The highly anticipated panel discussion on the hot topic of MRD at the Myeloma 2017 meeting in Edinburgh, UK produced thought-provoking debate. In this video the main points of debate are discussed by Jeffrey Wolf, MD from the University of California, San Francisco, CA, Roger Owen, MD, MRCP, MRCPath of Leeds Teaching Hospitals NHS Trust, Leeds, UK, Bruno Paiva, PhD from the University of Navarra, Pamplona, Spain, Nina Shah, MD of UCSF Medical Center, San Francisco, CA and Joaquin Martinez-Lopez, MD, PhD from the Hospital Universitario, Madrid, Spain. Questions asked in the discussion included: Should MRD be the primary endpoint…
Author: Editor
Fantastic advances in immunotherapy, including CAR T-cells, bispecific antibodies and potential immunotherapy combinations, were presented at the Myeloma 2017 meeting in Edinburgh, UK. In this panel discussion, Keith Stewart, MB, ChB and Leif Bergsagel, MD from the Mayo Clinic, Scottsdale, AZ and Gareth Morgan, MD, FRCP, FRCPath, PhD of UAMS Myeloma Institute, Little Rock, AR discuss the highlights from day 1 of the meeting. In addition to immunotherapy updates, the potential for a similar phenomenon to double hit lymphoma occurring in multiple myeloma (MM), which would identify a distinct MM subgroup in need of different therapies, is discussed. Furthermore, the…
The current baseline imaging technology for multiple myeloma (MM) management includes PET and MRI. In this interview, Ravi Vij, MD, MBA, from the Washington University School of Medicine, St Louis, WA, talks about how we can improve these existing technologies by referencing fusion scans, which can potentially provide a greater wealth of information. Dr Vij highlights the promising future of novel radiomimetics. This video was recorded at the Myeloma 2017 meeting in Edinburgh, UK.
There is currently a conundrum regarding the differentiation of acute myeloid leukemia and myelodysplastic syndromes. In this interview, Stéphane de Botton, MD, PhD of the Gustave Roussy Institute, Villejuif, France, speaking at the International Conference on Acute Myeloid Leukaemia 2017, Estoril, Portugal by the European School of Haematology (ESH), suggests diagnosing patients based on their genotype. He also stresses the significance of new and existing treatments, including chemotherapy, broad spectrum agents and immunotherapies.
The utilization of CAR T-cells for the treatment of multiple myeloma (MM) has great potential, with numerous different targets and production approaches. In this video, this exciting upcoming area is discussed by Adam Cohen, MD from the Abramson Cancer Center, Philadelphia, PA, Yi Lin, MD, PhD from the Mayo Clinic, Rochester, MD and Sabrina Prommersberger, PhD from the University Hospital Würzburg, Würzburg, Germany at the engaging Myeloma 2017 meeting in Edinburgh, UK. The experts summarize the promising findings of CAR T-cell clinical trials in MM patients thus far, including NCT02546167 and NCT02658929. Looking towards the future, the speakers discuss the…
Research into imaging for multiple myeloma (MM) is expanding into an exciting new field, which is explored in this discussion by Jens Hillengass, MD, from the University Hospital Heidelberg, Heidelberg, Germany, and Saad Usmani, MD, FACP, from the Levine Cancer Institute, Charlotte, NC, at the Myeloma 2017 meeting in Edinburgh, UK. They discuss the heterogeneity of MM, as as well as focal lesions, liquid biopsies and CT as the new standard of imaging for diseases of the bone marrow.
The mechanisms of therapy resistance in multiple myeloma (MM) are evolving. This is deliberated in this insightful discussion between Marc Raab, MD, from the University of Heidelberg, Heidelberg, Germany, and Jonathan Keats, PhD, from the Translational Genomics Research Institute, Phoenix, AZ, at the Myeloma 2017 meeting in Edinburgh, UK. Dr Keats and Dr Rabb discuss the latest results of the CoMMpass study (NCT01454297). They question what confers resistance in patients, referencing the tumor microenvironment, as well as discussing novel subgroups of patients based on their genomic features.
