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Physicians' Education Resource®, LLC is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

This activity is not approved for AMA PRA Category 1 Credit™.


Acknowledgment of Commercial Support

This activity is supported by educational grants from AbbVie; Ariad Pharmaceuticals, Inc; Baxalta US Inc; Bristol-Myers Squibb; Celgene; Genentech, Inc; Gilead; Incyte Corporation; Infinity Pharmaceuticals, Inc; Novartis Pharmaceuticals Corporation; Pharmacyclics LLC and Janssen Biotech, Inc; Seattle Genetics; Takeda Oncology; and TG Therapeutics, Inc.

20th Annual International Congress on Hematologic Malignancies - PER Pulse Recap

PER Pulse™ Recap

Resources

Community Practice Connections™: 20th Annual International Congress on Hematologic Malignancies®: Focus on Leukemias, Lymphomas and Myeloma
Earn up to 2.0 AMA PRA Category 1 Credits™
Community Practice Connections™: 20th Annual International Congress on Hematologic Malignancies®: Focus on Leukemias, Lymphomas and Myeloma consists of a series of interactive clinical vignettes, short video interviews of 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, as well as questions commonly faced in the community oncology practice setting.

PER Pulse™ Recap
PER Pulse™ Recaps from the 20th Annual International Congress on Hematologic Malignancies® focuses on multiple myeloma (MM), chronic lymphocytic leukemia (CLL), acute myeloid leukemia (AML) and acute lymphoblastic leukemia (ALL).



PER Pulse™ Recap

PER Pulse™ Recap
 


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PER Pulse™ Recap

20th Annual International Congress on Hematologic Malignancies®
Expanding Options for Patients with Multiple Myeloma

The 20th Annual International Congress on Hematologic Malignancies®, which was held March 18-20, 2016, featured internationally recognized experts in hematology/oncology discussing best practices and new approaches for the treatment of patients with leukemia, lymphoma, and myeloma. This first of 3 PER Pulse™ Recaps from the meeting focuses on multiple myeloma (MM), including recent developments in the first-line setting and new agents for patients with previously treated disease, as presented by Shaji Kumar, MD, and Jonathan Kaufman, MD.

Dr. Kumar summarized treatment approaches for patients with newly diagnosed MM. Of note, the randomized, phase 3 Southwest Oncology Group (SWOG) S0777 trial was carried out to confirm the activity of the triplet VRd regimen (bortezomib, lenalidomide, dexamethasone). This trial randomized 473 patients to either VRd or the standard Rd doublet. Patients receiving VRd achieved a median progression-free survival (PFS) of 43 months compared with 30 months with Rd (P =.0018). Overall survival was also improved with the triplet (75 months vs 64 months; P =.025).

Dr. Kaufman reviewed clinical data leading to the approval in November 2015 of several new agents for patients with previously treated MM, including daratumumab, elotuzumab, and ixazomib. Daratumumab, an anti-CD38 antibody, received accelerated approval based on overall response rates (ORRs) of 29%-36% with single-agent therapy. The anti-SLAMF7 antibody elotuzumab was combined with Rd in the phase 3 ELOQUENT-2 trial, yielding a median PFS of 19.4 months compared with 14.9 months with Rd alone (P <.001). The ORR was also higher with the addition of elotuzumab (79% vs 66%; P <.001). Ixazomib, the first oral proteasome inhibitor to receive approval, was studied in the phase 3 TOURMALINE-MM1 trial. Patients in this trial received Rd plus either ixazomib or placebo. The median PFS was higher in the ixazomib arm (20.6 months vs 14.7 months; P = .01).


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PER Pulse™ Recap

20th Annual International Congress on Hematologic Malignancies®
Therapeutic Advances for Patients with Chronic Lymphocytic Leukemia

The 20th Annual International Congress on Hematologic Malignancies®, which was held March 18-20, 2016, featured internationally recognized experts in hematology/oncology discussing best practices and new approaches for the treatment of patients with leukemia, lymphoma, and myeloma. This second of 3 PER Pulse™ Recaps from the meeting focuses on chronic lymphocytic leukemia (CLL), including recent developments in the first-line setting and new agents for patients with previously treated disease, as presented by John C. Byrd, MD, Susan O'Brien, MD, and Jennifer R. Brown, MD, PhD.

