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 1.5 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 AstraZeneca.

2018 Year in Review™: Reflecting on Recent Evidence for the Treatment of Hematologic Malignancies

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

Activity Overview

This Year in Review activity will cover exciting data reported in 2018 at major society meetings with the potential to impact your care of patients with hematologic malignancies. Recent advances in hematologic malignancies include emerging options in targeted therapies, novel combination therapies, and efforts to personalize care. This activity features a panel of experts who will review the key points of clinical trial design and safety, as well as efficacy data presented at major society meetings throughout 2018 while contextualizing this new information for optimized patient care. Each expert will focus on a different class of hematologic malignancies and the most noteworthy advancements in each. Emerging data across the spectrum of hematologic malignancies will be reviewed and discussed, from the frontline setting to the relapsed/refractory setting and maintenance therapies in acute and chronic lymphocytic leukemia, acute and chronic myeloid leukemia, multiple myeloma, and other B-cell malignancies. In addition, our panel of experts will discuss how they are applying this information to their practice right now, as well as its potential future implications.

Benefits of Participating in 2018 Year in Review™: Reflecting on Recent Evidence for the Treatment of Hematologic Malignancies

  • Improved knowledge and competence to identify key emerging data from clinical trials
  • Improved knowledge and competence to anticipate, monitor, and manage treatment-related toxicities in patients with hematologic malignancies
  • Ability to apply clinical trial data for management of patients with hematologic malignancies
  • Improved knowledge of ongoing clinical trials relevant to patients with hematologic malignancies

Acknowledgment of Commercial Support

This activity is supported by an educational grant from AstraZeneca.

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 educational activity is directed toward medical oncologists and hematologists involved in the treatment and management of patients with hematologic malignancies.

Learning Objectives

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

  • Evaluate emerging clinical data for current and novel therapeutic options in the treatment of hematologic malignancies
  • Delineate strategies for the proactive management and mitigation of adverse events associated with emerging treatment strategies
  • Integrate emerging data into optimized treatment plans, or consider in the context of evolving treatment paradigms for patients with hematologic malignancies
  • Identify patients who are eligible and may benefit from participation in clinical trials

Faculty, Staff, and Planners' Disclosures

Chair

Andre H. Goy, MD, MS
Andre H. Goy, MD, MS
Chairman & Director
John Theurer Cancer Center
Chief, Division of Lymphoma
Seton Hall - Hackensack Meridian School of Medicine
Hackensack, NJ

Disclosures: Grant/Research Support: Johnson & Johnson, Celgene, Gilead/Kite clinical trial support through institution; Consultant: Celgene; Speakers Bureau: Takeda, Johnson & Johnson/Pharmacyclics, Gilead/Kite; Shareholder: Cota Healthcare; Other: Member on advisory board: Cota Healthcare, Celgene, Takeda, Pharmacyclics, Johnson & Johnson, Acerta, Gilead/Kite.

Faculty

Anthony Mato, MD
Anthony Mato, MD
Hematologic Oncologist
Director, CLL Program
Memorial Sloan Kettering Cancer Center
New York, NY

Disclosures: Grant/Research Support: TG Therapeutics, Pharmacyclics, AbbVie, Johnson and Johnson, Acerta/AZ, Regeneron, DTRM BioPharma, Sunesis, Loxo; Consultant: TG Therapeutics, Pharmacyclics, AbbVie, Johnson and Johnson, Acerta/AZ, DTRM BioPharma, Sunesis, Celgene

Ruben Niesvizky, MD
Ruben Niesvizky, MD
Director, Oncology Operations
Director, Multiple Myeloma Center
Professor of Medicine, Division of Hematology/Oncology
NewYork-Presbyterian Hospital/Weill Cornell Medical Center
New York NY

Disclosures: Consultant: Amgen, Janssen, BMS, Celgene, Takeda

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 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™ Recaps

1 of 3
Insights from Andre H. Goy, MD, MS, chairman and director of John Theurer Cancer Center and chief of the Division of Lymphoma, Hackensack University Medical Center in New Jersey—PER Pulse™ Recap:
2018 Year in Review™: Reflecting on Recent Evidence for the Treatment of Hematologic Malignancies

In this continuing medical education–certified activity, 2018 Year in Review™: Reflecting on Recent Evidence for the Treatment of Hematologic Malignancies, expert faculty join program chair Andre Goy, MD, MS, to present exciting data with the potential to affect your care of patients with hematologic malignancies. Recent advances in hematologic malignancies include emerging options in targeted therapies, novel combination therapies, and efforts to personalize care. The panelists review key points of clinical trial design and safety, as well as efficacy data presented at major society meetings throughout 2018, while contextualizing this new information for optimized patient care. Each expert focuses on a different class of hematologic malignancies and the most noteworthy advancements in each. Emerging data across the spectrum of hematologic malignancies are reviewed and discussed, from the frontline setting to the relapsed/refractory (R/R) setting, including maintenance therapies in acute and chronic lymphocytic leukemia (ALL and CLL), acute and chronic myeloid leukemia (AML and CML), multiple myeloma, and other B-cell malignancies. In addition, the experts discuss how they are applying this information to their practice right now, as well as its potential implications.

