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Accreditation/Credit Designation

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.

Acknowledgment of Commercial Support

This activity is supported by an educational grant from Juno Therapeutics.

Community Practice Connections™: Current Status and the Future Potential of CAR T-Cell Therapy for Lymphoid Malignancies: The Experts Weigh-In on Recent Data and Clinical Experience


Release Date: January 31, 2018
Expiration Date: January 31, 2019
Media: Internet - based

 

Activity Overview

Chimeric antigen receptor (CAR) T cells has recently emerged as a novel therapeutic approach, yielding complete responses even in heavily pretreated patients with leukemia, lymphoma, and myeloma. Community Practice Connections™: Current Status and the Future Potential of CAR T-Cell Therapy for Lymphoid Malignancies: The Experts Weigh-In on Recent Data and Clinical Experience features case-based discussion on the application of CAR T-cell therapy in various hematologic malignancies. Interactive clinical vignettes are followed by short video interviews with leading oncology experts and short summaries of clinical data related to these clinical settings. The video interviews address decision points in the clinical vignettes, as well as questions commonly faced in the community oncology practice setting.

Acknowledgement of Commercial Support

This activity is supported by an educational grant from Juno Therapeutics.

CME Activity Table of Contents

  • Module 1. CAR T Cells: Introduction
  • Module 2. A Patient With Relapsed DLBCL
  • Module 3. A Patient With Relapsed, B-Cell Precursor ALL
  • Module 4. A Patient With Relapsed CLL
  • Module 5. A Patient With Relapsed MM

Instructions for This Activity and Receiving Credit

  • You will need to login to participate in the activity.
  • Each presentation may contain an interactive question(s). You may move forward through the presentation; however, you may not go back to change answers or review videos/content until you finish the presentation.
  • At the end of the activity, “educational content/video files” will be available for your reference.
  • In order to receive a CME certificate, participants must complete the activity.
  • Complete the posttest and pass with a score of 70% or higher, complete the evaluation and then click on request for credit. Participants may immediately download a CME certificate upon completion of these steps.


Target Audience

This activity is intended for medical oncologists, hematologists, and other oncology healthcare professionals interested in the latest advances in the use of CAR T-cell therapy for patients with hematologic malignancies. Fellows, investigators, nurses, nurse practitioners, physician assistants, and other healthcare professionals interested in the treatment of patients with hematologic malignancies are also invited to participate.

Learning Objectives

At the conclusion of this activity, you should be better prepared to:

  • Describe the structure and function of the CAR and the mechanism of action of CAR T cells in lymphoma
  • Review clinical trial evidence, with a focus on non-Hodgkin lymphoma and chronic lymphocytic leukemia, and describe where CAR T-cell therapies might fit into the treatment landscape
  • Review clinical trial evidence in other lymphoid malignancies, and describe where CAR T-cell therapy might fit into that treatment landscape
  • Identify and discuss the management of toxicities of CAR T-cell therapies

Faculty, Staff, and Planners' Disclosures

Faculty

David G. Maloney, MD, PhD
Member, Clinical Research Division
Fred Hutchinson Cancer Research Center
Professor of Medicine, Division of Oncology
University of Washington
Seattle, WA

Disclosure: Grant/Research Report: Juno Therapeutics, paid to institution; Consultant: Celgene, F. Hoffmann-La Roche, Gilead Sciences, Kite Pharma

Jeremy S. Abramson, MD
Assistant Professor of Medicine
Harvard Medical School
Director, Lymphoma Program, Cancer Center
Massachusetts General Hospital
Boston, MA

Disclosure: Consultant: Celgene, Genentech, Gilead Sciences, Novartis, Seattle Genetics

Stephen J. Schuster, MD
Director, Lymphoma Program
Director, Lymphoma Translational Research
Robert and Margarita Louis-Dreyfus Professor in Chronic Lymphocytic Leukemia and Lymphoma Clinical Care and Research
Penn Medicine
Philadelphia, PA

Disclosure: Grant/Research Report: Novartis, Celgene, Merck, Adaptive Biotechnologies, Janssen, ImmunoGen, Pharmacyclics, Gilead Sciences, Bristol-Meyers Squibb, Incyte, Genentech; Consultant: Merck, Celgene, Gilead Sciences, Nordic Nanovector, Novartis, Genentech, Seattle Genetics

James N. Kochenderfer, MD
Investigator, Experimental Transplantation and Immunology Branch
National Cancer Institute (NCI) Center for Cancer Research
Bethesda, MD
 
 

Disclosure: Principal Investigator of research agreements between NCI and both Kite Pharma and Bluebird Bio

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 activities. In compliance with ACCME guidelines, PER® requires everyone who is in a position to control the content of a CME 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 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 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)
 
CAR T-Cell Therapy for Patients With Relapsed/Refractory NHL

 
This first of 3 PER Pulse Recaps reviews long-term follow-up data with CAR T-cell therapy in patients with aggressive NHL.
 
