Oncology Knowledge into Practice Podcast

Developments in precision medicine have led to a paradigm shift in the management of advanced thyroid cancer. The ESMO Guidelines Committee recently developed a new clinical practice guideline on the use of systemic therapy in this setting. This episode offers guideline insights into the applications recently approved therapies that have been approved by the FDA and/or the EMA, including cabozantinib, selpercatinib, pralsetinib, and entrectinib. It also provides data updates of previously approved therapies and how guidelines have been adapted accordingly. To answer questions on the 2022 ESMO Clinical Practice Guideline update, we have invited Dr. Ahmad Awada to join us. He is Head of the Oncology Medicine Department at Jules Bordet Cancer Institute Brussels, Belgium. Target Audience: Oncologists, pathologists and other HCPs involved in the management of advanced thyroid cancer, with a focus on community practitioners. Learning objectives: After completing this educational activity, learners will be able to: Recall thyroid RET and TRK fusion-positive cancer diagnosis and relevant genomic testing guidelines, and identify ways to adapt the guidelines to local settings Discuss precision medicine and new technologies, including liquid biopsy Review the organization of care and strategies for more efficient care delivery Funding information: This independent educational activity is supported by an educational grant from Eli Lilly. The educational content has been developed by Liberum IME in collaboration with an independent steering committee; Eli Lilly had no influence on the content of this educational activity. Disclosures Dr. Ahmad Awada declares the following financial relationships from the past 24 months: Speaker fees: Amgen, AstraZeneca, Bayer, Daiichi Sankyo, Eisai, Genomic Health, Ipsen, Leo Pharma, Eli Lilly, Merck, MSD, Novartis, Pfizer, and Seattle Genetics. Liberum IME staff, ACHL staff and others involved with the planning, development, and review of the content for this activity have no relevant affiliations or financial relationships to disclose. ACHL requires that the faculty participating in an accredited continuing education activity disclose all affiliations or other financial relationships within 24 months (1) with the manufacturers of any commercial product(s) and/or provider(s) of commercial services discussed in an educational presentation and (2) with any ineligible companies. All relevant financial relationships have been mitigated prior to this activity. This CME/CE activity might describe the off-label, investigational, or experimental use of medications and/or devices that may exceed their FDA-approved labeling. Physicians should consult the current manufacturers' prescribing information for these products. ACHL requires its speakers to disclose that a product is not labeled for the use under discussion. Discussion of Off-Label, Investigational, or Experimental Drug Use: N/A

In today's episode, we welcome expert Oncologist Dr. Claire Arthur and expert Endocrinologist Dr. Sarimar Agosto Salgado to discuss the challenges they have encountered and strategies that they have implemented to improve multidisciplinary collaboration in the management of patients with thyroid cancer and continued integration of precision medicine approaches. References 1. Fenton ME et al. Variability in thyroid cancer multidisciplinary team meeting recommendations is not explained by standard variables: Outcomes of a single centre review. J Clin Med 2021;10:4150 2. Horgan D et al. Tackling thyroid cancer in Europe—The challenges and opportunities. Healthcare 2022;10:1621 3. Mehra S et al. Improving the quality of thyroid cancer care: How does the Thyroid Cancer Care Collaborative cross the Institute of Medicine's Quality Chasm? Thyroid 2014;24:615–624 Target Audience: Oncologists, pathologists and other HCPs involved in the diagnosis of RET and TRK cancers, with a focus on community practitioners. Learning Objective: 1. Recall thyroid RET andTRK fusion-positive cancer diagnosis and relevant genomic testing guidelines and identify ways to adapt the guidelines to local settings 2. Discuss “precision medicine” and new technologies, including “liquid biopsy” 3. Review the organisation of care and strategies for more efficient care delivery Funding Information: This episode is supported by an educational grant from Eli Lilly, who have had no influence on the content or choice of faculty. Disclosures: Dr Sarimar Agosto Salgado: - Speaker: Lilly - Advisor: Exelisis, Lilly, Blueprint medicines, Eisai Dr Claire Arthur Dr Claire Arthur has no relevant disclosures against this module Liberum IME staff, ACHL staff and others involved with the planning, development, and review of the content for this activity have no relevant affiliations or financial relationships to disclose.

In today's episode, we welcome Dr. Antonio Matrone, an endocrinologist at the University of Pisa, to discuss the many factors involved in treatment decision-making and strategies for the management of patients with advanced thyroid cancer where an oncogenic driver has been identified. References Matrone A et al. Differentiated thyroid cancer, from active surveillance to advanced therapy: Toward a personalized medicine. Front Endocrinol (Lausanne) 2019;10:884 Sherman SI. Evolution of targeted therapies for thyroid carcinoma. Trans Am Clin Climatol Assoc 2019;130:255–265 Filetti S et al. ESMO Clinical Practice Guideline update on the use of systemic therapy in advanced thyroid cancer. Ann Oncol 2022;33(7):P674–P684 Capdevila J et al. Molecular diagnosis and targeted treatment of advanced follicular cell-derived thyroid cancer in the precision medicine era. Cancer Treat Rev 2022;106:102380 Dabrafenib highlights of prescribing information. 2022 Wirth LJ et al. Efficacy of selpercatinib in RET-altered thyroid cancers. N Engl J Med 2020;383:825–835 Josfeld L et al. Cancer patient's perspective on shared decision-making and decision aids in oncology. J Cancer Res Clin Oncol 2021;147:1725–1732 Target Audience: Oncologists, pathologists and other HCPs involved in the diagnosis of RET and TRK cancers, with a focus on community practitioners. Learning Objective: Recall thyroid RET and TRK fusion-positive cancer diagnosis and relevant genomic testing guidelines and identify ways to adapt the guidelines to local settings Discuss “precision medicine” and new technologies, including “liquid biopsy” Review the organisation of care and strategies for more efficient care delivery These learning objectives are for the podcast series. This episode focuses on the first and third objective. Funding Information: This episode is supported by an educational grant from Eli Lilly, who have had no influence on the content or choice of faculty. Staff Disclosure: Dr. Matrone declares the following: Consultant - Eli Lilly

