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 educational grants from Actinium Pharmaceuticals; AstraZeneca, Daiichi Sankyo, Inc; Gilead Sciences, Inc; Novartis Pharmaceuticals Corporation; and Pfizer.

Online! Medical Crossfire®: Hematologic Malignancies

Release Date: September 30, 2019
Expiration Date: September 30, 2020
Media: Internet - based

Activity Overview

In this online enduring program, chaired by Hagop M. Kantarjian, MD; Kenneth C. Anderson, MD; and Anas Younes, MD, and featuring top faculty across all major hematologic malignancies, participants discuss best practices in application of the latest data across liquid tumors. This program clarifies the role of molecular and cytogenetic testing strategies across liquid tumors, offers clinical perspectives and contrasting viewpoints on application of clinical trial results across multiple lines of care, and enables identification of emerging data pertaining to optimized modern management of hematologic malignancies. In addition, this program discusses real-world management strategies to minimize the risk of financial toxicity in specific patient populations. Through a comprehensive discussion across hematologic malignancies, including lymphomas, myeloma, and leukemias, participants can develop practice-changing perspectives with the potential to improve patient outcomes in clinical practice.

Benefits of Participating

  • Place the latest clinical trial evidence in context using clinical cases to optimize decision making across hematologic malignancies
  • Understand differences of opinion and areas for further research in hematologic malignancies
  • Learn the thought process of experts behind the management of specific patient cases across liquid tumors and use these perspectives to confirm and update your practice
  • Apply the latest data to select treatments that may minimize adverse events and reduce financial toxicity in patients with specific hematologic malignancies

Acknowledgement of Commercial Support

This activity is supported by educational grants from Actinium Pharmaceuticals; AstraZeneca, Daiichi Sankyo, Inc; Gilead Sciences, Inc; Novartis Pharmaceuticals Corporation; and Pfizer.

Instructions for This Activity and Receiving Credit

  • You will need to log in 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” will be available for your reference.
  • In order to receive a CME Certificate, you 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.” You may immediately download a CME Certificate upon completion of these steps.

Target Audience

This educational activity is directed toward medical oncologists. Nurse practitioners, nurses, physician assistants, pharmacists, investigators, and other healthcare professionals interested in the treatment of cancer are also invited to participate.

Learning Objectives

Upon successful completion of this educational activity, you should be better prepared to:

  • Appraise testing strategies that may inform clinical decision making in the management of hematologic malignancies
  • Apply clinical trial results to multiple lines of care in the management of hematologic malignancies
  • Analyze disparities in care for patients with hematologic malignancies
  • Outline strategies to monitor and proactively manage treatment-related toxicities in patients with leukemia, lymphoma, and multiple myeloma
  • Identify key emerging data pertaining to the diagnosis and management of patients with hematologic malignancies

Faculty, Staff, and Planners’ Disclosures

Faculty

Anas Younes, MD
Anas Younes, MD
Professor and Chief, Lymphoma Service
Division of Hematologic Malignancies
Memorial Sloan Kettering Cancer Center
New York, NY

Disclosures: Grant Research Support: Bristol-Myers Squibb, Curis, Johnson & Johnson, Novartis, Roche; Consultant: Bayer, Bristol-Myers Squibb, Celgene, Genentech, Genetics, Incyte, Janssen, Merck, Millennium, Sanofi, Seattle/Takeda.

Kenneth C. Anderson, MD
Kenneth C. Anderson, MD
Program Director, Jerome Lipper Multiple Myeloma Center and LeBow Institute for Myeloma Therapeutics
Institute Physician
Kraft Family Professor of Medicine, Harvard Medical School
Boston, MA

Disclosures: Consultant: Bristol-Myers Squibb, Celgene, Gilead, Janssen, Millennium, Sanofi.

Hagop M. Kantarjian, MD
Hagop M. Kantarjian, MD
Professor and Chairman, Department of Leukemia
Samsung Distinguished University Chair in Cancer Medicine
The University of Texas MD Anderson Cancer Center
Houston, TX

Disclosures: Grant Research Support: AbbVie, Agios, Amgen, Ariad, Astex, Bristol-Myers Squibb, Cyclacel, Daiichi Sankyo, ImmunoGen, Jazz Pharma, Novartis, Pfizer.

