Author: Editor

BTK inhibitors like ibrutinib have shown impressive efficacy in treating mantle cell lymphoma (MCL) in the first relapse setting; however, there is an unmet need for a treatment that is effective in patients who dont respond to ibrutinib. Here, Toby Eyre, MRCP(UK), FRCPath(UK), MD, of Oxford University Hospitals NHS Foundation Trust, Oxford, UK, discusses his recent trial exploring the efficacy of venetoclax monotherapy in patients with relapsed/refractory MCL after therapy with BTK inhibitors. This yielded impressive overall and complete response rates with low toxicity, indicating that venetoclax is a viable monotherapy in this setting. Dr Eyre concludes that combination therapies…

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Many clinical trials are skewed towards a certain patient population, resulting in biased data. Here, Ruben Mesa, MD, of UT Health San Antonio Cancer Center, San Antonio, TX, discusses the MYMPN patient registry, which aims to aggregate large quantities of data from patients with myeloproliferative neoplasms (MPNs) across various institutions and trials. He discusses the positive patient recruitment data, as well as his hopes for the future of this resource, suggesting that along with international expansion, biomarker screening could be incorporated. This registry will provide a reliable resource for MPN researchers across the world with a wide-reaching, representative patient sample.

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Measurable residual disease (MRD) analysis is becoming increasingly commonplace as a prognostic indicator and tool for guiding the management of multiple myeloma (MM) and other hematological malignancies. Here, Nikhil Munshi, MD, of the Dana-Farber Cancer Institute, Boston, MA, discusses how MRD can be used both as a surrogate for other outcome indicators like progression-free and overall survival, and for treatment guidance. He elaborates on this concept, suggesting that MRD negative patients could avoid aggressive treatments like stem cell transplants, and that with further research, perhaps even maintenance therapy could be avoided or reduced. This video was recorded at the 23rd…

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Speaking from the 23rd Congress of the European Hematology Association (EHA) 2018, in Stockholm, Sweden, Thomas Alexander, MD, PhD, of the University of North Carolina School of Medicine, Chapel Hill, NC, discusses biomarker screening in the context of acute lymphoblastic leukemia (ALL). He speaks about a recent trial combining venetoclax, navitoxlax and chemotherapy in relapsed ALL (NCT03181126), and highlights the genomic and BH3 profiling that has been conducted in this cohort. He emphasizes the importance of moving beyond genomic profiling in the context of ALL treatment, suggesting that more rigorous functional assays are needed in order to properly understand disease…

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BTK inhibition is a popular avenue of treatment research in Waldenström’s macroglobulinemia (WM). In this video, recorded at the 23rd Congress of the European Hematology Association (EHA) 2018, in Stockholm, Sweden, Simon Rule, MD, of Plymouth University, Plymouth, UK, discusses the recent trial (NCT02180724) exploring the efficacy of BTK inhibitor acalabrutinib monotherapy in both the frontline and relapsed/refractory settings. The data were overwhelmingly positive, with response rate and overall survival at 2 years both reaching >90%, and a relatively low toxicity. Finally, Prof. Rule touches upon the positive data from ibrutinib/rituximab combination therapies, and suggests that even better results might…

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Symptom burden in patients with myeloproliferative neoplasms (MPNs), in the form of fatigue, night sweats and weight loss, can remain severe even with the newest treatments. In this video, recorded at the 23rd Congress of the European Hematology Association (EHA) 2018, held in Stockholm, Sweden, Ruben Mesa, MD, of UT Health San Antonio Cancer Center, San Antonio, TX, discusses the role of non-pharmaceutical interventions in reducing the impact of symptoms on quality of life alongside continued treatment. He speaks about a recent trial exploring the impact of an online, specialized yoga module on MPN patient symptoms, and the findings that…

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Nikhil Munshi, MD, of the Dana-Farber Cancer Institute, Boston, MA, presented results from the CRB-401 trial (NCT02658929) at the 23rd Congress of European Hematology Association (EHA) 2018, held in Stockholm, Sweden. This trial used the CAR T-cell therapy bb2121 to treat relapsed/refractory multiple myeloma (MM), and yielded deep responses in patients. The most intriguing finding of this study was that measurable residual disease (MRD) negativity was often achieved before traditional response criteria established by the International Myeloma Working Group (IMWG). This quick MRD response implies that the uses of MRD could be expanded in the future. For example, MRD status…

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There is an unmet need for treatment options for acute lymphoblastic leukemia (ALL) patients who have relapsed on multiple prior therapies. Thomas Alexander, MD, PhD, of the University of North Carolina School of Medicine, Chapel Hill, NC, presented data from his trial (NCT03181126) exploring the efficacy of the BCL2 inhibitors venetoclax and navitoclax with chemotherapy in these patient groups at the 23rd Congress of the European Hematology Association (EHA) 2018, in Stockholm, Sweden. In this video, he discusses certain ALL subgroups which respond better to BCL2 inhibition, how to extrapolate pediatric safety data from adult data, and the rationale behind…

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The treatment landscape for myeloproliferative neoplasms (MPNs) is constantly evolving, as Ruben Mesa, MD, of UT Health San Antonio Cancer Center, San Antonio, TX, explains in this video, recorded at the 23rd Congress of the European Hematology Association (EHA) 2018, held in Stockholm, Sweden. He discusses new standardized guidelines for managing MPN patients, and controlling the symptoms and risk of thrombosis. He also gives an overview of the newest clinical trial developments in the field, mentioning the use of ruxolitinib in both polycythemia vera and myelofibrosis, before finally highlighting the potential for combining ruxolitinib with PI3K inhibitors for more effective…

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Lenalidomide is widely used for multiple myeloma (MM); however, while it is effective, most patients relapse and become lenalidomide-refractory. In this interview, conducted at the 23rd Congress of the European Hematology Association (EHA) 2018, held in Stockholm, Sweden, Paul Richardson, MD, of the Dana-Farber Cancer Institute, Boston, MA, discusses the objectives of the OPTIMISMM trial (NCT01734928), which investigates the efficacy of the triplet regimen of pomalidomide, bortezomib and dexamethasone against the doublet of bortezomib and dexamethasone. Dr Richardson mentions some of the preliminary results that have been obtained, before speaking about the future potential for the regimen.

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Understanding the mutations and whole-genome interactions taking place in multiple myeloma (MM) is crucial for disease understanding and therapy research. In this video, recorded at the 23rd Congress of European Hematology Association (EHA) 2018, held in Stockholm, Sweden, Nikhil Munshi, MD, of the Dana-Farber Cancer Institute, Boston, MA, discusses how his group has used whole genome sequencing to identify two key mutational signals in MM: age-related mutation signatures and DNA repair pathway signatures. He explains how these data were combined with epigenetic analysis and RNA sequencing to explore the impact of these mutations on gene expression, which revealed an impact…

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Felice Bombaci, from the AIL patient group for chronic myeloid leukemia (CML), Rome, Italy, discusses some important key topics in patient support in Italy for hematological malignancies. He speaks about the importance of using patient-reported outcomes in research, his efforts to design a survey to record these responses, and the need for increased awareness about the stigma faced by cancer patients. This video was recorded at the 1st European Myeloma Network (EMN) Meeting 2018, held in Turin, Italy.

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Haematopoietic stem cells give rise to the multitude of blood cells in our circulatory system. In this video, Dominique Bonnet, PhD, of the Francis Crick Institute, London, UK, speaks to us about the need to understand how mesenchymal stem cells become cancerous. Dr Bonnet outlines some of the preliminary research taking place in mouse models and explains how, although these models allow us to study the disease progression, there are limitations as the biology of humans and mice is quite different. Dr Bonnet then concludes her interview by mentioning some of the new therapies and drugs that are currently under…

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The MURANO study (NCT02005471) is a Phase III trial looking at rituximab in combination with either bendamustine or venetoclax for the treatment of refractory chronic lymphocytic Leukemia (CLL). A key aim of the study is to assess whether mutated TP53 clone size affects treatment efficacy. Here, Arnon Kater, PhD, of Universiteit Van Amsterdam, Amsterdam, Netherlands, describes the interesting early results from a side study of the MURANO trial. Speaking from the 23rd Congress of the European Hematology Association (EHA) 2018, held in Stockholm, Sweden, Prof. Kater mentions that further results are needed to draw conclusions, and should be released at…

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Shaji Kumar, MD, of the Mayo Clinic, Rochester, MN, presents the results of some preclinical and clinical trials investigating the effects of venetoclax in combination with proteasome inhibitors at the 23rd Congress of the European Hematological Association (EHA) 2018, held in Stockholm, Sweden. Dr Kumar discusses the drugs venetoclax has been combined with and the results of these combinations, all of which seem promising regardless of whether the patients had previously been exposed to drugs of the same kind. For more Venetoclax coverage see this video entitled “Is Venetoclax + Ibrutinib better Ibrutinib Monotherapy in CLL?”

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Richard Clark, MA, MD, MRCP, FRCPath, of the Royal Liverpool University Hospital, Liverpool, UK, presented the final results of the DESTINY trial (NCT01804985) at the 23rd Congress of the European Hematology Association (EHA) 2018, held in Stockholm, Sweden. This trial investigated the effect of de-escalating imatinib, nilotinib or dasatinib therapies for chronic myeloid leukemia (CML) patients who had achieved major molecular response (MMR), but not necessarily MR4. Though responses from non-MR4 patients were not as good as those who had achieved this status, Prof. Clark emphasizes that these data provide a good rationale for de-escalating treatment across MMR patients in…

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Chemotherapy is becoming increasingly less desirable as a form of treatment, due to its systemic and burdensome nature. Instead, immunotherapy has been dominating the field of treatment, with agents that are often much more tolerable and, in some cases, more effective. Here, Robin Foà, MD, of Sapeinza Univesity of Rome, Rome, Italy, speaks to us about the use of tyrosine kinase inhibitors, which have revolutionized treatment for chronic myeloid leukemia (CML) and how this treatment is slowly being adapted for other hematological cancers, such as acute lymphoblastic leukemia (ALL). Prof. Foa, speaking from the 23rd Congress of the European Hematology…

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Speaking from the 23rd Congress of the European Hematology Association (EHA) 2018, held in Stockholm, Sweden, Paul Richardson, MD, of the Dana-Farber Cancer Institute, Boston, MA, tells us about isatuximab, a revolutionary new antibody that has already been making waves in the multiple myeloma (MM) field. Dr Richardson explains why this antibody has been dubbed next-generation, despite being developed at the same time as many others, including daratumumab, before mentioning ICARIA-MM (NCT02990338), a trial aimed at determining the effects of isatuximab in combination with pomalidomide and dexamethasone.

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Patients with relapsed, transplant ineligible diffuse large B-cell lymphoma (DLBCL) face extremely poor outcomes. In this video, recorded at the 23rd Congress of the European Hematology Association (EHA) 2018, held in Stockholm, Sweden, Marek Trneny, MD, PhD, of Charles University, Prague, Czech Republic, discusses a recent trial (NCT02257567) that aimed to improve care for these patients using a combination therapy of bendamustine, rituximab and the antibody-drug conjugate polatuzumab vedotin. The positive survival data from this study suggest a new treatment avenue for patients who previously had few options.

