: Justin Gainor, Heather Wakelee
Gastrointestinal Cancers: Philip Philip, Eric Van Cutsem
Breast Cancer: Sara Hurvitz, Ian Krop
Acute Myeloid Leukemia and Myelodysplastic Syndromes: Courtney DiNardo, Alexander Perl
Agenda
Module 1: Evolving treatment paradigm for patients with diffuse large B-celllymphoma (DLBCL) – Ann S LaCasce, MD, MMSc
Module 2: Optimal management of newly diagnosed and relapsed/refractory follicular lymphoma – Dr Leonard
Module 3: Available and emerging approaches for mantle cell lymphoma –Dr Williams
Module 4: Selection and sequencing of therapies for patients with advanced Hodgkin lymphoma – Dr Kuruvilla
Module 5: Advances in chimeric antigen receptor T-cell therapy for DLBCL and other lymphoma subtypes – Jonathan W Friedberg, MD, MMSc
CNS prophylaxis with high-dose methotrexatesignificantly reduces the rate of CNS relapse for patientswith DLBCL.
1. Agree2. Disagree3. There are no data to support this4. I don’t know
Puckrin R et al. ASH 2020;Abstract 477.
Puckrin R et al. ASH 2020;Abstract 477.
Puckrin R et al. ASH 2020;Abstract 477.
Gritti G et al. ASH 2020;Abstract 599.
Gritti G et al. ASH 2020;Abstract 599.
Selinexor has a novel mechanism of action: XPO-1 inhibitor
Kalakonda. Lancet Heme 2020
Decreases production of oncoproteins including c-MYC,
BCL2, BCL6 and BCL-XL
Induces nuclear accumulation of tumor suppressors including p53,
p73, IkBk and FOXO
XPO1 over-expressed in DLBCL and correlates with poor prognosis
Courtesy of Ann S LaCasce, MD, MMSc
Frontline Selinexor plus R-CHOP: Time on Study and Recommended Phase II Dose
Seymour E et al. ASH 2020;Abstract 2109.
Frontline Selinexor plus R-CHOP: Efficacy
Seymour E et al. ASH 2020;Abstract 2109.
Salles et al. Lancet Onc 2020
Lenalidomide enhances NK function with
enhanced ADCC in vitro
Tafasitamab (MOR208)
Tafasitamab
Tafasitamab
Courtesy of Ann S LaCasce, MD, MMSc
L-MIND: Study Design
Maddocks K et al. ASH 2020;Abstract 3021.
First-MIND: Study Design
Belada D et al. ASH 2020;Abstract 3028.
First-MIND: Treatment Emergent Adverse Events
Belada D et al. ASH 2020;Abstract 3028.
Which therapy would you generally recommend first for a patient with DLBCL who experiences disease progression on front-line R-CHOP and is not eligible for high-dose therapy and CAR T-cell therapy?
1. Polatuzumab vedotin/BR (bendamustine/rituximab)2. Tafasitamab/lenalidomide3. Selinexor4. CAR T-cell therapy5. I don’t know
Which therapy would you generally recommend first for a patient with DLBCL who experiences disease progression on front-line R-CHOP and is unfit for high-dose therapy and CAR T-cell therapy?
Tafasitamab/lenalidomide
Polatuzumab vedotin/BR
Polatuzumab vedotin/BR
Tafasitamab/lenalidomide
Tafasitamab/lenalidomide
Tafasitamab/lenalidomide
Tafasitamab/lenalidomide
Polatuzumab vedotin/BR
Polatuzumab vedotin/BR, Tafasitamab/lenalidomide
Agenda
Module 1: Evolving treatment paradigm for patients with diffuse large B-celllymphoma (DLBCL) – Dr LaCasce
Module 2: Optimal management of newly diagnosed and relapsed/refractory follicular lymphoma – Dr Leonard
Module 3: Available and emerging approaches for mantle cell lymphoma –Dr Williams
Module 4: Selection and sequencing of therapies for patients with advanced Hodgkin lymphoma – Dr Kuruvilla
Module 5: Advances in chimeric antigen receptor T-cell therapy for DLBCL and other lymphoma subtypes – Dr Friedberg
Mosunetuzumab: full length CD20/CD3 bispecific antibody
Initial treatment = 8 cycles; if CR achieved, treatment discontinued; if PR or SD, treatment
continued for up to 17 cyclesRetreatment allowed for CR patients who
relapse
• Schuster et al. ASH 2019
Phase I/Ib GO29781 Trial
Courtesy of Ann S LaCasce, MD, MMSc
Assouline S et al. ASH 2020;Abstract 702.
