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Dr. Hope Rugo and Dr. Giuseppe Curigliano discuss recent developments in the field of bispecific antibodies for hematologic and solid tumors, including strategies to optimize the design and delivery of the immunotherapy. TRANSCRIPT Dr. Hope Rugo: Hello and welcome to By the Book, a podcast series from ASCO that features engaging conversations between editors and authors of the ASCO Educational Book. I am your host, Dr. Hope Rugo. I am the director of the Women's Cancers Program and division chief of breast medical oncology at the City of Hope Cancer Center. I am also the editor-in-chief of the Educational Book. Bispecific antibodies represent an innovative and advanced therapeutic platform in hematologic and solid tumors. And today, I am delighted to be joined by Dr. Giuseppe Curigliano to discuss the current landscape of bispecific antibodies and their potential to reshape the future of precision oncology. Dr. Curigliano was the last author of an ASCO Educational Book piece for 2025 titled, "Bispecific Antibodies in Hematologic and Solid Tumors: Current Landscape and Therapeutic Advances." Dr. Curigliano is a breast medical oncologist and the director of the Early Drug Development Division and chair of the Experimental Therapeutics Program at the European Institute of Oncology in Milan. He is also a full professor of medical oncology at the University of Milan. You can find our disclosures in the transcript of this episode. Dr. Curigliano, Giuseppe, welcome and thanks for being here. Dr. Giuseppe Curigliano: Thanks a lot for the invitation. Dr. Hope Rugo: Giuseppe, I would like to first ask you to provide some context for our listeners on how these novel therapeutics work. And then perhaps you could tell us about recent developments in the field of bispecific antibodies for oncology. We are at a time when antibody-drug conjugates (ADCs) are all the rage and, trying to improve on the targeting of specific antigens, proteins, receptors in the field of oncology is certainly a hot and emerging topic. Dr. Giuseppe Curigliano: So, thanks a lot. I believe really it was very challenging to try to summarize all the bispecific antibodies that are under development in multiple solid tumors. So, the first thing that I would like to highlight is the context and the mechanism of action of bispecific antibodies. Bispecific antibodies represent a groundbreaking advancement in cancer immunotherapy, because these engineered molecules have the unique ability to target and simultaneously bind to two distinct antigens. That is why we call them bispecific. So typically, one antigen is expressed on the tumor cell and the other one is expressed on the immune effectors, like T-cell or natural killer cells. So this dual targeting mechanism offers several key advantages over conventional monoclonal antibodies because you can target at the same time the tumor antigen, downregulating the pathway of proliferation, and you can activate the immune system. So the primary mechanism through which bispecific antibodies exert their therapeutic effects are: First, T-cell redirecting. I mean, many bispecific antibodies are designed to engage tumor-associated antigens like epidermal growth factor receptor, HER2, on the cancer cell and a costimulatory molecule on the surface of T-cell. A typical target antigen on T-cell is CD3. So what does it mean? That you activate the immune system, immune cells will reach the tumor bed, and you have a dual effect. One is downregulating cell proliferation, the other one is activation of the immune system. This is really important in hematological malignancies, where we have a lot of bispecifics already approved, like acute lymphoblastic leukemia or non-Hodgkin lymphoma. The second, in fact, is the engagement of the tumor microenvironment. So, if you engage immune effector cells like NK cells or macrophages, usually the bispecific antibodies can exploit the immune system's ability to recognize and kill the immune cells, even if there is a lack of optimal antigen presentation. And finally, the last mechanism of action, this may have a role in the future, maybe in the early cancer setting, is overcoming immune evasion. So bispecific antibodies can overcome some of the immune evasion mechanisms that we see in cancer. For example, bispecific antibodies can target immune checkpoint receptors, like PD-L1 and CTLA-4. Actually, there is a bispecific under development in breast cancer that has a dual targeting on vascular endothelial growth factor receptor and on PD-L1. So you have a dual effect at the same time. So, what is really important, as a comment, is we need to focus first on the optimal format of the bispecific, the optimal half-life, the stability, because of course even if they are very efficient in inducing a response, they may give also a lot of toxicities. So in clinical trials already, we have several bispecifics approved. In solid tumors, very few, specifically amivantamab for non-small cell lung cancer, but we have a pipeline of almost 40 to 50 bispecifics under development in multiple solid tumors, and some of them are in the context of prospective randomized trials. Dr. Hope Rugo: So this is really a fascinating area and it's really exciting to see the expansion of the different targets for bispecific antibodies. One area that has intrigued me also is that some of the bispecifics actually will target different parts of the same receptor or the same protein, but presumably those will be used as a different strategy. It's interesting because we have seen that, for example, in targeting HER2. Dr. Giuseppe Curigliano: Oh, yes, of course. You may consider some bispecifics like margetuximab, I suppose, in which you can target specifically two different epitopes of the same antigen. This is really an example of how a bispecific can potentially be more active and downregulating, let us say, a pathway, by targeting two different domains of a specific target antigen. This is an important point. Of course, not all the bispecifics work this way, because some of the target antigen may