Inhibitors of exportin (XPO1), a nuclear export chaperone, are currently in early clinical trials for acute myeloid leukemia (AML). Speaking from the International Conference on Acute Myeloid Leukaemia 2017 in Estoril, Portugal by the European School of Hematology (ESH), Ramiro Garzon, MD, from the Ohio State University, Columbus, OH, explains why these inhibitors are effective, referencing their effect on both tumor suppressor genes and oncogenes. Dr Garzon also shares preliminary findings from the clinical trials.
There are currently several novel agents that target non-coding RNAs being tested in pre-clinical studies for the treatment of leukemia. In this video, Ramiro Garzon, MD, from the Ohio State University, Columbus, OH, discusses these exciting candidates and talks about the drug development process. This video was recorded at the International Conference on Acute Myeloid Leukaemia 2017 in Estoril, Portugal by the European School of Hematology (ESH).
“There are currently a number of ongoing clinical trials for acute myeloid leukemia (AML) that are targeting nuclear exporters. In this video, recorded at the International Conference on Acute Myeloid Leukaemia 2017 in Estoril, Portugal by the European School of Hematology (ESH), Ramiro Garzon, MD, from Ohio State University, Columbus, OH, discusses the promise of these novel agents. “
There are four commonly mutated spliceosome proteins in hematological malignancies. In this interesting interview, recorded at the International Conference on Acute Myeloid Leukaemia 2017 in Estoril, Portugal by the European School of Hematology (ESH), Omar Abdel-Wahab, MD from the Memorial Sloan Kettering Cancer Center, New York, NY, identifies these mutations, including the most common, which is in SRSF2. Dr Abdel-Wahab discusses how these mutations drive leukemogenesis.
New molecules targeting specific gene mutations are showing great potential for precisely treating diseases and lowering the toxicity of treatment. In this interview, recorded at the International Conference on Acute Myeloid Leukaemia 2017 in Estoril, Portugal by the European School of Hematology (ESH), Miguel Sanz, MD, of the University Hospital La Fe, Valencia, Spain, discusses his talk at the conference, where he discussed the use of the FLT3 inhibitor midostaurin, which was recently approved after the RATIFY clinical trial (NCT00651261), alongside standard chemotherapy for the treatment of AML. Dr Sanz also touches upon the improvements that could be made to…
Having an understanding of the inherited genetic components that can lead to cancer formation can be of great use to clinicians; it can explain why a patient may have developed a cancer, suggest a cancer that they may be at risk of developing, and identify potential therapeutic targets. In this interview, recorded at the European School of Hematology (ESH) International Conference on Acute Myeloid Leukaemia 2017 in Estoril, Portugal, Jane Churpek, MD, of the University of Chicago, Chicago, IL, highlights recent findings from her group linking hematologic malignancies with genetic elements, and suggests that there may be many other tumor…
Holistic therapies are often viewed unfavorably by the medical community, with many clinicians preferring to solely focus on pharmacological treatments. However, for chronic illnesses such as MPNs, where there is no drug that can currently cure the condition, treatments generally aim to reduce the burden of the disease as much as possible. In this interview, Ruben Mesa, MD, of UT Health San Antonio Cancer Center, San Antonio, TX, USA, discusses some of his clinics exploration of various complementary therapies for patients with MPNs, including cognitive, physical and nutritional therapies. This video was recorded at the Myeloproliferative Neoplasms Advances Day 2017,…
Myeloproliferative neoplasms (MPNs) are complex diseases, with current therapies primarily designed to prevent complications and reduce symptoms. In this insightful interview, Ruben Mesa, MD, from UT Health San Antonio Cancer Center, San Antonio, TX, USA, gives his opinion on the most important areas to the advancement of MPN treatment, including whether the treatment of patients needs to occur earlier. Dr Mesa emphasizes the need for the approval of further JAK inhibitors alongside ruxolitinib, and touches upon a few of the drugs that are currently in development, such as the phase III JAKARTA trial of fedratinib (NCT01437787). He also mentions brand…
“Technological advances have allowed for whole genome, exome and transcriptome sequencing of circulating multiple myeloma (MM) cells and cell-free tumor DNA. In this video, Jens Lohr, MD, PhD from the Dana-Farber Cancer Institute, Boston, MA, highlights the advantages of this. Dr Lohr also addresses the limitation of liquid biopsies, including patient selection and standardization. This video was recorded at the Myeloma 2017 meeting in Edinburgh, UK. “
It has become apparent in recent years that low levels of ciculating tumor DNA can be detected in multiple myeloma (MM) patients through liquid biopsies. In this interview, Suzanne Trudel, MD, MSc, FRCPC, of the Princess Margaret Hospital, Toronto, Canada, gives an overview of how this approach may be refined in the coming years, so that it may replace the more invasive and painful bone marrow biopsy, in both clinical and research contexts.
