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International Hematologic Oncology Tumor Board — Practical Perspectives on Current Challenging Cases of NHL/CLL and MM
Released April 2012

Proceedings from case-based symposia preceding the 53rd ASH Annual Meeting. Featuring perspectives from Drs Michele Cavo, Martin Dreyling, Alessandra Ferrajoli, Morie A Gertz, Stephanie A Gregory, Carol Ann Huff, Nikhil C Munshi, David S Siegel, Pieter Sonneveld, Julie M Vose, Andrew D Zelenetz and Pier Luigi Zinzani. (Video Program)

CE Disclosures and Faculty Information

  • TARGET AUDIENCE
    These activities are intended for hematologists, medical oncologists, hematology-oncology fellows and other healthcare providers involved in the treatment of non-Hodgkin lymphoma (NHL), chronic lymphocytic leukemia (CLL) and multiple myeloma (MM).

    OVERVIEW OF ACTIVITY

    The treatment of hematologic cancer remains a challenge for many healthcare professionals and patients despite recent gains made in the management of this spectrum of diseases. Determining which treatment approach is most appropriate for an individual patient requires careful consideration of unique clinical characteristics, physician expertise and available health system resources. To bridge the gap between research and patient care, these proceedings from 2 case-based CME satellite symposia held at the 2011 American Society of Hematology Annual Meeting attempt to provide the perspectives of clinical investigators on the evidence-based treatment of NHL, CLL and MM. By providing information on the latest research developments and their potential application to routine practice, this activity is designed to assist hematologists, medical oncologists and hematology-oncology fellows with the formulation of up-to-date clinical management strategies for NHL, CLL and MM.

    LEARNING OBJECTIVES

    NHL/CLL

    • Appraise recent data on therapeutic advances and changing practice standards in NHL, and integrate this information, when appropriate, into current clinical care.
    • Utilize prognostic and predictive clinical and molecular markers to aid in treatment decision-making for indolent and aggressive forms of NHL.
    • Educate patients with follicular lymphoma and CLL about the indications for active treatment and the differential efficacy and safety of acceptable systemic regimens.
    • Employ case-based learning to individualize the use of maintenance and/or consolidation therapy in the management of NHL.
    • Develop an algorithm for the risk-stratified and age-appropriate induction treatment of diffuse large B-cell lymphoma and mantle-cell lymphoma.
    • Apply the results of new research to the evidence-based treatment of T-cell lymphoma.
    • Recall emerging data exploring novel agents and combinations with promising activity in diverse subtypes of NHL.
    • Counsel appropriately selected patients about participation in ongoing clinical research studies.

    MM

    • Appraise recent data on therapeutic advances and changing practice standards in MM, and integrate this information, when appropriate, into current clinical care.
    • Communicate the benefits and risks of post-transplant maintenance therapy to appropriately selected patients with MM.
    • Recognize the treatment-associated side effects of immunomodulatory agents and proteasome inhibitors, and offer patients acceptable alternative dosing/administration options and/or supportive interventions to manage them.
    • Effectively apply the results of pivotal clinical research to treatment options for elderly patients with newly diagnosed MM.
    • Consider recent Phase III data on the frequency and duration of bisphosphonate therapy for patients with osteolytic and nonosteolytic MM.
    • Employ case-based learning to individualize the use of maintenance and/or consolidation therapy in the management of MM.
    • Recall emerging data exploring novel agents and combinations with promising activity in MM.
    • Counsel appropriately selected patients about participation in ongoing clinical research studies.

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

    CME credit is no longer available for this issue

    CREDIT DESIGNATION STATEMENT

    NHL/CLL

    CME credit is no longer available for this issue


    HOW TO USE THESE CME ACTIVITIES
    These CME activities consist of video and interactive text components. The participant should watch the video content.

    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 potential conflicts of interest with faculty, planners and managers of CME activities. Real or apparent 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 real or apparent conflicts of interest, which have been resolved through a conflict of interest resolution process:

    Maxime Benchetrit, MD
    Anatomic Pathology
    Nice Hospital
    Nice, France

    No real or apparent conflicts of interest to disclose.

    Preston Carvalho, MB, FRCP
    Staff Radiologist
    William Osler Health System
    Brampton, Ontario, Canada

    No real or apparent conflicts of interest to disclose.

    Michele Cavo, MD
    Professor of Hematology
    Institute of Hematology and Medical Oncology “Seràgnoli”
    Bologna University School of Medicine
    S Orsola’s University Hospital
    Bologna, Italy

    Advisory Committee: Celgene Corporation, Janssen-Cilag, Millennium: The Takeda Oncology Company; Consulting Agreements: Celgene Corporation, Janssen-Cilag, Novartis Pharmaceuticals Corporation; Honoraria: Celgene Corporation, Janssen-Cilag, Millennium: The Takeda Oncology Company, Novartis Pharmaceuticals Corporation; Speakers Bureau: Celgene Corporation, Janssen-Cilag.