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While the outcome for patients with chronic lymphocytic leukemia (CLL) has significantly improved over the last 30 years due to effective treatment options, the number of patients with CLL dying as a result of infection has not particularly decreased; indicating an unmet need in new patients with immune dysfunction. Here, Carsten Niemann, MD, PhD, of Copenhagen University Hospital, Copenhagen, Denmark, points to the statistic that >25% of patients with CLL will have a severe infection, and how the use of a machine learning algorithm developed in collaboration with the Danish Technical University may help prevent infection-related deaths in patients with…

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The BCL2 inhibitor venetoclax is just one example of a new therapeutic agent that has allowed patients with chronic lymphocytic leukemia (CLL) to reach measurable residual disease (MRD) negativity, though complete clonal eradication has yet to be reached in these patients. Speaking from the 23rd Congress of the European Hematology Association (EHA) 2018, held in Stockholm, Sweden, Arnon Kater, PhD, of Universiteit Van Amsterdam, Amsterdam, Netherlands, talks about the use of venetoclax and explains the synergistic mechanism behind its combination with the BTK inhibitor ibrutinib. Prof. Kater discusses current research that aims to improve the metabolic function of T-cells in…

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Speaking from the 23rd Congress of the European Hematology Association (EHA) 2018, held in Stockholm, Sweden, Simon Rule, MD, of Plymouth University, Plymouth, UK, discusses the current landscape of mantle cell lymphoma (MCL) treatment. He points to BTK inhibitors as the most exciting therapy option, explaining how using them earlier on in the treatment pathway improves their efficacy and toxicity. Along with highlighting key clinical trials in the field, he explores the concept of combination therapies, suggesting that combining BTK and BCL2 inhibitors might lead to more effective treatment. Finally, Prof. Rule highlights the important areas for future research, including…

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Clinical trials are designed to test the effect of new drugs and treatments in a highly controlled environment. While this allows researchers to obtain incredibly accurate results, the stark contrast between clinical environments and real world practice means that sometime these therapies may not be as effective as they previously seemed. Here, Paul Richardson, MD, of the Dana-Farber Cancer Institute, Boston, MA, discusses how real world practices must also be taken into account to ensure that the therapies being developed are effective in both settings. Speaking from the 23rd Congress of the European Hematology Association (EHA) 2018, held in Stockholm,…

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The response of patients with multiple myeloma (MM) to therapy is always variable. Speaking from the 23rd Congress of the European Hematological Association (EHA) 2018, held in Stockholm, Sweden, Shaji Kumar, MD, of the Mayo Clinic, Rochester, MN, explains why an immediate and strong response to therapy isnt always the best outcome to hope for, and mentions the factors that can have an impact on the efficacy of some drugs, from the biology of the disease to patient fitness.

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Mantle cell lymphoma (MCL) outcomes have improved in recent years as a result of an influx of improved treatments, including rituximab, high dose Ara-C and stem cell transplant. As Marek Trneny, MD, PhD, of Charles University, Prague, Czech Republic, explained at the 23rd Congress of the European Hematology Association (EHA) 2018, held in Stockholm, Sweden, however, there has been uncertainty as to which of these treatments is most responsible for the change. In this interview, he describes his retrospective analysis of MCL patients under a variety of treatment plans, and concludes that rituximab maintenance therapy after immunochemotherapy is key to…

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Achievement of a complete response and measurable residual disease (MRD) negativity are associated with improved survival in chronic lymphocytic leukemia (CLL). Pierre Feugier, MD, PhD, of the Centre Hospitalier Universitaire Régional de Nancy, Vandoeuvre les Nancy, France, presented induction phase results from the ICLL07 FILO study (NCT02666898) at the 23rd Congress of the European Hematology Association (EHA) 2018, held in Stockholm, Sweden. This trial investigated how MRD status could be used to guide treatment, with all patients receiving obinutuzumab and ibrutinib, followed by FC chemotherapy when MRD positivity was determined. Complete response rates were quite high, without excess toxicity; however,…

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In this video, Carsten Niemann, MD, PhD, of Copenhagen University Hospital, Copenhagen, Denmark, presents the first interim analysis of the HOVON-141 study (NCT03226301), involving patients with relapsed/refractory chronic lymphocytic leukemia (CLL). From the 23rd Congress of the European Hematology Association (EHA) 2018, held in Stockholm, Sweden, Dr Niemann describes the two parts to the study looking first at the safety of using a combination of venetoclax and ibrutinib, and then treatment efficacy. Measurable residual disease (MRD) negativity was assessed as an endpoint in patients, with those having reached MRD negativity selected to either cease treatment or receive maintenance therapy with…

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Therapies for acute lymphoblastic leukemia (ALL) have constantly been improving. Indeed, 35 years ago the survival rate for children was ~50%, whereas now it’s nearer to 85%. Here, Robin Foà, MD, of Sapeinza Univesity of Rome, Rome, Italy, gives an account of the improvements that have been made, both in terms of diagnosis and treatment, and speaks about the biology of the disease and how identification of the precise mutations can dramatically impact patient prognosis. Prof. Foa emphasizes the use of tyrosine kinase inhibitors and how they have revolutionized ALL treatment, before concluding his interview by mentioning some other topical…

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Defibrotide has previously been studied in post-stem cell transplant patients with veno-occlusive disease with a suitable investigational new drug (IND). Speaking from the 23rd Congress of the European Hematology Association (EHA) 2018, held in Stockholm, Sweden, Paul Richardson, MD, of the Dana-Farber Cancer Institute, Boston, MA, explains how >700 patients took part in the expanded access T-IND study (NCT00628498), and that the results obtained to date have been quite promising. Dr Richardson emphasizes just how optimistic these results are by comparing them to the results of previous drugs studied in this manner, and concludes his interview by mentioning the safety…

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Follicular lymphoma treatments are improving; however, there are subgroups of patients who still have poor outcomes. Here, Marek Trneny, MD, PhD, of Charles University, Prague, Czech Republic, evaluates different prognostic indices and their utility in follicular lymphoma management, at the 23rd Congress of the European Hematology Association (EHA) 2018, held in Stockholm, Sweden. He touches upon existing indices like FLIPI and FLIPI2, before focusing on the prognostic index developed from the PRIMA study (NCT00140582). The PRIMA-PI uses ?2-microglobulin level to categorize patients into risk level groups. Dr Trneny discusses how, after testing this index with his own group of patients,…

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With the many new second generation therapies for chronic myeloid leukemia (CML), there is some debate as to which therapy should be used in the first-line setting, and indeed whether the existing standard of care, imatinib, is adequate. In this video, recorded at the 23rd Congress of the European Hematology Association (EHA) 2018, held in Stockholm, Sweden, Richard Clark, MA, MD, MRCP, FRCPath, of the Royal Liverpool University Hospital, Liverpool, UK, gives his opinion on this contentious topic. He says that while response is greater with novel therapies, toxicity is also increased relative to imatinib. He suggests that new prognostic…

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Many tumor cells are able to evade apoptosis, with the potential to survive in the body indefinitely. Here, Shaji Kumar, MD, of the Mayo Clinic, Rochester, MN, explains some of the mutations that allow this to happen and highlights the need for therapies that target these anti-apoptotic pathways. Dr Kumar mentions clinical trials that are investigating the use of venetoclax to re-initiate apoptosis in multiple myeloma (MM). This interview was recorded at 23rd Congress of the European Hematological Association (EHA) 2018, held in Stockholm, Sweden.

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The HORIZON study (NCT02963493) aims to determine the efficacy of melflufen in combination with dexamethasone in relapsed/refractory multiple myeloma (MM). In this interview, Paul Richardson, MD, of the Dana-Farber Cancer Institute, Boston, MA, outlines the mechanisms of action of this peptidase enhanced cytotoxic and its specificity for MM cells. Dr Richardson also mentions other clinical trials currently investigating melflufen in combination with other drugs, such as the OCEAN study (NCT03151811), and speaks of the benefits of melflufen he hopes will be made clear as a result of these trials. This interview was recorded at the 23rd Congress of the European…

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Measurable residual disease (MRD) negativity is an important treatment endpoint for many hematological malignancies and has the potential to be used to inform therapy cessation decision making. Here, Arnon Kater, PhD, of Universiteit Van Amsterdam, Amsterdam, Netherlands, gives an overview of the HOVON-141 trial (NCT03226301) that utilizes MRD negativity as an endpoint in patients with chronic lymphocytic leukemia (CLL) that are treated with a combination of venetoclax and ibrutinib. Prof. Kater also discusses the research looking at venetoclax and obinutuzumab as a pre-treatment to lower the risk of tumor lysis syndrome in patients with CLL. Prof. Kater was speaking from…

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Locally advanced head and neck cancer is treated with chemotherapy and radiation as standard, with an aim to cure the disease. Unfortunately, this therapy is associated with severe toxicity, primarily in the form of oral mucositis. In this video, recorded at the at the American Society of Oncology (ASCO) 2018 Annual Meeting in Chicago, IL, Ezra Cohen, MD, FRCPC, FASCO, of the University of California, San Diego, CA, discusses a recent randomized trial (NCT02508389) which tested the impact of avisopasem manganese vs. a placebo on oral mucositis. The results were very promising: severe mucositis lasted an average of 3 weeks…

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The assessment and diagnostic workup of newly diagnosed patients with advanced non-small cell lung cancer (NSCLC) is evolving, as discussed here by Nathan Pennell, MD, PhD, of the Cleveland Clinic, Cleveland, OH. Speaking from the American Society of Oncology (ASCO) 2018 Annual Meeting, held in Chicago, IL, Prof. Pennell highlights the need for enough biopsy material to perform the array of biomarker tests now available, as well as the need for speed during this process.

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A variety of highlighly anticipated urological oncology research with great potential was shown at the American Society of Oncology (ASCO) 2018 Annual Meeting, held in Chicago, IL. Here, Neal Shore, MD, of Carolina Urologic Research Center, Myrtle Beach, SC, discusses the bladder and kindey cancer work that he was most excited about. Dr Shore highlights work targeting the FGFR pathway (BLC2001; NCT02365597) and Nectin-4 (EV-101; NCT02091999) in urothelial carcinoma. For renal cancer, he highlights the combination of nivolumab plus ipilimumab in the first-line setting, as well as tyrosine kinase inhibitor selection.

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Speaking from the American Society of Oncology (ASCO) 2018 Annual Meeting, held in Chicago, IL, Grant McArthur, MBBS, BMedSc, PhD, FRACP, of the Peter MacCallum Cancer Centre, Melbourne, Australia, discusses how to detect tumor recurrence in metastatic melanoma. In his specialty of brain metastases, he points to MRI imaging as the most effective technique. He also gives an overview of other potential techniques, including cell-free DNA analysis and plasma markers like S100, but concludes that these methods lack the sensitivity of MRI.

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The field of genomics is one of great promise, and there is hope that it can be implemented into all areas of medicine. Here, Willem Ouwehand, MD, PhD, of the University of Cambridge, Cambridge, UK ,speaks about how we can integrate genomics into clinical hematology at the British Society for Haematology (BSH) 2018 Annual Scientific Meeting, held in Liverpool, UK.. He cites the efforts of the 100,000 Genomes Project; applauding the involvement of not only patients, but family members and the public at large. Prof. Ouewehand suggests a key step towards integrating genomics to the bedside is allowing the NHS…

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The aims of treatment for chronic myeloid leukemia (CML) have changed in recent years, as explained here by Susanne Saussele, MD, of the University of Mannheim, Mannheim, Germany. With the introduction of tyrosine kinase inhibitors, overall survival has greatly improved. Prof. Saussele highlights the ultimate goal of CML treatment currently as treatment-free remission, and raising the number of patients who can acheive this. This interview took place at the British Society for Haematology (BSH) 2018 Annual Meeting in Liverpool, UK.

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At the British Society for Haematology (BSH) 2018 Annual Scientific Meeting, held in Liverpool, UK, Wendy Osborne, MBBS (Hons), MRCP, FRCPath, of Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle, UK, discusses the difficulties we face in treating Hodgkin Lymphoma (HL) within the geriatric population. In part, this is contributive to the heterogeneity of elderly patients with HL, making it difficult to ascertain a catch-all treatment decision. To resolve this, Dr Osborne suggests the utilization of geriatric assessment tools such as comorbidity scoring to resolve treatment decisions, including assessing how common treatments such as ABVD and bleomycin will affect an…

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Highlights of promising clinical trials of novel agents for chronic myeloid leukemia (CML) are overviewed here by Susanne Saussele, MD, of the University of Mannheim, Mannheim, Germany. Discussed are Phase I trial of the BCR-ABL inhibitor ABL001 (NCT02081378), and the use of ponatinib as a second line therapy. Prof. Saussele herself is working on the EURO-SKI trial (NCT01596114) in individuals with late relapse CML, partially assessing the effects of halting treatment with imatinib, nilotinib and dasatinib, and she holds promise for the upcoming results. This interview took place at the British Society for Haematology (BSH) 2018 Annual Meeting in Liverpool,…

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Great strides have been made in the treatment of advanced melanoma; these developments are now being translated into the adjuvant setting. Here, Paolo Ascierto, MD, of the National Cancer Institute of Naples, Naples, Italy, discusses how we now have the ability to use immunotherapy and targeted therapy in this setting, highlighting the CheckMate 238 study (NCT02388906), before pointing towards the questions still surrounding this area. This video was recorded at the American Society of Oncology (ASCO) 2018 Annual Meeting, held in Chicago, IL.