dimerize, and so you have a family of target antigen; an example is epidermal growth factor receptor, in which you have HER1, HER2, HER3, and HER4. So some of them can inhibit the dimerization between one target antigen and the other one, in order to exert a more antiproliferative effect. But to be honest, the new generation of them are more targeting two different antigens, one on the tumor and one on the microenvironment, because according to the clinical data, this is a more efficient way to reduce proliferation and to activate the immune system. Dr. Hope Rugo: Really interesting, and I think it brings us to the next topic, which is really where bispecific antibodies have already shown success, and that is in hematologic malignancies where we have seen very interesting efficacy and these are being used in the clinic already. But the expansion of bispecific antibodies into solid tumors faces some key challenges. It's interesting because the challenges come in different shapes and forms. Tell us about some of those challenges and strategies to optimize bispecific antibody design, delivery, patient selection, and how we are going to use these agents in the right kind of clinical trials. Dr. Giuseppe Curigliano: This is really an excellent question because despite bispecific antibodies having shown a remarkable efficacy in hematological malignancies, their application in solid tumors may have some challenges. The first one is tumor heterogeneity. In hematological malignancy, you have a clear oncogene addiction. Let us say that 90% of the cells may express the same antigen. In solid tumors, it is not the same. Tumor heterogeneity is a typical characteristic of solid tumors, and you have high heterogeneity at the genetic, molecular, and phenotypic levels. So tumor cells can differ significantly from one another, even if within the same tumor. And this heterogeneity sometimes makes it difficult to identify a single target antigen that is universally expressed in an hematological malignancy. So furthermore, sometimes the antigen expressed on a tumor cell can be also present on the normal tissue. And so you may have a cross-targeting. So let's say, if you have a bispecific against epidermal growth factor receptor, this will target the tumor but will target also the skin with a lot of toxicity. The second challenge is the tumor microenvironment. The solid tumor microenvironment is really complex and often immunosuppressive. It is characterized by the presence of immunosuppressor cells like the T regulators, myeloid derived suppressor cells, and of course the extracellular matrix. All these factors hinder immune cell infiltration and also may reduce dramatically the effectiveness of bispecific antibodies. And as you know, there is also an hypoxic condition in the tumor. The other challenge is related to the poor tumor penetration. As you know also with antibody-drug conjugate, only 1 to 3% of the drug will arrive in the tumor bed. Unlike hematological malignancies where tumor cells are dispersed in the blood and easily accessible, the solid tumors have a lot of barriers, and so it means that tumor penetration can be very low. Finally, the vascularity also of the tumor can be different across solid tumors. That is why some bispecifics have a vascular endothelial growth factor receptor or vascular endothelial growth factor as a target. Of course, what do we have to do to overcome these challenges? First, we have to select the optimal antigen. So knowing very well the biology of cancer and the tumor-associated antigens can really select a subgroup of epitopes that are specifically overexpressed in cancer cells. And so we need to design bispecifics according to the tumor type. Second, optimize the antibody format. So there are numerous bispecific antibody formats. We can consider the dual variable domain immunoglobulin, we specified this in our paper. The single chain variable fragments, so FC variable fragments, and the diabodies that can enhance both binding affinity and stability. And finally, the last point, combination therapies. Because bispecific antibodies targeting immune checkpoint, we have many targeting PD-1 or PD-L1 or CTLA-4, combined eventually with other immune checkpoint inhibitors. And so you may have more immunostimulating effect. Dr. Hope Rugo: This is a fascinating field and it is certainly going to go far in the treatment of solid tumors. You know, I think there is some competition with what we have now for antibody-drug conjugates. Do you see that bispecifics will eventually become bispecific ADCs? Are we going to combine these bispecific antibodies with ADCs, with chemotherapy? What is the best combination strategy do you think looking forward? Dr. Giuseppe Curigliano: So, yes, we have a bispecific ADC. We have actually some bispecifics that are conjugated with a payload of chemotherapy. Some others are conjugated with immunoactivation agents like IL-2. One of the most effective strategies for enhancing bispecific activity is the combination therapy. So which type of combination can we do? First, bispecific antibodies plus checkpoint inhibitors. If you combine a bispecific with an immune checkpoint, like anti-PD-1, anti-PD-L1, or anti-CTLA-4, you have more activity because you have activation of T-cells, reduction of immunosuppressive effect, and of course, the capability of this bispecific to potentiate the activity of the immune checkpoint inhibitor. So, in my opinion, in a non-small cell lung cancer with an expression of PD-L1 more than 50%, if you give pembrolizumab plus a bispecific targeting PD-L1, you can really improve both response rate and median progression-free survival. Another combination is chemotherapy plus bispecific antibodies. Combining chemotherapy with bispecific can enhance the cytotoxic effect because chemotherapy induces immunogenic cell death, and then you boost with a bispecific in order to activate the immune system. Bispecific and CAR T-cells, until now, we believe that these are in competition, but this is not correct. Because CAR T-cells are designed to deliver an activation of the immune system with