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To bridge the gap between research and patient care, this activity features one-on-one interviews conducted by Dr Neil Love with leading non-Hodgkin lymphoma investigators. By providing information on the latest research developments in the context of expert perspectives, this activity is designed to assist oncology nurses, clinical nurse specialists and nurse practitioners with the formulation of state-of-the-art clinical management strategies to facilitate optimal patient care. This content is available in a number of formats for listening on the go with a mobile device or in the office or at home on a computer.

 
Amy Goodrich, CRNP-AC
Nurse Practitioner
Johns Hopkins Kimmel
Cancer Center
Baltimore, Maryland
  INTERVIEW WITH MS GOODRICH
  • Case discussion: A 70-year-old woman with a prior history of breast cancer presents with asymptomatic Stage IIIA nonbulky follicular lymphoma (FL) and subsequently undergoes treatment with rituximab (R) on the RESORT study
    – Phase III ECOG-E4402 (RESORT) study comparing R maintenance to R re-treatment upon disease progression for low tumor burden indolent non-Hodgkin lymphoma (NHL)
    – Hypogammaglobulinemia and chronic infections in patients receiving maintenance R
    – Bendamustine-R (BR) as front-line therapy for FL
    – Counseling patients with FL about the similarities and differences between BR and R-CHOP
    – PRIMA: Maintenance R in patients with FL who achieve a response to R-chemotherapy
    – Use of R-lenalidomide (R2) in patients with FL who are intolerant to chemotherapy
  • Case discussion: A 63-year-old woman with widespread adenopathy and aggressive, high-risk diffuse large B-cell lymphoma (DLBCL)
    – Monitoring and treatment of tumor lysis syndrome
    – Use of rasburicase prophylaxis for tumor lysis syndrome
    – CNS prophylaxis for patients with DLBCL
  • Case discussion: A 64-year-old man with Stage IVA, Grade I FL is observed off treatment for 5 years and subsequently receives R in the face of progressive disease. The patient achieves a complete response to R followed by transformation to DLBCL
    – Treatment of transformed FL
           
Mitchell R Smith, MD, PhD
Director of Lymphoid Malignancies Program at Taussig Cancer Institute
Cleveland Clinic
Cleveland, Ohio
  INTERVIEW WITH DR SMITH
  • Case discussion: A 58-year-old woman with asymptomatic CLL and WBC rising to 200,000/mm3
    – Detection, diagnosis and prognosis of CLL
    – Indications to initiate treatment for CLL
    – Hypersplenism in CLL
    – Management of tumor lysis syndrome — hydration, allopurinol and rasburicase
    – Undefined role of R maintenance in CLL
    – Overview of the similarities and differences between FL and CLL
    – Educating patients with indolent lymphoma about a “watch-and-wait” approach versus active treatment
    – Promising investigational agents in CLL: ibrutinib, idelalisib (GS1101) and the Bcl-2 inhibitor ABT-199
    – Evolving role of lenalidomide ± R in CLL and other lymphomas
    – Avoidance of lenalidomide-associated tumor flare in CLL
    – Mechanisms of action of R and lenalidomide and rationale for their synergy when used in combination
    – Use of R monotherapy in CLL
    – Radioimmunotherapy (RIT) as a treatment option in indolent lymphomas
  • Case discussion: A 63-year-old man with massive splenomegaly and progressively worsening fatigue is diagnosed with mantle-cell lymphoma (MCL) and undergoes treatment with modified hyper-CVAD
    – Diagnostic workup for MCL
    – Treatment approaches for younger and older patients with MCL
    – Maintenance R in patients with MCL responding to R-CHOP
    – BR followed by maintenance R for relapsed MCL
    – Promising investigational agents in MCL: mTOR inhibitors everolimus and temsirolimus
  • Case discussion: A 60-year-old man with low-risk, germinal-center DLBCL receives R-CHOP-14, relapses 1 year later and receives R-ICE followed by HDT and ASCT followed by a second relapse 9 months later
    – Perspective on dose-dense R-CHOP-14 versus R-CHOP-21 in DLBCL
    – Phase III study of pixantrone/R versus gemcitabine/R for aggressive, relapsed NHL not eligible for stem cell transplant
 
Steven M Horwitz, MD
Assistant Attending
Lymphoma Service, Division of Hematologic Oncology
Memorial Sloan-Kettering
Cancer Center
New York, New York
  INTERVIEW WITH DR HORWITZ
  • Case discussion: A 69-year-old woman who responded well to initial treatment with EPOCH for angioimmunoblastic T-cell lymphoma (TCL) undergoes allogeneic stem cell transplant for a biopsy-proven recurrence and achieves remission
    – Overview of angioimmunoblastic TCL
    – Key clinical differences between B-cell and T-cell lymphomas
    – Activity and tolerability of EPOCH in angioimmunoblastic TCL
    – Common subtypes of systemic TCL
    – Perspective on allogeneic transplant for older patients with relapsed/refractory angioimmunoblastic TCL
    – Treatment options for relapsed/refractory angioimmunoblastic TCL
    – Mechanisms of action, efficacy and toxicity profiles of the novel agents romidepsin and pralatrexate used in the treatment of TCL
    – Activity and side effects of the antibody-drug conjugate brentuximab vedotin in CD30-positive lymphomas
    – Promising investigational agents in TCL: belinostat, bendamustine, KW-0761 and BTK inhibitors
    – Potential role of lenalidomide in the treatment of TCL
  • Case discussion: An 81-year-old man with Stage 1B mycosis fungoides is enrolled in a clinical trial of pralatrexate and bexarotene after disease transformation
    – Presentation and symptomatology of mycosis fungoides
    – Educating patients about phototherapy for the treatment of cutaneous TCL (CTCL)
    – Treatment options for patients with relapsed/refractory CTCL
    – Phase I study of pralatrexate in combination with bexarotene for patients with relapsed or refractory CTCL
 
Mollie Moran, MSN, CNP, AOCNP
The James Cancer Hospital at The Ohio State University
Columbus, Ohio
  INTERVIEW WITH MS MORAN
  • Case discussion: A 59-year-old man with MCL achieves a complete remission after treatment with R-hyper-CVAD
    – Overview of MCL
    – Educating patients about the side effects and toxicities of R-hyper-CVAD
    – Treatment options for recurrent MCL
    – Activity and side effects of bortezomib in MCL
    – Benefits and risks of lenalidomide in MCL
  • Case discussion: A 63-year-old woman with Stage IVB DLBCL receives R-EPOCH on a Phase III trial and remains in complete remission after 2 years
    – CNS prophylaxis in DLBCL
  • Case discussion: A 65-year-old man with FL who achieves a complete response to BR experiences disease relapse 2 years later and receives R2
    – Response and tolerability of BR versus R-CHOP as front-line therapy in FL
    – Consideration of R up front or as maintenance therapy for FL
    – Use of R2 in patients with relapsed/refractory FL
    – Lenalidomide-associated tumor flare in FL
    – RIT as a treatment option in FL
  • Case discussion: A 64-year-old man with CLL whose disease progresses through multiple lines of therapy is now under consideration for a clinical trial of the oral BTK inhibitor ibrutinib
    – Risk for infections in patients with CLL
    – Counseling patients with indolent lymphomas about their diagnosis, treatment and prognosis
 
EDITOR:
Neil Love, MD
Research To Practice
Miami, Florida