Assouline S et al. ASH 2020;Abstract 702.
Salles G et al. ASH 2020;Abstract 2047.
Leonard J et al. ASH 2020;Abstract 2052.
Regulatory and reimbursement issues aside, what would be your most likely initial treatment choice for a 78-year-old patient with Stage III, Grade I or II FL with fatigue and symptomatic bulky adenopathy who requires treatment?
1. Rituximab2. BR3. R-CHOP4. R-CVP5. Obinutuzumab/bendamustine6. Obinutuzumab/CHOP7. Rituximab/lenalidomide8. Other
Regulatory and reimbursement issues aside, what would be your most likely initial treatment choice for a 78-year-old patient with Stage III, Grade I or II FL with fatigue and symptomatic bulky adenopathy who requires treatment?
R-bendamustine
R monotherapy àR maintenance
R-bendamustine
R-bendamustine
Rituximab/lenalidomide
R-bendamustine
R-bendamustine
R-bendamustine
R-bendamustine
Regulatory and reimbursement issues aside, what is your usual second-line therapy for a 65-year-old patient with FL who attains a complete response to 6 cycles of BR but then experiences disease relapse 4 years later?
1. Re-treatment with BR2. Obinutuzumab/bendamustine3. R-CHOP4. Rituximab/lenalidomide5. PI3K inhibitor 6. Tazemetostat7. Chemotherapy à ASCT8. Other
Regulatory and reimbursement issues aside, what is your usual second-line therapy for a 65-year-old patient with FL who achieves a complete response to 6 cycles of bendamustine/rituximab (BR) but then experiences disease relapse 4 years later?
Rituximab/lenalidomide or Obinutuzumab/lenalidomide
R-CHOP à R maintenance
Rituximab/lenalidomide
Rituximab/lenalidomide
Chemotherapy àautologous transplant
Rituximab/lenalidomide
Rituximab/lenalidomide
Rituximab/lenalidomide
Rituximab/lenalidomide
What is your usual third-line treatment for a patient with FL (EZH2 wild type) who received first-line BR, second-line lenalidomide/rituximab and then develops disease progression?
R-CHOP
Depends on duration of remission
Copanlisib
Idelalisib
Copanlisib
Copanlisib
Copanlisib
Clinical trial
Idelalisib
What is your usual third-line treatment for a patient with FL with an EZH2 mutation who received first-line BR, second-line lenalidomide/rituximab and then develops disease progression?
Tazemetostat
Tazemetostat
Tazemetostat
Tazemetostat
Tazemetostat
Tazemetostat
Tazemetostat
Tazemetostat
Tazemetostat
Agenda
Module 1: Evolving treatment paradigm for patients with diffuse large B-celllymphoma (DLBCL) – Dr LaCasce
Module 2: Optimal management of newly diagnosed and relapsed/refractory follicular lymphoma – Dr Leonard
Module 3: Available and emerging approaches for mantle cell lymphoma –Dr Williams
Module 4: Selection and sequencing of therapies for patients with advanced Hodgkin lymphoma – Dr Kuruvilla
Module 5: Advances in chimeric antigen receptor T-cell therapy for DLBCL and other lymphoma subtypes – Dr Friedberg
Epstein-Peterson ZD et al. ASH 2020;Abstract 119.
Wang ML et al. ASH 2020;Abstract 117.
Wang ML et al. ASH 2020;Abstract 117.
Wang ML et al. ASH 2020;Abstract 117.
A 78-year-old patient with MCL initially treated with BR followed by 2 years of maintenance rituximab experiences disease relapse 3 years later. The patient is otherwise healthy. What would you recommend?