the same lymphocytes engineered of the patients, with a long-term effect. So I really do not believe that bispecifics are in competition with CAR T-cells because when you have a complete remission induced by CAR T-cell, the effect of this complete remission can last for years. The activity of a bispecific is a little bit different. So there are some studies actually combining CAR T-cells with bispecifics. For example, bispecific antibodies can direct CAR T-cells in the tumor microenvironment, improving their specificity and enhancing their therapeutic effect. And finally, monoclonal antibody plus bispecific is another next generation activity. Because if you use bispecific antibodies in combination with existing monoclonal antibodies like anti-HER2, you can potentially increase the immune response and enhance tumor cell targeting. In hematological malignancies, this has been already demonstrated and this approach has been particularly effective. Dr. Hope Rugo: That's just so fascinating, the whole idea that we have these monoclonal antibodies and now we are going to add them to bispecifics that we could maybe attach on different toxins to try and improve this, or even give them with different approaches. I suppose giving an ADC with a bispecific would sort of be similar to that idea of giving a monoclonal antibody with the bispecific. So it is certainly intriguing. We also will need to understand the toxicity and cost overall and how we are going to use these, the duration of treatment, the assessment of biomarkers. There are just so many different aspects that still need to be explored. And then with that idea, can you look ahead five or ten years from now, and tell us how you think bispecific antibodies will shape our next generation cancer therapies, how they will be incorporated into precision oncology, and the new combinations and approaches as we move forward that will help us tailor treatment for patients both with solid tumors and hematologic malignancies? Are we going to be giving these in early-stage disease in solid tumors? So far, the studies are primarily focusing on the metastatic setting, but obviously one of the goals when we have successful treatments is to move them into the early stage setting as quickly as possible. Dr. Giuseppe Curigliano: Let us try to look ahead five years rather than ten years, to be more realistic. So, personally I believe some bispecifics can potentially replace current approaches in specifically T-cell selected population. As we gather more data from ongoing clinical trials and we adopt a deeper understanding of the tumor immuno microenvironment, of course we may have potentially new achievement. A few days ago, we heard that bispecifics in triple negative breast cancer targeting VEGF and PD-L1 demonstrated an improvement in median progression-free survival. So, how to improve and to impact on clinical practice both in the metastatic and in the early breast cancer setting or solid tumor setting? First, personalized antigen selection. So we need to have the ability to tailor bispecific antibody therapy to the unique tumor profile of individual patients. So the more we understand the biology of cancers, the more we will be able to better target. Second, bispecific antibodies should be combined. I can see in the future a potential trial in which you combine a bispecific anti-PD-L1 and VEGF with immune checkpoint inhibitor selected also to the level of expression of PD-L1, because integration of antibody bispecific with a range of immunotherapies, and this cannot be only immune checkpoint inhibitors, but can be CAR T-cells, oncolytic viruses, also targeted therapy, will likely be a dominant theme in the coming years. This combination will be based on the specific molecular and immuno feature of the cancer of the patient. Then we need an enhanced delivery system. This is really important because you know now we have a next generation antibody. An example are the bicyclic. So you use FC fragment that are very short, with a low molecular weight, and this short fragment can be bispecific, so can target at the same time a target antigen and improving the immune system. And so the development of this novel delivery system, including also nanoparticles or engineered viral vectors, can enhance the penetration in the tumor bed and the bioavailability of bispecific antibodies. Importantly, we need to reduce toxicity. Until now, bispecifics are very toxic. So the more we are efficient in delivering in the tumor bed, the more we will reduce the risk of toxicity. So it will be mandatory to reduce off-target effects and to minimize toxicity. And finally, the expansion in new indication. So I really believe you raised an excellent point. We need to design studies in the neoadjuvant setting in order to better understand with multiple biopsies which is the effect on the tumor microenvironment and the tumor itself, and to generate hypotheses for potential trials or in the neoadjuvant setting or in those patients with residual disease. So, in my opinion, as we refine design, optimize patient selection, and explore new combination, in the future we will have more opportunity to integrate bispecifics in the standard of care. Dr. Hope Rugo: I think it is particularly helpful to hear what we are going to be looking for as we move forward to try and improve efficacy and reduce toxicity. And the ability to engineer these new antibodies and to more specifically target the right proteins and immune effectors is going to be critical, of course, moving forward, as well as individualizing therapy based on a specific tumor biology. Hearing your insights has been great, and it really has opened up a whole area of insight into the field of bispecifics, together with your excellent contribution to the ASCO Educational Book. Thank you so much for sharing your thoughts and background, as well as what we might see in the future on this podcast today. Dr. Giuseppe Curigliano: Thank you very much for the invitation and for this excellent interview. Dr. Hope Rugo: And thanks to our listeners for joining us today. You will find a link