Several trials have recently demonstrated durable complete responses (CRs) with CD19-targeting CAR T-cell therapy in patients with relapsed/refractory, aggressive NHL.
  • Axicabtagene ciloleucel was approved in October 2017 based on the ZUMA-1 trial enrolling 111 patients. The initial overall response rate (ORR) with 6 months of follow-up was 82%, including a CR in 52% of patients. With 15.4 months of follow-up, the CR rate was 40%. Responses did not appear to be affected by the use of tocilizumab or steroids.
  • Tisagenlecleucel has been investigated in the JULIET trial enrolling 99 patients. In this study, the best ORR was 53%, which included a CR rate of 40%. The 3-month CR rate was 32%. In January 2018, regulatory agencies in the United States and Europe granted priority review for this agent in patients with relapsed/refractory, diffuse large B-cell lymphoma (DLBCL).
  • Lisocabtagene maraleucel is being investigated in the TRANSCEND NHL 001 trial. In a core group of 27 patients with DLBCL treated with CAR T cells at the recommended registration dose, the best ORR was 81%, including a CR rate of 63%. With ≥3 months of follow-up the durable CR rate was 68%.
 
For additional commentary about this topic and the Current Status and the Future Potential of CAR T-Cell Therapy for Lymphoid Malignancies: The Experts Weigh In on Recent Data and Clinical Experience symposium, please visit www.gotoper.com.


PER Pulse Recap (2 of 3)
 
Establishing CAR T Cells in Patients With Relapsed/Refractory ALL
 

This second of 3 PER Pulse Recaps reviews recent data with CAR T-cell therapy in patients with relapsed/refractory ALL.
 
Early clinical investigation of CAR T cells focused on patients with leukemias. The first CAR T-cell therapy to be approved was tisagenlecleucel, which received regulatory authorization in August 2017 for patients aged ≤25 years with relapsed/refractory ALL, based on the ELIANA trial. In this study, the initial rate of complete response (CR) or CR with incomplete blood recovery (CRi) was 82%; with ≥6 months of follow-up, the CR/CRi rate remained similar (83%). In a separate trial carried out at the Memorial Sloan Kettering Cancer Center, a different CAR T-cell construct yielded a CR rate of 85%, with 67% of patients achieving minimal residual disease negativity.
 
For additional commentary about this topic and the Current Status and the Future Potential of CAR T-Cell Therapy for Lymphoid Malignancies: The Experts Weigh In on Recent Data and Clinical Experience symposium, please visit www.gotoper.com.
 

 PER Pulse Recap (3 of 3)
 
CAR T Cells in Patients with Previously Treated CLL and MM

 
This third of 3 PER Pulse Recaps reviews recent data with CAR T-cell therapy in patients with relapsed/refractory CLL and MM.
 
Patients with relapsed CLL who discontinue ibrutinib have a poor survival rate of only approximately 3 months. CAR T cells targeting CD19 have been investigated in this setting, yielding an overall response rate (ORR) of 71% in a study of 24 heavily pretreated patients. Therapy with CAR T cells also resulted in clearance of CLL cells from the marrow and clearance of baseline clonal malignant IGH sequences in a subset of patients.
 
In patients with MM, CAR T cells with specificity for the B-cell maturation antigen have been investigated. Early-phase studies enrolling patients with multiple previous lines of therapy have been carried out. Initial data have demonstrated ORRs of >90%, including complete responses in approximately 60% to 70% of patients, and registration trials are ongoing.
 
For additional commentary about this topic and the Current Status and the Future Potential of CAR T-Cell Therapy for Lymphoid Malignancies: The Experts Weigh In on Recent Data and Clinical Experience symposium, please visit www.gotoper.com.
 
 







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