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Cancer Conference Update: A Multimedia Review of Key Presentations from the 2016 American Society of Hematology Annual Meeting
Released June 2017

Featuring key slides from the most important presentations of ASH 2016 and video interviews with Drs Joseph Mikhael, Christopher Flowers and David P Steensma. (Video Program)

CE Disclosures and Faculty Information

  • TARGET AUDIENCE
    This activity is intended for medical oncologists, hematologists and hematology-oncology fellows, oncology nurses, radiation oncologists and other healthcare professionals involved in the diagnosis and treatment of hematologic cancers.

    OVERVIEW OF ACTIVITY
    Hematologic oncology and related blood disorders are some of the most rapidly evolving fields in all of medicine. Results presented at major conferences from a plethora of ongoing clinical trials lead to the continual emergence of new therapeutic agents and changes in the indications for existing treatments. In order to offer optimal patient care, the practicing hematologist-oncologist must be well informed of these advances. To bridge the gap between research and patient care, this issue of Cancer Conference Update uses one-on-one discussions with hematologic oncology clinical investigators to provide perspectives on the integration of key data sets presented at the 2016 American Society of Hematology Annual Meeting into the practical management of various hematologic cancers and related blood disorders. 

    LEARNING OBJECTIVES

    • Recall new data with investigational agents demonstrating promising activity in hematologic cancers.
    • Appraise recent data on therapeutic advances and changing practice standards in multiple myeloma (MM), and integrate this information, as appropriate, into current clinical care.
    • Evaluate new approaches to the treatment of AL amyloidosis, and consider promising investigational agents that may be available and appropriate for patients in ongoing clinical trials.
    • Develop an understanding of the biologic rationale for and early efficacy and toxicity data with the use of immunotherapeutic approaches for patients with various lymphoma subtypes and MM.
    • Translate an understanding of the emerging efficacy and side-effect data with novel agents and combination regimens into treatment planning for patients with indolent and aggressive B-cell non-Hodgkin lymphomas.
    • Formulate an approach incorporating brentuximab vedotin and anti-PD-1/anti-PD-L1 antibodies alone or in combination regimens for the treatment of Hodgkin lymphoma.
    • Assess emerging high-level evidence supporting the use of maintenance lenalidomide in the treatment of chronic lymphocytic leukemia.
    • Recognize the potential role of novel agents and regimens in the management of newly diagnosed and relapsed/refractory acute leukemia and myelodysplastic syndromes.
    • Examine therapeutic strategies under investigation for the treatment of myelofibrosis to inform patients about protocol and clinical options.

    ACCREDITATION STATEMENT
    Research To Practice is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

    CREDIT DESIGNATION STATEMENT
    Research To Practice designates this enduring material for a maximum of 2.5 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

    AMERICAN BOARD OF INTERNAL MEDICINE (ABIM) — MAINTENANCE OF CERTIFICATION (MOC)
    Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to 2.5 Medical Knowledge MOC points in the American Board of Internal Medicine’s (ABIM) Maintenance of Certification (MOC) program. Participants will earn MOC points equivalent to the amount of CME credits claimed for the activity. It is the CME activity provider’s responsibility to submit participant completion information to ACCME for the purpose of granting ABIM MOC credit.

    Please note, this program has been specifically designed for the following ABIM specialty: medical oncology.

    Personal information and data sharing: Research To Practice aggregates deidentified user data for program-use analysis, program development, activity planning and site improvement. We may provide aggregate and deidentified data to third parties, including commercial supporters. We do not share or sell personally identifiable information to any unaffiliated third parties or commercial supporters. Please see our privacy policy at ResearchToPractice.com/Privacy-Policy for more information.

    HOW TO USE THIS CME ACTIVITY
    This CME activity consists of slide and video components. To receive credit, the participant should review the slide presentations, watch the video, complete the Post-test with a score of 80% or better and fill out the Educational Assessment and Credit Form located at ResearchToPractice.com/CaCU117/Video/CME.

    CONTENT VALIDATION AND DISCLOSURES
    Research To Practice (RTP) is committed to providing its participants with high-quality, unbiased and state-of-the-art education. We assess conflicts of interest with faculty, planners and managers of CME activities. Conflicts of interest are identified and resolved through a conflict of interest resolution process. In addition, all activity content is reviewed by both a member of the RTP scientific staff and an external, independent physician reviewer for fair balance, scientific objectivity of studies referenced and patient care recommendations.

    FACULTY — The following faculty (and their spouses/partners) reported relevant conflicts of interest, which have been resolved through a conflict of interest resolution process:

    Joseph Mikhael, MD, MEd 
    Professor of Medicine
    Mayo College of Medicine 
    Associate Dean
    Mayo School of Graduate Medical Education 
    Deputy Director - Education
    Mayo Clinic Cancer Center 
    Mayo Clinic in Arizona 
    Phoenix, Arizona 

    Contracted Research: AbbVie Inc, Celgene Corporation, Sanofi Genzyme. 