to the Ed Book article we discussed today in the transcript of this episode. It is also, of course, on the ASCO website, as well as on PubMed. Please join us again next month on By the Book for more insightful views on the key issues and innovations that are shaping modern oncology. Disclaimer: The purpose of this podcast is to educate and to inform. This is not a substitute for professional medical care and is not intended for use in the diagnosis or treatment of individual conditions. Guests on this podcast express their own opinions, experience and conclusions. Guest statements on the podcast do not express the opinions of ASCO. The mention of any product, service, organization, activity or therapy should not be construed as an ASCO endorsement. Follow today's speakers: Dr. Hope Rugo @hope.rugo Dr. Giuseppe Curigliano @curijoey Follow ASCO on social media: @ASCO on X (formerly Twitter) ASCO on Bluesky ASCO on Facebook ASCO on LinkedIn Disclosures: Dr. Hope Rugo: Honoraria: Mylan/Viatris, Chugai Pharma Consulting/Advisory Role: Napo Pharmaceuticals, Sanofi, Bristol Myer Research Funding (Inst.): OBI Pharma, Pfizer, Novartis, Lilly, Merck, Daiichi Sankyo, AstraZeneca, Gilead Sciences, Hoffman La-Roche AG/Genentech, In., Stemline Therapeutics, Ambryx Dr. Giuseppe Curigliano: Leadership: European Society for Medical Oncology, European Society of Breast Cancer Specialists, ESMO Open, European Society for Medical Oncology Honoraria: Ellipses Pharma Consulting or Advisory Role: Roche/Genentech, Pfizer, Novartis, Lilly, Foundation Medicine, Bristol-Myers Squibb, Samsung, AstraZeneca, Daiichi-Sankyo, Boerigher, GSK, Seattle Genetics, Guardant Health, Veracyte, Celcuity, Hengrui Therapeutics, Menarini, Merck, Exact Sciences, Blueprint Medicines, Gilead Sciences Speakers' Bureau: Roche/Genentech, Novartis, Pfizer, Lilly, Foundation Medicine, Samsung, Daiichi Sankyo, Seagen, Menarini, Gilead Sciences, Exact Sciences Research Funding: Merck Travel, Accommodations, Expenses: Roche/Genentech, Pfizer, Daiichi Sankyo, AstraZeneca
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This content has been developed for healthcare professionals only. Patients who seek health information should consult with their physician or relevant patient advocacy groups.For the full presentation, downloadable Practice Aids, slides, and complete CME/MOC/NCPD/AAPA/IPCE information, and to apply for credit, please visit us at PeerView.com/NAW865. CME/MOC/NCPD/AAPA/IPCE credit will be available until July 6, 2026.Expanding the Bispecific Option Across Hematologic Cancers: Guidance for the Community on Collaborative Care and Accessing Innovative Immunotherapy for Myeloma and Lymphoma In support of improving patient care, PVI, PeerView Institute for Medical Education, is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.SupportThis program is supported by an independent educational grant from Regeneron Pharmaceuticals, Inc.Disclosure information is available at the beginning of the video presentation.
This content has been developed for healthcare professionals only. Patients who seek health information should consult with their physician or relevant patient advocacy groups.For the full presentation, downloadable Practice Aids, slides, and complete CME/MOC/NCPD/AAPA/IPCE information, and to apply for credit, please visit us at PeerView.com/NAW865. CME/MOC/NCPD/AAPA/IPCE credit will be available until July 6, 2026.Expanding the Bispecific Option Across Hematologic Cancers: Guidance for the Community on Collaborative Care and Accessing Innovative Immunotherapy for Myeloma and Lymphoma In support of improving patient care, PVI, PeerView Institute for Medical Education, is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.SupportThis program is supported by an independent educational grant from Regeneron Pharmaceuticals, Inc.Disclosure information is available at the beginning of the video presentation.
This content has been developed for healthcare professionals only. Patients who seek health information should consult with their physician or relevant patient advocacy groups.For the full presentation, downloadable Practice Aids, slides, and complete CME/MOC/NCPD/AAPA/IPCE information, and to apply for credit, please visit us at PeerView.com/NAW865. CME/MOC/NCPD/AAPA/IPCE credit will be available until July 6, 2026.Expanding the Bispecific Option Across Hematologic Cancers: Guidance for the Community on Collaborative Care and Accessing Innovative Immunotherapy for Myeloma and Lymphoma In support of improving patient care, PVI, PeerView Institute for Medical Education, is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.SupportThis program is supported by an independent educational grant from Regeneron Pharmaceuticals, Inc.Disclosure information is available at the beginning of the video presentation.
This content has been developed for healthcare professionals only. Patients who seek health information should consult with their physician or relevant patient advocacy groups.For the full presentation, downloadable Practice Aids, slides, and complete CME/MOC/NCPD/AAPA/IPCE information, and to apply for credit, please visit us at PeerView.com/NAW865. CME/MOC/NCPD/AAPA/IPCE credit will be available until July 6, 2026.Expanding the Bispecific Option Across Hematologic Cancers: Guidance for the Community on Collaborative Care and Accessing Innovative Immunotherapy for Myeloma and Lymphoma In support of improving patient care, PVI, PeerView Institute for Medical Education, is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.SupportThis program is supported by an independent educational grant from Regeneron Pharmaceuticals, Inc.Disclosure information is available at the beginning of the video presentation.
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Full article: Head-to-Head Comparison of 68Ga-PentixaFor PET/CT and FDG PET/CT for Detecting Hematologic and Solid Cancers: A Systematic Review and Meta-Analysis Aiasha Alam, MD, discusses the systematic review and meta-analysis by Wang et al. comparing 68Ga-PentixaFor PET/CT and FDG PET/CT for oncologic evaluation.
