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Blood Cancer Talks

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May 31, 2023 • 52min

Episode 23. Bispecific Antibodies in Myeloma

In this episode, we delve into the latest data on bispecific antibodies in multiple myeloma with Dr. Ajai Chari. Here are the key studies discussed:1. Teclistamab (MajesTEC-1 trial): https://pubmed.ncbi.nlm.nih.gov/35661166/2. Correlative analysis from MajesTEC-1 trial: https://ashpublications.org/blood/article/140/Supplement%201/241/4876193.  Talquetamab (MonumenTAL-1 trial): https://pubmed.ncbi.nlm.nih.gov/36507686/4. Phase 1 trial of fixed-duration cevostamab: https://ashpublications.org/blood/article/140/Supplement%201/4415/4923395. Phase 1 trial of ABBV-383: https://pubmed.ncbi.nlm.nih.gov/36029527/6. Paper summarizing infections with different bispecific antibodies in myeloma: https://pubmed.ncbi.nlm.nih.gov/36716411/
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May 20, 2023 • 1h 4min

Episode 22. Management of Low-Risk MDS

In this episode, we take a deep dive into low-risk MDS management. We have the privilege of being joined by the esteemed Dr. Mikkael Sekeres. We also explore his invaluable insights gained from his time at FDA ODAC and his latest literary endeavor, "Drugs and the FDA". Here are the key studies discussed:1. ASH choosing wisely: https://www.hematology.org/education/clinicians/guidelines-and-quality-care/choosing-wisely 2. International Consensus Classification (ICC): https://pubmed.ncbi.nlm.nih.gov/35767897/ 3. WHO classification 2022: https://pubmed.ncbi.nlm.nih.gov/35732829/ 4. IPSS-M: https://evidence.nejm.org/doi/full/10.1056/EVIDoa2200008 5. Romiplostim in MDS: https://pubmed.ncbi.nlm.nih.gov/29396092/ 6. Low-dose decitabine vs. low-dose azacItidine in lower-risk MDS: https://evidence.nejm.org/doi/full/10.1056/EVIDoa2200034 7. Luspatercept in MDS: https://www.nejm.org/doi/full/10.1056/nejmoa1908892 8. Lenalidomide in MDS: https://ascopubs.org/doi/10.1200/JCO.2015.66.0118https://pubmed.ncbi.nlm.nih.gov/21753188/ 9.Iron chelation therapy in MDS: https://pubmed.ncbi.nlm.nih.gov/32203980/ 
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May 3, 2023 • 46min

Episode 21. Newly Diagnosed Mantle Cell Lymphoma

In this episode, we delve into the management of newly diagnosed mantle cell lymphoma with Dr. Martin Dreyling. Here the shownotes:2:11 How to diagnose mantle cell lymphoma (MCL)?6:51 Clinical manifestations of mantle cell lymphoma7:52 How to manage leukemic variant of MCL? 12:08 Is Watch-and-Wait reasonable in selected cases of nodal MCL with low Ki-67?17:21 Overview on treatment of newly diagnosed MCL19:03 Are all cytarabine-based regimens for MCL created equally?  RCT of Autologous Transplantation in MCL: https://pubmed.ncbi.nlm.nih.gov/15591112/21:39 In a world without upfront ibrutinib access as per TRIANGLE trial, do all fit patients with MCL need consolidation with auto-transplant? 22:44 How to approach unfit patients with newly diagnosed MCL? RCT of bortezomib-based therapy (VR-CAP) in newly diagnosed MCL: https://pubmed.ncbi.nlm.nih.gov/25738670/24:57 SHINE Trial-RCT of Ibrutinib plus BR in newly diagnosed MCL: https://pubmed.ncbi.nlm.nih.gov/35657079/30:38 TRIANGLE Trial-RCT of upfront ibrutinib with or without auto-transplant in newly diagnosed MCL:https://ashpublications.org/blood/article/134/Supplement_1/2816/42350443:01: Does Allo-Transplant have any role in MCL?44:08: What are the likely next breakthroughs in newly diagnosed MCL space? 
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Apr 19, 2023 • 57min

Episode 20. Management of Myeloma in LMICs

In this episode, we discuss the management of multiple myeloma in LMICs with Dr. Andrés Gómez-De León from UANL, Monterrey, Mexico, and Dr. Aditya Jandial from PGIMER, Chandigarh, India. This episode was inspired by an article in Lancet Haematology titled “The Underrepresented Majority”, which highlighted the lack of access to some of the basic anti-myeloma drugs in LMICs and the resulting disparity in global outcomes. Here are some of the sections discussed in this episode:03:33 Diagnostic workup of myeloma in LMICs15:46 Induction therapy for new diagnosed transplant-eligible myeloma27:17 Early Transplant vs Delayed Transplant in the Context of LMICs33:11 Maintenance therapy 37:27 Management of relapsed myelomaAffordability of novel drugs in myeloma: https://pubmed.ncbi.nlm.nih.gov/29461639/45:30 Clinical Trials in LMICs. Is industry exploiting patients in LMICs?Article by Dr. Gómez-De León in Lancet Haematology:  https://pubmed.ncbi.nlm.nih.gov/36174637/
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Apr 6, 2023 • 59min