In today's episode, we welcome Principal Researcher Dr. David Tamborero who was integral to the development of the Molecular Tumor Board Portal to discuss the benefits associated with molecular tumor boards and the way in which the portal can support the discussions that take place at tumor board meetings, as well as how these initiatives can support the management of patients with thyroid cancer. References Larson KL et al. Clinical Outcomes of Molecular Tumor Boards: A Systematic Review. JCO Precis Oncol 2021;5:PO.20.00495 Capdevila J et al. Molecular diagnosis and targeted treatment of advanced follicular cell-derived thyroid cancer in the precision medicine era. Cancer Treat Rev 2022;106:102380 Mahmood U and Lorch JH. Precision Medicine in Aggressive Thyroid Cancer: Moving Beyond Multitargeted Tyrosine Kinase Inhibitors. Cancer Cytopathol 2022;130:8–11 VanderWalde A et al. Establishment of a Molecular Tumor Board (MTB) and Uptake of Recommendations in a Community Setting. J Pers Med 2020;10:252 Tamborero D et al. The Molecular Tumor Board Portal supports clinical decisions and automated reporting for precision oncology. Nat Cancer 2022;3:251–261 Target Audience: Oncologists, pathologists and other HCPs involved in the diagnosis of RET and TRK cancers, with a focus on community practitioners. Learning Objective: Recall thyroid RET and TRK fusion-positive cancer diagnosis and relevant genomic testing guidelines and identify ways to adapt the guidelines to local settings Discuss “precision medicine” and new technologies, including “liquid biopsy” Review the organisation of care and strategies for more efficient care delivery These learning objectives are for the podcast series. This episode focuses on the second and third objective. Funding Information: This episode is supported by an educational grant from Eli Lilly, who have had no influence on the content or choice of faculty. Staff Disclosure: Dr. David Tamborero has no relevant disclosures to announce

In today's episode, we welcome expert Oncologist Dr. Lori Wirth and expert Pathologist Dr. Thomas Giordano to discuss the challenges they have encountered and strategies that they have implemented to improve multidisciplinary collaboration in the management of patients with thyroid cancer and continued integration of precision medicine approaches. References Kilagat K, Griffin MJ, Baik F, et al. Thyroid Care Collaborative: an electronic health record facilitating multidisciplinary management of thyroid cancer. Int J Endo Oncol 2018;5(1):IJE03 Target Audience: Oncologists, pathologists and other HCPs involved in the diagnosis of RET and TRK cancers, with a focus on community practitioners. Learning Objective: Recall thyroid RET and TRK fusion-positive cancer diagnosis and relevant genomic testing guidelines and identify ways to adapt the guidelines to local settings Discuss “precision medicine” and new technologies, including “liquid biopsy” Review the organisation of care and strategies for more efficient care delivery These learning objectives are for the podcast series. This episode focuses on the third objective. By completing this module you can qualify for 0.25 CME credits. To claim your credits, you must listen to the podcast and successfully pass the post-module assessment. Funding Information: This episode is supported by an educational grant from Eli Lilly, who have had no influence on the content or choice of faculty. Staff Disclosures: Dr Lori Wirth Advisory Board - Bayer Healthcare, Coherus, Eli Lilly, Eisai, Exelixis, PDS Biotechnology Corp Consultant - Curie Therapeutics, Morphic Therapeutics Dr. Thomas Giordano No relevant disclosures to declare

