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Thursday, July 19, 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 Mantle Cell Lymphoma

Part 3 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:
Jeremy Abramson, MD
Director of the Lymphoma Program
Jon and Jo Ann Hagler Chair in Lymphoma
Massachusetts General Hospital Cancer Center
Assistant Professor of Medicine
Harvard Medical School
Boston, Massachusetts

Brad S Kahl, MD
Professor of Medicine
Washington University School of Medicine
St Louis, Missouri

John P Leonard, MD
Richard T Silver Distinguished Professor of Hematology and Medical Oncology
Associate Dean for Clinical Research
Weill Cornell Medical College
New York, New York

Julie M Vose, MD, MBA
Neumann M and Mildred E Harris Professor
Chief, Division of Hematology/Oncology
Nebraska Medical Center
Omaha, Nebraska

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: Risk Stratification and Initial Management of Newly Diagnosed Mantle Cell Lymphoma (MCL) — Dr Vose

Sample Consensus-Building/Investigator Survey Questions

  • Do you routinely use any genomic biomarkers (eg, SOX-11, Ki-67) to risk stratify patients with MCL? If so, which ones? How, if at all, does the presence of these biomarkers affect your approach to therapy?
  • Do you calculate an MCL International Prognostic Index (MIPI) score for every patient with newly diagnosed MCL? In your experience, how well does the MIPI score correlate with outcome?
  • How important is tumor burden in MCL? Do you incorporate CT and/or PET-CT scans when discussing prognosis with your patients? Do you generally order an upper gastrointestinal endoscopy or colonoscopy for your asymptomatic patients with newly diagnosed MCL? What about bone marrow biopsy?
  • Which patients with newly diagnosed MCL, if any, are you willing to observe off therapy? What is the longest period of time that you have used a “watch and wait” approach for a patient with newly diagnosed MCL?
  • A 60-year-old patient with MCL undergoes treatment with R-CHOP alternating with R-DHAP followed by autologous stem cell transplant (ASCT) and experiences a complete response. Would you recommend rituximab maintenance and, if so, for how long? What if the patient achieved a partial response? What if the patient were age 75 and received 6 cycles of BR induction and no transplant?

Faculty Presentation/Panel Discussion Topics

  • Existing and emerging research on genomic biomarkers or novel response signatures that may inform prognosis and clinical management
  • Long-term efficacy outcomes observed in published clinical trials of commonly employed induction regimens for transplant-eligible and ineligible patients with newly diagnosed MCL
  • Published research findings with the use of rituximab maintenance in the post-transplant and nontransplant settings
  • Available data with and ongoing evaluation of novel agents (eg, bortezomib, ibrutinib, acalabrutinib) as a component of induction therapy

MODULE 2: Selection and Sequencing of Therapy for Patients with Relapsed/Refractory (R/R) MCL — Dr Leonard

Sample Consensus-Building/Investigator Survey Questions

  • A 65-year-old patient with MCL receives BR followed by rituximab maintenance but 1 year later develops asymptomatic disease progression. In general, what would be your most likely next treatment recommendation? What if the patient were age 80? What if the patient had a history of atrial fibrillation and was receiving anticoagulation?
  • A 62-year-old patient with MCL receives R-hyper-CVAD → ASCT → rituximab maintenance but 1 year later develops asymptomatic disease progression. In general, what would you recommend?
  • How do you typically sequence BTK inhibitors, bortezomib and lenalidomide in the treatment of MCL? What clinical or biologic factors lead you to use one of these agents first before the others?
  • A 62-year-old patient with MCL receives R-hyper-CVAD → ASCT → rituximab maintenance but relapses 1 year later. The patient then receives ibrutinib for 10 months, at which point disease progression is noted. In general, what would be your most likely next treatment recommendation?
  • When do you send younger patients for evaluation for allogeneic stem cell transplant? What age cutoff do you believe is appropriate for referral?

