In this video, Ola Landgren, MD, PhD, Sylvester Comprehensive Cancer Center, University of Miami, Miami, FL, shares some insights into the future of the field of monoclonal gammopathy of undetermined significance (MGUS) and the treatment of multiple myeloma (MM). Dr Landgren mentions the likelihood that research will move away from measuring disease burden to precision medicine and genomic identification of individuals at risk of developing MM. Dr Landgren then draws focus on the importance of early detection in MM and analyzing the bone marrow as well as the microenvironment and concludes by mentioning the aims of an upcoming study on MGUS. This interview took place at the 63rd ASH Annual Meeting and Exposition congress in Atlanta, GA, 2021.
In this video, Ola Landgren, MD, PhD, Sylvester Comprehensive Cancer Center, University of Miami, Miami, FL, discusses some interesting results from a study which investigated factors predicting sustained minimal residual disease (MRD) negativity in patients with newly diagnosed multiple myeloma (MM). Dr Landgren first highlights some results from the MANHATTAN trial (NCT03290950), which investigated the safety and efficacy of daratumumab in combination with carfilzomib, lenalidomide and dexamethasone (D-KRd) in the treatment of newly diagnosed MM. Based on the promising results of this trial, Dr Landgren then discusses the aim of the current study to better understand the mechanisms behind MRD negativity. Using both single-cell sequencing and whole-genome sequencing, Dr Landgren explains the main findings, which show that there is a complex interplay of the immune microenvironment and tumor genomics associated with sustained MRD negativity. To conclude, Dr Landgren mentions the importance of this study, as it provides important insights into the role of the immune microenvironment in disease and may help to improve future studies in myeloma. This interview took place at the 63rd ASH Annual Meeting and Exposition congress in Atlanta, GA, 2021.
In this video, David Sallman, MD, Moffitt Cancer Center, Tampa, FL, highlights the current and future of frontline therapy in acute myeloid leukemia (AML) and myelodysplastic syndromes (MDS). Dr Sallman first mentions the results from the PANTHER trial (NCT03268954), which investigated the use of pevonedistat plus azacitidine versus azacitidine monotherapy as first-line treatment for patients with MDS and AML. Following this, Dr Sallman mentions some novel options being explored for frontline therapy, drawing focus on targeted inhibitors and intensive chemotherapy, and the hope that novel cellular therapies will be made more available to patients with MDS. This interview took place at the 63rd ASH Annual Meeting and Exposition congress in Atlanta, GA, 2021.
Eunice Wang, MD, Roswell Park Comprehensive Cancer Center, Buffalo, NY, shares an update from the LACEWING trial (NCT02752035), which investigated gilteritinib plus azacitidine versus azacitidine monotherapy in patients with newly diagnosed acute myeloid leukemia (AML) with FLT3 mutation ineligible for intensive chemotherapy. In this video, Dr Wang highlights some findings on patient-reported outcomes in this study, including quality of life, adverse events, and fatigue, and reports that there were no overall changes in these outcomes across the course of therapy. This interview took place at the 63rd ASH Annual Meeting and Exposition congress, Atlanta, GA, 2021.
David Sallman, MD, Moffitt Cancer Center, Tampa, FL, discusses PRGN-3006, a novel chimeric antigen receptor T-cell (CAR-T) therapy, in the treatment of patients with acute myeloid leukemia (AML) and myelodysplastic syndromes (MDS). Dr Sallman highlights the mechanism of action of this CAR, its manufacturing process, and concludes by discussing the safety of this product and promising response rates observed in patients. This interview took place at the 63rd ASH Annual Meeting and Exposition congress in Atlanta, GA, 2021.
Loretta Nastoupil, MD, University of Texas MD Anderson Center, Houston, TX, gives an overview on when to use targeted therapy in the treatment of follicular lymphoma (FL), highlighting several novel agents and trials investigating this. Dr Nastoupil first mentions some findings from the AUGMENT study (NCT01938001), which investigated the use of lenalidomide plus rituximab in relapsed/refractory (R/R) indolent lymphoma. Dr Nastoupil then draws focus on novel therapeutic agents such as tazemetostat, parsaclisib, CAR-T therapy, and bispecific antibodies, and the role that these will play in the future of targeted therapy for FL. This interview took place at the 63rd ASH Annual Meeting and Exposition congress in Atlanta, GA, 2021.
Paul Richardson, MD, Dana-Farber Cancer Institute, Boston, MA, gives an update on the long-term results of the TOURMALINE-MM2 trial comparing ixazomib-lenalidomide-dexamethasone (IRd) to placebo-lenalidomide-dexamethasone (pbo-Rd) in patients with relapsed/refractory (R/R) multiple myeloma (NCT01850524). The results of this study showing a significantly improved progression-free survival (PFS) in patients treated with IRd led to the approval of ixazomib in the relapsed/refractory (R/R) setting. Long-term subgroup analysis revealed that an improved quality of response over time was correlated with better patient outcomes and suggests that treatment with ixazomib should be prolonged over an extended period of time to maximize benefits. This interview took place at the 63rd ASH Annual Meeting and Exposition congress in Atlanta, GA.
