VJHemOnc Podcast

IMW 2021: treatment-free intervals in multiple myeloma

Continuous therapy has been a key aspect of the standard of care approaches for the treatment of multiple myeloma for many years, prolonging disease control and improving progression-free survival in comparison to fixed-duration approaches; however, it is now being discussed whether treatment-free interval strategies could be incorporated into the treatment paradigm. Evidence from the IFM/DFCI2009 (NCT01191060) study has suggested that patients with myeloma who achieve measurable residual disease (MRD) negativity have good outcomes without continuous treatment, and similar findings have been reported in part 2 of the Phase III Cassiopeia (NCT02541383) trial. Despite this, potential surrogate markers, such as MRD, still require validation in order to determine patient eligibility for management strategies involving treatment-free intervals in multiple myeloma.

In this podcast, Phil McCarthy, MD, of the Roswell Park Comprehensive Cancer Center, Buffalo, NY, and Luciano Costa, MD, PhD, of the UAB School of Medicine, Birmingham, AL, discuss the evidence for and against treatment-free intervals in the treatment of multiple myeloma, as debated at the 18th International Myeloma Workshop (IMW 2021).

Highlights from iwCLL 2021

The management of chronic lymphocytic leukemia (CLL) has evolved drastically over the last few years, with the introduction of novel therapies and the identification of new genetic markers. The current most effective therapies for CLL include venetoclax, obinutuzumab and BTK inhibitors, whilst ongoing clinical trials are investigating the use of BTK inhibitors in combination with BCL-2 inhibitors. Furthermore, novel genomic markers are increasingly being used to guide treatment decisions, as well as for prediction and prognostication purposes, and research into the optimal sequencing of targeted therapies is also showing promise in improving outcomes for patients who develop resistance to BCL-2 and BTK inhibitors.

In this podcast, Paolo Ghia, MD, PhD, of Università Vita-Salute San Raffaele and IRCCS Ospedale San Raffaele, Milan, Italy, Barbara Eichhorst, MD, of University Hospital Cologne, Cologne, Germany, Lydia Scarfò, MD, of Vita-Salute San Raffaele University & IRCCS San Raffaele Scientific Institute, Milan, Italy, Adrian Wiestner, MD, PhD, of the National Institutes of Health, Bethesda, MD, and Richard Rosenquist, MD, of the Karolinska Institute, Stockholm, Sweden, share some of the latest updates in CLL treatment, as presented at the 19th International Workshop on Chronic Lymphocytic Leukemia (iwCLL) Biennial Meeting in 2021.

IMW 2021: MRD in myeloma

Measurable residual disease (MRD) is emerging as an important prognostic marker in the management of multiple myeloma. Promising clinical evidence from trials, such as the MYELOMA XI trial, has linked MRD-negativity to improved outcomes in myeloma. Whilst research into MRD as a prognostic marker continues, MRD is further being explored as a tool to guide the adaptive treatment of patients, such as by intensifying treatment for MRD-positive patients, or by de-escalating treatment for MRD-negative patients. Future trials investigating the relative safety and efficacy of MRD-guided adaptive treatment will help to determine the optimal role of MRD in multiple myeloma.

In this podcast, Natalie Callander, MD, of the University of Wisconsin School of Medicine and Public Health, Madison, WI, Luciano Costa, MD, PhD, of the UAB School of Medicine, Birmingham, AL, Fredrik Schjesvold, MD, PhD, of the Oslo Myeloma Center Oslo University, Oslo, Norway, Lanny Kirsch, MD, Senior Vice President in Translational Medicine at Adaptive Biotechnologies, Seattle, WA, and Philippe Moreau, MD, of the Nantes University Hospital, Nantes, France, discuss the latest data on the use of MRD in the management and treatment of multiple myeloma, as presented at the 18th International Myeloma Workshop (IMW 2021).