Jorge Cortes, MD
Jorge Cortes, MD
Jane and John Justin Distinguished Chair in Leukemia Research
Chief, Chronic Myeloid Leukemia and Acute Myeloid Leukemia Sections
Deputy Chair, Department of Leukemia
The University of Texas MD Anderson Cancer Center
Houston, TX

Disclosures: Grant Research Support: Bristol-Myers Squibb, Novartis, Pfizer, Sun Pharma, Takeda; Consultant: Bristol-Myers Squibb, Novartis, Pfizer, Takeda.

Kieron Dunleavy
Kieron Dunleavy, MD
Professor of Medicine
Director, Lymphoma Program
Codirector, Microbial Oncology Program
The George Washington University
Washington, DC

Disclosures: Consultant: AbbVie.

Sergio A. Giralt
Sergio A. Giralt, MD, FACP
Melvin Berlin Family Chair in Myeloma Research
Chief Attending Physician
Chief, Adult Bone Marrow Transplant Service
Memorial Sloan Kettering Cancer Center
Professor of Medicine
Weill Cornell Medical College
New York, NY

Disclosures: Grant Research Support: Actinium Pharmaceuticals, Amgen, Celgene, Janssen, Miltenyi, Sanofi, Takeda; Consultant: Actinium Pharmaceuticals, Amgen, Celgene, Janssen, Jazz, Kite, Novartis, Pfizer, Sanofi, Takeda.

Elias Jabbour, MD
Elias Jabbour, MD
Professor, Department of Leukemia
The University of Texas MD Anderson Cancer Center
Houston, TX

Disclosures: Grant Research Support: AbbVie, Amgen, Bristol-Myers Squibb, Novartis, Pfizer, Takeda; Consultant: AbbVie, Adaptive, Amgen, Astellas, Bristol-Myers Squibb, Novartis, Pfizer, Takeda.

Nitin Jain, MD
Nitin Jain, MD
Associate Professor, Department of Leukemia
The University of Texas MD Anderson Cancer Center
Houston, TX

Disclosures: Grant Research Support: AbbVie, ADC Therapeutics, Bristol-Myers Squibb, Celgene, Genentech, Incyte, Infinity, Pharmacyclics, Pfizer, Seattle Genetics, Servier; Consultant: Adaptive Biotechnologies, ADC Therapeutics, Novartis, Novimmune, Pharmacyclics, Pfizer, Servier.

Marina Y. Konopleva
Marina Y. Konopleva, MD, PhD
Professor, Department of Leukemia
The University of Texas MD Anderson Cancer Center
Houston, TX

Disclosures: Grant Research Support: AbbVie, Ablynx, Calithera, Cellectis, Eli Lilly, Genentech, Stemline; Consultant: AbbVie, Cellectis, F. Hoffmann-La Roche, Genentech, Stemline; Shareholder: Reata Pharmaceuticals.

Suzanne Lentzsch, MD, PhD
Suzanne Lentzsch, MD, PhD
Professor of Medicine
Director, Multiple Myeloma and Amyloidosis Service
Columbia University Irving Medical Center
New York, NY

Disclosures: Grant Research Support: Sanofi; Consultant: AbbVie, Bayer, Bristol-Myers Squibb, Caelum Biosciences, Janssen, Proclara, Takeda; Speakers Bureau: Clinical Care Options; Shareholder: Caelum Biosciences; Other: Faculty for Clinical Care Options.

Selina Luger, MD
Selina Luger, MD
Professor of Medicine
Director, Leukemia Program
Abramson Cancer Center
Perelman School of Medicine
University of Pennsylvania
Philadelphia, PA

Disclosures: Grant Research Support: BioSight, Celgene, Cyclacel, F. Hoffmann-La Roche, Jazz, Kura, Onconova, Seattle Genetics; Consultant: Pfizer.

Peter Martin, MD
Peter Martin, MD
Associate Professor of Medicine
Weill Cornell Medicine
New York, NY

Disclosures: Consultant: Acerta/AstraZeneca, Celgene, Gilead, I-Mab, Janssen/Pharmacyclics, Karyopharm, Sandoz, Zenyaku Kogyo.

Thomas G. Martin, MD
Thomas G. Martin, MD
Interim Chief, Hematology
Clinical Professor of Medicine, Adult Leukemia and Bone Marrow Transplantation Program
Codirector, Myeloma Program
University of California, San Francisco
Helen Diller Family Comprehensive Cancer Center
San Francisco, CA

Disclosures: Grant Research Support: Amgen, Sanofi-Aventis, Seattle Genetics; Consultant: Juno Therapeutics, Roche.

