ISH 2016

Prof Shai Izraeli speaks with ecancertv at BSH 2016 about the landscape of childhood leukaemia. With the majority of childhood cases of ALL being curable, Prof Izraeli outlines avenues for further research: treating high-risk groups and reducing toxicity with targeted therapy. He also addresses the clinical significance of genomic data for risk stratification and therapy identification.

Dr Philippe Moreau speaks with ecancertv at BSH 2016 about his research into novel therapies to treat myeloma. Following recent approval in the USA and favourable views in the CHMP, Dr Moreau looks forward to the improved patient outlook possible with courses of elotuzumab or daratumumab. As combination therapies, elotuzumab and daratumumab have shown significant benefits to patient duration, progression free survival and toxicity profile. With an eye to the future, he looks forward to novel combinations to maximise patient benefit, up to complete remission.

Prof Stephen Mulligan speaks with ecancertv at BSH 2016 about the turning tides of chronic lymphocyctic leukaemia. With a consideration of the recent past, from novel treatment combinations that are extending patient survival up to four fold, to modern molecular understanding of the micro-environemnt, Dr Mulligan identifies upcoming trials he anticipates will continue to move survival rates forward.

Prof Lia Gore speaks with ecancertv at BSH 2016 about current and emerging treatments for all. With a childhood cure rate of 95%, Dr Gore explores how treatments of ALL might have significant impacts in a patients later life, and how to reduce undue risk where possible. The novel agents being trialled so far include courses of immunotherapy; monoclonal antibodies and CAR-T cells, and targeted therapies. Prof Gore also addresses toxicities associated with treatment, and the challenges in treating the unregulated cell growth of cancer in a patient who is still growing.

Dr Kevin Shannon speaks with ecancertv at BSH 2016 about heritable risks for leukaemia. Familial history of leukaemia has only recently been elucidated using genomic high-throughput techniques to identify the upregulation of certain genes, notably GATA2, AML1 and RUNX1. Dr Shannon describes the considerations clinicians and patients might experience when discovering they have a strong likelihood of passing on this predisposition.

Dr George Collins speaks with ecancertv at BSH 2016 about treating Hodgkin lymphoma while reducing the risk of developing secondary lesions in later life. With the risk of late-stage side effects from radiotherapy weighed against potential for relapse in primary lesions, Dr Collins describes a tailored approach on a patient-by-patient basis. With PET negative scans being a significant prognostic indicator, he describes their influence on treatment schedules of radiotherapy and immunotherapy.

Dr Peter Hillmen speaks with ecancertv at BSH 2016, reviewing the results from the RESONATE2 trial of ibrutinib and CLL115 trial of idelalisib. These results are also reviewed by Dr George Follows and Dr Andrew Zelenetz, though Dr Hillmen draws specific attention to toxicity profile exhibited by some idelalisib patients with a history of autoimmune disease. Looking forward, he describes the ongoing goals of reducing toxicity, isolating resistance and the risk-reward balance of combination therapies.

Dr George Collins speaks with ecancertv at BSH 2016 about therapy management in relapsed Hodgkin lymphoma. He explains what sets UK and USA therapeutics apart, including the choice of allograph or autograph, access to novel agents, and timing of stem cell transplants amidst chemotherapy. While Hodgkin lymphoma is comparably uncommon, Dr Collins emphasises the goal of relapse free survival in the first round of treatment considering its incidence among younger patients and children.

Professor Christine Mauz-Körholz speaks with ecancertv at BSH 2016 about paediatric Hodgkins lymphoma. The late effects caused by radiotherapy; increased risk of secondary lesions and organ damage, have led to it being phased out of many countries courses of treatment, with novel agents being investigated for further reduction of side effects. Chemotherapy is also a potentially toxic treatment, but Professor Mauz-Körholz highlights the need to match low toxicity treatments with treatment efficacy and relapse prevention.

Prof Elizabeth Molyneux speaks with ecancertv at BSH 2016 about designing a course of therapy for children when access to therapies is limited. Highlighting the need for feasibility and safety, she describes the process of building effective protocols to treat extremely sensitive patients. Prof Molyneux reports on trials in which Burkitt's lymphoma, Kaposi's Sarcoma, and Will's tumour patients have been treated with reduced dosages, due to limited drug access and tolerability, with significant improvements on patients survival.