Liquid biopsy has emerged as a novel diagnostic tool, enabling rapid, non-invasive molecular testing of thyroid cancers. This episode offers insight into some of the opportunities and challenges that are presented by liquid biopsy in this field. To answer questions on this topic, we have invited Professor Frederique Penault-Llorca to join us. She is Professor of Pathology at the University of Clermont-Ferrand and CEO of the Comprehensive Regional Cancer Institute Centre Jean Perrin in Clermont-Ferrand, France. Funding Information: This episode is supported by an educational grant from Eli Lilly, who have had no influence on the content or choice of faculty. Faculty Disclosures: Professor Frederique Penault-Llorca has disclosures are as follows: Advisory board: Roche, EliLilly, Illumina, Speaker: Roche, EliLilly, Illumina, References 1. Cooper DS, Doherty GM, Haugen BR, et al. Revised American Thyroid Association management guidelines for patients with thyroid nodules and differentiated thyroid cancer. Thyroid. 2009;19:1167–1214 2. Albarel F, Conte-Devolx B, Oliver C. From nodule to differentiated thyroid carcinoma: Contributions of molecular analysis in 2012. Ann Endocrinol (Paris). 2012;73:155–164 3. Nylen C, Mechera R, Marechal-Ross I, et al. Molecular markers guiding thyroid cancer management. Cancers (Basel). 2020;12:2164 4. National Comprehensive Cancer Network. NCCN Clinical Practice Guidelines in Oncology: Thyroid Carcinoma. Version 2.2022. May 5, 2022. Available at: https://www.nccn.org/professionals/physician_gls/pdf/thyroid.pdf (accessed June 2022) 5. Pinchot SN, Al-Wagih H, Schaefer S, et al. Accuracy of fine-needle aspiration biopsy for predicting neoplasm or carcinoma in thyroid nodules 4 cm or larger. Arch Surg. 2009;144:649–655 6. Bellevicine C, Sgariglia R, Nacchio M, et al. Molecular testing of thyroid fine-needle aspiration: local issues and solutions. An interventional cytopathologist perspective. J Mol Pathol. 2021;2:233–240 7. Kasraeian S, Allison DC, Ahlmann ER, et al. A comparison of fine-needle aspiration, core biopsy, and surgical biopsy in the diagnosis of extremity soft tissue masses. Clin Orthop Relat Res. 2010;468:2992–3002 8. Lindeman NI, Cagle PT, Aisner DL, et al. Updated molecular testing guideline for the selection of lung cancer patients for treatment with targeted tyrosine kinase inhibitors: Guideline from the College of American Pathologists, the International Association for the Study of Lung Cancer, and the Association for Molecular Pathology. Arch Pathol Lab Med. 2018;142:321–346 9. Pennell NA, Arcila ME, Gandara DR, et al. Biomarker testing for patients with advanced non-small cell lung cancer: Real-world issues and tough choices. Am Soc Clin Oncol Educ Book. 2019;39:531–542 10. Belli C, Penault-Llorca F, Ladanyi M, et al. ESMO recommendations on the standard methods to detect RET fusions and mutations in daily practice and clinical research. Ann Oncol. 2021;32:337–350 11. Li MM, Datto M, Duncavage EJ, et al. Standards and guidelines for the interpretation and reporting of sequence variants in cancer: A joint consensus recommendation of the Association for Molecular Pathology, American Society of Clinical Oncology, and College of American Pathologists. J Mol Diagn. 2017;19:4–23

Developments in RET-targeted therapies have led to a paradigm shift in the management of advanced thyroid cancer. However, resistance to these drugs has been observed to develop through a variety of mechanisms, so precise monitoring is required to detect and react to disease development. This episode offers insight into relevant mechanisms of resistance to RET inhibitors in thyroid cancer. It also considers how strategies such as combinations of targeted therapies and liquid biopsy could potentially help tackle the development of resistance. To answer questions on this topic, we have invited Professor Bruce Robinson to join us. He is a Professor of Medicine and Endocrinologist at the University of Sydney, Australia. Funding Information: This episode is supported by an educational grant from Eli Lilly, who have had no influence on the content or choice of faculty. References Román-Gil MS, Pozas J, Rosero-Rodríguez D, et al. Resistance to RET targeted therapy in Thyroid Cancer: Molecular basis and overcoming strategies. Cancer Treat Rev. 2022;105:102372. doi: 10.1016/j.ctrv.2022.102372 Subbiah V, Cascone T, Hess KR et al. Multi-kinase RET inhibitor vandetanib combined with mTOR inhibitor everolimus in patients with RET rearranged non-small cell lung cancer. Journal of Clinical Oncology. 36 (15). Doi: 10.1200/JCO.2018.36.15_suppl.9035

Rearranged during transfection (RET) and tropomyosin receptor kinase (TRK) fusions are involved in various adult and paediatric cancers, including thyroid cancers. There is a high mortality rate for some of these cancers, partly due to the lack of efficient detection, diagnosis, and prognosis. The US and European guidelines recommend genomic testing as a part of standard diagnostic evaluations for some cancers to identify driver mutations for which effective therapies or clinical trials are available. However, adherence to genomic testing guidelines presents challenges to practitioners, including coordination of sample handling, long turnaround times, test reimbursement (in applicable settings), access to targeted therapies, insufficient tissue, and patient harm from the repeat biopsies necessary if the tissue sample is insufficient. This episode offers some guidance around when and how to test for biomarkers of response to precision medicines. To answer our questions on the topic, we welcome the expertise of Professor Fernando López-Ríos. Professor López-Ríos is a pathologist at the ‘12 de Octubre' University Hospital in Spain. Funding Information: This episode is supported by an educational grant from Eli Lilly, who have had no influence on the content or choice of faculty. References 1. National Comprehensive Cancer Network. Thyroid Carcinoma. (Version 3.2021-October 15, 2021). Available at: https://www.nccn.org/professionals/physician_gls/pdf/thyroid.pdf. Accessed January 16, 2022. 2. Belli C, et al. ESMO recommendations on the standard methods to detect RET fusions and mutations in daily practice and clinical research. Ann Oncol. 2021 Mar;32(3):337-350. 3. Marchiò C, et al. ESMO recommendations on the standard methods to detect NTRK fusions in daily practice and clinical research. Ann Oncol. 2019 Sep 1;30(9):1417-1427. 4. OncoKB: MSK's Precision Oncology Knowledge Base. Available at: https://www.oncokb.org/. Accessed March 15, 2022. 5. Mosele F, et al. Recommendations for the use of next-generation sequencing (NGS) for patients with metastatic cancers: a report from the ESMO Precision Medicine Working Group. Ann Oncol. 2020 Nov;31(11):1491-1505.

