Spreading Newfound Treatment Strategies in Hematologic Malignancies in Seattle

OncLive Staff
Published: Wednesday, Oct 09, 2019


We recently traveled to Seattle, California for an OncLive® State of the Science Summit™ on Hematologic Malignancies. At the meeting, faculty from Seattle Cancer Care Alliance provided insight on current and evolving standards of care in leukemia, lymphoma, and myeloma, highlighting particular targets of interest for novel therapies.

First, we spoke with the chair of the meeting, Jerald Radich, MD, a member in the Clinical Research Division at Fred Hutchinson Cancer Research Center, a professor in the Division of Medical Oncology at the University of Washington School of Medicine, and a physician with Seattle Cancer Care Alliance. There are several ways to assess minimal residual disease in patients with acute lymphoblastic leukemia, explained Radich. And although there is some debate as to whether it should be termed “minimal” or “measurable,” it may become standard practice to test for MRD as a surrogate endpoint in clinical trials. Radich discussed the methods that are being used to measure MRD as well as the work that is being done to standardize its use in ALL.

Afterward, Mazyar Shadman, MD, MPH, an assistant member in the Clinical Research Division of Fred Hutchinson Cancer Research Center, sat down with us to discuss CAR T cells. Now that the CD19-targeted CAR T-cell therapies axicabtagene ciloleucel and tisagenlecleucel have shown durable responses in the relapsed/refractory settings of non-Hodgkin lymphoma, researchers are hopeful that earlier exposure may heighten the curative potential of this modality, explained Shadman. In our interview, Shadman, who is also an assistant professor at the University of Washington, and an attending physician with Seattle Cancer Care Alliance, discuss earlier use of CAR T-cell therapy in lymphoma, the impact of approved products on future development, and recent data with chemotherapy-free and time-limited therapy in CLL.

Even if a patient with chronic myeloid leukemia qualifies for TKI discontinuation, it does not mean they are out of the woods, explained Vivian G. Oehler, MD, an associate member in the Clinical Research Division of the Fred Hutchinson Cancer Research Center, who added that monitoring becomes even more important in this context. When Oehler, who is also an associate professor of medicine at the University of Washington School of Medicine and a physician with Seattle Cancer Care Alliance, sat down with us, she discussed the important aspects of TKI discontinuation and the patient factors that would warrant such an approach. Moreover, she highlighted ongoing developments in myeloproliferative neoplasms and shared her hopes for the future in light of the number of emerging drugs that are showing promise as monotherapy and in combination in clinical trials.

With the development of new agents in benign hematologic disorders and more in the pipeline, the outlook for patients with aplastic anemia, immune thrombocytopenia, and thrombotic thrombocytopenic purpura has brightened considerably. Kleber Yotsumoto Fertrin, MD, PhD, an assistant professor, at the University of Washington School of Medicine, and a physician with Seattle Cancer Care Alliance, shed light on the new options that have emerged in the treatment landscape of benign hematologic malignancies.

When it comes to multiple myeloma, combination regimens—especially in the form of triplet and quadruplet regimens—are the future of treatment, explained Andrew J. Cowan, MD, who cited the results of the phase III CASSIOPEIA and MAIA trials as examples. Listen on to hear Cowan, an assistant professor of medicine at the University of Washington School of Medicine and physician with Seattle Cancer Care Alliance, discuss pivotal trials in multiple myeloma and the potential for new treatments in the future.

There is no question that the availability of targeted agents, such as FLT3 and IDH1/2 inhibitors, has led to survival gains for patients with acute myeloid leukemia. Despite progress made, concerns over the timing and potential toxicities of treatment remain, said Mary-Elizabeth Percival, MD. Percival, an assistant member at Fred Hutchinson Cancer Research Center, an assistant professor of Hematology and Medicine at the University of Washington School of Medicine, and a physician with Seattle Cancer Care Alliance, joined us to discuss advances and challenges with targeted agents in AML and remaining questions in the field.

Finally, Chaitra S. Ujjani, MD, came by to explain that PI3K inhibitors, BTK inhibitors, and EZH2 inhibitors have taken greater precedence in the field of follicular lymphoma in recent years. In our interview, Ujjani, an associate member in the Clinical Research Division at Fred Hutchinson Cancer Research Center, a clinical associate professor of medical oncology at the University of Washington School of Medicine, and a physician with Seattle Cancer Alliance, discussed the various therapeutic classes and agents that are showing the most promise in the field of follicular lymphoma.

That’s all we have for today! Thank you for listening to OncLive® On Air. Check back on Wednesdays for new interviews from our State of the Science Summits™.
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