VJHemOnc Podcast

Myeloma at ASH 2020: talquetemab, CARTITUDE-1 & highlights

The field of multiple myeloma is rapidly evolving and can be credited to an increased understanding of the biology of the disease leading to an improvement in patients outcomes. Despite vast advances, the clinical management of patients with multiple myeloma remains challenging, namely resistance in relapsed patients as well as the identification of predictive and prognostic biomarkers.

In this podcast following the virtual annual American Society of Hematology (ASH) 2020 meeting, we hear from three leading experts in multiple myeloma, Niels van de Donk of the University Medical Center, Amsterdam, Netherlands, Yi Lin of Mayo Clinic, Rochester, MN and Maria-Victoria Mateos, of the University of Salamanca, Salamanca, Spain, who address the latest therapeutic approaches presented at ASH 2020 annual meeting.

Advances in CAR T-cell therapies for lymphoma from ASH 2020

Lymphoma is a group of malignant neoplasms of lymphocytes that progress in the lymphatic system. Generally, lymphomas are categorized into two groups: non-Hodgkin lymphoma and Hodgkin lymphoma. Depending on which type of lymphocyte is affected, NHL is classified into B-cell and T-cell NHL. The treatment landscape of B-cell NHL has evolved with the recent treatment developments, including chimeric antigen receptor (CAR) T-cell therapies. Axicabtagene ciloleucel (axi-cel), a CAR T-cell product, is currently being evaluated in patients with follicular lymphoma or marginal zone lymphoma in the ZUMA-5 trial. Additionally, lisocabtagene maraleucel (liso-cel) demonstrated promising clinical activity among patients with relapsed/refractory (R/R) mantle cell lymphoma (MCL), according to the TRANSCEND study. One of the novel CAR T-cell products, AUTO3, which contains two independent CARs targeting CD19 and CD22, is being evaluated in patients with R/R diffuse large B-cell lymphoma.

In this fascinating podcast, Sattva Neelapu, MD, University of Texas MD Anderson Cancer Center, Houston, TX, Michael Wang, MD, University of Texas MD Anderson Cancer Center, Houston, TX, and Aravind Ramakrishnan, MD, Sarah Cannon Blood Cancer Center at St. David’s South Austin Medical Center, Austin, TX, discuss CAR T-cell therapy updates in the lymphoma field presented at the 62nd American Society of Hematology (ASH) 2020 Annual Meeting and Exposition.

Moving forward in MPN: timing driver mutations and novel therapies from ASH 2020

Myeloproliferative neoplasms (MPNs) are a heterogeneous group of rare myeloid neoplasms characterized by the abnormal proliferation of hematopoietic stem cells within one or more terminal myeloid lineages. Recent advances in the field have drastically improved our understanding of the pathophysiology of MPNs, which have expanded the scope for potential novel therapies.

In this podcast, we are joined by Jyoti Nangalia, MBBChir, of Wellcome Sanger Institute, UK, Srdan Verstovsek, MD, of the University of Texas MD Anderson Cancer Center, Houston, TX, and Cem Akin, MD, of the University of Michigan, Ann Arbor, MI, to discuss pioneering data surrounding MPN pathogenesis and novel therapies presented at this year’s virtual American Society of Hematology (ASH) Annual Meeting and Exposition.   

The MDS sessions: lower-risk disease

Myelodysplastic syndromes (MDS) represent a range of disorders characterized by morphologic dysplasia, cytopenias, and a risk of progression to acute myeloid leukemia. Patients with lower-risk MDS are defined as having a risk of very low, low, or intermediate disease according to the IPSS-R. The armamentarium of treatment approaches is broadening in the field of lower-risk MDS, however, greater advances in treatment strategies are required before we can confidently alter the natural course of disease in the majority of patients.

In this podcast, Amer Zeidan, MBBS, Yale University and Yale Cancer Center, New Haven, CT, chairs an insightful discussion on lower-risk MDS, focusing on diagnostic approaches and associated challenges, current management of disease as well as future novel therapeutic options for MDS patients. Dr Zeidan is joined by Valeria Santini, MD, of the University of Florence, Florence, Italy, Rami Komrokji, MD, of H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, and Olatoyosi Odenike, MD, of the University of Chicago, Chicago, IL.

The AML Sessions: FLT3-mutated disease

Mutations in the FMS-like tyrosine kinase 3 (FLT3) gene are seen in 30% of all acute myeloid leukemia (AML) cases, most commonly involving the internal tandem duplication region (FLT3-ITD) which constitutively activate its kinase activity and thus, allows for leukemia cell proliferation and survival. A particularly poor prognosis is conferred by mutant FLT3, increasing relapse risk, and decreasing overall survival. For this reason, FLT3 genetic testing is advised at diagnosis, and the development of FLT3 inhibitors represent a significant research area over the past decade. Integration of these inhibitors, such as midostaurin and gilteritinib, have helped to improve outcomes of patients with AML but challenges remain, especially treatment resistance.