Anthony Mato, MD, MSCE
Anthony Mato, MD, MSCE
Director, Chronic Lymphocytic Leukemia Program
Memorial Sloan Kettering Cancer Center
New York, NY

Disclosures: Grant Research Support: AbbVie, Acerta, Adaptive, Loxo, Pharmacyclics, Regeneron, Sunesis, TG Therapeutics; Consultant: AbbVie, Acerta, Adaptive, Celgene, Johnson & Johnson, Loxo, Pharmacyclics, Regeneron, Sunesis, TG Therapeutics.

Michael J. Mauro, MD
Michael J. Mauro, MD
Leader, Myeloproliferative Neoplasms Program
Attending Physician, Leukemia Service
Member, Memorial Sloan Kettering Cancer Center
Professor of Medicine, Weill Cornell Medical College
New York, NY

Disclosures: Grant Research Support: Novartis Oncology; Consultant: Ariad, Bristol-Myers Squibb, Novartis Oncology, Pfizer.

Franck Morschhauser, MD, PhD
Franck Morschhauser, MD, PhD
Professor of Hematology
Centre Hospitalier Régional Universitaire de Lille
Lille, France

Disclosures: Consultant: Gilead, Janssen; Other: Honoraria: Bayer, Bristol-Myers Squibb, Celgene, Epizyme, Gilead, Janssen, Roche.

Noopur Raje, MD
Noopur Raje, MD
Professor of Medicine
Harvard Medical School
Director, Multiple Myeloma Center
Massachusetts General Hospital
Boston, MA

Disclosures: Grant Research Support: AstraZeneca; Consultant: Amgen, Bristol-Myers Squibb, Celgene, Janssen, Juno Therapeutics, Merck, Takeda.

Simon Rule, MD
Simon Rule, MD
Professor of Clinical Hematology
Faculty of Medicine and Dentistry
University of Plymouth
Plymouth, UK

Disclosures: Grant Research Support: Celgene, Janssen, Roche; Consultant: AstraZeneca, Celgene, Gilead, Janssen, Kite, Roche; Speakers Bureau: Janssen.

Neil Shah, MD, PhD
Neil P. Shah, MD, PhD
Professor, Department of Medicine (Hematology/Oncology)
Program Leader, Hematopoietic Malignancies Program
University of California, San Francisco
Helen Diller Family Comprehensive Cancer Center
San Francisco, CA

Disclosures: Grant Research Support: Ariad, Bristol-Myers Squibb.

David S. Siegel
David S. Siegel, MD, PhD
Chief, Multiple Myeloma
Founding Director, Institute for Multiple Myeloma
John Theurer Cancer Center
Hackensack, NJ

Disclosures: Consultant: Amgen, Bristol-Myers Squibb, Celgene, Janssen, Takeda; Speakers Bureau: Amgen, Bristol-Myers Squibb, Celgene, Janssen, Takeda.

Wendy Stock, MD
Wendy Stock, MD
Anjuli Seth Nayak Professor of Medicine
Director, Leukemia Program
Section of Hematology/Oncology
University of Chicago Medicine
Chicago, IL

Disclosures: Consultant: Agios, Amgen, Astellas, Daiichi Sankyo, Kite, Pfizer.

Richard M. Stone, MD
Richard M. Stone, MD
Professor of Medicine, Harvard Medical School
Chief of Staff
Director, Adult Leukemia Program
Dana-Farber Cancer Institute
Boston, MA

Disclosures: Grant Research Support: Agios, Arog, Novartis (Research); Consultant: AbbVie, Agios, Amgen, Arog, Astellas, AstraZeneca, Celgene, Cornerstone, Fujifilm, Janssen, Jazz, Juno Therapeutics, MacroGenics, Novartis, Ono, Orsenix, Otsuka/Astex, Pfizer, Sumitomo; Other: Argenx, Takeda and Celgene (Data and Safety Monitoring Board), Actinium Pharmaceuticals (Scientific Advisory Board).

