Blood Cancer Talks

In this episode, we discuss the management of acute toxicities of CAR T-cell therapy, including CRS, ICANS, and HLH with Dr. Michael Jain from Moffitt Cancer Center.

Here are some of the key articles we discussed:

1. “How I treat refractory CRS and ICANS after CAR T-cell therapy”. 

     https://pubmed.ncbi.nlm.nih.gov/36989488/

2. CAR-HEMATOTOX score: 

    https://pubmed.ncbi.nlm.nih.gov/34166502/

3. “How I treat cytopenias after CAR T-cell therapy”.

     https://pubmed.ncbi.nlm.nih.gov/36800563/

4. Immune Effector Cell-Associated HLH-Like Syndrome (ASTCT):

    https://pubmed.ncbi.nlm.nih.gov/36906275/

5. ASTCT consensus grading for CRS and ICANS:

    https://pubmed.ncbi.nlm.nih.gov/30592986/

6. Hematopoietic stem cell boost for persistent neutropenia after CAR T-cell therapy:

    https://pubmed.ncbi.nlm.nih.gov/35696759/

7. Modified EASIX score for predicting CRS and neurotoxicity:

    https://pubmed.ncbi.nlm.nih.gov/34432870/

In this episode, we discuss the latest updates on CAR T-cell therapy in multiple myeloma, including the studies presented at ASCO and EHA 2023. Here are the show notes:

1. For a primer on CAR T-cell therapy, listen to our episode aired on July 22nd 2022 with Dr. Surbhi Sidana: https://share.transistor.fm/s/efc4acf9

2. RCTs of BCMA CAR T-cell Therapy in Early Relapsed Multiple Myeloma:

a) KarMMa-3 (ide-cel): https://pubmed.ncbi.nlm.nih.gov/36762851/

b) CARTITUDE-4 (cilta-cel): https://pubmed.ncbi.nlm.nih.gov/37272512/

3. Clinical trials of GPRC5D CAR T-cell therapy in multiple myeloma:

a) MCARH109 (MSKCC Trial): https://pubmed.ncbi.nlm.nih.gov/36170501/

b) POLARIS Trial: https://pubmed.ncbi.nlm.nih.gov/36725117/

3. Phase 1 UNIVERSAL trial of ALLO-715 in Multiple Myeloma:
https://pubmed.ncbi.nlm.nih.gov/36690811/

4. Anti BCMA/CD19 CAR T-cells with IMiD maintenance therapy in myeloma:
https://pubmed.ncbi.nlm.nih.gov/36413381/

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%201/241/487619

3.  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%201/4415/492339

5. 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/

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.2015.66.0118

https://pubmed.ncbi.nlm.nih.gov/21753188/

9.Iron chelation therapy in MDS: 

https://pubmed.ncbi.nlm.nih.gov/32203980/

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 lymphoma

7:52 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 MCL

19:03 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_1/2816/423504

43:01: Does Allo-Transplant have any role in MCL?

44:08: What are the likely next breakthroughs in newly diagnosed MCL space? 

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 LMICs

15:46 Induction therapy for new diagnosed transplant-eligible myeloma

27:17 Early Transplant vs Delayed Transplant in the Context of LMICs

33:11 Maintenance therapy 

37:27 Management of relapsed myeloma

Affordability 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/

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.it
https://ascopubs.org/doi/full/10.1200/JCO.2017.76.4886

Genetically inspired prognostic scoring system (GIPSS):
https://www.nature.com/articles/s41375-018-0107-z

Type 1 CALR mutation:
https://ashpublications.org/blood/article/124/15/2465/33454

MYSEC-PM:
http://www.mysec-pm.eu
https://www.nature.com/articles/leu2017169

2. 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/fulltext

Pacritinib : https://ashpublications.org/blood/article/140/Supplement%201/1518/490663
https://jamanetwork.com/journals/jamaoncology/fullarticle/2674384

Fedratinib:
https://onlinelibrary.wiley.com/doi/10.1111/bjh.18284

3. Allogeneic Transplant in PMF
https://ashpublications.org/hematology/article/2021/1/453/482995

Black African-American patients with primary myelofibrosis
https://ashpublications.org/bloodadvances/article/doi/10.1182/bloodadvances.2022009611/494460

4. Imtelestat in PMF
https://www.nejm.org/doi/full/10.1056/NEJMoa1310523

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%201/292/490268

ASCENT: 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/

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/NEJM199105093241901

https://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

1.     Phase III ASAP trial

https://ash.confex.com/ash/2022/webprogram/Paper159962.html

2.     Phase III Dauno-Double Trial

https://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.html

https://ash.confex.com/ash/2022/webprogram/Paper167412.html

5.    Imetelstat in MDS: IMerge Phase 2

https://ash.confex.com/ash/2022/webprogram/Paper169050.html

6.    MOMENTUM: Momelotinib

https://ash.confex.com/ash/2022/webprogram/Paper162783.html

How I manage anemia related to myelofibrosis and its treatment regimens

 https://link.springer.com/article/10.1007/s00277-023-05126-4