Physicians’ Education Resource®, LLC, is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.
Physicians’ Education Resource®, LLC, designates this enduring material for a maximum of 2.0 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
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Acknowledgment of Commercial Support
This activity is supported by educational grants from Kite Pharma, Inc. and Takeda Oncology.
Community Practice Connections™: 2nd Annual European Congress on Hematology™: Focus on Lymphoid Malignancies
Release Date: December 30, 2017
Expiration Date: December 30, 2018
Media: Internet - based
Community Practice Connections™: 2nd Annual European Congress on Hematology™: Focus on Lymphoid Malignancies consists of a series of interactive clinical vignettes, short video interviews with leading experts in hematologic malignancies, and short summaries of clinical data related to these issues. The video interviews address decision points in the clinical vignettes and questions commonly faced in the community oncology practice setting.
Acknowledgement of Commercial Support
This activity is supported by educational grants from Kite Pharma, Inc. and Takeda Oncology.
CME/CE Activity Table of Contents
- Module 1: Lymphoma
- Module 2: Multiple Myeloma
- Module 3: Chronic Lymphocytic Leukemia
Instructions for This Activity and Receiving Credit
This educational activity is directed toward medical oncologists and other healthcare professionals (physicians, physicians-in-training, oncology nurses, pharmacists, physician assistants, etc) involved in the treatment and management of patients with hematologic malignancies.
At the conclusion of this activity, you should be better prepared to:
- Assess methods to stratify risk using genomic and molecular biomarkers and how they can be used to guide clinical decision making in the management of hematologic malignancies
- Explain key evidence and how it can be applied to real-world clinical scenarios to individualize care
- Identify interprofessional approaches to address treatment-related toxicities in patients who receive care for hematologic malignancies
- Detail how to ensure compliance among patients who receive oral therapies for the management of their hematological malignancies
- Describe emerging mechanistic approaches and evidence concerning novel strategies undergoing clinical development
- Place recent clinical trial findings on emerging treatment strategies in the context of evolving treatment paradigms in the field
Faculty, Staff, and Planners' Disclosures
John G. Gribben, MD, DSc, FRCP, FRCPath, FMedSci
Chair of Medical Oncology
Barts Cancer Institute
Barts and The London School of Medicine
Queen Mary University of London
London, England, United Kingdom
Disclosure: Grant/Research Support: Janssen, Acerta; Consultant/Advisory Boards: Unum, Cellectis, Celgene; Other: Honoraria from Celgene, Abbive, Acerta, Gilead, Janssen, Karyopharm, Pharmacyclis, TG Therapeutics, Roche
Ronald Levy, MD
Division of Oncology
Stanford School of Medicine
Stanford, California, USA
Disclosure: Grant/Research Support: Dynavax; Consultant/Advisory Boards: Kite, Immune Design, Five Prime, Corvus, Beigene, Innate Pharma
María-Victoria Mateos, MD, PhD
Associate Professor, Hematology
University Hospital of Salamanca
Disclosure: Grant/Research Support: Celgene; Consultant/Advisory Boards: Celgene, Janssen, Amgen, Takeda, Bristol-Myers Squibb
Anas Younes, MD
Professor and Chief, Lymphoma Service
Division of Hematologic Oncology
Memorial Sloan Kettering Cancer Center
New York, NY, USA
Disclosure: Grant/Research Support: Novartis, Johnson and Johnson, Curis, Roche, Bristol-Myers Squibb; Consultant/Advisory Boards: Bayer, Bristol-Myers Squibb, Celgene, Incyte, Janssen, Sanofi, Seattle Genetics, Takeda Millennium, Genentech, Merck
The staff of PER® have no relevant financial relationships with commercial interests to disclose.
Disclosure Policy and Resolution of Conflicts of Interest (COI)
As a sponsor accredited by the ACCME, it is the policy of PER® to ensure fair balance, independence, objectivity, and scientific rigor in all of its CME/CE activities. In compliance with ACCME guidelines, PER® requires everyone who is in a position to control the content of a CME/CE activity to disclose all relevant financial relationships with commercial interests. The ACCME defines “relevant financial relationships” as financial relationships in any amount occurring within the past 12 months that creates a COI.
Additionally, PER® is required by ACCME to resolve all COI. PER® has identified and resolved all COI prior to the start of this activity by using a multistep process.
Off-Label Disclosure and Disclaimer
This CME/CE activity may or may not discuss investigational, unapproved, or off-label use of drugs. Participants are advised to consult prescribing information for any products discussed. The information provided in this CME/CE activity is for continuing medical and nursing education purposes only, and is not meant to substitute for the independent clinical judgment of a physician relative to diagnostic, treatment, or management options for a specific patient’s medical condition. The opinions expressed in the content are solely those of the individual faculty members and do not reflect those of PER®.
PER Pulse Recap™PER Pulse Recap (1 of 3)
Immune-Based Therapies Come of Age in Lymphomas
The 2nd Annual European Congress on Hematology™: Focus on Lymphoid Malignancies, held 20-21 October, 2017, was convened to present information from expert faculty on recent advances in the fields of multiple myeloma, lymphoma, and chronic lymphocytic leukemia and to discuss the integration of new approaches in the clinic. This first of 3 PER Pulse™ Recaps focuses on advances with chimeric antigen receptor (CAR) T-cell therapy and antibody–drug conjugates in lymphomas.