William G. Wierda, MD, PhD
William G. Wierda, MD, PhD
D.B. Lane Cancer Research Distinguished Professor, Department of Leukemia, Division of Cancer Medicine
Head of Chronic Lymphocytic Leukemia Section, Department of Leukemia
Leukemia Center Medical Director
Executive Medical Director, Hematologic Malignancies
The University of Texas MD Anderson Cancer Center
Houston, TX

Disclosures: Grant Research Support: AbbVie, Acerta, Genentech, GlaxoSmithKline/Novartis, Gilead, Juno Therapeutics, Karyopharm, Kite, miRagen, Pharmacyclics, Sunesis; Consultant: Sanofi.

The staff of Physicians' Education Resource®, LLC (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 education purposes only and is not meant to substitute for the independent medical judgment of a physician relative to diagnostic or treatment 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® or the companies that provided commercial support for this program.

PER Pulse™ Recaps

1 of 3

Insight from Hagop M. Kantarjian, MD–PER Pulse™ Recap: Online! Medical Crossfire®: Hematologic Malignancies

Online! Medical Crossfire®: Hematologic Malignancies is a continuing medical education–certified program. For this program, chairs Hagop M. Kantarjian, MD; Kenneth C. Anderson, MD; and Anas Younes, MD, discussed the latest data in hematologic malignancy management.

This first of 3 PER Pulse™ Recaps summarizing the online activity focuses on strategies for individualizing decision making with regard to appropriate use of an expanding range of treatments across hematologic malignancies. Below are some highlights from an activity on acute myeloid leukemia (AML) featuring Dr Kantarjian:

  • Several targeted medications were approved over the past 3 years for the treatment of AML, including agents intended for patients with FLT3 mutations and IDH1/2 mutations.1
  • Targeted agents that are not paired with a molecular test include the smoothened inhibitor glasdegib, which may be used in older patients with new diagnoses who are unfit for intensive chemotherapy. This treatment is generally used with low-dose cytarabine (LDAC).
  • In a phase II randomized, open-label, multicenter study of glasdegib plus LDAC in patients with AML or high-risk myelodysplastic syndrome unsuitable for intensive chemotherapy, median overall survival was 8.8 months with glasdegib/LDAC versus 4.9 months with LDAC alone (HR, 0.51; P = .0004).2
  • Incorporating a variety of new treatments into clinical practice requires extensive collaboration among multidisciplinary healthcare professionals across centers, screening patients for cytogenetic and molecular abnormalities, and use of treatments in appropriate patient groups to optimize outcomes across the care continuum.

“Now we know that there are mutations in almost every patient with acute myeloid leukemia.”

—Hagop M. Kantarjian, MD

References

  1. NCCN Clinical Practice Guidelines in Oncology. Acute Myeloid Leukemia, version 2.2020. National Comprehensive Cancer Network website. nccn.org/professionals/physician_gls/pdf/aml.pdf. Published September 3, 2019. Accessed September 19, 2019.
  2. Cortes JE, Heidel FH, Hellmann A, et al. Randomized comparison of low dose cytarabine with or without glasdegib in patients with newly diagnosed acute myeloid leukemia or high-risk myelodysplastic syndrome. Leukemia. 2019;33(2):379-389. doi: 10.1038/s41375-018-0312-9.

2 of 3

Insight from Kenneth C. Anderson, MD–PER Pulse™ Recap: Online! Medical Crossfire®: Hematologic Malignancies

Online! Medical Crossfire®: Hematologic Malignancies is a continuing medical education–certified program. For this program, chairs Kenneth C. Anderson, MD; Hagop M. Kantarjian, MD; and Anas Younes, MD, discussed the latest data in hematologic malignancy management.

This second of 3 PER Pulse™ Recaps summarizing the online activity focuses on strategies for individualizing decision making with regard to appropriate use of an expanding range of treatments across hematologic malignancies. Below are some highlights from an activity on multiple myeloma featuring Dr Anderson:

  • A variety of treatment options are available for the treatment of acute lymphoblastic leukemia, including proteasome inhibitors, immunomodulatory agents, and monoclonal antibodies.1
  • Based on the MAIA study of patients with newly diagnosed multiple myeloma, the 3-drug combination of daratumumab, lenalidomide, and dexamethasone outperformed the 2-drug combination of lenalidomide and dexamethasone for transplant-ineligible patients.2
  • In MAIA, the 3-drug combination was significantly more likely to generate a response than the 2-drug combination (overall response rate, 93% vs 81%; P <.0001). Most important in this case, the 3-drug combination offered a significant survival advantage (not reached vs 31.9 months; HR, 0.55; 95% CI, 0.43-0.72; P <.0001).2
  • The results of this trial are clinically important, practice changing, and important for medical oncologists to be aware of, because medical oncologists are likely to treat patients with newly diagnosed patietns with multiple myeloma who have poor performance status at baseline. Antibody therapy can offer these patients a chance at improved survival.