CAR-T vs bispecifics: replacing ASCT in myeloma

Autologous stem cell transplantation (ASCT) has been the standard of care patients with multiple myeloma for the past three decades; however, high-risk patients still have poor outcomes. Many bispecific antibody therapies are currently under investigation for the treatment of myeloma, such as blinatumomab, teclistamab, talquetamab and cevostamab, and the chimeric antigen receptor (CAR) T-cell therapy, idecabtagene vicleucel, became the first CAR-T therapy to receive FDA approval for the treatment of multiple myeloma in March 2021. With CAR-T and bispecific antibodies demonstrating deep and sustained remissions, the role of ASCT in the future treatment of myeloma has become a subject of debate.

In this podcast, Hermann Einsele, MD, FRCP, of the University of Würzburg, Würzburg, Germany, and Parameswaran Hari, MD, MRCP, MS, of the Froedtert Hospital Cancer Center, Milwaukee, WI, discuss the benefits and drawbacks of the two immunotherapeutic modalities, CAR-T and bispecific antibodies as a replacement for ASCT in multiple myeloma.

EHA 2021: antibody therapies for NHL

Antibody therapies are rapidly transforming the treatment landscape of non-Hodgkin lymphoma (NHL). Since the development of rituximab as an anti-CD20 antibody, there has been an intense research interest in antibody-based therapeutic approaches. The use of antibody-drug conjugates, monoclonal antibodies, and bispecific antibodies are increasingly being investigated in clinical trials for the treatment of NHL, particularly in diffuse large B-cell lymphoma (DLBCL) and in the relapsed/refractory setting, offering alternative strategies for disease management.

In this podcast, Gilles Salles, MD, PhD, of the Memorial Sloan Kettering, New York, NY, Martin Hutchings, MD, PhD, of the Copenhagen University Hospital, Copenhagen, Denmark, Moshe Yair Levy, MD, of the Baylor Charles A. Sammons Cancer Center, Dallas, TX, Paolo Caimi, MD, of the University Hospitals Cleveland Medical Center and Case Western Reserve University, Cleveland, OH, and Nilanjan Ghosh MD, PhD, of the Levine Cancer Institute, Charlotte, NC, discuss the latest clinical updates on the use of antibody therapies for the treatment of NHL, as presented at the European Hematology Association (EHA) Congress 2021 and the International Conference on Malignant Lymphoma (ICML), 2021.

EHA 2021: updates on novel agents for AML

A significant number of patients with acute myeloid leukemia (AML) are unable to withstand intensive chemotherapy regimens due to older age and the presence of comorbidities, creating an unmet medical need. Recent advances in the understanding of the genomics underlying AML have led to the development of therapies targeting FLT3, IDH1/2 and BCL-2. Between 2017 and 2018 the US FDA approved a total of eight drugs for AML, including glasdegib, venetoclax, ivosidenib, midostaurin and gemtuzumab ozogamicin. Many trials are now reporting longer follow-up data on these drugs as well as on novel combinations and approaches.

In this podcast, Andrew Brunner, MD, of the Massachusetts General Hospital, Boston, MA, Mark Levis, MD, PhD, of the Sidney Kimmel Comprehensive Cancer Center, Baltimore, MD, Stéphane de Botton, MD, PhD, of the Gustave Roussy Institute, Paris, France, and Andrius Zucenka, MD, of the Vilnius University Hospital Santaros Klinikos, Vilnius, Lithuania, share updates on novel therapies for the treatment of AML, as presented at the European Hematology Association (EHA) 2021 congress.

Texas MPN Workshop 2021: updates on JAK inhibitors for MPNs

Janus kinase (JAK) inhibitors are becoming an increasingly prominent class of drug in the treatment of myeloproliferative neoplasms (MPNs), in particular for the management of myelofibrosis symptoms. With the FDA approval of ruxolitinib in 2011 followed by the approval of fedratinib in 2019, JAK inhibitors are already established in the myelofibrosis treatment landscape; however, studies investigating novel JAK inhibitors could potentially lead to further approvals. Both pacritinib and momelotinib have demonstrated promising results in the PERSIST-2 trial and the SIMPLIFY-1 and SIMPLIFY-2 trials and continue to be explored in the ongoing MOMENTUM and PACIFICA trials, respectively.