Episode 19. Management of Primary Myelofibrosis

In this episode, we discuss the diagnosis and management of primary myelofibrosis with Dr. Ayalew Tefferi at Mayo Clinic, Rochester, Minnesota. Here are the show notes, including key studies discussed in this episode:1. Risk stratification of PMF: MIPSS70 Score: http://www.mipss70score.ithttps://ascopubs.org/doi/full/10.1200/JCO.2017.76.4886Genetically inspired prognostic scoring system (GIPSS):https://www.nature.com/articles/s41375-018-0107-zType 1 CALR mutation: https://ashpublications.org/blood/article/124/15/2465/33454MYSEC-PM:http://www.mysec-pm.euhttps://www.nature.com/articles/leu20171692. Treatment of PMF with JAK inhibitors https://pubmed.ncbi.nlm.nih.gov/36680511/Momelotinib: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(22)02036-0/fulltextPacritinib : https://ashpublications.org/blood/article/140/Supplement%201/1518/490663https://jamanetwork.com/journals/jamaoncology/fullarticle/2674384Fedratinib:https://onlinelibrary.wiley.com/doi/10.1111/bjh.182843. Allogeneic Transplant in PMFhttps://ashpublications.org/hematology/article/2021/1/453/482995Black African-American patients with primary myelofibrosishttps://ashpublications.org/bloodadvances/article/doi/10.1182/bloodadvances.2022009611/4944604. Imtelestat in PMFhttps://www.nejm.org/doi/full/10.1056/NEJMoa1310523
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Mar 22, 2023 • 47min

Episode 18. Management of Smoldering Multiple Myeloma

1. How I Approach Smoldering Myeloma (Vaxman and Gertz):https://ashpublications.org/blood/article/140/8/828/485274 2. Risk-Stratification Models in SMM:Mayo 2018 model: https://pubmed.ncbi.nlm.nih.gov/29895887/PETHEMA (Spanish) model: https://pubmed.ncbi.nlm.nih.gov/17576818/PANGEA model: https://pubmed.ncbi.nlm.nih.gov/36858677/IMWG SMM model: https://pubmed.ncbi.nlm.nih.gov/33067414/ 3. QuiRedex RCT (Lenalidomide-Dexamethasone vs Observation in High-Risk SMM):https://pubmed.ncbi.nlm.nih.gov/36067617/ 4. ECOG E3A06 RCT (Lenalidomide vs Observation in SMM):https://pubmed.ncbi.nlm.nih.gov/31652094/ 5. Intensive Treatment in High-Risk Smoldering Multiple Myeloma:GEM-CESAR: https://ashpublications.org/blood/article/140/Supplement%201/292/490268ASCENT: https://ashpublications.org/blood/article/140/Supplement%201/1830/492739 6. Current Clinical Trial Landscape in Smoldering Myeloma:https://pubmed.ncbi.nlm.nih.gov/34114943/ 7. How Light Chain Proteinuria Modulates Risk of Progression in Patients with sFLC ratio>100 as the only Myeloma-Defining Event? https://pubmed.ncbi.nlm.nih.gov/35190659/
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Mar 8, 2023 • 46min

Episode 17. Acquired Aplastic Anemia

In this episode, we discuss the management of acquired aplastic anemia with Dr. Amy DeZern. Here are the links to some of the key articles discussed in this show:1. Review article on aplastic anemia: https://www.nejm.org/doi/10.1056/NEJMra1413485 2. RCTs testing whether addition of cyclosporine to ATG improves outcomes in aplastic anemia:https://www.nejm.org/doi/10.1056/NEJM199105093241901https://www.sciencedirect.com/science/article/pii/S0006497120489748 3. RCT testing horse versus rabbit ATG in aplastic anemia:https://www.nejm.org/doi/full/10.1056/nejmoa1103975 4. Single-arm study of eltrombopag in addition to standard immunosuppressive therapy in aplastic anemia: https://www.nejm.org/doi/10.1056/NEJMoa1613878 5. Long-term follow up of patients treated with immunosuppressive therapy and eltrombopag:https://ashpublications.org/blood/article/139/1/34/476916 6. RACE Trial: Standard immunosuppressive therapy +/- eltrombopag in aplastic anemia:https://www.nejm.org/doi/10.1056/NEJMoa2109965 7. Clinical and molecular determinants of clonal evolution in patients with aplastic anemia:https://ascopubs.org/doi/abs/10.1200/JCO.22.00710
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Feb 25, 2023 • 55min