The detection of various gene mutations, such as those in Ras and Raf, are important for risk stratification and identifying appropriate treatment plans for multiple myeloma (MM) patients. This genetic analysis has traditionally been performed through the extraction of bone marrow, which is an invasive and often painful procedure. In this interview, recorded at the Myeloma 2017 meeting in Edinburgh, UK, Suzanne Trudel, MD, MSc, FRCPC, of the Princess Margaret Hospital, Toronto, Canada, discusses how her group has developed a liquid biopsy to detect these mutations with high sensitivity and specificity.
The Myeloma 2017 meeting, held in Edinburgh, UK, saw more focus on epigenetic contributors to multiple myeloma (MM) than ever before, indicating a shift in the outlook and technological capabilites to research these factors in greater detail. In this interview, Felipe Prosper Cardoso, MD, of the University of Navarra, Pamplona, Spain, discusses the new studies highlighted at the meeting that were investigating the epigenetics of MM, including the CoMMpass study (NCT01454297), which is collecting the DNA methylation pattern profiles of its wide range of participants. Dr Prosper Cardoso highlights the benefits that a greater epigenetic understanding could have on the…
In recent years, researchers have become increasingly aware of the fact that epigenetic alterations can contribute to the formation of multiple myeloma (MM); however, our understanding of these remain unclear. In this interview, Felipe Prosper Cardoso, MD, of the University of Navarra, Pamplona, Spain, gives an insightful overview of the high-throughput technologies currently being used to investigate these epigenetic mechanisms, including ChIP-sequencing, chromosome conformation capture-on-chip (4C), and bisulfite sequencing. This video was recorded at the Myeloma 2017 meeting, held in Edinburgh, UK.
Although researchers are aware of the fact that epigenetic factors play a significant role in the development of multiple myeloma (MM), we do not yet understand these factors to the level we do the genomic components of the disease. Speaking from the Myeloma 2017 meeting held in Edinburgh, UK, Felipe Prosper Cardoso, MD, from the University of Navarra, Pamplona, Spain, explains why this is the case, and discusses his talk at the meeting, where he covered a new high-throughput technology, designed to study the changes in chromatin structure between MM and non-MM cells, and our current understanding of the epigenetics…
There are several different types of immunotherapy and associated conjunctional therapies currently being studied that have shown some degree of efficacy for the treatment of multiple myeloma (MM). Speaking from the Myeloma 2017 meeting held in Edinburgh, UK, David Avigan, MD, of the Beth Israel Deaconess Medical Center, Boston, MA, gives an overview of these therapies, including CAR-T cells and dendritic cell vaccines. Dr Avigan explains that whilst these therapies are spearheading an exciting future of MM treatment, there is still a need to develop our understanding of the immune system, and the durability and side effects of these treatments,…
Cancer immunotherapy is a very active area of research at the moment, with the potential to treat a cancer long-term by stimulating an individual’s immune system to recognize and destroy cancer cells. In this interview, David Avigan, MD, of Beth Israel Deaconess Medical Center, Boston, MA, discusses the development of a dendritic cell vaccine for multiple myeloma (MM), which has yielded promising results and led to a nationwide randomized follow up study. Dr Avigan also touches upon potential adjuvant therapies that could aid a vaccine in modulating the immune response and reducing relapse rates, such as microRNAs or effector cells.…
Drug resistance is a common problem in the treatment of multiple myeloma (MM), either through initial resistance to a drug, or a developed resistance associated with relapse. Speaking from the Myeloma 2017 meeting held in Edinburgh, UK, Brian Van Ness, PhD, of the University of Minnesota, Minneapolis, MN, outlines the talks given at the meeting regarding the problem of resistance, and the ways in which the MM community can address this issue.