1. Ibrutinib2. Acalabrutinib3. Zanubrutinib4. Lenalidomide5. Lenalidomide + rituximab6. Venetoclax 7. Venetoclax + rituximab8. Other
A 78-year-old patient with MCL initially treated with BR followed by 2 years of rituximab maintenance experiences disease relapse 3 years later. The patient is otherwise healthy. What would you recommend?
Acalabrutinib
Ibrutinib
Zanubrutinib
Acalabrutinib
Acalabrutinib
Acalabrutinib
Acalabrutinib
Ibrutinib
Ibrutinib, Acalabrutinib
Have you administered or would you administer a Bruton tyrosine kinase (BTK) inhibitor as front-line treatment to a patient with MCL who is too frail to receive chemotherapy?
1. I haven’t and would not2. I haven’t but would for the right patient3. I have
Have you administered or would you administer a BTK inhibitor as front-line treatment to a patient with MCL who is too frail to receive chemotherapy?
I haven’t and would not
I haven’t but would for the right patient I haven’t but would for the right patient I haven’t but would for the right patient
I haven’t but would for the right patient
I have
I have
I have
I haven’t but would for the right patient
Regulatory and reimbursement issues aside, would you attempt to access venetoclax for select patients with relapsed/refractory MCL?
1. Yes, as up-front treatment2. Yes, after a BTK inhibitor3. Yes, after a BTK inhibitor à lenalidomide4. Yes, in other situations5. No
Regulatory and reimbursement issues aside, would you attempt to access venetoclax for select patients with relapsed/refractory MCL?
Yes, after a BTK inhibitor àlenalidomide
Yes, after a BTK inhibitor
Yes, after a BTK inhibitor
Yes, after a BTK inhibitor àlenalidomide
Yes, after a BTK inhibitor
Yes, after a BTK inhibitor àlenalidomide
Yes, after a BTK inhibitor
Yes, after a BTK inhibitor
Yes, after a BTK inhibitor; Yes, after a BTK inhibitor à lenalidomide
In general, what would be your most likely treatment recommendation for a 70-year-old patient with MCL who responds to BR and then to ibrutinib on relapse but then develops rapid tumor progression?
1. Lenalidomide2. Lenalidomide + rituximab3. Bortezomib4. Bortezomib + rituximab5. Venetoclax6. Acalabrutinib7. Zanubrutinib8. Brexucabtagene autoleucel9. Other
In general, what would be your most likely treatment recommendation for a 70-year-old patient with MCL who responds to BR and then ibrutinib on relapse but then develops rapid tumor progression?
Brexucabtagene autoleucel
Brexucabtagene autoleucel
Brexucabtagene autoleucel
Brexucabtagene autoleucel
Venetoclax
Bridge therapy to CAR T-cell therapy
Brexucabtagene autoleucel
Brexucabtagene autoleucel
Venetoclax
Agenda
Module 1: Evolving treatment paradigm for patients with diffuse large B-celllymphoma (DLBCL) – Dr LaCasce
Module 2: Optimal management of newly diagnosed and relapsed/refractory follicular lymphoma – Dr Leonard
Module 3: Available and emerging approaches for mantle cell lymphoma –Dr Williams
Module 4: Selection and sequencing of therapies for patients with advanced Hodgkin lymphoma – Dr Kuruvilla
Module 5: Advances in chimeric antigen receptor T-cell therapy for DLBCL and other lymphoma subtypes – Dr Friedberg
Straus DJ et al. ASH 2020;Abstract 2973.
Straus DJ et al. ASH 2020;Abstract 2973.
Straus DJ et al. ASH 2020;Abstract 2973.
Yasenchak CA et al. ASH 2020;Abstract 471.
Yasenchak CA et al. ASH 2020;Abstract 471.
Yasenchak CA et al. ASH 2020;Abstract 471.
Herrera AF et al. ASH 2020;Abstract 472.
Herrera AF et al. ASH 2020;Abstract 472.
Ruan J et al. ASH 2020;Abstract 40.