    Christopher Flowers, MD, MS 
    Associate Professor of Hematology and Medical Oncology 
    Emory School of Medicine
    Winship Cancer Institute 
    Atlanta, Georgia 

    Consulting Agreements: Celgene Corporation, OptumRx Inc; Contracted Research: Acerta Pharma, Celgene Corporation, Gilead Sciences Inc, Infinity Pharmaceuticals Inc, Janssen Biotech Inc, Onyx Pharmaceuticals, an Amgen subsidiary, Pharmacyclics LLC, an AbbVie Company, Takeda Oncology, TG Therapeutics Inc; Unpaid Consulting Agreements: Genentech BioOncology, Takeda Oncology.

    David P Steensma, MD, FACP 
    Faculty Member
    Adult Leukemia Program 
    Dana-Farber Cancer Institute 
    Associate Professor of Medicine
    Harvard Medical School 
    Boston, Massachusetts 

    Consulting Agreements: Akebia Therapeutics, Amgen Inc, Celgene Corporation, Janssen Biotech Inc, Takeda Oncology. 

    EDITORDr Love is president and CEO of Research To Practice, which receives funds in the form of educational grants to develop CME activities from the following commercial interests: AbbVie Inc, Acerta Pharma, Adaptive Biotechnologies, Agendia Inc, Amgen Inc, Ariad Pharmaceuticals Inc, Array BioPharma Inc, Astellas Pharma Global Development Inc, AstraZeneca Pharmaceuticals LP, Baxalta Inc, Bayer HealthCare Pharmaceuticals, Biodesix Inc, bioTheranostics Inc, Boehringer Ingelheim Pharmaceuticals Inc, Boston Biomedical Pharma Inc, Bristol-Myers Squibb Company, Celgene Corporation, Clovis Oncology, CTI BioPharma Corp, Dendreon Pharmaceuticals Inc, Eisai Inc, Exelixis Inc, Foundation Medicine, Genentech BioOncology, Genomic Health Inc, Gilead Sciences Inc, Halozyme Inc, ImmunoGen Inc, Incyte Corporation, Infinity Pharmaceuticals Inc, Ipsen Biopharmaceuticals Inc, Janssen Biotech Inc, Jazz PharmaceuticalsInc, Kite Pharma Inc, Lexicon Pharmaceuticals Inc, Lilly, Medivation Inc, a Pfizer Company, Merck, Merrimack Pharmaceuticals Inc, Myriad Genetic Laboratories Inc, NanoString Technologies, Natera Inc, Novartis, Novocure, Onyx Pharmaceuticals, an Amgen subsidiary, Pharmacyclics LLC, an AbbVie Company, Prometheus Laboratories Inc, Puma Biotechnology Inc, Regeneron Pharmaceuticals Inc, Sanofi Genzyme, Seattle Genetics, Sigma-Tau Pharmaceuticals Inc, Sirtex Medical Ltd, Spectrum Pharmaceuticals Inc, Taiho Oncology Inc, Takeda Oncology, Tesaro Inc, Teva Oncology and Tokai Pharmaceuticals Inc.

    RESEARCH TO PRACTICE STAFF AND EXTERNAL REVIEWERS — The scientific staff and reviewers for Research To Practice have no relevant conflicts of interest to disclose.

    This educational activity contains discussion of published and/or investigational uses of agents that are not indicated by the Food and Drug Administration. Research To Practice does not recommend the use of any agent outside of the labeled indications. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications and warnings. The opinions expressed are those of the presenters and are not to be construed as those of the publisher or grantors.

    This activity is supported by educational grants from Celgene Corporation, Foundation Medicine, Gilead Sciences Inc, Incyte Corporation, Novartis, Seattle Genetics and Takeda Oncology. 

    Hardware/Software Requirements:
    A high-speed Internet connection
    A monitor set to 1280 x 1024 pixels or more
    Internet Explorer 7 or later, Firefox 3.0 or later, Chrome, Safari 3.0 or later
    Adobe Flash Player 10.2 plug-in or later
    Adobe Acrobat Reader
    (Optional) Sound card and speakers for audio

    Last review date: June 2017
    Expiration date: June 2018

    After completing the Post-test, learners may download and review the answers here in order to identify further areas of study.

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Watch video
(WIFI is recommended for best performance):
VIDEO PRESENTATIONS:

Up-front management of newly diagnosed multiple myeloma (MM)

  • Abstract LBA-1: StaMINA trial: Comparison of autologous hematopoietic cell transplant (auto-HCT), bortezomib, lenalidomide and dexamethasone consolidation with lenalidomide maintenance versus tandem auto-HCT with lenalidomide maintenance versus auto-HCT with lenalidomide maintenance for up-front treatment of MM
  • Abstract 674: Intergroupe Francophone Du Myélome (IFM) Phase II study of the oral ixazomib/lenalidomide/ dexamethasone (IRd) regimen before and after autologous stem cell transplantation (ASCT) followed by ixazomib maintenance in patients with newly diagnosed MM (NDMM)
  • Abstract 1142: IFM Phase II study of front-line therapy with carfilzomib, lenalidomide and dexamethasone (KRd) induction followed by ASCT, KRd consolidation and lenalidomide maintenance in NDMM