Dr Sahra Ali speaks to ecancertv at BSH 2016 about the complications facing diagnosis of AML during pregnancy. The likelihood of developing cancer grows with age, but many women are choosing to delay pregnancy, resulting in the chance of developing cancer during pregnancy rising to match these rates. With the safety of both mother and child at risk, Dr Ali describes complications possible during the course of pregnancy.

Dr Craig Moskowitz speaks with ecancertv at BSH 2016 about talks given at the conference, and patient therapies in trial and practice. Speaking on a range of therapies from pre-transplant PET imaging to combination therapies such as brentuximab-vedotin and incorporation of PD-1 checkpoint inhibitors, Dr Moskowitz describes the changing field of haemato-oncology. Looking to the near future, he comments on the potential of chemotherapy-free treatment from the perspective of patients, physicians and healthcare providers.

Dr Alberto Zamo speaks with ecancertv at BSH 2016 about current affairs in haematopathology. Currently, few laboratories have access to next generation sequencing technology, influencing regional abilities to reach accurate diagnoses. Dr Zamo describes the promising potential for affordable access to genomic techniques and improved patient risk stratification in the near future.

Dr Mike Dennis speaks with ecancertv at BSH 2016 about the most recent results of the multinational AML17 trial. Using varying dosages of duanorubicin across the randomized trial, Dr Dennis reports a maximum tolerated dose of 60mg, with significant benefits to patient survival. Most notably, he describes a specific benefit to patients with FLIP3 mutations. He also reflects on study construction between American, English and European trials, and how to optimise techniques for best patient outcomes.

Dr George Follows (Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK) talks with Dr Andrew Zelenetz (Memorial Sloan Kettering Cancer Centre, New York, USA) at the BSH 2016 conference in Glasgow. Dr Zelenetz was presenting in Glasgow with a late breaking poster detailing the outcomes of a trial to treat relapsed chronic lymphocytic leukaemia with a combination of idelalisib, bendamustine and rituximab The results of the trial report overwhelming efficacy of the combination compared to placebo or bendamustine with rituximab. Dr Follows and Dr Zelenetz discuss the impact of these results, considering risks such as infection, and the value of the combined IBR arm of the trial against BR alone, or the as-yet-unreported IR arm.

Dr George Follows (Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK) talks with Dr Andrew Zelenetz (Memorial Sloan Kettering Cancer Centre, New York, USA) at the BSH conference in Glasgow. Comparing first line schemes between USA and UK CLL treatment, with specific regard to the recent RESONATE-2 trial of frontline ibrutinib, they discuss toxicity, cost and combination of available treatments.

Dr George Follows speaks with ecancertv at BSH 2016 about the UK CLL session he chaired, reviewing the data presented, the background, and potential clinical applications of current research. Looking forward to patient impacts, he describes drugs currently moving through trial phases and approaching wider release.

Dr Jan Burger speaks with ecancertv at BSH 2016 reports on the results of the RESONATE2 trial in CLL patients. RESONATE2 was a comparative trial, assessing response rates of patients receiving traditional therapies compared to those receiving ibrutinib, a novel BTK inhibitor. The results favour ibrutinib as a frontline treatment, with prolonged patient survival and a lower toxicity profile, and follow from results gained in the previous RESONATE trial. Ibrutinib is now approved for treatment in the US, and has just received positive opinion in Europe for expanded use in previously untreated CLL patients

Dr Jan Burger speaks with ecancertv at BSH 2016 about the crosstalk targeting therapies presenting an alternative to chemotherapy in treating CLL. These include kinase inhibitors, which enable signals from the microenvironment which upregulate B and T Cell presence towards tumours. With regards to drug resistance, Dr Burger describes the need for strategies in novel treatment schemes to manage and reduce risk to patients.

Dr George Follows speaks with ecancertv at BSH 2016 about the UKCLL session he chaired, reviewing the data presented, the background, and potential clinical applications of current research. He describes the microenvironment required to sustain CLL in research, having previously been difficult to model and maintain cancer cells in situ.