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Monday, July 16, 2018, Lahaina, Hawaii, 1:00 PM – 3:00 PM

Dissecting the Decision: Documenting and Discussing the Clinical Practice Patterns of Hematologic Oncology Investigators in the Management of Follicular Lymphoma

Part 1 of a 3-Part CME/CNE Symposia Series Held in Conjunction with the 2018 Pan Pacific Lymphoma Conference

Event Details

Location:
Hyatt Regency Maui Resort and Spa
200 Nohea Kai Drive
Lahaina, HI 96761
Hotel Phone: (808) 661-1234

Time:
12:30 PM – 1:00 PM — Registration and Buffet Lunch
1:00 PM – 3:00 PM — Symposium

Meeting Room:
Monarchy 5, 6, 7 (Promenade Level)

There is no registration fee for this symposium. However, preregistration is advised as seating is limited.  
 
Faculty:
Stephen M Ansell, MD, PhD
Professor of Medicine
Division of Hematology
Mayo Clinic
Rochester, Minnesota

Nathan H Fowler, MD
Co-Director of Clinical and Translational Research
Lead, Phase I and Indolent Research Groups
Department of Lymphoma/Myeloma
The University of Texas MD Anderson Cancer Center
Houston, Texas

Laurie H Sehn, MD, MPH
Centre for Lymphoid Cancer
BC Cancer Agency and University of British Columbia
Vancouver, British Columbia, Canada

Andrew D Zelenetz, MD, PhD
Medical Director, Medical Informatics
Department of Medicine
Memorial Sloan Kettering Cancer Center
New York, New York

Moderator:
Neil Love, MD
Research To Practice
Miami, Florida

Agenda

12:30 PM – 1:00 PM — Registration and Buffet Lunch
1:00 PM – 3:00 PM — Symposium

MODULE 1: Optimizing the Care of Patients with Newly Diagnosed Follicular Lymphoma (FL) — Dr Fowler

Sample Consensus-Building/Investigator Survey Questions

  • What first-line therapy would you recommend for a 60-year-old woman with nonbulky Stage III, Grade II FL who is experiencing fever and moderate weight loss? How, if at all, might your recommendation change if she had a FLIPI score of 4? What if her performance status (PS) were 3?
  • What first-line therapy, if any, would you recommend for an 80-year-old man with a PS of 2 and progressive fatigue who presents with Stage IV, Grade I FL and a FLIPI score of 2? Given the patient’s age and PS, would you consider rituximab monotherapy in this situation?
  • In what situations, if any, do you consider the use of the R-squared regimen of lenalidomide/rituximab as up-front treatment for FL?
  • What first-line therapy, if any, would you recommend for a 65-year-old asymptomatic man with Stage IV, Grade IIIA FL?
  • The patient in the scenario above is observed for 1 year and subsequently develops night sweats without evidence of transformation. What treatment would you recommend at this point? What if he had bulky disease and a FLIPI score of 5? How, if at all, would your recommendation change if a PET/CT scan demonstrated a standardized uptake value (SUV) of 15 and a biopsy of the area still showed Grade IIIA FL?

Faculty Presentation/Panel Discussion Topics

  • Clinical and research implications of the Phase III RELEVANCE trial of the R-squared regimen of lenalidomide/rituximab compared to rituximab/chemotherapy in patients with newly diagnosed FL
  • Key efficacy and safety data from the GALLIUM study; FDA approval and integration of obinutuzumab-based induction and maintenance therapy for previously untreated FL
  • Clinical, biologic and patient-specific factors influencing the initiation of active therapy versus watchful waiting
  • Indications for rituximab monotherapy and optimal dose and schedule
  • Existing and emerging research on novel genomic markers or immune response signatures that might inform patient prognosis and related clinical management

MODULE 2: Current Clinical Role of Maintenance Therapy in FL — Dr Zelenetz

Sample Consensus-Building/Investigator Survey Questions

  • A 77-year-old man presents with Stage IV, Grade I FL and mild fatigue, receives 4 cycles of single-agent rituximab and achieves a partial response (PR) and resolution of symptoms. Would you recommend maintenance therapy at this point? If so, which agent and schedule would you use and for how long? What if the patient had received bendamustine/rituximab (BR) or bendamustine/obinutuzumab?
  • A 46-year-old woman presents with bulky Stage III, Grade II FL, receives 6 cycles of R-CHOP and experiences a complete response (CR). Would you recommend maintenance therapy? How, if at all, does the depth of response influence your decision regarding the use of maintenance therapy in FL? What about age?
  • A 65-year-old man with Stage IV, Grade I FL presents with mild fatigue and receives BR. After cycle 6 he is found to be in CR, but his fatigue is worse than before treatment and he does not wish to receive further chemotherapy. What maintenance therapy, if any, would you recommend in this situation?