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Melanoma that has metastasized to the brain is extremely high risk, and such metastasis is more likely in patients with higher stage disease. We interviewed Grant McArthur, MBBS, BMedSc, PhD, FRACP, of the Peter MacCallum Cancer Centre, Melbourne, Australia, at the American Society of Oncology (ASCO) 2018 Annual Meeting, held in Chicago, IL, about which patients have a higher risk of brain metastasis, and how these patients should be managed. He discusses biannual MRI scans and their current use for stage IV patients to monitor for brain metastases, and also suggests that MRI surveillance should be implemented in lower stage…

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Enriqueta Felip, MD, PhD, of Vall dHebron University Hospital, Barcelona, Spain, discusses the VISION trial (NCT02864992) of tepotinib for non-small cell lung cancer (NSCLC) patients with MET exon 14 skipping alterations. Dr Felip covers the rationale behind the use of this drug, as well as the cohort and promising results of the study. This interview was recorded at the 2018 American Society of Oncology (ASCO) Annual Meeting, held in Chicago, IL.

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Cetuximab monotherapy is the standard of care for platinum-resistant non-HPV related metastatic head and neck cancer; however, response and survival rates for this treatment are extremely poor. In this video, recorded at the American Society of Oncology (ASCO) 2018 Annual Meeting, in Chicago, IL, Douglas Adkins, MD, of Washington University School of Medicine, St. Louis, MO, explains that such cancers are driven by CDK4/6 activation through p16 inhibition. He uses this information as a rationale to support his recent clinical trial (NCT02101034), which combined the CDK4/6 inhibitor palbociclib with cetuximab. The data from this study are promising, with progression-free and…

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Speaking from the American Society of Oncology (ASCO) 2018 Annual Meeting, held in Chicago, IL, Paolo Ascierto, MD, of the National Cancer Institute of Naples, Naples, Italy, discusses some exciting new combination therapies for melanoma. He highlights the combination of PD-1 inhibitors with CD122 agonists (PIVOT-02; NCT02983045) or CD73 agonists. Dr Ascierto also emphasizes the potential of targeted therapy combinations, including: atezolizumab combined with cobimetinib and vemurafenib (NCT02908672); spartalizumab with dabrafenib and trametinib (NCT02967692); and pembrolizumab with dabrafenib and trametinib (KEYNOTE-022; NCT02130466).

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Promising genitourinary cancer updates were presented at the American Society of Oncology (ASCO) 2018 Annual Meeting, held in Chicago, IL. Neal Shore, MD, of Carolina Urologic Research Center, Myrtle Beach, SC, gives his top picks for advanced prostate cancer here. For metastatic castration-resistant prostate cancer (mCRPC), Dr Shore highlights updates in: the combination of olaparib with abiraterone (NCT01972217); pembrolizumab plus enzalutamide (NCT02312557); different dosing regimens of radium-223 (NCT02023697); and radiolabelled PSMA ligands for theranostics (12615000912583).

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While treatments for melanoma have been steadily improving over recent years, patients with brain metastases have consistently had poor outcomes. In this video, recorded at the American Society of Oncology (ASCO) 2018 Annual Meeting, held in Chicago, IL, Grant McArthur, MBBS, BMedSc, PhD, FRACP, of the Peter MacCallum Cancer Centre, Melbourne, Australia, discusses recent developments in targeted therapy and immunotherapy, which might improve these patients prognoses. He outlines the biology of melanoma brain metastases that make these therapies possible: disruption of the blood-brain barrier and tumor infiltration of CD8 T-cells improves efficacy of targeted therapies and immune checkpoint therapies. Dr…

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Bradley McGregor, MD, of the Dana-Farber Cancer Institute, Boston, MA, discusses exciting urothelial carcinoma therapy updates from the American Society of Oncology (ASCO) 2018 Annual Meeting, held in Chicago, IL. Dr McGregor covers results and updates from: the comparison of nab-paclitaxel and paclitaxel in the advanced setting (NCT02033993); the Phase I EV-101 study of enfortumab vedotin (NCT02091999) in platinum-refractory patients; the Phase II EV-201 study (NCT03219333) in platinum-refractory and naive patients; and the Phase II study of erdafitinib (NCT02365597) in patients with metastatic or unresectable disease with FGFR alterations. He also highlights the importance of continuing research to prevent disease…

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A variety of new therapeutics for melanoma are on the horizon, including IDO, immune checkpoint, LAG-3 and HDAC inhibitors. Here, Paolo Ascierto, MD, of the National Cancer Institute of Naples, Naples, Italy, discusses some of these exciting developments. He reflects upon the results from the KEYNOTE-252 trial (NCT02752074) of the IDO1 inhibitor epacadostat with the checkpoint inhibitor pembrolizumab, before moving onto the exciting combination of nivolumab with anti-LAG-3 antibody relatlimab (NCT02966548). Dr Ascierto also highlights the combination of HDAC inhibitor entinostat with pembrolizumab (NCT02437136). He then discusses potential avenues for the future, including triplet regimens, referencing preclinical data. This video…

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Aditya Bardia, MD, MPH, of Massachusetts General Hospital, Boston, MA, discusses the promising efficacy data of sacituzumab govitecan, an anti-Trop-2/SN-38 antibody-drug conjugate (ADC), for treatment-refractory HR+/HER2- metastatic breast cancer (NCT01631552). Prof. Bardia explains the next steps for the further development of this exciting agent, highlighting what indications this treatment is seeking approvals in. He also covers the potential of this ADC for early breast cancer and in combination with PARP inhibitors. This interview was recorded at the American Society of Oncology (ASCO) 2018 Annual Meeting, held in Chicago, IL.

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The treatment of melanoma is undergoing exciting advancements, as discussed here by Paolo Ascierto, MD, of the National Cancer Institute of Naples, Naples, Italy. Dr Ascierto highlights a promising area for further development: combination therapy. Speaking from the American Society of Oncology (ASCO) 2018 Annual Meeting in Chicago, IL, he highlights the different combinations to be considered. He first points towards the combination of talimogene laherparepvec with ipilimumab (NCT01740297), and a newer combination with pembrolizumab (KEYNOTE-034; NCT02263508), before considering the investigational drug PV-10 (NCT02288897), and the TLR-9 antagonist IMO-2125 in combination with ipilimumab or pembrolizumab (ILLUMINATE-204; NCT02644967).

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At the 2018 European School of Haematology (ESH) Clinical Updates on Acute Leukaemias, held in Budapest, Hungary, Mark Levis, MD, PhD, from Sidney Kimmel Comprehensive Cancer Centre, Baltimore, MD, gives us an update on novel chemotherapeutic agents for acute myeloid leukemia (AML). The majority of these novel agents target either FLT3 or IDH, such as midostaurin, quizartinib and gilteritinib, which are being tested at every disease stage. Although promising results have been produced, there has been resistance through signaling pathways such as Ras; thus, these agents may require testing in combination regimens.

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Drug development for multiple myeloma (MM) has recently reached such heights that there is now a plethora of novel inhibitors and antibodies available for treatment. In this interview, recorded at the 1st European Myeloma Network Meeting (EMN) 2018, held in Turin, Italy, Neils van de Donk, MD, PhD, of VU University Medical Centre, Amsterdam, Netherlands, explains how new drug combinations are tested and determined. Dr van de Donk highlights combinations that work well together, emphasizing the use of immunomodulatory drugs (IMiDs). These work in combination with many different drugs and, what was surprising in the initial research stages, behave differently…

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Checkpoint inhibitors are an exciting therapy across a range of cancer types. Speaking from the American Society of Oncology (ASCO) 2018 Annual Meeting, held in Chicago, IL, Maud Toulmonde, MD, of the Institut Bergonié, Bordeaux, France, discusses the PEMBROSARC trial (NCT02406781), which investigated the use of pembrolizumab plus metronomic cyclophosphamide in advanced sarcoma.

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Speaking from the American Society of Oncology (ASCO) 2018 Annual Meeting in Chicago, IL, Ezra Cohen, MD, FRCPC, FASCO, of the University of California, San Diego, CA, speaks about a recent clinical trial (NCT02101034) that examined the effect of palbociclib/cetuximab combination therapy in metastatic platinum-refractory head and neck cancer. The results were very positive, showing an additive and perhaps even synergistic effect from the two therapies. Dr Cohen discusses the data and touches upon the upcoming data from the Phase III stage of this trial.

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The American Society of Oncology (ASCO) 2018 Annual Meeting, held in Chicago, IL, hosted an array of exciting clinical trials updates in melanoma, as discussed here by Paolo Ascierto, MD, of the National Cancer Institute of Naples, Naples, Italy. Dr Ascierto covers: the CheckMate 238 study (NCT02388906); the 5-year KEYNOTE-001 (NCT01295827) update on survial and outcomes; the 4-year KEYNOTE-006 (NCT01866319) update; and the novel combination of encorafenib plus binimetinib (COLUMBUS; NCT01909453).

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There have previously been no randomized trials assessing systemic therapy activity for progressive desmoid tumors. Here, Maud Toulmonde, MD, of the Institut Bergonié, Bordeaux, France, discusses the aims, methods and results of the DESMOPAZ trial (NCT01876082). This French Sarcoma Group trial investigated the use of pazopanib vs. IV methotrexate/vinblastine in desmoid tumors. This interview was recorded at the American Society of Oncology (ASCO) 2018 Annual Meeting, held in Chicago, IL.

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Metastatic head and neck cancer that has progressed following platinum therapy generally has a very poor prognosis. In this video, Ezra Cohen, MD, FRCPC, FASCO, of the University of California, San Diego, CA, discusses the KEYNOTE-040 trial (NCT02252042) at the American Society of Oncology (ASCO) 2018 Annual Meeting in Chicago, IL. This study delivered groundbreaking results for treating this group of head and neck cancers with pembrolizumab over three different standard of care chemotherapies. Response rate, survival and quality of life were all improved with pembrolizumab, and Dr Cohen discusses the implications of these data.

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Cancer vaccines are a promising immunotherapeutic area, particularly in the field of prostate cancer. Here, Neal Shore, MD, of Carolina Urologic Research Center, Myrtle Beach, SC, discusses a clinical trial (NCT02514213) evalutating DNA vaccines, INO-5150 alone or with INO-9012, in biochemically relapsed prostate cancer. Dr Shore covers the method of administration, targets of the vaccine and the result observed, highlighting the reasons for his excitement about the potential of this treatment. This video was recorded at the American Society of Oncology (ASCO) 2018 Annual Meeting, held in Chicago, IL.

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Steroids were previously administered as a form of treatment for many different conditions, including cancer. However, the previous usage of steroids is now posing serious risks for patients who receive immunotherapy. In this interview, Marina Garassino, MD, of the Istituto Nazionale dei Tumori, Milan, Italy, mentions the outcomes of patients who were given immunotherapy drugs after being treated with steroids, and explains why many trials are now excluding steroid-treated patients. Dr Garassino emphasizes that the use of steroids should now be avoided, and highlights the need for alternative treatments to be developed for patients who have no other choice but…

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The use of sequential single-gene testing to detect genomic alterations in metastatic non-small cell lung cancer (NSCLC) can be costly, particularly with new mutations to test for being added as our knowledge of this disease expands. Here, Nathan Pennell, MD, PhD, of the Cleveland Clinic, Cleveland, OH, discusses the economic impact of next-generation sequencing (NGS) in this setting compared with exclusionary testing or hotspot panels. Prof. Pennell highlights the cost- and time-saving nature of NGS. This video was recorded at the American Society of Oncology (ASCO) 2018 Annual Meeting, held in Chicago, IL.