A 27-year-old man is diagnosed with Stage IVB classical HL with nodal, spleen and bone involvement. Albumin is 3.1 g/dL, Hgb is 8.6 g/dL and white blood cell count is 17,500. IPS (International Prognostic Score): 5. What initial treatment would you recommend?
1. Doxorubicin/bleomycin/vinblastine/dacarbazine (ABVD)2. PET-adapted ABVD3. Brentuximab vedotin + AVD4. AVD5. Other chemotherapy6. Other
A 27-year-old man is diagnosed with Stage IVB classical Hodgkin lymphoma (HL) with nodal, spleen and bone involvement. Albumin is 3.1 g/dL, Hgb is 8.6 g/dL and white blood cell count is 17,500. IPS = 5. What initial treatment would you recommend?
Brentuximab vedotin + AVD
PET-adapted BEACOPP
Brentuximab vedotin + AVD
Brentuximab vedotin + AVD
Brentuximab vedotin + AVD
Brentuximab vedotin + AVD
Brentuximab vedotin + AVD
Brentuximab vedotin + AVD
Brentuximab vedotin + AVD
AVD = doxorubicin/vinblastine/dacarbazine; BEACOPP = bleomycin/etoposide/doxorubicin/cyclophosphamide/vincristine/procarbazine/prednisone
An 85-year-old frail patient with advanced-stage symptomatic HL is not a candidate for aggressive chemotherapy but is seeking active treatment. Regulatory and reimbursement issues aside, what would you recommend?
Brentuximab vedotin/dacarbazine
Sequential brentuximab vedotin à ABVD
Brentuximab vedotin/dacarbazine
Brentuximab vedotin/dacarbazine
Brentuximab vedotin
Brentuximab vedotin + nivolumab
Brentuximab vedotin + nivolumab
Brentuximab vedotin
Brentuximab vedotin, Brentuximab vedotin + nivolumab
ABVD = doxorubicin/bleomycin/vinblastine/dacarbazine
Regulatory and reimbursement issues aside, what would generally be your preferred bridge to transplant for a patient with HL who is experiencing relapse after up-front ABVD?
1. ICE (ifosfamide/carboplatin/etoposide)2. Brentuximab vedotin3. Brentuximab vedotin + nivolumab4. Brentuximab vedotin + pembrolizumab5. Other
Regulatory and reimbursement issues aside, what would generally be your preferred bridge to transplant for a patient with HL who is experiencing relapse after up-front ABVD?
Brentuximab vedotin + nivolumab
Gemcitabine/dexamethasone/cisplatin
ICE if later relapse; brentuximab vedotin + nivolumab for early relapse
Brentuximab vedotin + bendamustine
ICE
Brentuximab vedotin + nivolumab
Brentuximab vedotin + bendamustine
Brentuximab vedotin
Brentuximab vedotin, Brentuximab vedotin + nivolumab
Regulatory and reimbursement issues aside, what is generally your preferred second-line therapy for a patient with HL who is experiencing relapse after up-front ABVD and who is not considered a candidate for transplant?
1. Other chemotherapy2. Brentuximab vedotin3. Brentuximab vedotin + nivolumab4. Brentuximab vedotin + pembrolizumab5. Nivolumab6. Pembrolizumab7. Other
Regulatory and reimbursement issues aside, in general, what is your preferred second-line therapy for a patient with HL who is experiencing relapse after up-front ABVD and who is not considered a candidate for transplant?
Brentuximab vedotin
Pembrolizumab
Brentuximab vedotin + nivolumab
Pembrolizumab
Brentuximab vedotin + nivolumab
Brentuximab vedotin + nivolumab
Brentuximab vedotin + nivolumab
Brentuximab vedotin
Brentuximab vedotin, Brentuximab vedotin + nivolumab
Agenda
Module 1: Evolving treatment paradigm for patients with diffuse large B-celllymphoma (DLBCL) – Dr LaCasce
Module 2: Optimal management of newly diagnosed and relapsed/refractory follicular lymphoma – Dr Leonard
Module 3: Available and emerging approaches for mantle cell lymphoma –Dr Williams
Module 4: Selection and sequencing of therapies for patients with advanced Hodgkin lymphoma – Dr Kuruvilla
Module 5: Advances in chimeric antigen receptor T-cell therapy for DLBCL and other lymphoma subtypes – Dr Friedberg
Maloney DG et al. ASH 2020;Abstract 2116.