Sundar Jagannath, MD, Tisch Cancer Institute at Mount Sinai, New York, NY, discusses the rationale, design and findings of the ongoing Connect® MM Disease Registry investigating the clinical, economic and humanistic burden in patients with triple-class refractory multiple myeloma (NCT01081028). This prospective study enrolled 240 patients who were refractory to immunomodulatory drugs (IMiDs), proteasome inhibitors, and anti-CD38 antibodies. Among patients that received further treatment, it was revealed that retreatment with IMiDs, proteasome inhibitors or anti-CD38 drugs in different combinations were the most common strategies. Median overall survival (OS) was estimated at 8.9 months in all patients, and was 1 month among patients who did not receive further treatment. Interestingly, patients who were treated with selixenor and belantamab mafodotin, two drugs approved in the triple-class refractory setting had similar outcomes to patients who had received more than one line of prior therapy, with a median OS of 10.8 months. Moreover, using various quality of life (QoL) assessment tools, it was found that patients experienced a progressive decline in QoL. Dr Jagannath emphasizes the importance of introducing novel more effective drugs for this patient population with a poor prognosis and poor QoL. This interview took place at the 63rd ASH Annual Meeting and Exposition congress in Atlanta, GA.
Martin Hutchings, MD, PhD, Copenhagen University Hospital, Copenhagen, Denmark, comments on the ongoing, Phase I NP40126 trial (NCT03467373) of glofitamab, a CD20xCD3 T-cell-engaging bispecific antibody, with R-CHOP in patients with relapsed/refractory non-Hodgkin lymphoma (NHL) or treatment naïve diffuse large B-cell lymphoma (DLBCL). A promising safety profile was reported, with a toxicity similar to that of R-CHOP monotherapy, and a reduced rate of cytokine release syndrome (CRS) compared with glofitamab monotherapy. Treatment was additionally administered in a timely fashion, important in curing patients. This interview took place at the 63rd ASH Annual Meeting and Exposition congress in Atlanta, GA.
Peter Voorhees, MD, Levine Cancer Institute, Charlotte, NC, updates us on the findings from the Phase II GRIFFIN trial assessing the addition of daratumumab to lenalidomide-bortezomib-dexamethasone (D-RVd) versus lenalidomide-bortezomib-dexamethasone (RVd) alone in patients with newly diagnosed multiple myeloma (NCT02874742). By the end of two years of maintenance therapy, the complete response (CR) rate was 79.8% in the D-RVd group vs 60.8% in the RVd group. Measurable residual disease (MRD) negativity and sustained MRD negativity were also significantly higher in the D-RVd arm. Interestingly, the rates of MRD negativity increased significantly from the end of the first year of maintenance therapy to the second year of maintenance therapy. Moreover, although the data is still premature and statistical significance for progression-free survival (PFS) has not yet been reached, there is a trend towards improved PFS in the daratumumab arm. This interview took place at the 63rd ASH Annual Meeting and Exposition congress in Atlanta, GA.
In this video, Jan Philipp Bewersdorf, MD, Yale University, New Haven, CT, gives a detailed overview on maintenance therapies in acute myeloid leukemia (AML). First, Dr Bewersdorf mentions the importance of considering the context in which AML maintenance therapies are discussed: maintenance therapy after allogeneic transplant vs maintenance therapy after induction chemotherapy. In the first context, Dr Bewersdorf reports on advances in the use of FLT3 inhibitors, drawing focus on sorafenib and its benefits and drawbacks. Following this, Dr Bewersdorf discusses advances in the use of hypomethylating agents (HMAs) in AML, reporting on clinical trials that have used both injectable azacitidine (AZA) and oral azacitidine (CC-486) in treatment. To conclude, Dr Bewersdorf then draws focus on trial updates and findings from the QUAZAR AML-001 trial (NCT01757535) and the future of research in this area. This interview took place at the 63rd ASH Annual Meeting and Exposition Congress, Atlanta, 2021.
Faith Davies, MBBCh, MRCP, MD, FRCPath, NYU Langone Medical Center, New York, NY, provides updates in the field of minimal residual disease (MRD) testing in multiple myeloma, including studies assessing the MRD status of patients receiving daratumumab at different points in time, as well as data linking MRD negativity to better outcomes in patients. Prof. Davies additionally highlights the need for MRD testing in the clinic, and how MRD testing can build on existing treatments such as dexamethasone and lenaliomide. This interview took place at the 63rd ASH Annual Meeting and Exposition congress in Atlanta, GA.