Dr. John Sweetenham and Dr. Marc Braunstein highlight top research on hematologic malignancies from the 2025 ASCO Annual Meeting, including abstracts on newly diagnosed chronic phase CML, relapsed B-cell lymphoma, and multiple myeloma. Transcript Dr. John Sweetenham: Hello, and welcome to the ASCO Daily News Podcast. I'm your host, Dr. John Sweetenham. On today's episode, we'll be discussing promising advances in newly diagnosed chronic phase CML, relapsed B-cell lymphoma, multiple myeloma, and other hematologic malignancies that were presented at the 2025 ASCO Annual Meeting. Joining me for this discussion is Dr. Marc Braunstein, a hematologist and oncologist at the NYU Perlmutter Cancer Center. Our full disclosures are available in the transcript of this episode. Marc, there were some great studies in the heme space at this year's Annual Meeting, and it's great to have you back on the podcast to highlight some of these advances. Dr. Marc Braunstein: Yes, I agree, John, and thank you so much for inviting me again. It's great to be here. Dr. John Sweetenham: Let's start out with Abstract 6501. This was a study that reported on the primary endpoint results of the phase 3B ASC4START trial, which assessed asciminib versus nilotinib in newly diagnosed chronic phase CML. And the primary endpoint of this, as you know, was time to treatment discontinuation because of adverse events. Can you give us your insights into this study? Dr. Marc Braunstein: Absolutely. So, like you mentioned, you know, asciminib is an allosteric inhibitor of the BCR-ABL kinase that has activity in CML, and that includes patients with the T315I mutation that confers resistance to first- and second-generation TKIs. So, the ASC4FIRST study, which was published last year in the New England Journal of Medicine, showed superior efficacy of asciminib compared to investigator-selected first- or second-generation TKIs, actually leading to the FDA approval of asciminib in first-line CML. So, the authors of that study presented data at this year's ASCO meeting from the phase 3 ASC4START comparing safety and time to discontinuation due to adverse events of asciminib versus nilotinib, a second-generation TKI. So, 568 patients with newly diagnosed CML were randomized one-to-one to once-daily asciminib or twice-daily nilotinib. So, at a median follow-up of 9.7 months, about 11% in the asciminib group and 17% in the nilotinib group discontinued treatment, with significantly fewer discontinuations with asciminib due to adverse events. There was also a secondary endpoint of major molecular response, which was also better with asciminib. For example, the MR 4.5, which is a deep response, was 2.5% versus 0.4% favoring asciminib by week 12. So, I think in conclusion, these results build on the ASC4FIRST study, making the case for the superior safety and efficacy of asciminib versus other first- or second-generation TKIs in newly diagnosed CML. Dr. John Sweetenham: Thanks, Marc. Do you think this is going to change practice? Dr. Marc Braunstein: I think so. I think there are still some questions to be answered, such as what resistance mutations occur after first-line treatment with asciminib. But I think the sum of these studies really make the case for using asciminib upfront in CML. Dr. John Sweetenham: Okay, great. Thank you. And let's move on to our second abstract. This was Abstract 7015 and was reported from Mass General Hospital. And this was a study in patients with relapsed and refractory diffuse large B-cell lymphoma and reported the 2-year results of the so-called STARGLO study. This is a comparison of glofitamab, a T-cell engaging bispecific antibody, with gemcitabine and oxaliplatin in this group of patients. Can you tell us a little bit about your impressions of this study? Dr. Marc Braunstein: Absolutely. So just for background, the treatment landscape for relapsed/refractory large B-cell lymphoma is expanding, now with two bispecific antibodies targeting CD20 that are approved after two or more lines of therapy. Among these, glofitamab was approved in 2023 based on phase 2 data showing an objective response rate of 52%, with 39% complete responses in relapsed/refractory large B-cell lymphoma patients after a median of three prior lines of therapy. Distinguishing glofitamab from epcoritamab, the other approved bispecific, glofitamab was given for 12 cycles and then stopped. Additionally, when combined with gemcitabine and oxaliplatin in the phase 3 STARGLO study, there was significantly improved overall survival compared to rituximab plus gemcitabine and oxaliplatin in transplant-ineligible relapsed/refractory large B-cell lymphoma patients at a median follow-up of 11 months. The authors of that study published last year in Lancet now present at ASCO this year the 2-year follow-up of the STARGLO study. Two hundred and seventy-four patients with a median of one prior line of therapy were randomized two-to-one to glofitamab plus GemOx versus rituximab plus GemOx, with the primary endpoint of overall survival. Here, the median overall survival was not reached versus 13.5 months, with a median PFS also significantly improved at about 14 months versus 4 months in the control. CRS of note in the glofitamab arm was mostly grade 1 or 2, with only about 2.3% grade 3 events. And three of the four patients had grade 1 or 2 neurotoxicity. So, John, putting this into context, I think it's encouraging that we now have randomized data showing the superiority of a bispecific plus chemotherapy over rituximab plus chemotherapy in transplant-ineligible patients. And while only 8% of the patients in the STARGLO study had prior anti-CD19 CAR T-cell therapy, I think this regimen could be considered in those patients who are ineligible for transplant or CAR T-cell therapy. Dr. John Sweetenham: Yeah, I agree. I think a couple of other compelling numbers to me were the fact that around 55% of these patients were alive