In this podcast, Naval Daver, MD, The University of Texas MD Anderson Cancer Center, Houston, TX chairs an insightful discussion on FLT3 mutated AML as part of the AML sessions, together with Amir Fathi, MD, MPH, Massachusetts General Hospital, Boston, MA; Jessica Altman, MD, Northwestern University, Chicago, IL; and Eunice Wang, MD, Roswell Park Comprehensive Cancer Center, Buffalo, NY. They discuss novel treatment combinations for FLT3 mutated cancer, as well as treatment options for front-line and post-transplant maintenance settings, and mechanisms of resistance.

 

The Lymphoma Sessions: highlights from iwNHL 2020

This year’s virtual International Workshop on Non-Hodgkin Lymphoma (iwNHL) highlighted key progress in our understanding of various non-Hodgkin lymphoma (NHL) subtypes, the role of the immune microenvironment, as well as evaluating novel therapeutic strategies in development for patients with NHL.

In this podcast, John Gribben, MD, DSc, FRCP, FRCPath, FMed Sci, of Barts Cancer Institute, London, UK, chairs a compelling discussion on key highlights from the iwNHL 2020 virtual meeting, including the next questions from the results of the KEYNOTE-204 trial in Hodgkin lymphoma, the significance of immunotherapy and the microenvironment, and an overview of exciting novel agents in NHL. Prof. Gribben is joined by Peter Borchmann, MD, of the University Hospital Cologne, Cologne, Germany, Martin Hutchings, MD, PhD, Copenhagen University Hospital, Copenhagen, Denmark, and Stephen Ansell, MD, PhD, Mayo Clinic, Rochester, MN.

The MDS sessions: clinical trial participation, endpoints & approvals

Myelodysplastic syndromes (MDS) represent a range of disorders characterized by morphologic dysplasia, cytopenias, and a risk of progression to acute myeloid leukemia. With hematopoietic stem cell transplantation representing the only curative option for patients with MDS, the field has not seen the rapid evolution in treatments witnessed in other hematological malignancies.

In this podcast, Amer Zeidan, MBBS, Yale University and Yale Cancer Center, New Haven, CT, chairs a discussion evaluating issues pertaining to MDS, from clinical trial designs to the latest understanding of disease biology as well as future outlooks. Dr Zeidan is joined by Amy DeZern, MD, MHS, of Sidney Kimmel Comprehensive Cancer Center, Baltimore, MD, Michael Savona, MD, of Vanderbilt University Medical Center, Nashville, TN, Mikkael Sekeres, MD, MS, of The Cleveland Clinic, Cleveland, OH and David Steensma, MD, Dana-Farber Cancer Institute, Boston, MA.

The AML sessions: venetoclax-based regimens

The BCL-2 inhibitor venetoclax has been evaluated in many hematological malignancies, including acute myeloid leukemia (AML). More recently, emerging mechanisms of resistance and future directions of venetoclax in combination with hypomethylating agents and IDH inhibitors have been evaluated and data presented at EHA 2020, as well as SOHO 2020 has shown promising results in AML.

In this podcast, Naval Daver, of The University of Texas MD Anderson Cancer Center, Houston, TX, leads an exciting discussion alongside Courtney DiNardo and Marina Konopleva, also from The University of Texas MD Anderson Cancer Center, as well as Andrew Wei of Monash University, Melbourne, Australia, on the latest updates in the use of venetoclax-based regimens for the treatment of AML.

 

The AML Sessions: IDH inhibitors

IDH mutations are present in 20% of acute myeloid leukemia (AML) patients and the use of IDH targeting agents has shown favorable clinical responses in AML, with ivosidenib and enasidenib (IDH1 and IDH2 inhibitors) being approved by the US F.D.A for relapsed/refractory AML patients.

In this podcast, Amir Fathi of Massachusetts General Hospital, Boston, MA, chairs a panel discussion evaluating the use of IDH inhibitors in AML and myelodysplastic syndromes, the potential of combination therapies using these agents, and the development of differentiation syndrome in AML. Dr Fathi is joined by Stephane De Botton of Gustave Roussy Institute, Villejuif, France, and Daniel Pollyea of the University of Colorado, Denver, CO.

The AML sessions: advances in immuno-oncology from SOHO 2020

The field of acute myeloid leukemia (AML) has seen rapid progression in the field of immuno-oncology which has led to vast improvements in patient outcomes. The annual Society of Hematological Oncology (SOHO) allowed great discussion of the translation of key data into clinical practice, including the state of the art in immunotherapy for AML.

In this podcast, Marion Subklewe of LMU Hospital Munich, Munich, Germany, leads a panel discussion evaluating checkpoint inhibitors, anti-CD47 therapy, BiTEs and CAR T-cell approaches in AML alongside Naval Daver of the University of Texas MD Anderson Center, Houston, TX, David Sallman of H. Lee Moffit Cancer Center, Tampa, FL and Amer Zeidan of Yale University and Yale Cancer Center, New Haven, CT.