MSK Researchers Making Strides in Hematologic Malignancies

Faculty from Memorial Sloan Kettering Cancer Center shed light on some of the intriguing research in hematologic cancer being conducted at their institution.

In interviews during the 2019 OncLive® State of the Science Summit on Hematologic Malignancies, faculty from Memorial Sloan Kettering Cancer Center shed light on some of the intriguing research in hematologic cancer being conducted at their institution.

Sergio A. Giralt, MD

Sergio A. Giralt, MD: Professor of Medicine at Weill Cornell Medical College, Chief of Adult Bone Marrow Transplant Service, and Melvin Berlin Family Chair in Multiple Myeloma, Memorial Sloan Kettering Cancer Center

“We’re making transplant easier by doing pharmacokinetics-directed melphalan and by using interleukin-6 antibodies to prevent posttransplant fatigue. We have been very encouraged from the results [we have seen with these approaches] and we’re looking forward to starting follow-up studies.”

Jae Park, MD

Jae Park, MD: Hematologic Oncologist and Associate Attending Physician, Memorial Sloan Kettering Cancer Center

“My focus in acute lymphoblastic leukemia (ALL) is trying to figure out how to incorporate some of the novel therapies that are emerging in the relapsed setting and bring them into frontline treatment. If we can, we want to avoid chemotherapies and reduce the duration of therapy.

Currently, ALL treatment consists of almost 1 year of intense chemotherapy and 2 years of a maintenance therapy. However, now, I’m hoping that we can incorporate some of these novel therapies early on to reduce the total duration of therapy. In order to do so, we are trying to understand good prognostic indicators [for] patients who can benefit from shortened duration of therapy and from emerging novel therapies. Also, for those patients who don’t respond as well, we want to know the reasons why, and what therapy we be should be adding. [We are also] thinking about [what we can do] for those patients who are refractory to currently available treatments.”

Sham Mailankody, MBBS

Sham Mailankody, MBBS: Medical Oncologist and Assistant Attending Physician, Memorial Sloan Kettering Cancer Center

“Our services have different physicians who focus on research and clinical care for patients with multiple myeloma. We’re working on improving treatment for patients with newly diagnosed disease, including new 4-drug combinations. We’re also looking at novel technologies for minimal residual disease (MRD) assessments. Additionally, my colleagues are evaluating the role of genomic sequencing and the prediction and prognosis of outcomes for patients. My own work is focused on advanced multiple myeloma, particularly with regard to CAR T-cell therapies, which includes BCMA-directed therapies.”

Anthony Mato, MD, MSCE

Anthony Mato, MD, MSCE: Director of the Chronic Lymphocytic Leukemia Program, and Hematologic Oncologist, Memorial Sloan Kettering Cancer Center

“At our institution, we have had an explosion of clinical trials available for patients [with chronic lymphocytic leukemia (CLL)]. We are designing and conducting trials to allow us to discontinue targeted therapies based on depth of response. We are designing combination trials so that we can add targeted therapies to the treatment of patients who have persistent disease, or MRD-detectable disease. We’re studying next-generation BTK inhibitors, specifically to address the question of resistance. We have active trials with CAR T cells, trials specifically for patients with Richter’s transformation, and exciting novel combinations [under exploration] in the frontline setting. We probably have anything between 7 and 10 trials open for CLL, and we’re always happy to evaluate patients for them.”

Raajit K. Rampal, MD, PhD

Raajit K. Rampal, MD, PhD: Hematologic Oncologist, Memorial Sloan Kettering Cancer Center

“Our program focuses on both preclinical work, which is the investigation of drugs in mice before they get into humans, and drugs that are under clinical investigation. We are pursuing a number of ideas as part of the Myeloproliferative Neoplasms Consortium. For example, there is currently a phase I study of a drug called AVID200, which is a TGF-beta inhibitor, for patients with myelofibrosis. Another study that is about to open is examining the combination of ruxolitinib (Jakafi) and enasidenib (Idhifa) for patients with advanced myelofibrosis who have an IDH2 mutation.”

Miguel-Angel Perales, MD

Miguel-Angel Perales, MD: Deputy Chief of Adult Bone Marrow Transplant Service, and Director of the Adult Bone Marrow Transplantation Fellowship Program, Memorial Sloan Kettering Cancer Center

“Currently, at Memorial Sloan Kettering Cancer Center, we are doing a lot of investigational work with CAR T cells. Beyond the use of commercial products, we also have clinical trials open; this is true in ALL, different lymphomas, and even solid tumors. We’re always looking for potential patients who can benefit from these therapies.”

Alison J. Moskowitz, MD

Alison J. Moskowitz, MD: Clinical Director of the Lymphoma Inpatient Unit, and Assistant Attending Physician in the Lymphoma Service, Memorial Sloan Kettering Cancer Center

“I’d like to highlight the work that we’re doing in T-cell lymphoma, particularly because this is a disease where outcomes tend to be fairly poor. For patients with relapsed/refractory disease, treatment options are limited, so there’s a significant need for the development of new drugs. Several targeted drugs appear to have some activity in this disease. The goal of our studies is to determine the efficacy of these drugs, which diseases are more likely to respond [to these treatments], and what biomarkers will help us to predict which patients are most likely to respond these agents. We’re blessed at this time to have several different options [being evaluated in clinical trials] for patients with relapsed/refractory T-cell lymphoma. We have the opportunity to provide treatment for these patients who often have limited options.”

Eytan M. Stein, MD

Eytan M. Stein, MD: Hematologic Oncologist and Assistant Attending Physician of Leukemia Service, Memorial Sloan Kettering Cancer Center

“The combination of azacitidine and venetoclax (Venclexta) is a new standard of care for older patients with acute myeloid leukemia (AML). As such, we’re doing a lot of clinical work to figure out what we can combine with azacitidine and venetoclax to improve overall survival.

We also have a real effort being made in targeting a specific subtype of leukemia called mixed lineage leukemia-rearranged leukemia; this is predominantly seen in patients with AML that has arisen from a prior therapy [used] for other solid tumors or in the pediatric population. We have a specific interest in that [area of research] and a whole bunch of clinical trials that are aiming to target that specific subset of patients.

The other thing that I would like to highlight is that at Memorial Sloan Kettering Cancer Center, we recently launched a dedicated phase I program called the Center for Drug Development in Leukemia. [Here], our goal is to rapidly bring novel phase I agents to patients who need them and to do really excellent correlative science to understand why patients might respond or not. We’re always happy to hear from [other] doctors who want to send us patients and work with them to get patients [on] treatment as rapidly as possible.”