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The KEYNOTE-189 ( NCT02578680) trial investigated the effects of adding pembrolizumab to cisplatin and pemetrexed in patients with non-small cell lung cancer (NSCLC). Here, Marina Garassino, MD, of the Istituto Nazionale dei Tumori, Milan, Italy, explains the methodology behind the trial and goes through the promising results that have been obtained to date, emphasizing how slight variations in pembrolizumab dosage can affect the overall efficacy of the treatment. This interview was recorded at the American Society of Oncology (ASCO) 2018 Annual Meeting in Chicago, IL.

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Prostate cancer therapy has seen radical changes and improvements recently, with a multitude of clinical trials currently underway. Speaking from the American Society of Oncology (ASCO) 2018 Annual Meeting in Chicago, IL, Karim Fizazi, MD, PhD, of the University of Paris-Sud, Orsay, France, briefly mentions the current therapies available before talking about promising new avenues being explored. Prof. Fizazi covers a range of therapetic targets, including PSMA, which can be be targeted using radioactive isotope-labeled ligands.

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The ATLANTIC trial (NCT02087423) is currently underway to determine the effects of durvalumab on patients with advanced non-small cell lung cancer (NSCLC). Speaking from the American Society of Oncology (ASCO) 2018 Annual Meeting in Chicago, IL, Marina Garassino, MD, of the Istituto Nazionale dei Tumori, Milan, Italy, outlines the three different arms of the study and differences between them. Dr Garassino also highlights some of the preliminary results, including long-term survival.

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The treatment landscape of metastatic breast cancer (mBC) is advancing rapidly. Here, Aditya Bardia, MD, MPH, of Massachusetts General Hospital, Boston, MA, discusses therapeutic developments and novel avenues for exploration in the field of mBC. Prof. Bardia highlights PI3K, AKT, HDAC and BCL-2 inhibitors, as well as novel drug combinations, as promising therapies for different types of mBC, including triple negative and HR+/HER2-. He also emphasizes the interest surrounding antibody-drug conjugates, which could increase chemotherapy delivery while maintaining a good toxicity profile.

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In relapsed/refractory diffuse large B-cell lymphoma (DLBCL), response rates are poor for salvage treatments and autologous stem cell transplants. Here, Christian Gisselbrecht, MD, of the Hôpital Saint Louis, Paris, France speaks about CAR T-cell therapy in DLBCL. He highlights data from the ZUMA-1 trial (NCT02348216), which demonstrated improved response rates, as well as greatly improved complete remission rates, with CAR T-cells in comparison to the standard of care. Prof. Gisselbrecht also discusses the legislative processes and cost-effectiveness analyses involved in approving CAR T-cell therapies worldwide, as well as potential combination of CAR T-cells with novel therapies to improve response. This…

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New drugs for acute myeloid leukemia (AML) are constantly being developed. In this video, recorded at the 23rd Congress of the European Hematological Association (EHA) 2018, held in Stockholm, Sweden, Naval Daver, MD, of MD Anderson Cancer Center, Houston, TX, discusses four new drugs that have recently been approved in the US. These are: midostaurin, a FLT3 inhibitor to be used with induction chemotherapy for FLT3-mutated AML; enasidenib, an IDH2 inhibitor for relapsed IDH2-mutated AML that can be taken orally; gemtuzumab ozogamicin, an antibody-drug conjugate that targets cells expressing CD33; and the combination of cytarabine and daunorubicin, which increases bone…

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There has been growing evidence that the combination of hypomethylating agents like azacitidine with immune checkpoint inhibitors could be a highly potent treatment option in acute myeloid leukemia (AML) and myelodysplastic syndromes (MDS). We interviewed Naval Daver, MD, of the MD Anderson Cancer Center, Houston, TX, at the 23rd Congress of the European Hematological Association (EHA) 2018 in Stockholm, Sweden, about his recent studies exploring this combination. He discusses the data from these trials, including NCT02397720, highlighting the key findings, as well as the close relationship between pre-therapy CD3 and CD8 presence in the bone marrow with response rate. He…

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In this video, Lydia Scarfò, MD, of Vita-Salute San Raffaele University, Milan, Italy, describes the studies on chronic lymphocytic leukemia (CLL) currently being undertaken by the European Research Initiative on CLL (ERIC). Speaking from the 23rd Congress of the European Hematology Association (EHA) 2018, held in Stockholm, Sweden, Dr Scarfòalso discusses the future work that ERIC hopes to carry out, before concluding that the group will have their first official meeting exclusively on CLL in October 2018.

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A large proportion of acute myeloid leukemia (AML) patients are treated by non-specialist community oncologists, who may not have the time or energy to attend conferences or lectures presenting specialized AML research. We interviewed Naval Daver, MD, of MD Anderson Cancer Center, Houston, TX, at the 23rd Congress of the European Hematological Association (EHA) 2018 in Stockholm, Sweden about the importance of creating new, easy-access platforms for AML education, such as VJHemOnc. He discusses the benefits of such platforms, along with a few of the dangers that may be accompanied by poor knowledge of the newest AML treatments and research.

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Epigenetic therapies are constantly developing in the field of acute myeloid leukemia (AML). In this video, recorded at the 23rd Congress of the European Hematological Association (EHA) 2018, held in Stockholm, Sweden, Andrew Wei, MBBS, PhD, of Monash University, Melbourne, Australia, gives an overview of the current landscape of epigenetic therapies for AML, as well as his predictions for the future directions that this field will take. He discusses the utility of hypomethylating agents, such as decitabine, for patients with TP53 mutations, as well as second generation hypomethylating agents, like guadecitabine, and newer therapies in the clinical setting. Finally, Dr…

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Acute myeloid leukemia (AML) has shown good responses to immunotherapies, including monoclonal antibodies, immune checkpoint inhibitors and bispecific antibodies. Here, Naval Daver, MD, of the MD Anderson Cancer Center, Houston, TX, gives an overview of these therapies, and delivers an in-depth description of the evidence that has accumulated suggesting checkpoint inhibitors in combination with hypomethylating agents, such as azacitidine, could be beneficial in AML. The evidence includes: the infiltration of CD8+ immune cells into the bone marrow; a raised expression of PD1 in leukemic cells; and the fact that hypomethylating agents upregulate the expression of beneficial immune proteins. This video…

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Here, Lydia Scarfò, MD, of Vita-Salute San Raffaele University, Milan, Italy, gives an interesting insight about the possible reasons behind ibrutinib resistance in patients with chronic lymphocytic leukemia (CLL). Referring to two particular genetic mutations, BTK and PLC?2, Dr Scarfò, speaking at the 23rd Congress of the European Hematology Association (EHA) 2018, held in Stockholm, Sweden, discusses the prevalence of these mutations in patients who have relapsed post-ibrutinib treatment compared with those who are still responding, and outlines the need for future research to treat this subset of patients.

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Speaking from the 23rd Congress of the European Hematological Association (EHA) 2018 in Stockholm, Sweden, Naval Daver, MD, of the MD Anderson Cancer Center, Houston, TX, speaks about three new targeted therapies for acute myeloid leukemia (AML). These agents are BCL-2 inhibitor venetoclax, and FLT3 inhibitors quizartinib and gilteritinib. Dr Daver gives an overview of the positive data emerging from clinical trials of these therapies, and provides insight into what the next steps might be for them. He suggests the development of first-line combination therapies using these agents, and emphasizes the importance of reaching unequivocally preferable response rates compared to…

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Chemotherapy is ineffective against a certain subset of diffuse large B-cell lymphoma (DLBCL) types. In this video, recorded at the 23rd Congress of the European Hematology Association (EHA) 2018, held in Stockholm, Sweden, Christian Gisselbrecht, MD, of the Hôpital Saint Louis, Paris, France, discusses how the standard of care for DLBCL can be improved through the identification of high-risk patients. He describes how poor prognosis subtypes, like germinal center B-cell like (GCB) DLBCL, can be identified with immunophenotyping, and how adverse BCL-2 rearrangements can be identified in these patients with a FISH test. Identifying GCB DLBCL with BCL-2 rearrangements allows…

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Andrew Wei, MBBS, PhD, of Monash University, Melbourne, Australia, presented results from the CAVEAT trial (ACTRN12616000445471) at the 23rd Congress of the European Hematological Association (EHA) 2018, held in Stockholm, Sweden. This study explored the effect of venetoclax with high dose cytarabine and idarubicin in elderly acute myeloid leukemia (AML) patients. Induction stage results are promising, with good remission rates and toxicities within expected limits. In consolidation, however, there was substantial risk of thrombocytopenia and neutropenia, and platelet and neutrophil recovery times were longer than expected, suggesting myelosuppression. Nevertheless, the positive induction results imply a promising future for this therapy,…

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Clinical trials have demonstrated the positive response rates for FLT3 inhibitors like quizartinib in relapsed FLT3-mutated acute myeloid leukemia (AML). A major problem for quizartinib monotherapy, however, is that the durability of the response is quite low, meaning that without stem cell transplants, patients are likely to relapse quickly. In this video, recorded at the 23rd Congress of the European Hematological Association (EHA) 2018 in Stockholm, Sweden, Naval Daver, MD, of the MD Anderson Cancer Center, Houston, TX, discusses preclinical data which show that response durability is increased significantly when quizartinib is combined with the MDM2 inhibitor milademetan. He explores…

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Measurable residual disease (MRD) is an important indicator of disease progression and prognosis. Here, Stephan Grupp, MD, PhD, of the Childrens Hospital of Philadelphia, Philadelphia, PA, explains how MRD is used in pediatric and adult acute lymphoblastic leukemia (ALL). In pediatric ALL, MRD may be used as a signal to increase treatment intensity, and Dr Grupp highlights how MRD is currently being used in clinical trials to identify which patients should receive first-line CAR T-cell therapy. In adults, the relationship between treatment planning and MRD status is less well defined. Dr Grupp discusses the different MRD measurement techniques, including flow…

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The use of checkpoint inhibitors in multiple myeloma (MM) is an exciting area. The data from two KEYNOTE studies examining this are discussed here by Noopur Raje, MD, of Massachusetts General Hospital Cancer Center, Boston, MA: KEYNOTE-185 (NCT02579863), investigating pembrolizumab in the frontline setting; and KEYNOTE-183 (NCT02576977), which looked at prembrolizumab plus pomalidamide and dexamethasone in the relapsed/refractory setting. Prof. Raje highlights the factors that must be taken into account when using checkpoint inhibitors in MM. Lastly, she covers the trial (NCT01729091) of a umbilical cord blood?derived NK-cell therapy for MM patients undergoing high dose chemotherapy and auto?HSCT.

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Vincent Rajkumar, MD, of the Mayo Clinic, Rochester, MN, gives an overview of his top 5 abstract presentations at the American Society of Oncology (ASCO) 2018 Annual Meeting, held in Chicago, IL. These include: the CRB-401 study (NCT02658929) showing positive results for anti-BCMA CAR T-cell agent bb2121; ARROW (NCT02412878), which showed that once-weekly carfilzomib was as effective and well-tolerated as a twice-weekly dosage; COLUMBA (NCT03277105), which demonstrated subcutaneous daratumumab was safe and effective; OPTIMISMM (NCT01734928), which showed that a triplet therapy of pomalidomide, bortezomib and dexamethasone was well tolerated and more effective than bortezomib/dexamethasone alone; and SWOG-S1304 (NCT01903811), which showed…

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While CAR T-cells are a potentially revolutionary therapy option across a variety of cancer types, their associated side effects include cytokine release syndrome (CRS) and neurotoxicity. Here, Stephan Grupp, MD, PhD, of the Childrens Hospital of Philadelphia, Philadelphia, PA, discusses what influences the intensity of these adverse reactions at the American Society of Oncology (ASCO) 2018 Annual Meeting, held in Chicago, IL. In acute lymphoblastic leukemia (ALL), CRS appears to increase in proportion with disease severity. However, in lymphoma overall toxicity is generally lower, though there does seem to be increased toxicity with axicabtagene ciloleucel compared to tisagenlecleucel.