Dr. Byrd reviewed first-line options for patients with CLL. One new addition is based on the approval, in March 2016, of the Bruton's tyrosine kinase (BTK) inhibitor ibrutinib for patients with newly diagnosed disease, based on the phase 3 RESONATE-2 trial comparing ibrutinib to chlorambucil. Patients in this trial were age ≥65 years and did not have the del(17p) chromosomal aberration. The median progression-free survival was not reached in the ibrutinib arm and was 18.9 months in the chlorambucil arm; this difference was statistically significant (HR, 0.16; P <.001). The overall survival rate at 2 years was also higher with ibrutinib (98% vs 85%; P =.001).

Dr. O'Brien discussed emerging agents for patients with CLL. A next-generation BTK inhibitor, acalabrutinib, has been studied in patients with relapsed CLL. Phase 1/2 results demonstrated an overall response rate of 95% in 60 evaluable patients, and all 18 patients with del(17p) achieved a response.

Dr. Brown discussed a new class of agents, namely Bcl-2 inhibitors, that has been established for use in CLL with the accelerated approval of venetoclax in April 2016. In the phase 2 trial leading to approval, 107 patients with previously treated CLL and del(17p) were enrolled, and 79% of the patients achieved a response, including 7.5% who had a complete response (CR) or a CR with incomplete bone marrow recovery. Laboratory tumor lysis syndrome was observed in 5 patients, although clinical consequences were not observed.


3 of 3
PER Pulse™ Recap

20th Annual International Congress on Hematologic Malignancies®
Targeted Agents for Patients with Acute Leukemias

The 20th Annual International Congress on Hematologic Malignancies®, which was held March 18-20, 2016, featured internationally recognized experts in hematology/oncology discussing best practices and new approaches for the treatment of patients with leukemia, lymphoma, and myeloma. This third of 3 PER Pulse™ Recaps from the meeting focuses on acute myeloid leukemia (AML) and acute lymphoblastic leukemia (ALL), including therapies targeting the biology of AML and ALL, as presented by Richard M. Stone, MD, Eytan M. Stein, MD, and Elias Jabbour, MD.

Drs. Stone and Stein discussed therapy for patients with AML, including the use of the kinase inhibitor midostaurin in patients with FLT3-mutated disease. The phase 3 RATIFY trial, carried out by the Cancer and Leukemia Group B, randomized patients with previously untreated AML and a FLT3 mutation to receive induction daunorubicin plus cytarabine with either midostaurin or placebo, followed by consolidation and maintenance therapy in patients achieving a complete response. The primary endpoint of overall survival was increased in the midostaurin arm (74.7 months vs 25.6 months; HR, 0.77; P =.0074). Based on these results, the US Food and Drug Administration granted Breakthrough Therapy designation to midostaurin in February 2016.

Dr. Jabbour discussed the use of antibodies in patients with ALL. In the GRAALL-R 2005 study, 220 patients with newly diagnosed, Philadelphia chromosome‒negative, B-cell precursor ALL were randomized to receive standard intensive chemotherapy with or without rituximab. The primary endpoint of event-free survival (EFS) was met with the addition of rituximab (2-year EFS, 65% vs 52%; P =.038). The effect of the bispecific antibody blinatumomab, which engages CD19 on tumor cells and CD3 on T cells, on minimal residual disease (MRD) in patients with ALL was investigated in the phase 2 BLAST trial. Patients in this trial had achieved a complete hematological remission, but had MRD (≥10-3) prior to receiving blinatumomab. Following 1 cycle of therapy, 78% of 113 patients achieved a complete MRD response, defined as the absence of polymerase chain reaction amplification with a minimum sensitivity of 10-4.

For further commentary on this topic and others, visit Community Practice Connections™: 20th Annual International Congress on Hematologic Malignancies®: Focus on Leukemias, Lymphomas and Myeloma.



Physicians' Education Resource®, LLC is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

This activity is not approved for AMA PRA Category 1 Credit™.

This activity is supported by educational grants from AbbVie; Ariad Pharmaceuticals, Inc; Baxalta US Inc; Bristol-Myers Squibb; Celgene; Genentech, Inc; Gilead; Incyte Corporation; Infinity Pharmaceuticals, Inc; Novartis Pharmaceuticals Corporation; Pharmacyclics LLC and Janssen Biotech, Inc; Seattle Genetics; Takeda Oncology; and TG Therapeutics, Inc.







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