This first of 3 PER Pulse™ Recaps summarizing the online program focuses on AML, ALL, and other B-cell malignancies, including mantle cell lymphoma (MCL), hairy cell leukemia (HCL), follicular lymphoma, and Waldenström macroglobulinemia.

Below are some highlights from the activity featuring Dr Goy:

  • Faculty review the novel drugs approved by the FDA for the treatment of AML and highlight the importance of molecular testing prior to treatment decision in AML patients.
  • Faculty discuss the most relevant trials for patients with ALL1-3, as well as associated adverse events to be taken in consideration by clinicians when integrating these novel treatments into clinical practice.
  • Faculty provide an overview of novel impactful advances in MCL4,5, HCL,6 follicular lymphoma,7 and Waldenström macroglobulinemia.8,9
  • Faculty present key results of acalabrutinib as monotherapy or in combination for patients with R/R MCL.
  • Faculty offer an overview of treatment advances in HCL with the approval of moxetumomab pasudotox in heavily pretreated patients with R/R HCL, follicular lymphoma with the approval of duvelisib in the R/R setting, and Waldenström macroglobulinemia with the approval of the combination of ibrutinib and rituximab.

“It is very important to understand that AML is not 1 disease, and it’s important to have a molecular characterization of patients to take advantage of the targeted therapies that are truly changing the landscape in AML.

“Instead of having to go to an intensive chemotherapy regimen induction used typically in ALL in younger patients, we can start seeing the integration of antibody–drug conjugates and [tyrosine kinase inhibitors] in patients who have [Philadelphia-positive] ALL with very promising results, and I think this is going to be something very important when it comes to maintenance and achieving complete responses.”

—Andre Goy, MD, MS

References

  1. Ottman OG, Pfeifer H, Cayuela J-M, et al. Nilotinib (Tasigna) and chemotherapy for first-line treatment in elderly patients with de novo Philadelphia chromosome/BCR-ABL1 positive acute lymphoblastic leukemia (ALL): a trial of the European Working Group for Adult ALL (EWALL-PH-02). Presented at: 56th American Society of Hematology Annual Meeting; December 6-9, 2014; San Francisco, CA. Abstract 798. bloodjournal.org/content/124/21/798?sso-checked=true.
  2. Himelstein AL, Qin R, Novotny PJ, et al. CALGB 70604 (Alliance): a randomized phase III study of standard dosing vs longer interval dosing of zoledronic acid in metastatic cancer. J Clin Oncol. 2015;33(suppl 15, abstr 9501). ascopubs.org/doi/abs/10.1200/jco.2015.33.15_suppl.9501.
  3. Jabbour E, Ravandi F, Kebriaei P, et al. Salvage chemoimmunotherapy with inotuzumab ozogamicin combined with mini-hyper-CVD for patients with relapsed or refractory Philadelphia chromosome-negative acute lymphoblastic leukemia: a phase II clinical trial. JAMA Oncol. 2018;4(2):230-234. doi: 10.1001/jammaoncol.2017.2380.
  4. Wang M, Rule S, Zinzani PL, et al. Long-term follow-up of acalabrutinib monotherapy in patients with relapsed/refractory mantle cell lymphoma. Presented at: 2018 American Society of Hematology Annual Meeting; Dec. 1-4, 2018; San Diego, CA. Abstract 2876. bloodjournal.org/content/132/Suppl_1/2876?sso-checked=true.
  5. Wang M, Rule S, Zinzani PL, et al. Acalabrutinib in relapsed or refractory mantle cell lymphoma (ACE-LY-004): a single-arm, multicentre, phase 2 trial. Lancet. 2018;391:659-667. doi: 10.1016/S0140-6736(17)33108-2.
  6. Kreitman RJ, Dearden C, Zinzani PL, et al. Moxetumomab pasudotox in heavily pretreated patients with relapsed/refractory hairy cell leukemia: results of a pivotal international study. J Clin Oncol. 2018;36(suppl; abstr 7004). ascopubs.org/doi/abs/10.1200/JCO.2018.36.15_suppl.7004.
  7. Verastem Oncology receives FDA approval of COPIKTRA (duvelisib) capsules [press release]. Boston, MA: Verastem, Inc; September 24, 2018. bit.ly/2NDQm80. Accessed September 24, 2018.
  8. Dimopoulos MA, Tedeschi A, Trotman J, et al. Randomized phase 3 trial of ibrutinib/rituximab vs placebo/rituximab in Waldenström’s macroglobulinemia. J Clin Oncol. 2018;36 (suppl; abstr 8003). ascopubs.org/doi/abs/10.1200/JCO.2018.36.15_suppl.8003?segCode=MMABS&et_cid=40377592&et_rid=933037860&linkid=http://ascopubs.org%2Fdoi%2Fabs%2F10.1200%2FJCO.2018.36.15_suppl.8003%3FsegCode%3DMMABS&utm_medium=cpc&utm_campaign=J_Clin_Oncol_TrendMD_0&utm_source=TrendMD.
  9. Dimopoulos MA, Tedeschi A, Trotman J, et al; INNOVATE Study Group and the European Consortium for Woldenström’s Macroglobulenimia. Phase 3 trial of ibrutinib plus rituximab in Waldenström’s macroglobulinemia [published online June 1, 2018). N Engl J Med. doi: 10.1056/NEJMoa1802917.