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CAR T-cells represent an important step forward in the treatment of a variety of hematological malignancies. At the American Society of Oncology (ASCO) 2018 Annual Meeting, held in Chicago, IL, Stephan Grupp, MD, PhD, of the Childrens Hospital of Philadelphia, Philadelphia, PA, gave an overview of the current state of CAR T-cell therapy in the clinic and research across several blood cancer types. He discusses tisagenlecleucel in acute lymphoblastic leukemia (ALL) and lymphoma. In both diseases, he highlights the potential for using these therapies outside of the currently recommended criteria, for example in the frontline setting or in ultra high-risk…

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Multiple myeloma (MM) updates in the relapsed/refractory setting at the American Society of Oncology (ASCO) 2018 Annual Meeting in Chicago, IL, focused on optimizing the use of carilzomib, in addition to improving the treatment of lenalidomide refractory patients. Speaking from the meeting, Noopur Raje, MD, of Massachusetts General Hospital Cancer Center, Boston, MA, discusses these updates, including the ARROW trial (NCT02412878) of once vs. twice weekly carfilzomib, and the MMY1001 study (NCT01998971) of carfilzomib plus daratumumab. The OPTIMISMM trial (NCT01734928), which evaluated the efficacy and safety of pomalidomide, bortezomib and low-dose dexamethasone, is also explored.

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Cutting-edge trial data in the field of lymphoma was presented at the American Society of Oncology (ASCO) 2018 Annual Meeting in Chicago, IL. Here, Nathan Fowler, MD, of the MD Anderson Cancer Center, Houston, TX, discusses the key data on show. Prof. Fowler, who presented data from the RELEVANCE trial (NCT01476787), highlights the promising results from the combination of bendamustine-rituximab plus the antibody-drug conjugate polatuzumab vedotin (NCT02257567) for relapsed/refractory follicular and diffuse large B-cell lymphoma. In addition, he picks out the TRANSCEND-NHL-001 trial (NCT02631044) of CAR T-cell product lisocabtagene maraleucel, and a trial of a promising novel anti-CD47 antibody, Hu5F9-G4…

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In this video, Ryan Cassaday, MD, of the University of Washington, Seattle, WA, gives an overview of recent developments in the field of acute lymphoblastic leukemia (ALL). He touches upon inotuzumab ozogamicin, and discusses the CD3/CD19 bispecific T-cell engager blinatumomab in more depth, suggesting avenues for future research to understand how therapy sequence, biomarker screening and transplant can be optimized relative to this therapy. Finally, he discusses CAR T-cells, and the goal to increase the range of patients for whom they are an approved therapy. This interview took place at the American Society of Oncology (ASCO) 2018 Annual Meeting, held…

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CAR T-cells are an exciting therapeutic avenue for multiple myeloma (MM). Here, Noopur Raje, MD, of Massachusetts General Hospital Cancer Center, Boston, MA, discusses exciting future routes for this therapy and gives an expert insight into the key focuses of this research. This video was recorded at the American Society of Oncology (ASCO) 2018 Annual Meeting in Chicago, IL.

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Speaking from the American Society of Oncology (ASCO) 2018 Annual Meeting in Chicago, IL, Nathan Fowler, MD, of the MD Anderson Cancer Center, Houston, TX, discusses the decision-making process when selecting the best frontline treatment for a follicular lymphoma patient. Prof. Fowler highlights the factors that should be taken into consideration, including specific comorbities, disease progression and side effects.

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Speaking from the American Society of Oncology (ASCO) 2018 Annual Meeting, held in Chicago, IL, Stephan Grupp, MD, PhD, of the Childrens Hospital of Philadelphia, Philadelphia, PA, speaks about his excitement over the CRB-401 study (NCT02658929), which uses anti-BCMA CAR T-cell agent bb2121 for refractory multiple myeloma (MM). BCMA targeting represents a new area for CAR T-cells, and Dr Grupp emphasizes the importance of these positive findings in MM and other hematological malignancies.

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A number of novel treatment strategies for multiple myeloma (MM) are being studied. A few such studies are discussed here by Noopur Raje, MD, of Massachusetts General Hospital Cancer Center, Boston, MA. Prof. Raje covers the use of venetoclax in combination with carfilzomib for relapsed/refractory MM (NCT02899052). She also mentions the combination of low-dose lenalidomide with the JAK inhibitor ruxolitinib (NCT03110822). This video was recorded at the American Society of Oncology (ASCO) 2018 Annual Meeting in Chicago, IL.

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Multiple myeloma (MM) is an expensive cancer to treat, with costly drugs that are often used in combination. In this video, recorded at the American Society of Oncology (ASCO) 2018 Annual Meeting, held in Chicago, IL, Vincent Rajkumar, MD, of the Mayo Clinic, Rochester, MN, discusses why this treatment is so expensive, and how to combat this problem. He gives an overview of the reasons behind extortionate drug prices, including some issues specific to the USA, such as the fact that Medicare cannot negotiate drug prices and there is no value-based pricing system. He suggests how these issues can be…

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Tisagenlecleucel (CTL019), a CAR T-cell agent, was approved for acute lymphoblastic leukemia (ALL) treatment in children and young adults last year after positive results from the ELIANA trial (NCT02435849). In this video, recorded at the American Society of Oncology (ASCO) 2018 Annual Meeting, held in Chicago, IL, Stephan Grupp, MD, PhD, of the Childrens Hospital of Philadelphia, Philadelphia, PA, discusses data from this trial, as well as the current landscape of CAR T-cell therapy in hematological oncology. He also speaks about future aims for this field, including the goal of cultivating long-term disease management with CAR T-cells and without bone…

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Speaking from the American Society of Oncology (ASCO) 2018 Annual Meeting, held in Chicago, IL, Ryan Cassaday, MD, of the University of Washington, Seattle, WA, discusses the INO-VATE trial (NCT01564784). This study compared the effect of the anti-CD22 antibody-drug conjugate inotuzumab ozogamicin with the standard of care for relapsed/refractory acute lymphoblastic leukemia (ALL). The results from this study showed improved complete response rates, greater levels of measurable residual disease (MRD) negativity, and better survival with inotuzumab than the standard of care, though survival was still quite low. Dr Cassaday highlights the key future aims for this therapy, suggesting targeting certain…

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The anti-BCMA CAR T-cell therapy bb2121 looks extremely promising in multiple myeloma (MM). Here, Noopur Raje, MD, of Massachusetts General Hospital Cancer Center, Boston, MA, discusses the results of CRB-401 (NCT02658929), a first-in-human trial of bb2121 in relapsed/refractory MM, which were presented at the American Society of Oncology (ASCO) 2018 Annual Meeting in Chicago, IL. Prof. Raje also highlights avenues for further study and the key questions that remain to be answered.

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Douglas W. Blayney, MD, explains the significant improvement in PFS in the fulvestrant + ribociclib arm of the MONALEESA-3 study in HR+/HER2- advanced breast cancer         advanced breast cancer, HR+/HER2, MONALEESA-3 study, fulvestrant + ribociclib, significant improvement in PFS

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Prognoses for patients with relapsed metastatic head and neck cancer that has progressed on prior platinum therapy are poor. Here, Kevin Harrington, PhD, MBBS, of the Institute of Cancer Research and the Royal Marsden NHS Foundation Trust, London, UK, discusses data from the KEYNOTE-040 study (NCT02252042), which compared the effect of pembrolizumab against the investigators choice of standard chemotherapy. The results were in favor of pembrolizumab over the standard of care: overall survival, toxicity and patient-reported quality of life scores were better in the pembrolizumab arm of the study. This video was recorded at the American Society of Oncology (ASCO)…

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Speaking from the American Society of Oncology (ASCO) 2018 Annual Meeting in Chicago, IL, Karim Fizazi, MD, PhD, of the University of Paris-Sud, Orsay, France, presents the objectives and motivations behind the CheckMate 9KD trial (NCT03338790). This trial investigated nivolumab in combination with either rucaparib, docetaxel or enzalutamide in men with castration-resistant metastatic prostate cancer. Prof. Fizazi highlights how this trial was created to help find novel drug combinations that could be given to different patients.

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Speaking about symptoms can often be a difficult experience for patients, as it can confirm their fears of the disease. However, the sooner symptoms are presented, the sooner treatment can be administered. For this reason, Jalid Sehouli, MD, of the Charité Comprehensive Cancer Center, Berlin, Germany, gives an interview regarding the benefits of supportive care along with medical treatment. Dr Sehouli believes both men and women should be educated with regards to recognizing the symptoms of ovarian cancer and concludes his interview by mentioning the results of a study he presented the previous year, which investigated similar ideas. Speaking about…

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Kevin Harrington, PhD, MBBS, of the Institute of Cancer Research and the Royal Marsden NHS Foundation Trust, London, UK, presented data from the Phase Ib MASTERKEY-232 trial (NCT02626000) at the American Society of Oncology (ASCO) 2018 Annual Meeting in Chicago, IL. This study combined oncolytic virus therapy talimogene laherparepvec (T-VEC) with anti-PD-1 monoclonal antibody pembrolizumab in an attempt to enhance the anti-tumor immune response in relapsed metastatic head and neck cancer. While safety data for this trial were adequate, the response rate of 16.7% was too similar to the standard of care, pembrolizumab monotherapy, to justify continuation to Phase III.

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In this interview, Karim Fizazi, MD, PhD, of the University of Paris-Sud, Orsay, France gives an overview of the LATITUDE study (NCT01715285), which investigated whether patients with newly diagnosed metastatic prostate cancer would benefit from combination therapy involving abiraterone acetate, low-dose prednisone and androgen deprivation therapy. Speaking from the American Society of Oncology (ASCO) 2018 Annual Meeting in Chicago, IL, Prof. Fizazi outlines the progress LATITUDE has made and the overall promising results of the study.

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The diagnosis of ovarian cancer often occurs in the late stages due to a lack of adequate screening facilities. However, it is coming to light that the patients quality of life may be just as important as the therapy that they are receiving when it comes to treating the disease. Speaking from the American Society of Oncology (ASCO) 2018 Annual Meeting, held in Chicago, IL, Jalid Sehouli, MD, of the Charité Comprehensive Center, Berlin, Germany, explains how patient care and quality of life can have an impact on survival. Dr Sehouli describes a recent meta-analysis his research group conducted to…

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Exciting updates in the field of breast cancer were presented at the American Society of Oncology (ASCO) 2018 Annual Meeting, held in Chicago, IL. In this interview, Robert Coleman, MBBS, MD, FRCP, FRCPE, of the University of Sheffield, Sheffield, UK, discusses the results of the Phase III D-CARE study (NCT01077154), which investigated adjuvant denosumab in early breast cancer (EBC). He highlights the unsual primary endpoint of bone metastasis-free survival and the issues surrounding this. Dr Coleman also discusses the results of a similar study, which used a lower dose of denosumab (EudraCT: 2005-005275-15). Finally, he gives an insight into what…

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Speaking from the American Society of Oncology (ASCO) 2018 Annual Meeting in Chicago, IL, David Carbone, MD, PhD, of Ohio State University, Athens, OH, discusses the KEYNOTE-042 trial (NCT02220894), which compared pembrolizumab with chemotherapy for lung cancer. The results were positive in favor of pembrolizumab, and potentially practice-changing, as they represent a previously unmet need for treating certain lung cancer patient groups. Watch Dr. Jack West review of the KEYNOTE-042 trial here.

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Trastuzumab has revolutionized the treatment of HER2+ breast cancer; however, the benefit of a longer duration of this therapy is uncertain. The PERSEPHONE trial (ISRCTN52968807) looked at the efficacy of 6-month vs. 12-month adjuvant trastuzumab use in patients with HER2+ early breast cancer. In this interview, Robert Coleman, MBBS, MD, FRCP, FRCPE, of the University of Sheffield, Sheffield, UK, discusses the results of this study and their wider implications.This video was recorded at the American Society of Oncology (ASCO) 2018 Annual Meeting, held in Chicago, IL.