at 2 years in the group who'd received glofitamab, and that almost 90% of those having that arm of the study who had a CR at the end of treatment were alive at 12 months. So, clearly, it's an active agent and also a kind of great off-the-shelf fixed-duration alternative in these relapsed and refractory patients. Dr. Marc Braunstein: I agree, and I would also note that the phase 3 SKYGLO study is looking at glofitamab plus Pola-R-CHP versus Pola-R-CHP alone. So, we may even be using these eventually in the first-line setting. Dr. John Sweetenham: Absolutely. Let's stay on the theme of diffuse large B-cell lymphoma and look at one other abstract in that space, which was Abstract 7000. This was a study from the HOVON group in the Netherlands, which looked at the prospective validation of end-of-treatment circulating tumor DNA in the context of a national randomized trial. What are your thoughts on this? Dr. Marc Braunstein: So, non-invasive liquid biopsies to detect and monitor cancers via circulating tumor-derived DNA or ctDNA, you know, is really emerging as a valuable tool in both solid and liquid tumors to understand disease biology, and also for drug development. So, to date, the most established application of ctDNA in lymphoma, I would say, is really for monitoring of minimal residual disease. So, in this correlative study by Steven Wang and colleagues in the HOVON group, they evaluated the prognostic significance of MRD status as assessed by ctDNA following first-line treatment with curative intent with either R-CHOP or dose-adjusted R-EPOCH. At the end of treatment, encouragingly, 76% of patients were MRD-negative, and 24% were MRD-positive. Now, of note, MRD-positive status at the end of treatment predicted inferior progression-free survival at 2 years, with only 28% of patients who are MRD-positive being progression-free versus 88% who are MRD-negative. And in fact, all the patients who failed to achieve a complete response after first-line treatment and were MRD-positive ultimately relapsed. So, circulating tumor cells are rarely found in large B-cell lymphomas, and so this study really builds on accumulating data that ctDNA has clinical value to detect residual disease with a non-invasive approach. So, there are many implications of how we could potentially use this to detect early signs of relapse, to potentially escalate treatment for consolidation if patients remain MRD-positive. So, I think this will eventually become utilized in clinical practice. Dr. John Sweetenham: Yeah, I agree. I think it's interesting that it provided an independent assessment of response, which was independent, in fact, of the results of PET-CT scanning and so on, which I think was very interesting to me. And the authors of the abstract actually commented in their presentation that they think this should be integrated as part of the standard response assessment now for patients with large B-cell lymphoma. Would you agree with that? Dr. Marc Braunstein: I would. For one thing, it allows repeated sampling. It's a non-invasive approach; it doesn't necessarily require a bone marrow biopsy, and it may have more sensitivity than conventional response measures. So, I think having a standardized system to assess ctDNA will be helpful, and definitely, I think this will be a valuable biomarker of disease response. Dr. John Sweetenham: Okay, great. Thanks. We're going to change gear again now, and we're going to highlight two abstracts in the multiple myeloma space. The first one of these is Abstract 7507. And this abstract reported on the long-term results of the CARTITUDE study for patients with relapsed and refractory multiple myeloma. What are your comments on this presentation? Dr. Marc Braunstein: So, this study actually got a lot of press, and I've already had multiple patients asking me about CAR T-cells as a result. Just as some background, CAR T-cells targeting BCMA, which is pretty much universally expressed on malignant plasma cells in myeloma, have really shown remarkable responses, especially in heavily pretreated patients, showing superior progression-free survival in both later and earlier phases of the disease, including in randomized studies in patients with second-line or beyond. So, the CARTITUDE-1 was really the original Phase 1/2 study of ciltacabtagene autoleucel, one of the two approved anti-BCMA CAR T-cell products, which was investigated in patients with a median of six to seven prior lines of therapy. So, these were patients who were pretty heavily pretreated. So, in the study presented by Voorhees at this year's ASCO meeting, this was the long-term follow-up at a median of 5 years from the one-time CAR infusion in these patients with a median of five prior lines of therapy. And remarkably, of the 97 patients, 33% remained progression-free at 5 years plus, without needing any further myeloma treatment during that time. And among those 33% of patients, 23% had high-risk cytogenetics, which we know are notoriously difficult to achieve responses in. What was interesting that they presented as correlative studies was there were some biomarkers that were distinguishing the patients who had the long PFS, including enrichment of more naive T-cells in the product, lower neutrophil-to-T-cell ratio, higher hemoglobin and platelets at baseline, and higher CAR T-cell levels relative to soluble BCMA levels. And the fact that they reported a median overall survival of 61 months in these really heavily pretreated patients, I think these data are impressive. I think we're going to continue to be using CAR T even earlier in the disease status than fifth or sixth line, as it was studied in CARTITUDE-1. There are even ongoing studies looking at first-line treatment with CAR T-cells. Dr. John Sweetenham: So, do you think that those 33% of patients who are disease-free at 5 years, do you think any of those are cured? Dr. Marc Braunstein: That was one of the headlines in