Faculty Presentation/Panel Discussion Topics

  • Available clinical research data evaluating the use of bortezomib, lenalidomide and ibrutinib in MCL
  • Natural history of MCL; diminishing sensitivity to treatment and remission duration after sequential therapeutic interventions
  • Monitoring for and management of toxicities associated with the use of agents frequently employed in the management of R/R MCL

MODULE 3: FDA Approval of Acalabrutinib in R/R MCL and Integration into Clinical Treatment Algorithms — Dr Kahl

Sample Consensus-Building/Investigator Survey Questions

  • Based on current clinical trial data and your own personal experience, how would you compare the global efficacy of acalabrutinib to that of ibrutinib?
  • Based on current clinical trial data and your own personal experience, how would you compare the global tolerability of acalabrutinib to that of ibrutinib? Are there clinically meaningful differences in rates of atrial fibrillation, hemorrhage, cytopenias and infections between these agents? Do you use prophylactic antimicrobial therapies when starting patients on acalabrutinib?
  • For a patient receiving ibrutinib for whom you have determined discontinuation is warranted because of uncontrollable atrial fibrillation, would you consider switching to acalabrutinib?
  • Have you seen or do you expect to see responses to acalabrutinib after disease progression on ibrutinib? Are there any situations in which you would use one after the other?

Faculty Presentation/Panel Discussion Topics

  • Mechanistic and pharmacodynamic similarities and differences between ibrutinib and acalabrutinib
  • Clinical research data supporting the recent FDA approval of acalabrutinib in MCL; patient selection for this approach in routine practice
  • Frequency of side effects observed in patients receiving acalabrutinib; optimal preventative, supportive and dose reduction strategies
  • Ongoing and planned clinical trials evaluating acalabrutinib in patients with MCL

MODULE 4: Emerging Research with and Ongoing Evaluation of Venetoclax and Other Novel Agents in R/R MCL — Dr Abramson

Sample Consensus-Building/Investigator Survey Questions

  • Reimbursement and regulatory issues aside, would you attempt to access venetoclax for select patients with R/R MCL? If so, where in the treatment algorithm would you consider this and for which patients?
  • Does Bcl-2 overexpression correlate with response to venetoclax in patients with MCL? What about the presence of t(11;14)?
  • How would you globally compare the potential for tumor lysis syndrome with venetoclax in MCL versus that when it is used in chronic lymphocytic leukemia? What preventative measures, if any, should be undertaken prior to initiating treatment?
  • What is the biologic rationale for combining ibrutinib with venetoclax for R/R MCL? Is there a patient population in which this approach is particularly appealing?
  • Can potentially targetable mutations be found in patients with MCL? If so, do you currently order next-generation sequencing for any of your patients?
  • Which novel agents or strategies, if any, do you believe are particularly promising for patients with MCL?

Faculty Presentation/Panel Discussion Topics

  • Biologic rationale for and existing data with venetoclax in patients with MCL; current clinical role, if any, and ongoing evaluation in MCL
  • Incidence of tumor lysis syndrome observed in patients with MCL treated with venetoclax; indications for and implementation of prophylactic measures based on patient- and disease-related factors
  • Mechanism of action, tolerability and ongoing investigation of other novel agents in MCL

CE Information

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

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

  • Individualize the selection of systemic therapy for patients with newly diagnosed MCL considering the patient’s clinical presentation, fitness and willingness to undergo autologous stem cell transplant and psychosocial status (eg, desire for active treatment).
  • Formulate an evidence-based approach to the use of maintenance therapy for transplant-eligible and transplant-ineligible patients with MCL.
  • Recall the mechanisms of action, efficacy and safety of approved agents commonly employed for the treatment of relapsed/refractory (R/R) MCL to determine the current and/or potential utility of each in clinical practice.
  • Appreciate the recent FDA approval of the second-generation BTK inhibitor acalabrutinib for patients with R/R MCL, and discern how this agent can be appropriately and safely integrated into routine clinical practice.
  • Design a plan of care to recognize and manage side effects and toxicities associated with the use of existing and recently approved systemic therapies in the management of MCL to support quality of life and continuation of therapy.
  • Recall available and emerging data with other investigational agents currently under evaluation for MCL, and where applicable, refer eligible patients for trial 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 AbbVie Inc, Acerta Pharma — A member of the AstraZeneca Group and Janssen Biotech Inc, administered by Janssen Scientific Affairs LLC.

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 Thursday, July 19th. 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.