“There are now 24 FDA approvals of combination regimens for multiple myeloma, including 2 in the past year. However, more than 32,000 new individuals will receive diagnoses and more than 13,000 will die of myeloma. In spite of all this progress, we have much to do.”

—Kenneth C. Anderson, MD

References

  1. NCCN Clinical Practice Guidelines in Oncology. Multiple Myeloma, version1.2020. National Comprehensive Cancer Network. nccn.org/professionals/physician_gls/pdf/myeloma.pdf. Published September 6, 2019. Accessed September 19, 2019.
  2. Facon T, Kumar SK, Plesner T, et al. Phase 3 randomized study of daratumumab plus lenalidomide and dexamethasone (D-Rd) versus lenalidomide and dexamethasone (Rd) in patients with newly diagnosed multiple myeloma (NDMM) ineligible for transplant (MAIA). Blood. 2018;132(suppl 1; abstr LBA-2). bloodjournal.org/content/132/Suppl_1/LBA-2?sso-checked=true.

3 of 3

Insight from Hagop M. Kantarjian, MD–PER Pulse™ Recap: Online! Medical Crossfire®: Hematologic Malignancies

Online! Medical Crossfire®: Hematologic Malignancies is a continuing medical education–certified program. For this program, chairs Hagop M. Kantarjian, MD; Kenneth C. Anderson, MD; and Anas Younes, MD, discussed the latest data in hematologic malignancy management.

This third of 3 PER Pulse™ Recaps summarizing the online activity focuses on strategies for individualizing decision making with regard to appropriate use of an expanding range of treatments across hematologic malignancies. Below are some highlights from an activity on chronic lymphocytic leukemia (CLL) featuring Dr Kantarjian:

  • Multiple advances have been made in the management of CLL in the past year, including the potential for definitive therapy with a limited duration of treatment.1
  • The combination of venetoclax and obinutuzumab has been shown to attain an overall response rate of 85.7% versus an overall response rate of 71.2% with the combination of chlorambucil and obinutuzumab (P <.001). This combination has also been shown to improve progression-free survival (HR, 0.35; 95% CI, 0.23-0.53; P <.001).2
  • Ibrutinib alone and in combination with anti-CD20 therapy has also been shown to outperform standard therapy with fludarabine, cyclophosphamide, and rituximab (FCR). In patients with IGHV-unmutated CLL, the combination of ibrutinib and rituximab improved progression-free survival versus FCR (HR, 0.26; 95% CI, 0.15-0.50; P <.00001).3
  • Ibrutinib and venetoclax in combination with anti-CD20 therapies are among potential treatment options in patients with CLL lacking unfavorable mutations. Recognizing ongoing studies with these agents, including combinations such as ibrutinib, fludarabine, cyclophosphamide, and obinutuzumab (IFCG) and ibrutinib-venetoclax is important for identifying appropriate treatment options in this fast-changing field.

“I think the most important breakthrough has happened in the last 5 to 8 years in CLL was the availability of targeted therapy against BCL2, as well as against the Bruton tyrosine kinase.”

—Hagop M. Kantarjian, MD

References

  1. NCCN Clinical Practice Guidelines in Oncology. Chronic Lymphocytic Leukemia/Small Lymphocytic Lymphoma, version 1.2020. nccn.org/professionals/physician_gls/pdf/cll.pdf. Published August 23, 2019. Accessed September 19, 2019.
  2. Fischer K, Al-Sawaf O, Bahlo J, et al. Venetoclax and obinutuzumab in patients with CLL and coexisting conditions. N Engl J Med. 2019;380(23):2225-2236. doi: 10.1056/NEJMoa1815281.
  3. Shanafelt TD, Wang V, Kay NE, et al. A randomized phase III study of ibrutinib (PCI-32765)–based therapy vs. standard fludarabine, cyclophosphamide, and rituximab (FCR) chemoimmunotherapy in untreated younger patients with chronic lymphocytic leukemia (CLL): a trial of the ECOG-ACRIN Cancer Network. Blood. 2018;132(suppl 1; abstr LBA-4). bloodjournal.org/content/132/Suppl_1/LBA-4.

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