the press. I think if we're going to discuss things like "operational cures," where we're transforming myeloma into really a chronic disease, where patients can live practically a normal life expectancy, I think the measure of 5 years, especially in this population that was explored in CARTITUDE-1, I think we can call that close to a cure. Dr. John Sweetenham: Okay. Well, thank you. Exciting data, for sure. We're going to conclude today with another abstract in the multiple myeloma space. And this was Abstract 7500, which looked at an MRD, minimal residual disease-driven strategy following induction and transplant-eligible newly diagnosed multiple myeloma patients and reported on the primary endpoints of the phase 3 MIDAS trial. Can you walk us through this one, Marc? Dr. Marc Braunstein: Absolutely. It is a bit more complicated than the prior one we discussed because this is a randomized study with four arms. So, I'll start by saying that anti-CD38-based quadruplet regimens continue to show superior outcomes in both transplant-eligible and -ineligible newly diagnosed multiple myeloma patients. The MIDAS study mentioned is an open-label phase 3 trial with four arms in transplant-eligible newly diagnosed myeloma patients. And initially, these patients were all treated with quadruplet therapy with the anti-CD38 antibody isatuximab combined with carfilzomib, lenalidomide, and dexamethasone in 718 newly diagnosed myeloma patients. So, they received the quadruplet regimen for six cycles and then were randomized based on their MRD status at 10 to the negative fifth following six cycles of induction. And that first randomization, if they were MRD-negative, was to either consolidation with six more cycles of the quadruplet regimen or transplant, autologous transplant, plus two cycles additionally of the quadruplet regimen. And both arms were followed by lenalidomide maintenance. The primary endpoint was MRD negativity at 10 to the negative sixth prior to entering the lenalidomide maintenance component. And in addition, the patients who were MRD-positive after induction were randomized to transplant plus two cycles of consolidation or a tandem autologous transplant. So, the median follow-up of the study was about 16 months, and the pre-maintenance rate of MRD negativity was high, between 84 to 86% between the two arms who were MRD-negative, which was not significantly different. And as far as the 233 patients who were MRD-positive, the pre-maintenance MRD negativity was also not significantly different at 40% for those who received autologous transplant, and 32% who received a tandem transplant. So, there's a lot of debate in the myeloma field about the evolving role of autologous transplant and whether transplant still plays a significant role in patients who are either MRD-negative after induction or who have deep remissions and are of standard risk. So, I think these data suggest that patients who are MRD-negative after induction with a quadruplet regimen studied here, which was Isa-KRd, plus consolidation, may possibly be able to forego consolidation with autologous transplant. And likewise, for those patients who are MRD-positive after induction, tandem transplant didn't seem to provide much of a benefit compared to single transplant, which is consistent with prior studies such as the StaMINA study. Dr. John Sweetenham: So, where do you think this leaves us, Marc? Are we going to need more studies before we have any definitive guidance on whether an autologous transplant is still appropriate for those patients who are MRD-negative? Dr. Marc Braunstein: Well, as clinicians, we want to do what's best for our patient. And in myeloma, the best we can do is to get as deep remissions as possible, meaning MRD negativity. And so, I think it's clear from the MIDAS study and others that quadruplet regimens provide the deepest remissions when given upfront. We can debate the role of autologous transplant. I think certainly the role of tandem autologous transplant is fading. But as far as a single autologous transplant as consolidation, I think it's reasonable as a goal to try to achieve MRD negativity after the transplant, especially for patients who remain MRD-positive after induction. Dr. John Sweetenham: Okay, great. Marc, thanks as always for sharing your insights on the heme malignancies studies from the ASCO meeting this year and for joining us on the ASCO Daily News Podcast. Always appreciate hearing your thoughtful and balanced input on these. Dr. Marc Braunstein: My pleasure. Thank you, John. Dr. John Sweetenham: And thank you to our listeners for joining us today. You'll find links to the abstracts discussed today in the transcript of this episode. Finally, if you value the insights that you hear on the ASCO Daily News Podcast, please take a moment to rate, review, and subscribe wherever you get your podcasts. Disclaimer: The purpose of this podcast is to educate and to inform. This is not a substitute for professional medical care and is not intended for use in the diagnosis or treatment of individual conditions. Guests on this podcast express their own opinions, experience, and conclusions. Guest statements on the podcast do not express the opinions of ASCO. The mention of any product, service, organization, activity, or therapy should not be construed as an ASCO endorsement. Find out more about today's guest: Dr. John Sweetenham Dr. Marc Braunstein @docbraunstein Follow ASCO on social media: @ASCO on Twitter ASCO on Bluesky ASCO on Facebook ASCO on LinkedIn Disclosures: Dr. John Sweetenham: Consulting or Advisory Role: EMA Wellness Dr. Marc Braunstein: Consulting or Advisory Role: Pfizer, Bristol-Myers Squibb/Celgene, Adaptive Biotechnologies, GlaxoSmithKline, ADC Therapeutics, Janssen Oncology, Abbvie, Guidepoint Global, Epizyme, Sanofi, CTI BioPharma Corp Speakers' Bureau: Janssen Oncology Research Funding (Institution): Janssen, Celgene/BMS