2 of 3
Insights from Anthony Mato, MD, a hematologic oncologist and director of the chronic lymphoblast leukemia program at Memorial Sloan Kettering Cancer Center in New York, New York—PER Pulse™ Recap:
2018 Year in Review™: Reflecting on Recent Evidence for the Treatment of Hematologic Malignancies

As a follow-up to the continuing medical education–certified activity 2018 Year in Review™: Reflecting on Recent Evidence for the Treatment of Hematologic Malignancies, this second of 3 PER Pulse™ Recaps summarizing the online program focuses on evolving approaches for patients with newly diagnosed and relapsed/refractory (R/R) chronic lymphoblastic leukemia (CLL), as well as promises and challenges in the CLL treatment landscape, by presenting strategies to manage adverse events associated with novel treatments and discussing combination and sequence of novel therapies. Dr. Mato also provides a brief overview of the chronic myeloid leukemia (CML) pipeline and the most promising drugs available through clinical trials for CML patients.

Below are some highlights from the activity featuring Dr Mato:

  • Faculty present evolving approaches for patients with newly diagnosed and R/R CLL by presenting the most important results and key points from practice-changing clinical trials.
  • Faculty discuss 5 practice-changing trials exploring ibrutinib and ibrutinib combinations in the frontline setting.
  • Faculty approach novel treatment options for R/R CLL. Duvelisib1, venetoclax, rituximab2, and acalabrutinib3 adverse events (AEs) and safety profile are presented and discussed.
  • Faculty provide strategies to manage AEs associated with novel treatments, providing strategies to minimize toxicities when integrating novel agents into clinical practice and discussing combination and sequence of novel therapies.
  • Faculty discuss the importance of minimal residual disease in CLL and how to address differences between what is observed in clinical trials and clinical practice, as well as the emerging role of real-world evidence in the management of patients with CLL.
  • Faculty provide an overview of current results and future perspectives in optimizing therapy for CML.

“Unlike cytotoxic chemotherapy, which has its own set of AEs—which are quite predictable, largely hematologic cytopenias and, potentially, organ dysfunction—each of the novel agents really [does] have a unique cytotoxicity profile, and there is a learning curve in terms of how to use these agents, and the AEs appear to be very class specific.

“I do believe MRD is the first step toward getting to a situation where CLL might be completely eradicated with combinations and new therapies.

“Probably one of the most promising agents that [is] in development for CML is asciminib, which is the first allosteric inhibitor of the tyrosine kinase activity of BCR-ABL.”

—Anthony Mato, MD

References

  1. Verastem Oncology Receives FDA Approval of COPIKTRA™ (duvelisib) Capsules [press release]. Boston, MA: Verastem, Inc; September 24, 2018. bit.ly/2NDQm80. Accessed September 24, 2018.
  2. Seymour JF, Kipps TJ, Eichhorst N, et al. MURANO trial establishes feasibility of time-limited venetoclax-rituximab (VenR) combination therapy in relapsed/refractory (R/R) chronic lymphocytic leukemia (CLL). In: Proceedings from the 2018 American Society of Hematology Annual Meeting; December 1-4, 2018; San Diego, CA. Abstract 184.
  3. Sun CC, Nierman P, Ahn IE, et al. Acalabrutinib in patients with relapsed/refractory (R/R) and high-risk, treatment-naive (TN) chronic lymphocytic leukemia (CLL). Presented at: 2018 American Society of Hematology Annual Meeting and Exposition; December 4-8, 2018; San Diego, CA. Abstract 4424.