    Robert H Crabtree, MD
    Pathologist
    North Coast Clinical Laboratories Inc
    Sandusky, Ohio

    No real or apparent conflicts of interest to disclose.

    Martin Dreyling, MD, PhD
    Professor of Medicine
    Department of Medicine III
    University Hospital - LMU Munich
    Munich, Germany

    Advisory Committee and Speaking Honoraria: Celgene Corporation, Janssen Pharmaceuticals Inc, Mundipharma International Limited, Pfizer Inc, Roche Laboratories Inc; Clinical Trials Support: Celgene Corporation, Janssen Pharmaceuticals Inc, Mundipharma International Limited, Roche Laboratories Inc; Paid Research: GlaxoSmithKline, Roche Laboratories Inc.

    Alessandra Ferrajoli, MD
    Associate Professor
    Department of Leukemia
    Division of Cancer Medicine
    The University of Texas MD Anderson Cancer Center
    Houston, Texas

    Paid Research: Celgene Corporation, Genentech BioOncology, GlaxoSmithKline.

    Morie A Gertz, MD
    Roland Seidler Jr Professor and Chair
    Department of Medicine
    Mayo Clinic
    Rochester, Minnesota

    Advisory Committee: Celgene Corporation, Millennium: The Takeda Oncology Company.

    Stephanie A Gregory, MD
    The Elodia Kehm Chair of Hematology
    Professor of Medicine
    Director, Section of Hematology
    Rush University Medical Center
    Chicago, Illinois

    Paid Research: Celgene Corporation, MedImmune Inc, Novartis Pharmaceuticals Corporation, Onyx Pharmaceuticals Inc; Scientific Advisory Board: Amgen Inc, Genentech BioOncology, Spectrum Pharmaceuticals Inc, Teva Pharmaceutical Industries Ltd.

    Vineet Gupta, MD
    Diplomate American Board
    Internal Medicine, Hematologist
    Medical Oncologist
    Group Medical Director — Health Care
    Global Enterprises Ltd
    Bangalore, India

    No real or apparent conflicts of interest to disclose.

    Carol Ann Huff, MD
    Director, Myeloma Program
    Associate Professor of Oncology and Medicine
    Johns Hopkins University
    Baltimore, Maryland

    Advisory Committee: Amgen Inc, Bristol-Myers Squibb Company, Johnson & Johnson Pharmaceuticals, Onyx Pharmaceuticals Inc; Paid Research: Bristol-Myers Squibb Company, Geron.

    Raymond L Lobins, DO
    Clinical Physician
    Hematology and Oncology
    North Coast Cancer Care
    Sandusky, Ohio

    No real or apparent conflicts of interest to disclose.

    Govindarajan J Mallarajapatna, MBBS, MD
    Radiologist
    Consultant in Diagnostic and Interventional Radiology
    Health Care Global Enterprises Ltd
    Bangalore Institute of Oncology
    Bangalore, India

    No real or apparent conflicts of interest to disclose.

    Nicolas Charles Mounier, MD
    Full Professor of Medical Oncology at
    Sophia-Antipolis University
    Head of Onco-Hematology Department
    L’Archet Hospital
    Nice, France

    No real or apparent conflicts of interest to disclose.

    Nikhil C Munshi, MD
    Associate Professor of Medicine
    Harvard Medical School
    Associate Director
    Jerome Lipper Multiple Myeloma Center
    Dana-Farber Cancer Institute
    Boston, Massachusetts

    Advisory Committee: Celgene Corporation, Millennium: The Takeda Oncology Company, Novartis Pharmaceuticals Corporation, Onyx Pharmaceuticals Inc; Consulting Agreements: Celgene Corporation, Millennium: The Takeda Oncology Company, Novartis Pharmaceuticals Corporation.

    Brian R Murphy, MD, FACP
    Medical Oncologist, Hematologist
    North Coast Cancer Care Inc
    Sandusky, Ohio

    Stock Ownership: Bristol-Myers Squibb Company, Genomic Health Inc, Lilly USA LLC, Pfizer Inc.

    Shilpa A Prabhudesai, MD, DNB
    Consultant Pathologist and Laboratory Director
    Triesta Reference Laboratory
    Health Care Global Enterprises Ltd
    Bangalore, India

    No real or apparent conflicts of interest to disclose.

    Theodora Ruijs, MD, FRCPC, FASCP
    Staff Pathologist (AP/CP)
    William Osler Health System
    Brampton, Ontario, Canada

    Advisory Committee: CSL Behring, Octapharma.

    Sandeep Sehdev, MD, FRCPC, BC (ABIM)
    Medical Oncologist
    William Osler Health System
    Brampton, Etobicoke and Orangeville
    Ontario, Canada
    Director, CHE and Clinical Trials, Oncology
    Assistant Professor, Adjunct
    McMaster University
    Hamilton, Ontario, Canada
    Director, Cancer Advocacy Coalition of Canada
    Toronto, Ontario, Canada

    No real or apparent conflicts of interest to disclose.