Faculty Presentation/Panel Discussion Topics

  • Available research data evaluating the use of maintenance therapy in FL
  • Effect of patient age, depth of response to induction treatment and other clinical factors on the use of maintenance therapy in FL
  • Adverse events associated with maintenance rituximab and obinutuzumab
  • Efficacy, safety and pharmacokinetic data with the use of subcutaneous rituximab in indolent lymphomas; recent FDA approval and utility in clinical practice

MODULE 3: Management of Relapsed/Refractory (R/R) FL; Novel Agents and Strategies Under Investigation — Dr Ansell

Sample Consensus-Building/Investigator Survey Questions

  • A 65-year-old otherwise healthy patient with low-grade FL receives BR followed by 2 years of rituximab maintenance and experiences relapse 3 years later. What systemic therapy would you recommend at this point?
  • The patient in the scenario above receives R-squared and has a PR after 6 months of treatment. Would you consider autologous stem cell transplant (ASCT)? How do age and depth/duration of response affect your decision about whether to consider an ASCT as consolidation?
  • When using the R-squared regimen, how do you approach the dose and schedule of rituximab and lenalidomide? Do you adjust the starting dose of either drug for patients who are elderly or have a compromised PS? Do you continue both the rituximab and the lenalidomide at the same dose and schedule indefinitely in a patient who is experiencing a durable response?
  • Based on available research data and your own clinical experience, which adverse events are most problematic for patients receiving copanlisib? How would you approach the administration of copanlisib in a patient experiencing Grade 3 hypertension? What about treatment-related hyperglycemia? Are there patients for whom you recommend PCP prophylaxis?

Faculty Presentation/Panel Discussion Topics

  • Available data with and current clinical role of the R-squared regimen for patients with R/R disease
  • Current clinical indications for idelalisib in relapsed FL
  • Mechanism of action of, available data with and FDA approval of copanlisib for R/R FL; patient selection for copanlisib
  • Ongoing investigation of novel therapies in FL, including venetoclax and polatuzumab vedotin
  • Biologic rationale for the evaluation of CAR T-cell therapies in patients with FL; ongoing clinical trials evaluating this strategy

MODULE 4: Treatment Strategies for Patients with Early Disease Relapse; Histologic Transformation of FL — Dr Sehn

Sample Consensus-Building/Investigator Survey Questions

  • A 66-year-old man with Stage IV, Grade II FL achieves a CR to rituximab x 8. Fifteen months into maintenance rituximab, he develops biopsy-proven FL recurrence. What therapy would you recommend now? Does cross resistance occur between rituximab and obinutuzumab?
  • A 69-year-old man presents with Stage III, Grade IIIA FL and receives 6 cycles of BR with a CR followed by 2 years of maintenance rituximab. Nine months after maintenance therapy he presents with symptomatic cervical and abdominal adenopathy. Excisional lymph node biopsy reveals FL with several foci of diffuse large B-cell lymphoma. PET scan shows diffuse adenopathy with maximum SUV of 11 in several abdominal lymph nodes. What therapy would you recommend? If PR is achieved, what additional therapy, if any, would you recommend? What if CR is achieved?

Faculty Presentation/Panel Discussion Topics

  • Available clinical trial data to guide management decisions for FL after early relapse (within 2 years of initial diagnosis)
  • Role of autologous stem cell transplant (ASCT) for patients with early relapse; optimal salvage therapy; selection of treatment for patients not eligible for ASCT
  • Histologic transformation of FL: Clinical, pathologic and genetic risk factors, diagnosis and appropriate therapeutic management
  • Use of PET scans to aid in identification of histologic transformation

CE Information

Target Audience:
This activity is intended for hematologists, medical oncologists, hematology-oncology fellows and other healthcare providers involved in the treatment of follicular lymphoma (FL).