In today's episode, we're going to talk about how precision medicine fits into thyroid cancer treatment guidelines. To answer our questions on this topic, we welcome the expertise of Dr. Lori Wirth. Dr. Wirth is Medical Director of the Center for Head and Neck Cancers at the Massachusetts General Hospital, and an Associate Professor in Medicine at Harvard Medical School. Funding statement: This independent educational activity is supported by an educational grant from Eli Lilly. The educational content has been developed by Liberum IME in conjunction with an independent steering committee; Eli Lilly has had no influence on the content of this education. References: Filetti S, Durante C, Hartl D, et al. Thyroid Cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol. 2019; 30:1856-1883. National Comprehensive Cancer Network. Thyroid Carcinoma. (Version 3.2021-October 15, 2021). Available at: https://www.nccn.org/professionals/physician_gls/pdf/thyroid.pdf. Accessed January 16, 2022. Fleeman N, Houten R, Chaplin M, et al. A systematic review of lenvatinib and sorafenib for treating progressive, locally advanced or metastatic, differentiated thyroid cancer after treatment with radioactive iodine. BMC Cancer. 2019;19:1209. https://doi.org/10.1186/s12885-019-6369-7 Naoum GE, Morkos M, Kim B, Arafat W. Novel targeted therapies and immunotherapy for advanced thyroid cancers. Mol Cancer. 2018;17:51. Pekova B, Sykorova V, Mastnikova K, et al. NTRK fusion genes in thyroid carcinomas: Clinicopathological characteristics and their impacts on prognosis. Cancers.2021;13:1932. https://www.mdpi.com/2072-6694/13/8/1932 Pitoia F. Complete response to larotrectinib treatment in a patient with papillary thyroid cancer harboring an ETV6-NTRK3 gene fusion. Clin Case Rep. 2021;9:1905-1912. doi: 10.1002/ccr3.3900 VITRAKVI, Prescribing information. Bayer HealthCare Pharmaceuticals Inc. Revised: March 2021. ROZLYTREK, Prescribing information. Genentech USA, Inc. Revised: November 2021. Hong DS, DuBois SG, Kummar S, et al. Larotrectinib in patients with TRK fusion-positive solid tumours: a pooled analysis of three phase 1/2 clinical trials. Lancet Oncol. 2020;21:531-540. Chu YH, Dias-Santagata D, Farahani AA, et al. Clinicopathologic and molecular characterization of NTRK-rearranged thyroid carcinoma (NRTC). Mod Pathol. 2020;33:2186-2197. Doebele RC, Drilon A, Paz-Ares L, et al. Entrectinib in patients with advanced or metastatic NTRK fusion-positive solid tumours: integrated analysis of three phase 1–2 trials. Lancet Oncol. 2020;21:271-282. RETEVMA, Prescribing information. Lilly USA, LLC. Initial US approval: 2020. GAVRETO, Prescribing information. Genentech USA, Inc. and Blueprint Medicines Corporation. Revised: April 2021. Krajewska J, Kukulska A, Oczko-Wojciechowska M, Jarzab B. Recent advances in precision medicine for the treatment of medullary thyroid cancer. Expert Review of Precision Medicine and Drug Development. 2021;6(5): 307-315. https://doi.org/10.1080/23808993.2021.1964952 European Medicines Agency. Retsevmo. December 11, 2020. Accessed January 18, 2022. https://www.ema.europa.eu/en/medicines/human/EPAR/retsevmo European Medicines Agency. Gavreto. September 17, 2021. Accessed January 18, 2022. https://www.ema.europa.eu/en/medicines/human/EPAR/gavreto