3 of 3
Insights from Ruben Niesvizky, MD, director of the Multiple Myeloma Center and professor of medicine in the Division of Hematology/Oncology at NewYork-Presbyterian Hospital/Weill Cornell Medical Center in New York, New York—PER Pulse™ Recap:
2018 Year in Review™: Reflecting on Recent Evidence for the Treatment of Hematologic Malignancies

As a follow-up to the continuing medical education–certified activity 2018 Year in Review™: Reflecting on Recent Evidence for the Treatment of Hematologic Malignancies, this third of 3 PER Pulse™ Recaps summarizing the online program focuses on multiple myeloma (MM) and the most relevant trials for patients with newly diagnosed MM, followed by the presentation of relevant trials in the relapsed/refractory (R/R) setting and novel data on maintenance therapy options for patients with MM. Additionally, the importance of assessing minimal residual disease in patients with MM and the importance of optimizing sequencing therapies in MM is discussed.

Below are some highlights from the activity featuring Dr Niesvizky:

  • Faculty present the MAIA trial and the rationale behind adding daratumumab to improve outcomes in patients with newly diagnosed MM ineligible for stem cell transplant.1
  • Faculty discuss the POLLUX2 and CASTOR3 trials in the R/R MM setting, as well as ELOQUENT-34 and OPTIMISMM5 studies in the same setting.
  • The phase III TOURMALINE6 trial using ixazomib as maintenance therapy following autologous stem cell transplantation in patients with newly diagnosed MM is presented.
  • Faculty discuss selinexor as an emerging option for penta-refractory MM.7
  • Faculty provides his perspective on the importance of MRD in MM and of optimizing sequencing therapies in MM.

References

  1. 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). Presented at: 2108 American Society of Hematology Annual Meeting and Exposition; December 4-8, 2018; San Diego, CA. Abstract LBA-2. bloodjournal.org/content/132/Suppl_1/LBA-2?sso-checked=true.
  2. Dimopoulos MA, Oriol A, Nahi H, et al; POLLUX Investigators. Daratumumab, lenalidomide, and dexamethasone for multiple myeloma. N Engl J Med. 2016;375(14):1319-1331. doi: 10.1056/NEJMoa1607751.
  3. Palumbo A, Chanan-Khan A, Weisel K, et al; CASTOR Investigators. Daratumumab, bortezomib, and dexamethasone for multiple myeloma. N Engl J Med. 2016;375(8):754-766. doi: 10.1056/NEJMoa1606038.
  4. Dimopoulos MA, Dytfeld D, Grosicki S, et al. Elotuzumab plus pomalidomide/dexamethasone (EPd) vs Pd for treatment of relapsed/refractory multiple myeloma (RRMM): results from the phase 2, randomized open-label ELOQUENT-3 study. Presented at: 2018 European Hematology Association Congress; June 14-17, 2018; Stockholm, Sweden. Abstract LB2606. learningcenter.ehaweb.org/eha/2018/stockholm/218888/meletios.a.dimopoulos.elotuzumab.plus.pomalidomide.dexamethasone.28epd29.vs.pd.html?f=topic=1574*media=3.
  5. Richardson PG, Rocafiguera AO, Beksac M, et al. Pomalidomide (POM), bortezomib, and low‐dose dexamethasone (PVd) vs bortezomib and low-dose dexamethasone (Vd) in lenalidomide (LEN)-exposed patients (pts) with relapsed or refractory multiple myeloma (RRMM): phase 3 OPTIMISMM trial. J Clin Oncol. 2018;36(suppl; abstr 8001). ascopubs.org/doi/abs/10.1200/JCO.2018.36.15_suppl.8001.
  6. Morgan G, Dimopoulos M, Gay F, et al. Maintenance therapy with the oral proteasome inhibitor (PI) ixazomib significantly prolongs progression-free survival (PFS) following autologous stem cell transplantation (ASCT) in patients with newly diagnosed multiple myeloma (NDMM): phase 3 Tourmaline-MM3 trial. In: Proceedings from the 2019 Transplantation & Cellular Therapy Meetings; February 20-24, 2019; Houston, TX. Abstract 23. bbmt.org/article/S1083-8791(18)30909-1/fulltext.
  7. Chari A, Vogl DT, Dimopoulos MA, et al. Results of the pivotal STORM study (part 2) in penta-refractory multiple myeloma (MM): deep and durable responses with oral selinexor plus low dose dexamethasone in patients with penta-refractory MM. In: Proceedings from the 2018 American Society of Hematology Annual Meeting; Dec. 1-4, 2018; San Diego, CA. Abstract 598. bloodjournal.org/content/132/Suppl_1/598?sso-checked=true.

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