Prof John Gribben (Barts Cancer Institute, London, UK) chairs a discussion with Dr Wyndham Wilson (National Cancer Institute, Bethesda, USA), Prof Anton Hagenbeek (Academic Medical Center, Amsterdam, Netherlands), Prof Michael Pfreundschuh (University of Saarland, Homburg-Saar, Germany) and Dr Myron Czuczman (Roswell Park Cancer Institute, Buffalo, USA) about the highlights from day two of the 12th iwNHL.
The group discusses the value of a multidisciplinary approach in cancer management. Understanding of myeloma biology and therapies is proposed to be applicable to NHL; specifically, there is an emerging paradigm of tumour subclones that facilitate drug resistance. Implications of investigational lymphoma therapies are considered: the PI3k inhibitor, idelalisib, and associated toxicities; cancer immunotherapy with chimeric antigen receptor (CAR) T-cells against a range of lymphomas and the limitations of current trial design in this field; the proteasome inhibitor, carfilzomib, and its prospective combination activity; the immunomodulatory drug (IMiD), lenalidomide, in single and combination therapy; the Bcl-2 inhibitor, ABT-199, in single and combination therapy plus minimising ABT-199-mediated tumour lysis syndrome; the biologic, R-Squared (lenalidomide [Revlimid®] plus rituximab [Rituxan®]) regimen, is evaluated as a potential alternative to traditional chemotherapy.