Precision medicine is a promising field that's opening doors to novel therapeutics for many patients. But how does it fit into thyroid cancer specifically? What treatments are available or in the pipeline, for which patient subgroup, and what are the potential benefits? We'll start off our series by exploring these questions, and we've invited Dr Eric Sherman, medical oncologist and thyroid cancer expert at the Memorial Sloan Kettering Cancer Center in New York, to provide his insights. Funding statement: This independent educational activity is supported by an educational grant from Eli Lilly. The educational content has been developed by Liberum IME in conjunction with an independent steering committee; Eli Lilly has had no influence on the content of this education. References: American Cancer Society. Key Statistics for Thyroid Cancer. Updated January 12, 2021. Accessed November 23, 2021. American Cancer Society website. https://www.cancer.org/cancer/thyroid-cancer/about/key-statistics.html. Araque KA, Gubbi S, Klubo-Gwiezdzinska J. Updates on the Management of Thyroid Cancer. Horm Metab Res. 2020;52(8):562-577. doi: 10.1055/a-1089-7870. Cancer Connect. Therapies Show Initial Effectiveness in Subset of Papillary Thyroid Cancer. Cancer Connect website. Published July 18, 2018. Accessed December 14, 2021. https://news.cancerconnect.com/thyroid-cancer/therapies-show-initial-effectiveness-in-subset-of-papillary-thyroid-cancer?redir=1. ClinicalTrials.gov website search results: pembrolizumab / Thyroid Cancer / Phase 2. Accessed December 14, 2021. https://clinicaltrials.gov/ct2/results?term=pembrolizumab&cond=Thyroid+Cancer&age_v=&gndr=&type=&rslt=&phase=1&Search=Apply Dabrafenib With or Without Trametinib in Treating Patients With Recurrent Thyroid Cancer. ClinicalTrials.gov identifier: NCT01723202. Updated February 25, 2021. Accessed December 14, 2021. Drilon A, Laetsch TW, Kummar S, et al. Efficacy of Larotrectinib in TRK Fusion-Positive Cancers in Adults and Children. N Engl J Med. 2018;378(8):731-739. doi: 10.1056/NEJMoa1714448. Pekova B, Sykorova V, Mastnikova K, et al. NTRK Fusion Genes in Thyroid Carcinomas: Clinicopathological Characteristics and Their Impacts on Prognosis. Cancers. 2021;13(8):1932. doi: 10.3390/cancers13081932. U.S. Food & Drug Administration. FDA approves selpercatinib for lung and thyroid cancers with RET gene mutations or fusions. FDA website. Updated May 11, 2020. Accessed November 23, 2021. https://www.fda.gov/drugs/resources-information-approved-drugs/fda-approves-selpercatinib-lung-and-thyroid-cancers-ret-gene-mutations-or-fusions. U.S. Food & Drug Administration. FDA approves pembrolizumab for adults and children with TMB-H solid tumors. Updated June 17, 2020. Accessed December 14, 2021. https://www.fda.gov/drugs/drug-approvals-and-databases/fda-approves-pembrolizumab-adults-and-children-tmb-h-solid-tumors#:~:text=The%20recommended%20pembrolizumab%20dosage%20regimen%20for%20TMB-H%20solid,pediatric%20patients.%20View%20full%20prescribing%20information%20for%20KEYTRUDA. U.S. Food & Drug Administration. FDA approves larotrectinib for solid tumors with NTRK gene fusions. FDA website. Updated December 14, 2018. Accessed November 25, 2021. https://www.fda.gov/drugs/fda-approves-larotrectinib-solid-tumors-ntrk-gene-fusions. Weaver CH. Precision Cancer Medicine Treatment of Thyroid Cancers. Cancer Connect website. Published October 24, 2020. Updated September 20, 2021. Accessed November 23, 2021. https://news.cancerconnect.com/thyroid-cancer/precision-cancer-medicine-treatment-of-thyroid-cancers.

In this episode we speak with Dr Navel Daver, Associate Professor, Department of Leukemia, The University of Texas MD Anderson Cancer Center, USA, to get his thoughts on the highlights of ASCO and EHA for patients with MDS and AML. Funding Statement: This series is supported by educational grants from Servier Pharmaceuticals LLC and Takeda, who have had no influence on the content or choice of faculty

At the ASCO and EHA conferences, there were many interesting posters and presentations in the field of haemato-oncology. To share their conference highlights, we've invited our ALL expert Dr Dieter Hoelzer, director of internal medicine at the University of Frankfurt in Germany, and our MDS and AML expert Dr Amer Zeidan, Associate Professor Of Internal Medicine at the Yale University School Of Medicine in the US. Funding statement: This series is supported by educational grants from Servier Pharmaceuticals LLC and Takeda, who have had no influence on the content or choice of faculty

Adult guidelines for acute myeloid leukaemia recommend determining a patient's fitness before treating with standard therapy, but what does this mean, what are the implications, and how does this work in practice for both adults and children? To answer our questions on this topic, we've invited the expertise of Dr Courtney DiNardo, Associate Professor in the Department of Leukemia at The University of Texas MD Anderson Cancer Center. References Heuser et al. Ann Oncol. 2020 Mar 17;S0923-7534(20)36079-8 PDQ Adult Treatment Editorial Board. Adult Acute Myeloid Leukemia Treatment (PDQ®): Health Professional Version. 2020 Aug 11 Krug U, et al. Lancet. 2010;376(9757):2000-8 Sorror, et al. 2017 Dec 1;3(12):1675-1682 PDQ Pediatric Treatment Editorial Board. Childhood Acute Myeloid Leukemia/Other Myeloid Malignancies Treatment (PDQ®): Health Professional Version. 2020 Aug 20 This series is supported by educational grants from Servier Pharmaceuticals LLC and Takeda, who have had no influence on the content or choice of faculty

Despite available treatments, many patients with acute myeloid leukaemia, or AML, are in need of additional therapeutic options. Thankfully, there hundreds of clinical trials for new interventions that could rectify this, but which options can we start to consider, for which patients and when? To answer our questions on this topic, we've invited the expertise of Dr Navel Daver, Associate Professor in the Department of Leukemia at The University of Texas MD Anderson Cancer Center in Houston, Texas. References: Swords, et al. Blood. 2018;131(13):1415-1424 Stahl, et al. Curr Oncol Rep. 2019;21(4):37 Yee at al. Blood (2014) 124 (21): 116. Montesinos et al. Future Oncol. 2020 May;16(13):807-815. Ades, et al. ASCO 2020. Abstract 7506 DeAngelo, et al. Blood (2017) 130 (Supplement 1): 894. Ravandi, et al. Lancet Haematol. 2019 Sep; 6(9): e480-e488 Hofmann, et al. J Clin Med. 2019 Feb; 8(2): 200. This series is supported by educational grants from Servier Pharmaceuticals LLC and Takeda, who have had no influence on the content or choice of faculty