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Exciting new data for metastatic renal cell carcinoma (mRCC) was presented at the American Society of Oncology (ASCO) 2018 Annual Meeting, held in Chicago, IL. Here, Toni Choueiri, MD, of the Dana Farber Cancer Institute, Cambridge, MA, provides an update on the latest data in this field. Prof. Choueiri first highlights the use of pembrolizumab monotherapy in untreated mRCC in KEYNOTE-427 (NCT02853344), giving an interesting insight into the role of single agent immunotherapy in this setting. Another highlight was the results of the RESORT trial (NCT01444807) of sorafenib in mRCC following radical resection of metastases. In addition, the E2810 study…

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Exciting updates in the field of breast cancer were presented at the American Society of Oncology (ASCO) 2018 Annual Meeting, held in Chicago, IL. In this interview, Robert Coleman, MBBS, MD, FRCP, FRCPE, of the University of Sheffield, Sheffield, UK, discusses the results of the Phase III D-CARE study (NCT01077154), which investigated adjuvant denosumab in early breast cancer (EBC). He highlights the unsual primary endpoint of bone metastasis-free survival and the issues surrounding this. Dr Coleman also discusses the results of a similar study, which used a lower dose of denosumab (EudraCT: 2005-005275-15). Finally, he gives an insight into what…

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Treatment options for small cell lung cancer (SCLC) have not advanced significantly in the past few decades, and patients with multiple relapses have no approved treatment options. In this video, recorded at the American Society of Oncology (ASCO) 2018 Annual Meeting in Chicago, IL, David Carbone, MD, PhD, of Ohio State University, Athens, OH, describes the Phase II trial TRINITY (NCT02674568). This trial treated patients with two or more prior relapses with the DLL3 antibody-drug conjugate rovalpituzumab tesirine (Rova-T). The response rates were positive, and side effects from the treatment were manageable, suggesting that Rova-T could be a much sought…

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Currently, CAR T-cell products are primarily tested in the relapsed setting. However, bringing these novel agents to patients earlier in the treatment pathway could improve responses. In this interview, Jeremy Abramson, MD, of the Massachusetts General Hospital Cancer Center, Boston, MA, discusses the TRANSFORM trial (NCT03575351), comparing the use of lisocabtagene maraleucel to the standard of care in relapsed/refractory aggresive B-cell non-Hodgkin lymphoma, and the TRANSCEND-NHL-006 trial (NCT03483103), which is investigating lisocabtagene maraleucel in the second-line setting for diffuse large B-cell lymphoma. This video was recorded at the American Society of Oncology (ASCO) 2018 Annual Meeting, held in Chicago, IL.

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IV administration of daratumumab has several issues, including a long infusion time (~7 h) and the likelihood of infusion-related toxicities. In this video, recorded at the 2018 American Society of Oncology (ASCO) Annual Meeting, held in Chicago, IL, Ajai Chari, MD, PhD, of Mount Sinai School of Medicine, New York, NY, discusses a trial (NCT02519452) for a subcutaneous method of administering daratumumab. Daratumumab is combined with hyaluronidase, yielding improved convenience and safety compared to IV administration, and encouraging efficacy data.

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CAR T-cell monotherapies have produced promising results; however, the duration of remission needs to be optimized. Here, Jeremy Abramson, MD, of the Massachusetts General Hospital Cancer Center, Boston, MA, highlights how combination regimens could improve response durability. He highlights the PLATFORM trial (NCT03310619), which is investigating CAR T-cell product lisocabtagene maraleucel combinations in relapsed/refractory B-cell malignancies. This video was recorded at the American Society of Oncology (ASCO) 2018 Annual Meeting, held in Chicago, IL.

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CAR T-cells represent an exciting new treatment frontier across a variety of blood cancers. We interviewed David Maloney, MD, PhD, of the Fred Hutchinson Cancer Research Center, Seattle, WA, at the American Society of Oncology (ASCO) 2018 Annual Meeting in Chicago, IL, about the newest CAR T-cell therapies on the market. In diffuse large B-cell lymphoma (DLBCL), he highlights axicabtagene ciloleucel, tisagenlecleucel and lisocabtagene maraleucel, the latter of which has extremely promising safety results, with low levels of cytokine release syndrome and neurotoxicity. Dr Maloney also discusses new multiple myeloma (MM) CAR T-cell treatments, pointing out a trial (NCT02658929) showing…

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Ajai Chari, MD, PhD, of Mount Sinai School of Medicine, New York, NY, presented data from the recent Phase Ib trial NCT02332850 at the 2018 American Society of Oncology (ASCO) Annual Meeting, held in Chicago, IL. This trial explored the impact of CD38-targeting monoclonal antibody isatuximab with carfilzomib and dexamethasone in relapsed/refractory multiple myeloma (MM). The safety data obtained in this study were in line with expected values, and the efficacy data showed that this combination could be greatly beneficial in heavily pre-treated patient groups.

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CAR T-cell monotherapies have produced promising results; however, the duration of remission needs to be optimized. Here, Jeremy Abramson, MD, of the Massachusetts General Hospital Cancer Center, Boston, MA, highlights how combination regimens could improve response durability. He highlights the PLATFORM trial (NCT03310619), which is investigating CAR T-cell product lisocabtagene maraleucel combinations in relapsed/refractory B-cell malignancies. This video was recorded at the American Society of Oncology (ASCO) 2018 Annual Meeting, held in Chicago, IL.

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Francesca Gay, MD, of the University of Torino, Torino, Italy, provides an efficacy data update from the FORTE trial (NCT02203643), which investigated carfilzomib plus lenalidomide or cyclophosphamide for the treatment of newly diagnosed multiple myeloma (MM) prior to transplant. She highlights complete response rates with both regimens, as well as the results of MRD analysis. This video was recorded at the American Society of Oncology (ASCO) 2018 Annual Meeting, held in Chicago, IL.

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With the recent influx of targeted, highly effective novel agents to the field of acute lymphoblastic leukemia (ALL), there is some uncertainty surrounding the role of aggressive treatments like stem cell transplant. In this video, recorded at the American Society of Oncology (ASCO) 2018 Annual Meeting in Chicago, IL, David Maloney, MD, PhD, of the Fred Hutchinson Cancer Research Center, Seattle, WA, discusses the role of stem cell transplants in ALL. He explores data on the subject, and concludes that in adults there is still a definite use for stem cell transplants, particularly in the relapsed setting. He points out…

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While there are many clinical trials exploring the effect of various novel agents in combination with lenalidomide-dexamethasone therapy in multiple myeloma (MM), patients who are lenalidomide refractory would not be eligible for these studies. Ajai Chari, MD, PhD, of Mount Sinai School of Medicine, New York, NY, presented results from a subgroup analysis of the MMY1001 trial (NCT01998971) at the 2018 American Society of Oncology (ASCO) Annual Meeting, held in Chicago, IL, which saw lenalidomide refractory MM patients given the combination of daratumumab plus carfilzomib-dexamethasone. Prof. Chari discusses the data from this trial, which showed lenalidomide refractory patients had a…

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Kinase inhibitors are one of the most successful forms of therapy for hematological malignancies, with further potential due to new advances. Speaking from the 1st European Myeloma Network Meeting (EMN) in Turin, Italy, Fabio Malavasi, MD, of the University of Turin, Turin, Italy, describes some of the work currently being performed regarding predictive biomarkers for kinase inhibitor treatment response. Prof. Malavasi also mentions daratumumab and its synergistic action when given to patients in combination with novel kinase inhibitors.

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The contemporary viewpoint is that multiple myeloma (MM) is a group of separate diseases, rather than just one type of cancer. This has allowed patients to be grouped according to their specific form of MM and receive treatment tailored to their subtype. In this video, recorded at the 1st European Myeloma Network Meeting (EMN) held in Turin, Italy, Vittorio Montefusco, MD, of the IRCCS Foundation, National Cancer Institute of Milan, Milan, Italy, describes some of the different subgroups of patients, how they are defined and what treatments are being developed for each of these groups.

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In this video, Fabio Malavasi, MD, of the University of Turin, Turin, Italy, discusses immunotherapy in multiple myeloma (MM) from the 1st European Myeloma Network Meeting (EMN) 2018, in Turin, Italy. Prof. Malavasi highlights the innovative apporach of CAR T-cells, before mentioning the current limitations preventing the further development and application of this treatment.

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Despite recent advances in drug development, autologous stem cell transplant (ASCT) is still, to date, the most effective treatment for multiple myeloma (MM). Speaking from the 1st European Myeloma Network Meeting (EMN) in Turin, Italy, Vittorio Montefusco, MD, of the IRCCS Foundation, National Cancer Institute of Milan, Milan, Italy, explains why this is the case. Dr Montefusco outlines the benefits of using drugs in combination with ASCT, and highlights how the difference in patient fitness between older and younger populations can influence the course of treatment.

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Abstracts are often the most informative parts of scientific publications, as they contain a complete overview of the entire paper. Therefore, selecting the best abstract out of hundreds can be a daunting task due to the sheer volume of information. At the 1st European Myeloma Network Meeting (EMN), in Turin, Italy, Fabio Malavasi, MD, of the University of Turin, Turin, Italy, had to do just that. Prof. Malavasi briefly mentions that he chose four abstracts as the top contenders, then describes the content of one in particular, which focused on how multiple myeloma (MM) cells are able to create a…

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While daratumumab is one of the most effective treatments for multiple myeloma (MM), ~50% of all patients who the drug intravenously develop infusion-related reactions. In this video, Torben Plesner, MD, of the University of Southern Denmark, Vejle, Denmark, describes why subcutaneous formulation of daratumumab is superior to IV formulation in more ways than one. Speaking from the 1st European Myeloma Network Meeting (EMN), in Turin, Italy, Dr Plesner references the PAVO trial (NCT02519452), which is currently investigating the safety and efficacy of a subcutaneous formulation of daratumumab, and explains some of the results that have already been obtained, all of…

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Autologous stem cell transplantation (ASCT) for multiple myeloma (MM) patients has often been capped at 65 years of age. However, Mohamad Mohty, MD, PhD, of the University Pierre & Marie Curie, Paris, France, explains why limiting ASCTs to those younger than 65 is a mistake, and outlines what guidelines would be more applicable when screening for patients eligible for transplants. Speaking from the 1st European Myeloma Network (EMN) Meeting, in Turin, Italy. Prof. Mohty emphasizes that when suitable patients >65 years old do receive stem cell transplants, the results are often very positive, further encouraging the age cap of 65…

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Autologous stem cell transplantation is here to stay for multiple myeloma (MM). However, once a treatment has been developed, there is no reason why it should not be improved. Here, Mohamad Mohty, MD, PhD, of University Pierre & Marie Curie, Paris, France, goes through some of the constant refinements that are being made to the drugs used to treat MM. Prof. Mohty discusses the debates these new improvements have sparked, and what he believes the most interesting drug innovations are, supported by findings by the staMINA trial (NCT01109004), before concluding his interview by giving a brief overview of maintenance therapy…

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Measurable residual disease (MRD) status is a valuable prognostic marker in multiple myeloma (MM), but questions still remain. Speaking from the 1st European Myeloma Network (EMN) Meeting, in Turin, Italy, Niels van de Donk, MD, PhD, of VU University Medical Center, Amsterdam, Netherlands, describes how although MRD tests are critically important, perhaps their true value has not yet been determined when it comes to making decisions about patient treatment, before mentioning how several trials are currently investigating the many different ways MRD can be measured and interpreted.

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Measurable residual disease (MRD) is evaluated and analyzed in clinical trials, but less attention is currently given to it in practice, particularly in elderly patients, even those fit enough for transplant. Speaking from the 1st European Myeloma Network (EMN) Meeting, held in Turin, Italy, Elena Zamagni, MD, PhD, from the University of Bologna, Bologna, Italy, points out that although there are a number of difficulties involving combining imaging techniques to analyze MRD, it may help increase the success of treatment regimens and can help determine which course of treatment is best.