Episode 16. ASH 2022 Leukemia and Myeloid Malignancies Recap

1.     Phase III ASAP trialhttps://ash.confex.com/ash/2022/webprogram/Paper159962.html  2.     Phase III Dauno-Double Trialhttps://ash.confex.com/ash/2022/webprogram/Paper157126.html  3.     Reduced venetoclax exposure: https://ash.confex.com/ash/2022/webprogram/Paper165464.html  4.    Menin Inhibitors in AML https://ash.confex.com/ash/2022/webprogram/Paper164849.htmlhttps://ash.confex.com/ash/2022/webprogram/Paper167412.html  5.    Imetelstat in MDS: IMerge Phase 2https://ash.confex.com/ash/2022/webprogram/Paper169050.html  6.    MOMENTUM: Momelotinibhttps://ash.confex.com/ash/2022/webprogram/Paper162783.htmlHow I manage anemia related to myelofibrosis and its treatment regimens https://link.springer.com/article/10.1007/s00277-023-05126-4
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Feb 8, 2023 • 54min

Episode 15. Management of Newly Diagnosed DLBCL (Including Bonus ASH22 Updates)

In this episode, we discuss the management of newly diagnosed DLBCL with Dr. Pallawi Torka. We also have a few bonus ASH22 updates on DLBCL. Links to articles and abstracts discussed in the episode are as follows: 1. A comprehensive review article on DLBCL:https://pubmed.ncbi.nlm.nih.gov/33657296/ 2. RCT testing CHOP vs Three Intensive Regimens in DLBCL:https://www.nejm.org/doi/full/10.1056/nejm199304083281404  3. RCT testing R-CHOP vs CHOP in DLBCL in older adults:https://www.nejm.org/doi/full/10.1056/nejmoa011795  4. RCT testing R-CHOP vs CHOP in young (MINT):https://pubmed.ncbi.nlm.nih.gov/21940214/  5. PHOENIX trial: R-CHOP +/- Ibrutinib:https://pubmed.ncbi.nlm.nih.gov/30901302/ 6. R-CHOP +/- Lenalidomide (ECOG-ACRIN E1412):https://pubmed.ncbi.nlm.nih.gov/33555941/  7. R-CHOP vs Pola-R-CHP (POLARIX Trial):https://www.nejm.org/doi/full/10.1056/NEJMoa2115304 8. Comparison of 3 IPI scores in DLBCL:https://ashpublications.org/blood/article/135/23/2041/452696 9. RCT testing R-CHOP vs Dose-Adjusted R-EPOCH (CALGB 50303):https://ascopubs.org/doi/full/10.1200/JCO.18.01994 10. Timing of CNS Prophylaxis in DLBCL:https://pubmed.ncbi.nlm.nih.gov/34995350/ 11. RCT testing R-CHOP vs R-CHOP + Bortezomib (REMoDL-B):https://pubmed.ncbi.nlm.nih.gov/30948276/ 12. Interim PET in DLBCL? https://ashpublications.org/bloodadvances/article/5/9/2375/475850 13. RCTs in Limited Stage DLBCL: CHOP x 8 vs CHOP x 3 + XRT (S8736):https://ascopubs.org/doi/10.1200/JCO.2015.65.4582 CHOP x 4 + Rituximab x 6 vs R-CHOP x 6 (FLYER):https://pubmed.ncbi.nlm.nih.gov/31868632/ PET-adapted therapy with R-CHOP (S1001):https://pubmed.ncbi.nlm.nih.gov/32658627/ 14.   ASH 2022 updates:REMoDL-B update: https://ashpublications.org/blood/article/140/Supplement%201/1770/493225 Glofitamab update: https://ashpublications.org/blood/article/140/Supplement%201/1062/491024 Epcoritamab update: https://ashpublications.org/blood/article/140/Supplement%201/9443/488543
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Jan 25, 2023 • 54min

Episode 14. MRD in Multiple Myeloma

1.      Excellent paper on harmonization of performing and reporting MRD in multiple myeloma:          https://www.nature.com/articles/s41375-020-01012-42.     Does CR really matter in the era of MRD? Landmark paper from the Spanish Group:         https://pubmed.ncbi.nlm.nih.gov/35560160/3.     Meta-analysis showing individual-level prognostic impact of MRD on long-term outcomes in multiple myeloma:        https://pubmed.ncbi.nlm.nih.gov/33284948/4.     MASTER Trial-The first trial testing MRD-adapted treatment strategy in multiple myeloma :         https://pubmed.ncbi.nlm.nih.gov/34898239/

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