Although most commonly a disease of the old, Acute Myeloid Leukaemia is also a significant burden for younger patients, but it can present in different ways and they should not be treated equal. So how should younger and older patients be classified and treated? To help answer some of our questions on this topic is Dr. Tapan Kadia, Associate Professor in the Department of Leukemia at The University of Texas MD Anderson Cancer Center in Houston, Texas. References Public Health England. NCIN. 2015: 2013548 Tarlock, et al. Pediatr Clin North Am. 2015 Feb;62(1):75-93 Vakiti and Mewawalla. StatPearls: StatPearls Publishing; 2020 Jan PDQ Pediatric Treatment Editorial Board. Childhood Acute Myeloid Leukemia/Other Myeloid Malignancies Treatment (PDQ®): Health Professional Version. 2020 Aug 20 Bolouri. et al. Nat Med. 2018 Jan; 24(1): 103–112 Silva, et al. Leukemia. 2017 Jul;31(7):1640-1644 Nagal, et al. Ann Hematol. 2017; 96(12): 1993–2003 Creutzig, et al. Blood. 2012 Oct 18;120(16):3187-205 Sekeres, et al. Blood Adv. 2020 Aug 11;4(15):3528-3549 Heuser et al. Ann Oncol. 2020 Mar 17;S0923-7534(20)36079-8 Joon Im. Blood Res. 2018 Mar; 53(1): 1–2 This series is supported by educational grants from Servier Pharmaceuticals LLC and Takeda, who have had no influence on the content or choice of faculty.

For patients with myelodysplastic syndrome, or MDS, their therapy options vary considerably depending on their prognosis and risk of developing AML. Today we discuss risk stratification systems and their rationale, and consider their utility in clinical practice. To answer our questions on this topic, we welcome Professor Detlaf Haase, medical director of the special diagnostic laboratories at the clinic for hematology & medical oncology in at the University Medical Center in Göttingen, Germany. References Greenberg, et al. Blood. 2012 Sep 20; 120(12): 2454–2465 Montalban-Bravo & Garcia-Manero. Am J Hematol. 2018 Jan;93(1):129-147 This series is supported by educational grants from Servier Pharmaceuticals LLC and Takeda, who have had no influence on the content or choice of faculty.

Last week we discussed the array of therapeutic options in the pipeline for patients with MDS. Today we shine a spotlight on NAE inhibitors, the first of which recently received FDA breakthrough designation to bring it to the clinic faster. To answer our questions about the current data and future therapeutic use for this novel class of drugs, we welcome Dr Magnus Tobiasson, senior consultant in internal medicine and hematology at Karolinska University Hospital in Huddinge, Sweden. References: Swords, et al. Br J Haematol. 2015 (4):534-43 Zhu, et al. Genes (Basel). 2020; 11(9): E990 Majidi, et al. Blood. 2017; 130(1): 5298 Ades, et al. ASCO 2020. Abstract 7506 This series is supported by educational grants from Servier Pharmaceuticals LLC and Takeda, who have had no influence on the content or choice of faculty.

Despite available treatments, there is still an unmet need to improve outcomes for some patients with myelodysplastic syndrome, or MDS. Thankfully, there is a wide array of therapies in development that could fill this gap, but which therapies can we start to consider as real future options for which patients? To answer our questions on this topic, we've invited the expertise of invited Dr Amer Zeidan, Associate Professor of Internal Medicine, Hematology, at the Yale University School of Medicine. References @Dr_AmerZeidan Swords, et al. Blood. 2018;131(13):1415-1424 Ades, et al. ASCO 2020. Abstract 7506 Swoboda, et al. Curr Opin Hematol. 2020 Mar; 27(2): 58-65 Germing, et al. Expert Rev Hematol. 2019; 12(10): 893-908 Fenaux, et al. N Engl J Med. 2020 Jan 9; 382(2): 140-151 Vousden & Lu. Nat Rev Cancer. 2002 Aug; 2(8): 594-604 Lindberg, et al. Haematologica. 2020 Jul; 105(7): 1765–1779 Braun, et al. Cells. 2020 Jun 26; 9(6): 1559 Platzbecker, et al. EHA Library. 2020; 295003; S183 Hamed. Canc Therapy & Oncol Int J.2019; 13(5): 1-4 Ravandi, et al. Lancet Haematol. 2019 Sep; 6(9): e480-e488 This independent educational activity is supported by an educational grant from Servier Pharmaceuticals LLC and Takeda. The educational content has been developed by Liberum IME in conjunction with an independent steering committee; Servier and Takeda have had no influence on the content of this education.

Myelodysplastic syndrome, or MDS is a rare blood disorder that often develops into acute myeloid leukaemia. Guideline recommendations can support treatment decisions for these patients, but some questions remain about best practice. In today's episode, we've invited Dr Platzbecker, clinical director in the Hematology and Cellular Therapy department at the University Hospital Leipzig, Germany, to expand on the guidelines to help you further improve your capacity to support patients with MDS. References Wells, et al. 2016; 188(10): 751 Greenberg, et al. J Natl Compr Canc Netw. 2017 Jan;15(1):60-87. Fenaux, et al. Ann Oncol. 2014; 25 Suppl 3: iii57-69 Fenaux, et al. Ann Oncol. 2020;S0923-7534(20)43129-1 This independent educational activity is supported by an educational grant from Servier Pharmaceuticals LLC and Takeda. The educational content has been developed by Liberum IME in conjunction with an independent steering committee; Servier and Takeda have had no influence on the content of this education.