    Chirag A Shah, MD
    Director, Dept of Hematology, Oncology and Stem Cell Transplant
    Diplomate American Board of Oncology
    Diplomate American Board of Hematology
    Apollo Hospital, Ahmedabad
    Gujarat, India

    Advisory Committee: Novartis Pharmaceuticals Corporation, Roche Laboratories Inc.

    David S Siegel, MD, PhD
    Division Chief of Myeloma
    John Theurer Cancer Center at Hackensack University Medical Center
    Hackensack, New Jersey

    Advisory Committee: Celgene Corporation, Millennium: The Takeda Oncology Company, Onyx Pharmaceuticals Inc; Speakers Bureau: Celgene Corporation, Millennium: The Takeda Oncology Company.

    Pieter Sonneveld, MD, PhD
    Erasmus University
    Medical Center Rotterdam
    Rotterdam, The Netherlands

    Advisory Committee: Celgene Corporation, Janssen, Millennium: The Takeda Oncology Company, Onyx Pharmaceuticals Inc; Paid Research: Celgene Corporation, Janssen.

    Philippe Viau, MD
    University Hospital of Archet
    Nuclear Medicine
    Nice, France

    No real or apparent conflicts of interest to disclose.

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

    Paid Research: Allos Therapeutics, AstraZeneca Pharmaceuticals LP, Bristol-Myers Squibb Company, Celgene Corporation, Exelixis Inc, Genentech BioOncology, Genzyme Corporation, GlaxoSmithKline, Millennium: The Takeda Oncology Company, Novartis Pharmaceuticals Corporation, Pharmacyclics Inc, S*BIO Pte Ltd, US Biotest Inc.

    Andrew D Zelenetz, MD, PhD
    Chief, Lymphoma Service
    Memorial Sloan-Kettering Cancer Center
    New York, New York

    Consulting Agreements: Celgene Corporation, Cell Therapeutics Inc, Cephalon Inc, Genentech BioOncology, GlaxoSmithKline; Paid Research: Amgen Inc, Genentech BioOncology, GlaxoSmithKline.

    Steven Zieber, MD
    Radiologist
    Bellevue, Ohio

    No real or apparent conflicts of interest to disclose.

    Pier Luigi Zinzani, MD
    Associate Professor in Hematology
    Institute of Hematology “Seràgnoli”
    University of Bologna
    Bologna, Italy

    Advisory Committee: Celgene Corporation, Genzyme Corporation, Millennium: The Takeda Oncology Company.

    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: Abbott Laboratories, Allos Therapeutics, Amgen Inc, ArQule Inc, Astellas, Bayer HealthCare Pharmaceuticals/Onyx Pharmaceuticals Inc, Biodesix Inc, Biogen Idec, Boehringer Ingelheim Pharmaceuticals Inc, Bristol-Myers Squibb Company, Celgene Corporation, Cephalon Inc, Daiichi Sankyo Inc, Dendreon Corporation, Eisai Inc, EMD Serono Inc, Genentech BioOncology, Genomic Health Inc, ImClone Systems, a wholly owned subsidiary of Eli Lilly and Company, Incyte Corporation, Lilly USA LLC, Medivation Inc, Millennium: The Takeda Oncology Company, Mundipharma International Limited, Novartis Pharmaceuticals Corporation, Regeneron Pharmaceuticals, Sanofi, Seattle Genetics, Spectrum Pharmaceuticals Inc and Teva.

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

    These educational activities contain 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.

    These activities are supported by educational grants from Celgene Corporation, Cephalon Inc, Genentech BioOncology/Biogen Idec, Millennium: The Takeda Oncology Company and Mundipharma International Limited.

    Hardware/Software Requirements:
    An Internet connection that is at least 28.8 Kbps
    A monitor set to 1280 x 1024 pixels or more
    Internet Explorer 6.x or newer, Firefox 2.x or newer, or Safari 2.x or newer
    Macromedia Flash plug-in 6.0 or greater
    Adobe Acrobat Reader
    (Optional) Sound card and speakers for audio

    Last review date: April 2012
    Expiration date: April 2013

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NHL/CLL Symposium Proceedings:
Introduction: Dr Love
Module 1:
Dr Zelenetz
Diffuse Large B-Cell Lymphoma
Module 2:
Dr Gregory
Follicular Lymphoma (FL)
Module 3:
Dr Dreyling
Mantle-Cell Lymphoma/Leukemia
Module 4:
Dr Ferrajoli
Chronic Lymphocytic Leukemia
Module 5:
Dr Vose
T-Cell Lymphoma
Module 6:
Dr Zinzani
Transformed FL
MM Symposium Proceedings
Introduction: Dr Love
Module 1:
Dr Cavo
Transplant-Eligible MM
Module 2:
Dr Sonneveld
Post-Transplant Maintenance
Module 3:
Dr Gertz
Safety of IMiDs: New Agents
Module 4:
Dr Siegel
Peripheral Neuropathy
Module 5:
Dr Munshi
MM in Older Patients
Module 6:
Dr Huff
Bone-Directed Treatment for MM