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Elderly patients with multiple myeloma (MM) are often denied intensive treatment due to the fear they will not be able to tolerate it. However, Mohamad Mohty, MD, PhD of the University Pierre & Marie Curie, Paris, France, explains how, with slight adjustments and refinements to the screening and treatment processes, many elderly patients, including those previously thought too frail, can successfully receive and respond to treatment. Speaking from the 1st European Myeloma Network (EMN) Meeting, in Turin, Italy, Prof. Mohty outlines how different elderly patients should be treated based on their fitness, rather than age, and states some of the…

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Measurable residual disease (MRD) can be determined using a variety of techniques. However, the majority of trials perform bone marrow MRD evaluation, while few are determining the effectiveness of PET-CT and MRI. Here, Elena Zamagni, MD, PhD, from the University of Bologna, Bologna, Italy, explains some of the complications regarding interpreting patient MRD and how incorporating these imaging techniques could help reduce this ambiguity. This interview took place at the 1st European Myeloma Network (EMN) Meeting, held in Turin, Italy.

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While it is understandable that elderly patients with multiple myeloma (MM) are generally excluded from more aggressive treatments, Mohamad Mohty, MD, PhD, of University Pierre & Marie Curie, France, speaking from the 1st European Myeloma Network (EMN) Meeting, in Turin, Italy, explains how, with the proper screening tests, elderly MM patients can tolerate and respond to treatment just as well as younger patients, and calls for improvements and refinements to the patient screening process to allow capable elderly patients to be treated.

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Howard Hochster, MD, shares his perspective on the outcomes of the PRODIGY7 study in metastatic colorectal cancer patients using heated single agent oxaliplatin after surgery at the 2018 Annual Meeting.         metastatic colorectal cancer patients, prodigy7 study, mcrc, perspective on the outcomes

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Patients with advanced chronic lymphocytic leukemia (CLL) don’t respond well to chimeric antigen receptor (CAR) T-cell therapy. In this interview, Chris Fegan, MB, MD, FRCP, FRCPath, from Cardiff University, Cardiff, UK, discusses a study carried out on T-cell telomeres from CLL patients, in which it was observed that these telomeres shorten even more rapidly than those in CLL cells. This interview was recorded at the British Society for Hematology (BSH) 2018 Annual Scientific Meeting, Liverpool, UK

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The British Society for Haematology (BSH) 2018 Annual Meeting in Liverpool, UK, had a record number of clinical experts in attendance. Speaking from the Annual Meeting, Simon Rule, MD, from Plymouth University, Plymouth, UK, incoming BSH Vice President, explains the importance of such events in improving access to the latest clinical research in hematology for healthcare professionals who otherwise may not be able to attend some larger congresses. Social media plays a key part in improving communication of clinical research, and Dr Rule believes that this medium can help engage cancer nurses by giving education targeted for their needs.

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The UK is in a leading position internationally for use of minimal residual disease (MRD) measurements in acute myeloid leukemia (AML). In this interview, Richard Dillon, MBBS, from King’s College London, UK, discusses the importance of using MRD in these patients and how its use in the UK has advanced. Dr Dillion discusses the Phase III MyeChild01 (NCT02724163) and AML19 (ISRCTN78449203) trials for children and younger adults with AML. These studies are effectively utilizing MRD measurement as a key marker to choose which patients undergo transplantation. The studies are also collecting additional data, on factors such as quality of life,…

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Chris Fegan, MB, MD, FRCP, FRCPath, from Cardiff University, Cardiff, UK, touches on several of the national and international cohort studies he has been involved in, proposing that telomere length is a prognostic factor in chronic lymphocytic leukemia (CLL). The studies have all identified the association between long telomere length and a better clinical outcome for patients. Moving forward, Dr Fegan suggests the use of telomere length to inform patients better on what is likely to happen to them, as it iss the only prognostic marker that is present at diagnosis This interview was recorded at the British Society for…

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There are three times more patients with sickle cell disease (SCD) than cystic fibrosis (CF) in the USA, yet SCD receives 10 times less research funding than CF. In this interview, Sonia Wolf, MD, from Barts Health NHS Trust, London, UK discusses her Crucible Prize-winning presentation titled Young, Black and Stigmatised: how haematologists harm patients with sickle cell disease. Dr Wolf explains how misconceptions healthcare professionals have about patients with SCD may influence the care given, and how hematologists can cause harm in three key ways: admitting patients for excessive durations, administering opioids inappropriately and failing to ensure sufficient psychological…

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BTK inhibitors have seen success in treating various hematological malignancies, and their approval has been extended to mantle cell lymphoma (MCL). Here, Simon Rule, MD, from Plymouth University, Plymouth, UK, discusses the challenges of treatment resistance, pointing out that the earlier use of BTK inhibitors, such as ibrutinib, lead to more effective treatment together with reduced side effects. Speaking at the British Society for Haematology (BSH) 2018 Annual Meeting in Liverpool, UK, Prof. Rule alludes to the potential of the BCL-2 inhibitor venetoclax, and the exciting promise of CAR T-cell therapy in patients previously treated with ibrutinib. Prof. Rule concludes…

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Richard Dillon, MBBS, from King’s College London, UK, discusses the current landscape for minimal residual disease (MRD) in acute myeloid leukemia (AML). The evolution of MRD-guided therapies is timely, with MRD moving to being clinically relevant. Dr Dillion mentions multiple studies conclusively proving that MRD is one of the most, if not the most, relevant prognostic factor in AML. In the last few years, MRD measurement has been incorporated into treatment protocols, enabling physicians to choose the best treatment for each individual patient. This interview was recorded at the British Society for Hematology (BSH) 2018 Annual Scientific Meeting, held in…

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Telomere erosion and fusion play an important role in the pathology of many common human malignancies, including chronic lymphocytic leukemia (CLL). In this interview, Chris Fegan, MB, MD, FRCP, FRCPath, from Cardiff University, Cardiff, UK, discusses the findings of a study analyzed the telomere profiles of CLL patients, to give a better idea of the replicative history of the disease. The study identified the shortest telomeres ever recorded in primary human tissue, reinforcing the concept that there is significant cell division in CLL. The study also provided evidence that critical telomere shortening, dysfunction and fusion contribute to disease progression. This…

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Could patients who remain MRD negative long-term whilst on maintenance treatment cease treatment? Here, Ola Landgren, MD, PhD, from Memorial Sloan Kettering Cancer Center, NY, discusses the utilization of MRD measurement as a strategy for treatment-free survival. This video was recorded at the 23rd congress of European Hematology Association (EHA) 2018, held in Stockholm, Sweden.

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There are many questions surrounding minimal residual disease (MRD) detection and its role in decision making; for example, whether drug administration should be continued in a multiple myeloma (MM) patient who is MRD negative, or whether to change the treatment given if a patient is MRD positive. Here, Niels van de Donk, MD, PhD, of VU University Medical Center, Amsterdam, Netherlands, speaking from the 23rd congress of European Hematology Association (EHA) 2018, held in Stockholm, Sweden, discusses the importance of MRD negative complete remission, and how clinical trials such as POLLUX (NCT02076009) and CASTOR (NCT02136134) have established that MRD negative…

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Timothy Hughes, MD, of the Royal Adelaide Hospital, Adelaide, Australia, talks about the TARGET survey, a survey of real-world management of chronic myeloid leukemia (CML) across 33 countries. This survey looked at how physicians chose front-line therapy and selected who would be eligible for treatment-free remission, as well as their practice of molecular monitoring. Dr Hughes explains that there is a concern, as many physicians reported that they are not able to perform molecular monitoring on a regular basis. This has an impact on the likelihood of successful outcomes in CML, so it is important for physicians to monitor their…

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Ola Landgren, MD, PhD, from Memorial Sloan Kettering Cancer Center, NY, describes novel uses for minimal residual disease (MRD) measurement in multiple myeloma (MM), including his experience of monitoring MRD ‘over time’, how we might think of the definition of relapse going forward, and the studies his institute is working on in these areas. This video was recorded at the 23rd congress of European Hematology Association (EHA) 2018, held in Stockholm, Sweden.

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Niels van de Donk, MD, PhD, of VU University Medical Center, Amsterdam, Netherlands, discusses an exciting preclinical investigation of the safety and tolerability of a BCMAxCD3 bispecific antibody for the treatment of multiple myeloma (MM). This form of therapy redirects T-cells to myeloma cells, and is considered to be efficacious in newly diagnosed patients, heavily pre-treated patients, and patients that are refractory to all available therapies, including lenalidomide, pomalidomide and bortezomib. In the future, this drug may be considered for MM patients with detectable minimal residual disease (MRD) after transplant or reinduction therapy. This interview was recorded at the 23rd…

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Treatments for multiple myeloma (MM) in newly diagnosed and relapsed patients differ between regions, particularly with the rapid advancements in treatment in recent years. Here, Ola Landgren, MD, PhD, from Memorial Sloan Kettering Cancer Center, NY, discusses how MM is treated in the US; highlighting the differences compared with Europe, as a European who now works in the US. Notably, the use of more drugs in combination; namely IMiDs, proteasome inhibitors and steroids, although four-agent regimens with the addition of a monoclonal antibody are in clinical trials. Dr Landgren also discusses the future of MM treatment in the US, with…

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Timothy Hughes, MD, of the Royal Adelaide Hospital, Adelaide, Australia, gives us an overview of the follow-up study of ENESTcmr. The ENESTop trial (NCT01698905) was designed to address whether deep molecular response in chronic myeloid leukemia (CML) could be translated into treatment-free remission (TFR). Over 50% of patients who started on imatinib and had switched to nilotinib remained in TFR. This suggests that switching a patient onto a diffeent tyrosine kinase inhibitor, in order to achieve a deaper response, will eventually translate into acheiving higher rates of TFR. This video was recorded at the 23rd congress of European Hematology Association…

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Ramon Garcia-Sanz, MD, PhD from the University Hospital of Salamanca, Salamanca, Spain, shares exciting data in Waldenströms macroglobulinemia (WM) from the 23rd congress of European Hematology Association (EHA) 2018, held in Stockholm, Sweden. Dr Garcia-Sanz comments on the current limitations of treatments available for WM, including toxicities and the need for multiple agents. Novel BTK inhibitors hold promise for these patients, with ibrutinib in combination with rituximab showing positive results when compared to rituximab alone.

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Very soon, minimal residual disease (MRD) testing will become a routine part of clinical practice. Therefore, it is important that clinicians understand when and how to use the tests for the optimal management of multiple myeloma (MM) patients. In this interview, Ola Landgren, MD, PhD, from Memorial Sloan Kettering Cancer Center, NY, describes when you can use MRD testing throughout the treatment journey in MM, in order to support clinical decision making and monitoring of response. This video was recorded during the 23rd congress of the European Hematology Association (EHA) 2018, held in Stockholm, Sweden.

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Previous clinical trial investigations have established that daratumumab plus bortezomib, melphalan and prednisone, also known as dara+VMP, is significantly more effective than VMP alone in terms of response and progression-free survival in multiple myeloma (MM). Speaking from the 23rd congress of European Hematology Association (EHA) 2018, held in Stockholm, Sweden, Niels van de Donk, MD, PhD, of VU University Medical Center, Amsterdam, Netherlands, provides us with an update on the feasibility and tolerability of darazumumab, and explains how the drug can now be conveniently administered as a subcutaneous infusion, as well as to elderly patients.

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Newer treatments for hematological malignancies, including immunotherapies and cellular therapies, are more targeted than historical chemotherapies. This means that the presence of the specific target is critical for the treatment to be efficacious. Speaking from the 3rd congress of European Hematology Association (EHA) 2018, held in Stockholm, Sweden, Ola Landgren, MD, PhD, from Memorial Sloan Kettering Cancer Center, NY, discusses the predictive biomarkers that can be used to aid treatment decisions. He also comments on the potential reasons for the different responses between patients with the same biomarkers treated with the same drug.