We're taking a break over the Christmas period, but we'll be back in January with an exciting panel of experts discussing acute myeloid leukaemia, or AML. Until then, happy holidays and we'll see you in the new year!

Asparaginase is an important component of effective treatment strategies for adolescent and young adult patients with acute lymphoblastic leukaemia, but its associated adverse events must be effectively managed. To discuss this, we welcome Dr Dieter Hoelzer, Director of Internal Medicine and ALL specialist at the University of Frankfurt in Germany. Access more free education today! Visit the website, follow us on Twitter (@onckip) or connect on LinkedIn. References: Aldoss I, Douer D. Blood (2020) 135 (13): 987–995. Koprivnikar J, et al. Onco Targets Ther. 2017; 10: 1413–1422. Kamal N, et al. Hepatol Int. 2019; 13(5): 641–648. Hijiya N, Van der Sluis I. Leuk Lymphoma. 2016; 57(4): 748–757. This independent educational activity is supported by an educational grant from Servier Pharmaceuticals LLC and Takeda. The educational content has been developed by Liberum IME in conjunction with an independent steering committee; Servier and Takeda have had no influence on the content of this education.

Adolescent and young adult patients with acute lymphoblastic leukaemia have been shown to benefit from paediatric inspired treatment regimens, however these regimens present unique challenges when it comes to adverse-event management. Today we've invited Dr Patrick Brown, Director of the Paediatric Leukaemia Programme at Johns Hopkins Medicine, Baltimore, to discuss how to reduce the risk of adverse events in these settings. Access more free education today! Visit the website, follow us on Twitter (@onckip) or connect on LinkedIn. References: - Silverman LB, et al. Blood. 2001; 97(5):1211-8. - Verma A, et al. Pediatr Hematol Oncol. 2019; 36(5):277-286. - Baruchel A, et al. ESMO Open 2020;5:e000977 - Cooper SL, et al. Pediatr Blood Cancer. 2019; 66(8):e27797. - Verma A, et al. Blood. 2018; 132(Suppl 1):5205 - Marini BL, et al. Leuk Lymphoma. 2019; 60(12):2854-2868. This independent educational activity is supported by educational grants from Servier Pharmaceuticals LLC and Takeda. The educational content has been developed by Liberum IME in conjunction with an independent steering committee; Servier and Takeda have had no influence on the content of this education.

In our second episode on ALL we'll be looking at adolescent and young adult (AYA) patients. Although these patients are commonly seen in the adult setting, evidence suggests that paediatric-inspired regimens may improve their outcomes. But how should these be implemented practically? Joining us this week is Dr Emily Curran, Assistant Professor in the Department of Medicine, Section of Hematology & Oncology at the UC College of Medicine. Access more free education today! Visit the website, follow us on Twitter (@onckip) or connect on LinkedIn. References - Malard F, Mohty M. Lancet 2020; 395(10230):1146-1162 - Moskoff B, et al. Blood 2016; 128(22):5195 - Huguet F, et al. J Clin Oncol. 2009; 27(6):911-8. - Burke PW, et al. Leuk Res2018; 66:49-56 - Alacacioglu I, et al. Chemotherapy. 2014;60(4):219-23 - El-Cheikh J, et al. Clin Lymphoma Myeloma Leuk. 2017; 17(3):179-185 This independent educational activity is supported by educational grants from Servier Pharmaceuticals LLC and Takeda. The educational content has been developed by Liberum IME in conjunction with an independent steering committee; Servier and Takeda have had no influence on the content of this education.

To start off our mini-series on ALL, this episode we'll be looking at adolescent and young adult (AYA) patients. Although these patients are commonly seen in the adult setting, evidence suggests that pediatric-inspired regimens may improve their outcomes. But how should these be implemented practically? Joining us this week is Dr Adam DuVall, Assistant Professor of Medicine and specialist in AYA cancer management at the University of Chicago. Access more free education today! Visit the website, follow us on Twitter (@onckip) or connect on LinkedIn. References: - Terwilliger T, Abdul-Hay M. Blood Cancer Journal 2019; 7:e577 - Muffly L, et al. Blood Adv. 2018; 2(8):895-903 - Siegel SE, et al. JAMA Oncol. 2018; 4(5):725-734 - Stock W, et al. Blood. 2019; 133(14):1548-1559 This independent educational activity is supported by educational grants from Servier Pharmaceuticals LLC and Takeda. The educational content has been developed by Liberum IME in conjunction with an independent steering committee; Servier and Takeda have had no influence on the content of this education.

Although breast cancer was once considered a “non-immunogenic” cancer, numerous studies demonstrate PD-L1 expression in the breast cancer micro-environment, and now several immune checkpoint inhibitors are under investigation in this patient group. To help us to interpret the results of all of these trials and to begin thinking about how this class of drugs fits into breast cancer treatment plans, we've invited Professor Peter Schmid, Centre Lead of the Centre of Experimental Cancer Medicines at Bart's Cancer Institute, London, to answer our questions on the topic. References: Plaines-Laine, et al. Cancers (Basel). 2019; 11(7): 1033 Cyprian, et al. Bosn J Basic Med Sci. 2019; 19(3): 227-233 Schmid, et al. N Engl J Med. 2020 Feb 27;382(9):810-821 Access more free education today! Visit the website, follow us on Twitter (@onckip) or connect on LinkedIn. This episode is supported by an educational grant from Merck, Sharpe and Dohme corp., who has had no influence on the content or choice of faculty.

