VJHemOnc Podcast

The MDS Sessions: highlights from ASCO/EHA 2021

Treatment options for patients with myelodysplastic syndromes (MDS) remain limited, with the rapid advances seen in other hematological malignancies not replicated in this space. Aside from hematopoietic stem cell transplantation, current approaches are non-curative, instead aiming to delay disease progression and manage cytopenias. The development of second-line therapies is a particularly urgent need. However, much research is underway to address this paucity of available options. Many new agents, targets, and treatment approaches are in development or under investigation, such as novel HMA-based combinations, immunotherapies including magrolimab and sabatolimab, and first-in-class agents like pevondenistat.

Researchers and clinicians from across the world came together to share anticipated trial data and state-of-the-art developments with the MDS community at the recent 2021 American Society of Clinical Oncology (ASCO) and European Hematology Association (EHA) meetings.

In this episode, VJSession chair Amer Zeidan, Yale University School of Medicine and Yale Cancer Center, New Haven, CT, is joined by renowned experts Andrew Wei, Alfred Hospital and Monash University, Melbourne, Australia, and David Sallman, Moffitt Cancer Center, Tampa, FL, to discuss exciting developments in the MDS space reported at the ASCO and EHA 2021 meetings. This MDS session features updates on the latest trial data for key approved and investigational agents, novel targets and therapeutics, and patient selection considerations in light of a broadening treatment armamentarium.

EHA 2021: fixed-duration therapies and sequencing in CLL

Over the last years, the chronic lymphocytic leukemia (CLL) field has seen significant growth in new drugs and new treatment combinations. One emergent strategy is fixed-duration therapy, which combines two or more agents for a set timeframe. Fixed-duration therapy is an appealing option for different reasons, including shorter treatment times and lower costs. Ongoing clinical trials investigating fixed-duration therapy combinations, such as ibrutinib-venetoclax, will help determine the best drug combination as well as the patient populations that will benefit the most. Another increasingly important topic in the CLL field is the optimal treatment selection and sequencing of therapies in the era of targeted therapies.

In this exclusive podcast, Paolo Ghia, MD, Università Vita-Salute San Raffaele, Milan, Italy, Arnon Kater, MD, PhD, University of Amsterdam, Amsterdam, The Netherlands, and Jacqueline Barrientos, MD, MS, Feinstein Institute for Medical Research, Manhasset, NY, discuss some of the latest updates in CLL treatment presented at the European Hematology Association (EHA) Congress 2021.

The AML Sessions: highlights from ASCO/EHA 2021

Acute myeloid leukemia (AML) is a clonal hematologic malignancy defined by genetic heterogeneity due to recurrent gene mutations. Precision medicine has gained importance in the treatment of AML, with important developments in gene mutation-targeted therapeutic agents transforming the treatment landscape. The role of measurable residual disease (MRD), an independent, postdiagnosis, prognostic indicator, in AML has been explored for many years. Still, the implementation of standardized MRD techniques remains critical for their use in clinical practice. Although the field has seen major therapeutic advances, novel agents, targets, and regimens continue to be investigated to offer patients a more promising outcome.

In this VJSession, Naval Daver, MD, University of Texas MD Anderson Cancer Center, Houston, TX, is joined by Eunice Wang, MD, Roswell Park Comprehensive Cancer Center, Buffalo, NY, and Felicitas Thol, MD, Hannover Medical School, Hannover, Germany, who discuss the exciting updates in the field of AML from the 2021 EHA and ASCO meetings, including developments in targeted therapeutic agents, MRD approaches and emerging therapies and targets.

EHA 2021: key trial updates in myeloma

The treatment and management of multiple myeloma has evolved drastically over the last ten years with the introduction of many novel drug classes and therapies, resulting in notable improvements in overall survival. However, many patients remain relapsed or refractory and thus clinical trials of novel agents and combinations are key to improving the outcomes of high-risk subgroups. In particular, there has been a rapid increase in the number of immunotherapies being trialled for myeloma patients, including monoclonal antibody and chimeric antigen receptor T-cell (CAR-T) therapies.

In this podcast, Saad Usmani, MD, MBBS, MBA, from the Levine Cancer Institute and Atrium Health, Charlotte, NC, Maria-Victoria Mateos, MD, PhD, from the University of Salamanca, Salamanca, Spain, Enrique M. Ocio, MD, PhD, from the Marqués de Valdecilla University Hospital, Santander, Spain, Amrita Krishnan, MD, from City of Hope, Duarte, CA, and Evangelos Terpos, MD, PhD, from the National and Kapodistrian University of Athens, Athens, Greece, share key updates on clinical trials of novel therapies and regimens for the treatment of multiple myeloma, as presented at this year’s Congress of the European Hematology Association (EHA 2021).

Key updates on CAR-T therapy for ALL

There are several forms of acute lymphoblastic leukemia (ALL), with B-cell ALL being the most common (~75% of cases). A range of treatments are available for ALL, including chemotherapy, radiation therapy, and stem cell transplantation. Chimeric antigen receptor T-cell (CAR-T) therapy is a novel cellular therapy that has demonstrated potential for treating other forms of leukemia, such as B-cell non-Hodgkin lymphoma and multiple myeloma.