Aggressive B-Cell Non-Hodgkin Lymphoma
For patients with relapsed/refractory aggressive B-cell non-Hodgkin lymphoma, tisagenlecleucel was approved in October 2017. In December 2017, updated results with this agent and other CAR T-cell therapies were presented showing durable complete responses (Table). These data show clear activity for this approach in patients who have experienced multiple relapses.
The antibody–drug conjugate, brentuximab vedotin, is currently approved in patients with classical Hodgkin lymphoma as consolidation therapy following autologous stem cell transplantation (ASCT) and for patients who have failed either ASCT or 2 prior chemotherapy regimens. The phase III ECHELON trial was carried out to investigate brentuximab vedotin as part of initial chemotherapy. Patients received either standard therapy (doxorubicin, bleomycin, vinblastine, dacarbazine [ABVD]) or brentuximab vedotin plus doxorubicin, vinblastine, and dacarbazine (A+AVD). The primary endpoint was modified progression-free survival (time to progression, death, or noncomplete response followed by anticancer therapy). The 2-year assessment of this endpoint was superior in the A+AVD arm (82% vs 77%; HR, 0.77; P = .03). Key grade ≥3 adverse events that were higher in the A+AVD arm included neutropenia (54% vs 39%, respectively) and peripheral neuropathy (4% vs <1%).
PER Pulse Recap (2 of 3)
Targeted Combinations for Patients With Relapsed/Refractory CLL
The 2nd Annual European Congress on Hematology™: Focus on Lymphoid Malignancies, held 20-21 October, 2017, was convened to present information from expert faculty on recent advances in the fields of multiple myeloma, lymphoma, and chronic lymphocytic leukemia (CLL) and to discuss the integration of new approaches in the clinic. This second of 3 PER Pulse™ Recaps focuses on combinations of targeted agents for patients with relapsed/refractory CLL presented in December 2017.
The CLARITY trial investigated the feasibility of combining ibrutinib with venetoclax in patients with relapsed/refractory CLL. In 38 patients reaching 8 months of treatment, 100% achieved a response, with a complete response rate of 39%. Negativity for minimal residual disease (<.01% CLL cells) was achieved in 37% of patients in the peripheral blood and in 32% of patients in the bone marrow. One case of grade 3 tumor lysis syndrome was observed.
The phase III MURANO trial compared venetoclax/rituximab to bendamustine/rituximab in 389 patients, the majority of whom had received 1 or 2 prior lines of therapy. Approximately a quarter of the patients had the unfavorable del(17p) chromosomal deletion. The primary endpoint of progression-free survival per investigators was superior in the venetoclax/rituximab arm (not reached vs 17 months; HR, 0.17; P <.0001). The benefit observed with venetoclax/rituximab in patients with del(17p) (HR, 0.13) was similar to that of the overall cohort. An overall survival benefit was also observed in the venetoclax/rituximab arm (HR, 0.48; P = .0186). Grade 3/4 adverse events that were higher in the venetoclax arm included neutropenia (58% vs 39%) and tumor lysis syndrome (3% vs 1%).
PER Pulse Recap (3 of 3)
Improving First-Line and Salvage Regimens for Patients With Multiple Myeloma
The 2nd Annual European Congress on Hematology™: Focus on Lymphoid Malignancies, held 20-21 October, 2017, was convened to present information from expert faculty on recent advances in the fields of multiple myeloma (MM), lymphoma, and chronic lymphocytic leukemia and to discuss the integration of new approaches in the clinic. This third of 3 PER Pulse™ Recaps focuses on data presented in December 2017 on chimeric antigen receptor (CAR) T cells in patients with relapsed/refractory MM and the addition of daratumumab to bortezomib/melphalan/prednisone (VMP) as initial therapy in transplant-ineligible patients.
A phase I trial is investigating bb2121, a CAR T cell with specificity for the B-cell maturation antigen (BCMA). Twenty-one patients with a median of 7 prior lines of therapy have received bb2121. Responses have been observed in 17 of 18 patients (94%), with a complete response (CR) in 10 of 18 patients (56%). With a median follow-up of approximately 9 months, the median progression-free survival (PFS) has not yet been reached. Grade ≥3 cytokine release syndrome was observed in 10% of patients; no grade ≥3 neurotoxicity was reported.
The phase III ALCYONE trial investigated the addition of the anti-CD38 antibody, daratumumab, to VMP (D-VMP) as first-line therapy in 706 patients with MM who were not eligible for autologous stem cell transplantation. The primary endpoint of PFS was superior in the D-VMP arm compared with VMP (not reached vs 18.1 months; HR 0.50; P < .0001). In the D-VMP arm, 43% of patients achieved a CR or stringent CR compared with 24% in the VMP arm. Negativity for minimal residual disease with a sensitivity of 10-5 was achieved in 22% of patients in the D-VMP arm compared with 6% of patients receiving VMP (P <.0001). Data for overall survival were not yet mature at the time of reporting. Patients in the D-VMP arm experienced a higher rate of grade 3/4 pneumonia (11% vs 4%).
For additional commentary about these topics and others, visit www.gotoper.com to access more resources from the 2nd Annual European Congress on Hematology™, including downloadable slides from the meeting.
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