Management of relapsed/refractory MM

  • Abstracts 1149, 1150: Daratumumab for relapsed/refractory MM (RRMM)
  • Abstract 1145: A multicenter, Phase I/II study of carfilzomib, pomalidomide and dexamethasone in patients with RRMM
  • Abstract 490: Pembrolizumab in combination with pomalidomide and dexamethasone for RRMM
  • Abstracts 488, 975: Venetoclax as monotherapy or in combination with bortezomib/dexamethasone for RRMM
  • Abstract 978: MYRE randomized study of intensive hemodialysis with high cutoff or standard high-flux dialyzer for myeloma cast nephropathy in patients receiving a bortezomib-based regimen

Smoldering myeloma and primary amyloidosis

  • Abstract 976: A Phase II trial of elotuzumab, lenalidomide and dexamethasone in high-risk smoldering MM
  • Abstract 646: A Phase III trial of melphalan and dexamethasone versus bortezomib, melphalan and dexamethasone for untreated immunoglobulin light chain (AL) amyloidosis
  • Abstracts 643, 644: Monoclonal antibodies — 11-1F4 and NEOD001 — targeting light chain deposits in patients with AL amyloidosis
  • Abstract 4525: Hematologic responses and cardiac organ improvement in patients with heavily pretreated cardiac AL amyloidosis receiving daratumumab

Non-Hodgkin lymphomas

  • Abstract 6: GALLIUM Phase III study of obinutuzumab- versus rituximab-based induction and maintenance therapy for patients with previously untreated follicular lymphoma
  • Abstract 104: Brentuximab vedotin with R-CHP as front-line therapy in high-intermediate/high-risk diffuse large B-cell lymphoma (DLBCL)
  • Abstract 470: Results of the Phase III GOYA study evaluating obinutuzumab or rituximab with CHOP in patients with previously untreated DLBCL
  • Abstracts 471, 474: Maintenance lenalidomide in patients with DLBCL
  • Clinical development of the antibody-drug conjugate denintuzumab mafodotin in combination with chemotherapy for patients with CD19-positive DLBCL
  • Abstract 619: Results from KEYNOTE-013 — A Phase Ib study of pembrolizumab in relapsed/refractory primary mediastinal large B-cell lymphoma
  • Abstract 145: Final results of the Phase III LyMa study of rituximab maintenance after ASCT in younger patients with mantle cell lymphoma
  • Abstract 182: Phase III ALCANZA — Brentuximab vedotin demonstrates superior clinical outcomes compared to methotrexate or bexarotene in CD30-expressing cutaneous T-cell lymphoma

Hodgkin lymphoma

  • Abstract 1105: Brentuximab vedotin in combination with nivolumab for patients with relapsed or refractory Hodgkin lymphoma
  • Abstracts 1106, 183: Nivolumab and ipilimumab for relapsed/refractory hematologic cancers

Chronic lymphocytic leukemia

  • Abstracts 229, 230: Maintenance lenalidomide in the first-line (CLL M1 study) and second-line (CONTINUUM) settings in chronic lymphocytic leukemia (CLL)
  • Abstract 637: Venetoclax monotherapy for patients with CLL and disease progression during or after treatment with ibrutinib or idelalisib
  • Abstract 231: Overall survival in a Phase III study evaluating the addition of idelalisib to bendamustine/rituximab in patients with relapsed/refractory CLL

Acute myeloid leukemia (AML)

  • Abstract 102: Venetoclax and low-dose cytarabine in patients age 65 or older with treatment-naïve AML
  • Abstract 449: Interim analyses of AMLSG 16-10 — Effect of age and midostaurin dose on response and outcome for patients with AML with FLT3-ITD mutations
  • Abstracts 590, 591: Antibody-drug conjugate vadastuximab talirine alone or in combination with hypomethylating agents in patients with CD33-positive AML
  • Abstract 763: Rationale for and results of a Phase Ib/II study of azacitidine and nivolumab for relapsed AML
  • Abstract 905: CC-486 (oral azacitidine) in patients with hematologic cancers who received prior treatment with injectable hypomethylating agents
  • Abstract 1069: Final results of CHRYSALIS — A first-in-human Phase I/II study of the oral FLT3/AXL inhibitor gilteritinib (ASP2215) in relapsed/refractory AML
  • Abstract 1070: Isocitrate dehydrogenase 1 (IDH1) mutational burden and clearance in patients with IDH1 mutation-positive acute leukemias receiving the first-in-class inhibitor of IDH1 AG-120

Myelodysplastic syndromes (MDS)

  • Abstracts 223, 224: Lenalidomide with or without epoetin alfa in patients with MDS
  • Abstract 343: Enasidenib (AG-221), a potent oral inhibitor of mutant IDH2 enzyme, induces hematologic responses in MDS
  • Abstract 344: Outcomes of a Phase II study evaluating nivolumab or ipilimumab with azacitidine in patients with previously treated or untreated MDS

Myelofibrosis

  • Abstract 478: A Phase II study of sotatercept (ACE-011) in myeloproliferative neoplasm-associated myelofibrosis and anemia
  • Abstract 1127: Ruxolitinib in combination with azacitidine as treatment for myelofibrosis