In this podcast, Reuben Benjamin, MBBS, FRCPath, PhD, from King's College Hospital, London, UK, Cameron Turtle, MBBS, PhD, FRACP, FRCPA, from the Fred Hutchinson Cancer Research Center, Seattle, WA, Claire Roddie, MD, PhD, from University College London, London, UK, Nirali Shah, MD, from the National Cancer Institute, Bethesda, MD, and Bianca Santomasso, MD, PhD, from the Memorial Sloan Kettering Cancer Center, New York, NY, discuss the latest updates and future directions for the use of CAR-T therapy in the treatment of ALL.

The Myeloma Sessions: post-COMY 2021 myeloma patients session

During the COVID-19 pandemic, myeloma support and advocacy groups were forced to adapt to a new way of working in order to continue helping patients with myeloma and improving their quality of life. The COVID-19 pandemic has changed the way that patients with myeloma interact with their doctors, with phone and video appointments filling in for face-to-face appointments, as well as impacting on the role of nurses. Furthermore, the emotional burden of lockdowns and increased risk of severe COVID-19 infection for patients with hematological malignancies has made the role of myeloma nurses and advocacy groups more important than ever.

In this VJSession, chaired by leading myeloma expert Mohamad Mohty, MD, PhD, Saint-Antoine Hospital, Paris, France, myeloma nurse Sarah Henshaw, BSc, MSc, and patient advocates Jack Aiello, Cindy Chmielewski and Jim Omel, MD, discuss myeloma from the patient’s perspective, highlighting challenges during the pandemic and the role of the patient advocate.

EHA 2021: MRD in myeloma

Over the past ten years, the approval of several new and effective therapies for multiple myeloma has significantly improved overall survival outcomes. The introduction of novel therapies has led to high levels of complete response, and many novel techniques are now being explored for the assessment of the depth of response, one of the most effective thus far being measurable residual disease (MRD). MRD describes a small number of cancer cells which remain after treatment but can only be detected by highly sensitive tests. MRD negativity has been demonstrated to be predictive of longer progression-free survival in a number of studies.

In this podcast, Bruno Paiva, PhD, of the University of Navarra in Pamplona, Spain, Noemi Puig, MD, PhD, of the University Hospital Salamanca in Spain, and Benjamin Derman, MD, of the University of Chicago in IL, discuss key research, presented at this year’s Congress of the European Hematology Association (EHA 2021), investigating the role of MRD in the management of multiple myeloma.

Latest updates on CAR-T therapy for CLL

Chronic lymphocytic leukemia (CLL) is slow to develop and can be hard to treat as patients relapse or become refractory to currently available therapies. Chimeric antigen receptor T-cell (CAR-T) therapy is a novel type of treatment which is currently being explored for several forms of hematological cancer, with FDA approvals of CAR-T therapies for acute lymphoblastic leukemia and diffuse large B-cell lymphoma already in place. Recent trials, such as the TRANSCEND CLL004 trial, have reported promising data on the effectiveness of CAR-T in treating patients with CLL.

In this podcast, Jordan Gauthier, MD, MSc, from the Fred Hutchinson Cancer Research Center, WA, Tanya Siddiqi, MD, from the City of Hope National Medical Center, CA, and David Porter, MD, from the Abramson Cancer Center, PA, report on the latest results from clinical trials and discuss at what point we can consider the idea of curing CLL with CAR-T therapy.

The Myeloma Sessions: post-COMy 2021 roundtable

Age is an important prognostic factor in multiple myeloma, with patients aged over 75 years showing inferior outcomes when compared to younger patients. Several factors play into the poor survival observed, including a higher incidence of severe disease, and high rates of comorbid conditions and functional impairment. However, the elderly population is heterogeneous, ranging from fit and active to frail and dependent. Thus, caring for older adults with myeloma is complex, with many patient factors influencing outcomes. The clinical approach in this patient population must be modified to account for comorbidities and the likelihood of higher treatment-related toxicity. The introduction of proteasome inhibitors in the last 20 years was a huge step to improving survival in elderly patients. These advancements have continued, with ongoing investigations into optimal PI-based combinations and other novel agents.

In this Post-COMy 2021 Myeloma Session, Mohamad Mohty, MD, PhD, Saint-Antoine Hospital, Paris, France; Thierry Facon, MD, Lille University Hospital, Lille, France; and Alessandra Larocca, MD, PhD, of the University Hospital Città della Salute e della Scienza, Torino, Italy, discuss the latest in the treatment of elderly multiple myeloma. Featuring insights into how elderly myeloma treatment evolved to where we are today, frailty assessment, the challenges associated with the extremes of the frailty spectrum, and a look towards the future.

Focus on ALL: treating older patients, Ph-like ALL & post-transplant interventions

Advances in both the treatment landscape and the pathology of the disease have improved the outcome of children and adults with acute lymphoblastic leukemia (ALL). However, many challenges still remain, including the treatment of older patients with ALL, diagnosis of Philadelphia chromosome-like (Ph-like) ALL, a newly identified aggressive subtype, as well as the evolving role of hematopoietic stem cell transplantation.

In this exclusive podcast, VJHemOnc spoke with Selina Luger, MD, of the University of Pennsylvania, Philadelphia, PA, Sarah Tasian, MD, from The Children’s Hospital of Philadelphia, Philadelphia, PA and David Marks, MBBS, PhD, FRACP, FRCPath, of the University Hospitals Bristol NHS Foundation Trust, Bristol, UK, who discuss the challenges in managing older patients with ALL, diagnostic testing modalities for Ph-like ALL and post-allogeneic stem cell transplantation interventions to prevent and treat relapse in patients.