In this podcast, Ruben Mesa, MD, of the Mays Cancer Center at UT Health San Antonio MD Anderson Cancer Center, San Antonio, TX, Aaron Gerds, MD, of the Cleveland Clinic, Cleveland, OH, and Abdulraheem Yacoub, MD, MBBS, of The University of Kansas, Westwood, KS, discuss the latest updates on JAK inhibitors for the treatment of MPNs, as presented at the Texas MPN Workshop: Second Annual Meeting and Workshop 2021.

EHA 2021: targeted therapies for ALL

Great progress has been made in the treatment of acute lymphocytic leukemia (ALL), primarily owing to the development of targeted therapies such as monoclonal antibodies and tyrosine kinase inhibitors. The use of targeted therapies has significantly improved survival outcomes for patients with ALL and has become a mainstay of frontline treatment. Since the FDA approval of blinatumomab, inotuzumab ozogamicin, and tisagenlecleucel, clinical trials have been increasingly investigating combination regimens with these targeted agents with the goal of optimizing their use and reducing the need for cytotoxic therapies.

In today’s podcast, Bijal Shah, MD, of the H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL, Daniel W. Lee, MD, of the University of Virginia, Charlottesville, VA, Nicholas Short, MD, of the MD Anderson Cancer Center, Houston, TX, and Robin Foà, MD, of the Sapienza University of Rome, Rome, Italy, talk on the latest clinical updates on the use of targeted therapies for the treatment of ALL, as presented at the European Hematology Association (EHA) Congress 2021.

Texas MPN Workshop 2021: updates on interferons for MPNs

Many clinical trials are currently investigating the potential benefits of interferons in the treatment of myeloproliferative neoplasms (MPNs), in particular for polycythemia vera, essential thrombocythemia and myelofibrosis. Interferon-alfa was originally explored for MPN treatment many years ago, however it’s frequent dosing and toxicity profile present barriers to widespread use. More recently, ropeginterferon-alfa-2b-vjft reported promising results for patients with polycythemia vera in the PROUD and CONTINUATION-PV clinical trials (NCT01949805; NCT02218047) and is now being reviewed for approval by the FDA, and pegylated-interferon-alfa has also demonstrated efficacy.

In this podcast, we hear from Richard Silver, MD, and Nicole Kucine, MD, MS, both from the Weill Cornell Medical College, New York, NY, who share the latest clinical updates on the use of interferons for the treatment of polycythemia vera and essential thrombocythemia, as presented at the Texas MPN Workshop: Second Annual Workshop and Meeting in 2021.

EHA 2021: real-world data on myeloma, lymphoma and CLL

Real-world data gained through scientific studies is essential in the advancement of treatments for all hematologic malignancies. Historically, pharmaceutical companies have been restricted to randomized clinical trials as their only form of testing a treatment. However, due to technological advancement, there are now ways in which data from real-world treatment settings can be collected by clinical researchers. Real-world data is used to support decision making regarding the usage, overall benefits, and risks associated with specific drugs and therapeutic combinations.

In this podcast, David Miklos, BSc, MD, PhD, of Stanford University, Stanford, CA, Elena Zamagni, MD, PhD, of the University of Bologna, Bologna, Italy, Heinz Ludwig, MD, of the Wilhelminen Cancer Research Institute, Wilhelminenspital, Vienna, Austria, and Andrea Visentin, MD, PhD, of the University of Padua, Padova, Italy, discuss some of the latest real-world data to have been shared in the fields of lymphoma, myeloma and chronic lymphocytic leukemia (CLL), as presented at the European Hematology Association (EHA) Congress 2021.