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The current treatment landscape of CML is at a very exciting time. Here, Timothy Hughes, MD, of the Royal Adelaide Hospital, Adelaide, Australia, talks about the importance of achieving early molecular response (EMR) in the first 3 months. There is a direct link between the potency of the tyrosine kinase inhibitor used and its capacity to reduce EMR failure to a minimum. For example, in patients receiving imatinib, the chances of EMR failure is between 30-40%. More potent drugs, such as dasatinib and nilotinib, bring this down further. He goes on to explain that another important factor is the biology…

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The combination of brentuximab vedotin and ESHAP has had positive results when used prior to autologous stem cell transplant in patients with refractory/relapsed Hodgkin lymphoma. Here, Ramon Garcia-Sanz, MD, PhD, from the University Hospital of Salamanca, Salamanca, Spain describes how this combination resulted in high complete remission rates and increased time to treatment failure in this challenging patient group. This interview was recorded at the 23rd congress of European Hematology Association (EHA) 2018, held in Stockholm, Sweden.

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The measurement and use of minimal residual disease (MRD) is an exciting development in the world of hematological oncology. So, what is MRD, how can it be measured, why is it important, and how can it be used in the clinic? Here, Ola Landgren, MD, PhD, from Memorial Sloan Kettering Cancer Center, NY, discusses this exciting topic and answers these key questions surrounding its use. This video was recorded at the 23rd congress of European Hematology Association (EHA) 2018, held in Stockholm, Sweden.

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The 23rd congress of the European Haematology Association (EHA) 2018, held in Stockholm, Sweden, presented exciting data from multiple myeloma (MM) trials. In this interview, Niels van de Donk, MD, PhD, of VU University Medical Center, Amsterdam, Netherlands, discusses the long-term results of the HOVON-50 study (NCT00028886), which investigated thalidomide/adriamycine/dexamethasone (TAD) followed by high-dose melphalan/ASCT and thalidomide maintenance therapy. This exciting study showed improved survival with thalidomide use prior to and following transplant.

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A small proportion (~20%) of multiple myeloma (MM) patients are at a high risk of relapse and aggressive disease progression. Identification of these patients can lead to more informed, individualized treatment plans to improve the standard of care in both high- and low-risk patients. In this video, recorded at the 23rd Congress of the European Hematology Association (EHA) 2018, held in Stockholm, Sweden, Matthew Jenner, MBBS, MRCP, FRCPath, PhD, of University Hospital Southampton NHS Foundation Trust, Southampton, UK, discusses the MUK Nine trial (NCT03188172), which has shown that screening for gene copy abnormalities, adverse gene translocations and gene expression profiling…

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CAR T-cells are gaining traction as a therapy for a variety of hematological malignancies. Here, Oliver Ottmann, MD, FRCPath, of Cardiff University, Cardiff, UK, discusses their role in acute lymphoblastic leukemia (ALL) at the 23rd Congress of the European Hematology Association (EHA) 2018, held in Stockholm, Sweden. He outlines the toxicities associated with CAR T-cells, including neurotoxicity and cytokine release syndrome, and also discusses the potential role for CAR T-cells in ALL treatment. Finally, he touches upon the possibility of combining CAR T-cell therapy with bispecific antibodies, and the impact this combination would have on toxicity and efficacy.

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Daratumumab is one of the most promising new therapies in multiple myeloma (MM). Here, Matthew Jenner, MBBS, MRCP, FRCPath, PhD, of University Hospital Southampton NHS Foundation Trust, Southampton, UK, discusses the impact that this drug has had in multiple treatment settings. He predicts future roles for daratumumab in MM, discussing how it is being tested beyond its initial niche in the relapsed/refractory setting, and how it is now being used as a frontline therapy. He emphasizes the positive future for daratumumab, saying it will demonstrate improvements in depth of response, measurable residual disease (MRD) negativity, and survival. This video was…

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Lenalidomide monotherapy has proven to be an effective maintenance treatment for multiple myeloma (MM). Matthew Jenner, MBBS, MRCP, FRCPath, PhD, of University Hospital Southampton NHS Foundation Trust, Southampton, UK, presented data from part of the Myeloma XI trial (NCT01554852), which aimed to compare vorinostat plus lenalidomide maintenance therapy with lenalidomide alone, at the 23rd Congress of the European Hematology Association (EHA) 2018, held in Stockholm, Sweden. This study did not meet its primary endpoint of improving progression-free or overall survival in the vorinostat-lenalidomide arm, primarily because the toxicity of this combination proved too great for most patients to tolerate. Dr…

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To determine the true impact of ibrutinib treatment in patients with chronic lymphocytic leukemia (CLL) within a population-based setting rather than a clinical trial setting, Lina van der Straten, PhD, of the Albert Schweitzer Hospital, Dordrect, Netherlands, outlines her collaboration with the Netherlands Cancer Registry, which allowed her to analyze patient survival over a prolonged period of time and draw some promising conclusions. Dr van der Straten presented these results at the 23rd Congress of the European Hematology Association (EHA) 2018 in Stockholm, Sweden.

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Venetoclax is making headlines due to its effectiveness against many hematological cancers. In this video, Giovanni Martinelli, MD, of the Istituto Scientifico Romagnolo, Meldola, Italy, outlines how this drug is able to induce apoptosis in cancerous cells and how this has led to a recent breakthrough in drug development. Speaking at the 23rd Congress of the European Hematology Association (EHA) 2018, held at Stockholm, Sweden, Prof. Martinelli refers to his previous work that described the different metabolic pathways of cancerous and normal cells, and mentions how this is the starting point of action of venetoclax. Finally, Prof. Martinelli touches upon…

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Stem cell transplants are one of the most well-studied and effective therapies for blood cancers. In this video, Anna Sureda, MD, PhD, of the Catalan Institute of Oncology, Duran I Reynals Hospital, Barcelona, Spain, discusses the objectives and results of recent studies carried out in collaboration by the CIBMMTR-LC and the EMBT-LWP. Two different donors were used to source the stem cells, donors that were haploidentical to the patients and donors who were unrelated, and the results were compared with each other in terms of PFS, mortality and relapse rate. Although no conclusive evidence has been presented as of yet,…

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Howard Hochster, MD, weighs in on the VALENTINO study regarding the effectiveness of maintenance 5FU/LV following FOLFOX + panitumumab induction in metastatic colorectal cancer patients

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Randall A. Oyer, MD, Dr. Oyer explains how ACCC is contributing to the work being done to address disparities in healthcare, including the implementation of the Optimal Care Coordination Model (OCCM) at Annual Meeting 2018.

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After presenting the initial results of a study investigating the efficacy of ibrutinib for chronic lymphocytic leukemia (CLL) within a population-based setting, Lina van der Straten, PhD, of the Albert Schweitzer Hospital, Dordrecht, Netherlands, offers some explanations for these results. Dr van der Straten contrasts the difference in the initial health of the patients, followed by the differing levels of patient care between her study and those conducted as a part of clinical trials. Concluding her talk, Dr van der Straten discusses an interesting point about the prognosis of patients with anemia. This interview took place at the 23rd Congress…

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Cancerous cells in acute myeloid leukemia (AML) utilize different metabolic pathways to normal cells. Using this difference in their biology, Giovanni Martinelli, MD, of the Istituto Scientifico Romagnolo, Meldola, Italy, explains how the discovery of two genes that, when mutated, contribute to this altered metabolic pathway and have led to the development of targeted drugs. Prof. Martinelli concludes the interview by stating that although the drugs are still in the early stages of clinical trials, the preliminary results have been very promising. This interview was recorded at the 23rd Congress of the European Hematology Association (EHA) 2018, held at Stockholm,…

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Trends in the use of stem cell transplantation in relapsed and refractory Hodgkin lymphoma are currently being studied by the European Society for Blood and Marrow Transplantation (EBMT). In this interview, Anna Sureda, MD, PhD, of the Catalan Institute of Oncology, Duran I Reynals Hospital, Barcelona, Spain, summarizes the results that have been obtained so far by the Lymphoma Working Party of the EBMT, which have focused on both autologous and allogenic stem cell transplants. She puts a particular emphasis on allogenic transplants and draws attention to the advances that have been made with this line of therapy, before briefly…

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The 23rd Congress of the European Hematological Association (EHA) 2018 in Stockholm, Sweden, saw many researchers presenting the newest data from their recent clinical trials. In this video, Mohamad Mohty, MD, PhD, of Saint-Antoine Hospital, Paris, France, speaks about his highlights for multiple myeloma (MM), giving a critical overview of the data and their implications for the future of MM care. He includes: ARROW (NCT02412878), which has demonstrated that carfilzomib has a PFS benefit in once-weekly vs. twice-weekly dosing; OPTIMISMM (NCT01734928), which reported a PFS benefit from pomalidomide, bortezomib and dexamethasone in the relapsed/refractory setting; and a sub-group analysis of…

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Since its approval in late 2014, ibrutinib has primarily been studied in clinical trials, such as RESONATE (NCT01578707), and in compassionate use programs. In this video, Lina van der Straten, PhD, of the Albert Schweitzer Hospital, Dordrecht, Netherlands, outlines a recent study that aims to determine the effect of ibrutinib on patients with chronic lymphocytic leukemia (CLL) within a population-based setting. Speaking from the 23rd Congress of the European Hematology Association (EHA) 2018, held in Stockholm, Sweden, Dr van der Straten explains the key preliminary results from her initial study on a group of patients treated with ibrutinib between 2014-15,…

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The treatment of acute myeloid leukemia (AML) patients who have relapsed has, to date, been quite difficult as there has been a notable lack of knowledge behind the cause of the changes leading to relapse. In this video, Giovanni Martinelli, MD, of the Istituto Scientifico Romagnolo, Meldola, Italy, discusses a recent revelation in the mechanisms behind AML relapse and what new advances this has led to. Prof. Martinelli refers specifically to the QuANTUM-R trial (NCT02039726) currently underway, which is investigating the effects of quizartinib on relapsed/refractory AML. Speaking from the 23rd Congress of the European Hematology Association (EHA) 2018, held…

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While the current frontline ABVD (doxorubicin, bleomycin, vinblastine, dacarbazine) regimen for treating advanced-stage Hodgkin lymphoma is effective with manageable side effects, ~30% of patients eventually relapse. Anna Sureda, MD, PhD, of the Catalan Institute of Oncology, Duran I Reynals Hospital, Barcelona, Spain, speaks at the 23rd Congress of the European Hematological Association (EHA) 2018 held in Stockholm, Sweden, about the latest advances in the treatment of Hodgkin lymphoma. Dr Sureda emphasizes the use of PET scans to determine the intensity of treatment and discusses results of the ECHELON-1 trial (NCT01712490). Dr Sureda outlines how this trial highlighted the positives and…

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Acute lymphoblastic leukemia (ALL) is currently treated with a regimen of drugs that, while effective to an extent, could be improved upon. In this interview, Giovanni Martinelli, MD, of the Istituto Scientifico Romagnolo, Meldola, Italy, talks about a recently developed drug, blinatumomab. While the data from the current clinical trial, D-ALBA (NCT02744768), has only recently become available, Prof. Martinelli is hopeful enfor this treatment. This interview took place at the 23rd Congress of the European Hematology Association (EHA) 2018, held in Stockholm, Sweden.

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The purpose of the iNNOVATE study (NCT02165397) was to evaluate the safety and efficacy of ibrutinib and rituximab for the treatment of Waldenströms macroglobulinemia (WM). Here, at the 23rd congress of the European Haematology Association (EHA) 2018, held in Stockholm, Sweden, Meletios Dimopoulos, MD, from Kapodistrian University of Athens School of Medicine, Athens, Greece, discusses the results of this Phase III trial. Dr Dimopoulos highlights how this trial has produced exciting results in terms of patient outcomes; surprisingly, most of all in high risk patient groups. Improvements for the future are then discussed, looking at treatment duration and other drug…

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Pomalidomide combinations in randomized trials are generating exciting data for relapsed/refractory multiple myeloma (MM). Here, Meletios Dimopoulos, MD, from the Kapodistrian University of Athens School of Medicine, Athens, Greece, provides insight into the ELOQUENT-3 (NCT02654132) and OPTIMISMM (NCT01734928) trials for patients who have failed proteosome inhibitor and immunomodulatory agent therapy, whilst also touching upon the future of treatment. Both of these trials compared different combinations and doses of pomalidomide and dexamethasone with either elotuzumab or bortezomib, resulting in great tolerability with few adverse events. This was recorded at the 23rd congress of the European Haematology Association (EHA) 2018, held in…

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