Immune checkpoint inhibitors are a relatively new treatment option for patients with metastatic, unresectable head and neck squamous cell carcinoma (HNSCC), and so they have not yet been incorporated into clinical practice guidelines. For this reason, we interview Professor Frederic Peyrade, Head of Clinical Research and Professor of Oncology, Antoine Lacassagne Cancer Centre, France, to get expert advice on incorporating immune checkpoint inhibitors into current treatment protocols. References - Grégoire V, et al. Ann Oncol. 2009; 20 Suppl 4: 121-2 - Dimitrios Colevas, et al. J Natl Compr Canc Netw. 2018 May; 16(5): 479-490 - Cohen, et al. J Immunother Cancer. 2019 Jul 15; 7(1): 184 Access more free education today! Visit the website, follow us on Twitter (@onckip) or connect on LinkedIn. This independent educational activity is supported by an educational grant from Merck, Sharpe & Dohme Corp. The educational content has been developed by Liberum IME in conjunction with an independent steering committee; MSD corp. has had no influence on the content of this education.

Several immune checkpoint inhibitors have indications in non small-cell lung cancer (NSCLC), but it is not always easy to decide which patients to treat when, and with which regimen. In today's episode, we've invited Professor Martin Reck from the Lung Clinic Grosshansdorf in Germany to answer some of our questions about best practice when considering immune checkpoint inhibitors for patients with NSCLC. References: Postmus PE, et al. Annals of Oncology. 2017; 28: iv1-iv21 Socinski MA et al. JCO. 2019; 37(15_suppl): 9012-9012 Pacheco JM. Translational Lung Cancer Research. 2019; 8(5): 723-727 Funazo T et al. J Thorac Oncol. 2017; 12(9): e140-e141 Sridhar S et al. Clin Lung Cancer. 2019; 20(6): e601-e608 Chai Q-Q et al. Frontiers in Pharmacology. 2019; 10:1260 Peng M et al. OncoTargets and Therapy. 2018; 11: 7369-7383 Gadgeel S et al. JCO. 2020; 38(14): 1505-1517 Ettinger DS et al. J Natl Compr Canc Netw. 2017; 15(4): 504-535 Access more free education today! Visit the website, follow us on Twitter (@onckip) or connect on LinkedIn. This independent educational activity is supported by an educational grant from Merck, Sharpe & Dohme Corp. The educational content has been developed by Liberum IME in conjunction with an independent steering committee; MSD corp. has had no influence on the content of this education.

Histological specimens are recommended to assess a patient's PD-L1 status; however, it is not always easy or even feasible to secure a histological specimen in advanced cancers such as stage IV NSCLC. Cytological specimens are typically used in this setting to assess other molecular markers such as ALK or ROS1 – should they also be used to assess PD-L1 status? This episode summarises the evidence for and against a cytological approach, before joining Professor Frederique Penault-Llorca for her opinion on whether cytology should be used to assess PD-L1 status in real-world practice. References: Gosney J, et al. Lung Cancer. 2020; 141:101-106 Heymann J, et al. Cancer Cytopathology. 2017; 125(12): 896-907 Wagner C, et al. Eur Respir J. 2018; 52: Suppl. 62, PA2217. Access more free education today! Visit the website, follow us on Twitter (@onckip) or connect on LinkedIn. This independent educational activity is supported by an educational grant from Merck, Sharpe & Dohme Corp. The educational content has been developed by Liberum IME in conjunction with an independent steering committee; MSD corp. has had no influence on the content of this education.

PD-L1 status has long been explored as a predictive biomarker for immune checkpoint inhibitors. However, the clinical evidence for its efficacy has been mixed, so how should PD-L1 status be used in clinical practice? In the first episode in this series on immuno-oncology, Dr Vaibhav Patel from the Icahn School of Medicine at Mount Sinai, New York, answers questions about how PD-L1 status can or cannot influence treatment decisions in oncology. References: Kulangara K, et al. Arch Pathol Lab Med. 2019; 143(3): 330-337 Mok S, et al. Lancet. 2019; 393(10183): 1819-1830 Pacheco J. Transl Lung Cancer Res. 2019; 8(5): 723-727 Xu Y, et al. Transl Lung Cancer Res. 2019; 8(4): 413-428 Access more free education today! Visit the website, follow us on Twitter (@onckip) or connect on LinkedIn. This independent educational activity is supported by an educational grant from Merck, Sharpe & Dohme Corp. The educational content has been developed by Liberum IME in conjunction with an independent steering committee; MSD corp. has had no influence on the content of this education.

In this bi-weekly podcast, cancer experts discuss game-changing topics in clinical oncology. Produced by Oncology Knowledge into Practice (www.onckip.com), this podcast series will support and inform your practice in cancer management. This podcast is intended for healthcare professionals only. Funding information is available in each episode's notes. Access more free education today! Visit the website, follow us on Twitter (@onckip ) or connect on LinkedIn. https://www.oncologyknowledgeintopractice.com/