Clinical trials to determine the efficacy of a drug are costly, particularly when there are many subtypes of a certain disease that could vary greatly in their response to a molecule. In this interview, Brian Van Ness, PhD, of the University of Minnesota, Minneapolis, MN, gives an overview of a specialised core facility that allows for the modelling of drug responses by multiple myeloma (MM) subtype through the identification of gene expression patterns in individualized cells, and can help identify the subclonal architecture of heterogeneous tumors. This interview was recorded at the Myeloma 2017 meeting in Edinburgh, UK.
Immunomodulatory drugs (IMiDs) are a class of drugs including the likes of thalidomide, which are used in the treatment of cancers such as multiple myeloma (MM). In this interview, recorded at the Myeloma 2017 meeting in Edinburgh, UK, Benjamin Barwick, MD, of Emory University, Atlanta, GA, discusses the talks given at the meeting which discussed IMiDs, and how resistance to them in MM can be driven by various enhancers and transcription factors that lead to worse outcomes for patients.
Epigenetic modifications, such as DNA methylation, can lead to or complicate disease, and lead to worse patient outcomes. Speaking from the Myeloma 2017 meeting in Edinburgh, UK, Benjamin Barwick, MD, of Emory University, Atlanta, GA, outlines how these alterations could be explored in terms of targeting them for multiple myeloma (MM) therapies. Dr Barwick highlights the potential to perform clinical trials for MM treatment with approved drugs that target DNA methylation in myelodysplastic syndromes and leukemia.
The Multiple Myeloma Research Foundation (MMRF) is sponsoring the CoMMpass trial (NCT01454297), which aims to define subsets of multiple myeloma (MM) patients according to their molecular profiles. In this interview, Benjamin Barwick, MD, of Emory University, Atlanta, GA, discusses his groups work analyzing the CoMMpass study data. This analysis aims to identify translocations that result in worse outcomes for myeloma patients, and study specimens from the trial to discover common epigenetic alterations, such as DNA methylation patterns, that contribute to high-risk MM. This interview was recorded at the Myeloma 2017 meeting in Edinburgh, UK.
Speaking from the International Conference on Acute Myeloid Leukaemia 2017, Estoril, Portugal by the European School of Haematology (ESH), Stéphane de Botton, MD, PhD of the Gustave Roussy Institute, Villejuif, France, talks about his experience of working with a smaller company of researchers and their medical team during drug development. Dr de Botton compared this to working for bigger pharmaceutical companies, where, in his experience, collaboration tends to be different.
The IDH2 inhibitor drug, enasidenib has previously only been administered to elderly populations with acute myeloid leukemia. Stéphane de Botton, MD, PhD of the Gustave Roussy Institute, Villejuif, France, discusses why this is the case, as well as the next steps for the drug. This includes further Phase II and III trials in all age groups to determine the efficiency of combination therapies. This video was recorded at the International Conference on Acute Myeloid Leukaemia 2017, Estoril, Portugal by the European School of Haematology (ESH).
Stéphane de Botton, MD, PhD of the Gustave Roussy Institute, Villejuif, France, discusses the efficiency of differentiation therapies for the elimination of acute myeloid leukemia at the International Conference on Acute Myeloid Leukaemia 2017, Estoril, Portugal by the European School of Haematology (ESH). Dr de Botton emphasizes the need to further improve results via the use of combination therapies, and describes how enasidenib can be combined with a wide variety of targeted drugs and other agents.
In this video, Stéphane de Botton, MD, PhD of the Gustave Roussy Institute, Villejuif, France, describes the rapid progression of IDH1/2 mutant inhibitors through clinical trials for the potential treatment of acute myeloid leukemia. Despite these mutations only being discovered in 2009, the IDH2 inhibitor drug, enasidenib has already been FDA approved. In this video, Dr de Botton discusses the reasons behind this success, namely the very high response rates experienced, as well as the complications they were anticipating. This video was recorded at the International Conference on Acute Myeloid Leukaemia 2017, Estoril, Portugal by the European School of Haematology…
The potential advantage of a therapy compared to its cost is an important factor to consider when approving novel treatments. In this video, Saar Gill, MD, PhD from the University of Pennsylvania, Philadelphia, PA, speaking from the International Conference of Acute Myeloid Leukaemia 2017, Estoril, Portugal by the European School of Hematology (ESH), talks about the resource-intensive nature of CAR T- cells and the optimal way to utilize them in the clinic in the future in regards to this.