Learning Objectives:
At the conclusion of this activity, participants should be able to:

  • Explore the self-reported practice patterns employed by lymphoma clinical investigators, and apply this knowledge to the diagnosis and treatment of their own patients with FL.
  • Recognize emerging research data and recent FDA authorizations when designing an optimal therapeutic approach for patients with newly diagnosed FL requiring active therapy.
  • Appreciate emerging Phase III data with rituximab/lenalidomide as front-line treatment for patients with FL, and assess investigator perspectives on the current utility of this novel therapeutic approach in the nonresearch management of previously untreated and relapsed/refractory FL.
  • Individualize the use of maintenance therapeutic approaches in the care of patients with previously untreated FL who have completed induction chemoimmunotherapy.
  • Consider published research data and other clinical factors in the best-practice selection, sequencing or combining of available therapeutic agents in the nonresearch care of patients with relapsed/refractory FL.
  • Develop practical strategies to prevent, recognize and/or ameliorate the toxicities associated with therapies routinely used in the management of FL.
  • Identify ongoing clinical trials evaluating innovative investigational approaches for FL, and obtain consent from appropriate patients for study participation.

CME/CNE Accreditation and Credit Designation Statements:
This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education through the joint providership of the University of Nebraska Medical Center, Center for Continuing Education (UNMC CCE), University of Nebraska Medical Center College of Nursing Continuing Nursing Education (UNMC CON CNE) and Research To Practice.

PHYSICIANS: The University of Nebraska Medical Center, Center for Continuing Education is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

The University of Nebraska Medical Center, Center for Continuing Education designates this live activity 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.

NURSES: The University of Nebraska Medical Center College of Nursing Continuing Nursing Education is accredited with distinction as a provider of continuing nursing education by the American Nurses Credentialing Center’s Commission on Accreditation.

This activity is provided for 2.0 contact hours under ANCC criteria.

CME/CNE Credit Form:
A CME/CNE credit form will be given to each participant at the conclusion of the activity.

In order to receive credit, attendees must check in at registration and turn in a completed credit form at the conclusion of the activity. CME and CNE credit certificates will be issued directly to attendees by UNMC CCE within 4 to 6 weeks after the symposium.

Disclosure Policy:
It is the policy of the UNMC CCE and UNMC CON CNE to ensure balance, independence, objectivity and scientific rigor in all their educational symposia. All faculty, planners and managers participating in these activities are required to disclose any relevant financial relationship(s) they (or spouse/partner) have with a commercial interest that benefits the individual in any financial amount that has occurred within the past 12 months; and the opportunity to affect the content of CME/CNE about the products or services of the commercial interest. UNMC CCE, UNMC CON CNE and Research To Practice will ensure that any conflicts of interest are resolved before the educational activity occurs. Financial disclosures will be provided in symposium materials.

Supporters:
This activity is supported by educational grants from Bayer HealthCare Pharmaceuticals Inc, Celgene Corporation and Genentech.

Location

Location:
Hyatt Regency Maui Resort and Spa
200 Nohea Kai Drive
Lahaina, HI 96761
Hotel Phone: (808) 661-1234

Meeting Room:
Monarchy 5, 6, 7 (Promenade Level)

Directions:
The Hyatt Regency Maui Resort and Spa is the host hotel for the 2018 Pan Pacific Lymphoma Conference.

 

Registration

Thank you for your interest in our CME/CNE program. At this time online preregistration is closed for this event. Seats are still available for the program.  You may register on site starting at 12:00 PM (Hawaii Standard Time) on Monday, July 16th. If you are interested in attending, please visit our onsite registration desk located outside the Monarchy 5, 6, 7 Ballroom (Promenade Level) at the Hyatt Regency Maui Resort and Spa (200 Nohea Kai Drive, Lahaina, HI). 

If seats become available for the program, we will accept new registrations on a first come, first serve basis. Please note, onsite registration does not guarantee participation in the session or meal service and seating is limited to clinicians in practice.

If you have any questions, please feel free to contact us via email at Meetings@ResearchToPractice.com or call (800) 233-6153.

NOTICE:

Registration for this event is independent of registration for the 2018 Pan Pacific Lymphoma Conference.