Maloney DG et al. ASH 2020;Abstract 2116.
NEW
Background
Jacobson C et al. ASH 2020;Abstract 700.
Jacobson C et al. ASH 2020;Abstract 700.
Jacobson C et al. ASH 2020;Abstract 700.
Anti-CD30 CAR-T cell therapy in relapsed/refractory Hodgkin lymphoma
Ramos et al, JCO online 2020
41 patients
Median 7 prior lines of therapy: Checkpoint inhibitors, Brentuximab
ASCT/alloSCT.
Low grade CRS; no neurologic toxicity; common skin rash
ORR 72%; CR 59%
One year PFS: 36%
Courtesy of Jonathan W Friedberg, MD, MMSc
TumorTumor
Macrophage
CAR T
CNS
Microglia / Myeloid cells
CAR T
IL-1, IL-6, IL-8, IL-10, IFN-g,
GM-CSF, CCL2
Blood
Monocytes
IL-1, IL-6, IL-8, IL-10, IFN-g,
GM-CSF, CCL2
BBB disruption
IL-1, IL-2, IL-6, IL-8, IL-10, IFN-g,
GM-CSF, CCL2, NO
CAR T
Cytokines
CRS
ICANS
Pathophysiology of CAR T-cell-associated neurotoxicity and cytokine release syndrome
Reagan and Neelapu, JCO in press 2020Courtesy of Jonathan W Friedberg, MD, MMSc
Patient identification and appropriate referral for CAR-T cell therapy
• EARLY referral is most important– Numerous open trials in novel settings
• Considerations:– Avoid lymphotoxic therapy (purine analogs, bendamustine)– Avoid immunosuppressive therapy, including steroids– (?) avoid tafasitamab and other CD19-targeting agents
• For DLBCL:– Refer before starting salvage therapy– New products may allow treatment of older individuals– “Real world” experiences variable
Jain et al, BBMT 25:2305-21 2019Courtesy of Jonathan W Friedberg, MD, MMSc
A patient with DLBCL should be in adequate physical condition to undergo autologous stem cell transplant in order to be a suitable candidate for CAR T-cell therapy.
1. Agree2. Disagree3. I don’t know
A patient with diffuse large B-cell lymphoma (DLBCL) should be in adequate physicial condition to undergo autologous stem cell transplant in order to be a suitable candidate for CAR T-cell therapy.
Agree
Disagree
Disagree
Agree
Agree
Agree
Disagree
Disagree
Agree
Cases from the Community: Investigators Discuss Emerging Research and Actual Patients
with Gastroesophageal Cancers (Part 2 of a 3-Part Series)
Thursday, February 4, 20215:00 PM – 6:30 PM ET
Daniel Catenacci, MDYelena Y Janjigian, MD
Rutika Mehta, MD, MPHZev Wainberg, MD, MSc
ModeratorNeil Love, MD
Faculty
Current Concepts and Recent Advances in Oncology: A Daylong Clinical Summit Hosted in Partnership with
North Carolina Oncology Association (NCOA) and South Carolina Oncology Society (SCOS)
Saturday, February 13, 20218:30 AM – 4:30 PM ET
ModeratorNeil Love, MD
FacultyCourtney D DiNardo, MD, MSCE
Robert Dreicer, MD, MSJustin F Gainor, MD
Sara Hurvitz, MDIan E Krop, MD, PhD
John M Pagel, MD, PhDAlexander Perl, MD
Daniel P Petrylak, MDPhilip A Philip, MD, PhD, FRCP
Paul G Richardson, MD
Mitchell R Smith, MD, PhDEric Van Cutsem, MD, PhD
Peter Voorhees, MDHeather Wakelee, MD
Thank you for joining us!
CME credit information will be emailed to each participant within 3 business days.