The recent RATIFY study (NCT00651261), which led to the approval of midostaurin for the treatment of FLT3-mutated AML patients, was made possible through the cooperation of many hospitals sharing patient data. Speaking from the European School of Hematology (ESH) International Conference on Acute Myeloid Leukaemia 2017 in Estoril, Portugal, Miguel Sanz, MD, of the University Hospital La Fe, Valencia, Spain, discusses why this collaboration is so vital to identifying new subtypes of and treatments for diseases.
When new drugs are being tested as a treatment for a cancer, they are typically trialled in combination with standard chemotherapy. Here, Miguel Sanz, MD, of University Hospital La Fe, Valencia, Spain, explores why this is the case, and touches upon a notable exception to this tendency in the therapy of acute promyelocytic leukemia (APL). This video was recorded at the International Conference on Acute Myeloid Leukaemia 2017 in Estoril, Portugal by the European School of Hematology (ESH).
In the RATIFY clinical trial (NCT00651261), the FLT3 inhibitor midostaurin plus standard chemotherapy was shown to have an advantage over standard chemotherapy alone when treating AML patients who were positive for the FLT3 mutation. In this interview, Miguel Sanz, MD, of the University Hospital La Fe, Valencia, Spain, discusses how midostaurin use will start to become widespread in the near future in Spain, and touches upon current trials that may show it to have use in other clinical contexts as well. This video was recorded at the International Conference on Acute Myeloid Leukaemia 2017 in Estoril, Portugal by the European…
The RATIFY trial (NCT00651261) showed that midostaurin, a FLT3 inhibitor that was a previously ineffective monotherapy for acute myeloid leukemia (AML), could improve survival when combined with other chemotherapies. In this interview, Katherine Smith of the University of California, San Francisco, CA, discusses how the immediate future of AML treatment appears to be the therapeutic combination of FLT3 inhibitors with other agents that target different pathways, in order to maximize efficacy. This interview was recorded at the International Conference on Acute Myeloid Leukaemia 2017, Estoril, Portugal by the European School of Hematology (ESH).
Over recent years, inhibition of excessive FLT3 signalling has been a primary area of research to find an effective targeted therapy for acute myeloid leukemia (AML). However, FLT3 inhibitors have often shown an initial short duration of action, followed by the development of resistance. Speaking from the European School of Hematology (ESH) International Conference on Acute Myeloid Leukaemia 2017, Estoril, Portugal, Katherine Smith, MD, of the University of California, San Francisco, CA, gives an overview of the mechanisms by which these resistances develop, including on-target FLT3 mutations and off-target clone swapping. She also touches upon the next steps required to…
Acute myeloid leukemia (AML) is a complex disease with many subtypes; treatment can be more effective and efficient if there is a system in place for centers to cooperate and network to share data and resources. In this interview, Jorge Sierra, MD, PhD, of the Hospital de la Santa Creu i Sant Pau, Barcelona, Spain, gives an overview of the current AML treatment center network in Spain, and the resources that the country has access to in order to treat their patients. This interview was recorded at the International Conference on Acute Myeloid Leukaemia 2017, Estoril, Portugal by the European…
The long-term survival rate of acute myeloid leukemia (AML) patients who have relapsed, or whose disease is progressing, is poor. In this interview, Jorge Sierra, MD, PhD, of the Hospital de la Santa Creu i Sant Pau, Barcelona, Spain, discusses the current treatment strategies and new agents being developed for for this patient group; including hypomethylating agents, monoclonal antibodies, CAR-T cells and FLT3 inhibitors. This interview was recorded at the International Conference on Acute Myeloid Leukaemia 2017, Estoril, Portugal by the European School of Hematology (ESH).
Reflecting upon past research is key to the development of new treatments. In this interview at the International Conference of Acute Myeloid Leukaemia 2017, Estoril, Portugal by the European School of Hematology (ESH), Saar Gill, MD, PhD from the University of Pennsylvania, Philadelphia, PA, reflects upon the lessons learnt from treating acute lymphoblastic leukemia and how these lessons can be applied when tackling acute myeloid leukemia using CAR T-cells or bispecific antibodies.
Novel technologies have the potential to allow us to treat more ailments, but often come at the price of new toxicities. Speaking from the International Conference of Acute Myeloid Leukaemia 2017, Estoril, Portugal by the European School of Hematology (ESH ), Saar Gill, MD, PhD from the University of Pennsylvania, Philadelphia, PA discusses how stronger regulations and greater transparency between scientists, patients and physicians has impacted these new technologies. Dr Gill also highlights the necessity of controlling side effects and the importance of managing expectations.
New and invigorating methods of tackling acute myeloid leukemia (AML) are being researched at present. In this interview, Saar Gill, MD, PhD from the University of Pennsylvania, Philadelphia, PA talks about his research into AML, which focuses on CD33 and CD123 using CAR T-cell therapy. Dr Gill discusses the current issues with this therapy and provides an overview of how his group is planning to overcome these problem by utilising CRISPR-Cas9. This interview was recorded at the International Conference of Acute Myeloid Leukaemia 2017, Estoril, Portugal by the European School of Hematology (ESH).
This is an exciting time for leukemia treatment, with multiple new therapies being approved and various agents on the horizon. At the International Conference of Acute Myeloid Leukaemia 2017 in Estoril, Portugal by the European School of Hematology (ESH), Ravindra Majeti, MD, PhD, from Stanford University, Stanford, CA, discusses why he is enthusiastic about novel treatments against leukemia and details the improvements required to move this treatment forwards.
As innovative research investigating acute myeloid leukemia (AML) progresses, the chances of developing effective treatments against the ailment increase. In this video, Ravindra Majeti, MD, PhD, from Stanford University, Stanford, CA, speaking from the International Conference of Acute Myeloid Leukaemia 2017 in Estoril, Portugal by the European School of Hematology (ESH), discusses his groups research into hemopoietic stem cells, including the mutations causing pre-leukemic stem cells and their relation to the development of AML. Dr Majeti details the various models being used to assess these genetic mutations, including the CRISPR-Cas9 system.
Eosinophilia is a highly variable disease that can be relatively mild or potentially fatal; it can occur due to primary or secondary causes, or it can be idiopathic in nature. Because of this variance in its causes and outcomes, there were previously no standardized guidelines for how clinicians should investigate and treat the condition. Speaking from the Myeloproliferative Neoplasms Advances Day 2017 in London, UK, Nauman Butt from the Royal Liverpool and Broadgreen University Hospital NHS Trust, Liverpool, UK, outlines the first UK guidelines for eosinophilia, which he and a group of other UK clinicians published in early 2017.
Systemic mastocytosis, though a rare disease, is more common than clinicians may think and diagnosis of the condition can often be missed. In this insightful interview, Deepti Radia, MBBS, MRCPI, FRCPath, of Guys and St Thomas Hospital NHS Foundation Trust, London UK, details the latest updates in the field, such as the new WHO classification guidelines for diagnosis and classification. Dr Radia also discusses the treatment options for this condition, which often consists of symptomatic treatment, but in cases of aggressive systemic mastocytosis there are now targeted treatments available, such as midostaurin, BLU-285 and DCC-2618. This video was recorded at…
Myeloproliferative Neoplasms (MPNs) carry a risk of complications, such as thrombosis; the degree of risk is influenced in part by genetic factors. In this interview, recorded at the Myeloproliferative Neoplasms Advances Day 2017 in London, UK, Angela Hamblin, MD, PhD, of Oxford Molecular Diagnostics Centre, Oxford UK, discusses how her team uses next-generation sequencing to identify known mutations in a patient sample, and the exciting applications that this may have in the future, including personalized treatment and minimal residual disease monitoring.
It is well known that studying larger patient groups produces more robust results in research. Omar Abdel-Wahab, MD, from the Memorial Sloan Kettering Cancer Center, New York, NY, highlights this in this interview, recorded at the International Conference on Acute Myeloid Leukaemia 2017 in Estoril, Portugal by the European School of Hematology (ESH). Dr Abdel-Wahab emphasizes the need for collaboration both within and between countries to further acute myeloid leukemia research.