An expert panel highlights key presentations in multiplemyeloma, lymphoma, and other hematologic malignancies at the 2025 ASCO Annual Meeting.CancerNetwork®, in collaboration with The American Societyfor Transplantation and Cellular Therapy (ASTCT), organized an X Space hosted by Rahul Banerjee, MD, FACP; Taha Al-Juhaishi, MD; and Muhammad Salman Faisal, MD. This expert panel convened to discuss key presentations and abstracts of interest at the 2025 American Society of Clinical Oncology (ASCO) Annual Meeting featuring noteworthy developments in modalities like CAR T-cell therapy and transplantation across multiple myeloma, lymphoma, and other disease types.Banerjee is an assistant professor in the Clinical Research Division at the Fred Hutchinson Cancer Center in Seattle, Washington. Al-Juhaishi is the associate director of the Hematopoietic Stem Cell Transplantation and Cell Therapy Program at Oklahoma University Health Stephenson Cancer Center and an assistant professor of medicine at the University of Oklahoma College of Medicine. Faisal is a hematologist/oncologist at Oklahoma University HealthStephenson Cancer Center and serves as an ambassador for ASCO.The group highlighted several late-breaking abstracts,plenary sessions, and poster presentations focused on significant clinical trial data and other findings across the hematologic oncology landscape. Topics of interest included the following:Phase 1b/2 CARTITUDE-1 trial (NCT03548207,NCT05201781)1Long-term follow-up showed that approximately one-third(33%; n = 32) of patients with relapsed/refractory multiple myeloma maintained progression-free status for at least 5 years following a single infusion of ciltacabtagene autoleucel (cilta-cel; Carvykti). An equal likelihood of progression-free survival occurred in patients with high-risk cytogenetics or extramedullary plasmacytomas.With a median follow-up of 61.3 months, the median overall survival (OS) with cilta-cel was 60.7 months (95% CI, 41.9-notevaluable [NE]). Real-world axicabtagene ciloleucel (axi-cel; Yescarta) use2Across inpatient and outpatient treatment settings, safety and efficacy outcomes were comparable for patients who received axi-cel for relapsed/refractory large B-cell lymphoma.Multivariate analysis showed no associations between intended care setting and cytokine release syndrome or immune effector cell-associated neurotoxicity syndrome.Investigators noted that these real-world data support the consideration of axi-cel in appropriate outpatient settings.Phase 1b/2 NEXICART-2 trial (NCT06097832)3Investigators assessed NXC-201, a sterically optimized CAR T construct, as a treatment for patients with relapsed/refractory light chain amyloidosis, a population with no FDA-approved options.Among 12 patients who received the agent at 450x 106 cells, 100% achieved rapid and deep hematologic responses at a median time to first and best response of 7 and 26 days, respectively. With a median follow-up of 121 days (range, 29-289), no hematologic relapses or progression had occurred.References1. Voorhees P, Martin T, Lin Y, et al. Long-term (≥5 year) remission and survival after treatment with ciltacabtagene autoleucel (cilta-cel) in CARTITUDE-1 patients (pts) with relapsed/refractory multiple myeloma (RRMM). J Clin Oncol. 2025;43(suppl 16):7507. doi: 10.1200/JCO.2025.43.16_suppl.75072. Furqan F, Hemmer M, Tees M, et al. Trends and outcomes by inpatient and outpatient infusion of axicabtagene ciloleucel (axi-cel) in the US for patients (pts) with relapsed/refractory large B-celllymphoma (R/R LBCL). J Clin Oncol. 2025;43(suppl 16):7023. doi:10.1200/JCO.2025.43.16_suppl.70233. Landau H, Hughes C, Rosenberg A, et al. Safety and efficacy data from Nexicart-2, the first US trial of CAR-T in R/R light chain (AL) amyloidosis, Nxc-201. J Clin Oncol. 2025;43(suppl 16):7508.doi:10.1200/JCO.2025.43.16_suppl.7508
This content has been developed for healthcare professionals only. Patients who seek health information should consult with their physician or relevant patient advocacy groups.For the full presentation, downloadable Practice Aids, slides, and complete CME/MOC/NCPD/AAPA/IPCE information, and to apply for credit, please visit us at PeerView.com/PJA865. CME/MOC/NCPD/AAPA/IPCE credit will be available until May 27, 2026.Planting Roots for Next-Gen Bispecific Antibodies in Hematologic Cancers: Collaborative Principles to Extend the Reach of Immunotherapy in Myeloma and Lymphoma In support of improving patient care, PVI, PeerView Institute for Medical Education, is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.SupportThis activity is supported by an independent medical education grant from Regeneron Pharmaceuticals, Inc.Disclosure information is available at the beginning of the video presentation.
This content has been developed for healthcare professionals only. Patients who seek health information should consult with their physician or relevant patient advocacy groups.For the full presentation, downloadable Practice Aids, slides, and complete CME/MOC/NCPD/AAPA/IPCE information, and to apply for credit, please visit us at PeerView.com/PJA865. CME/MOC/NCPD/AAPA/IPCE credit will be available until May 27, 2026.Planting Roots for Next-Gen Bispecific Antibodies in Hematologic Cancers: Collaborative Principles to Extend the Reach of Immunotherapy in Myeloma and Lymphoma In support of improving patient care, PVI, PeerView Institute for Medical Education, is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.SupportThis activity is supported by an independent medical education grant from Regeneron Pharmaceuticals, Inc.Disclosure information is available at the beginning of the video presentation.
This content has been developed for healthcare professionals only. Patients who seek health information should consult with their physician or relevant patient advocacy groups.For the full presentation, downloadable Practice Aids, slides, and complete CME/MOC/NCPD/AAPA/IPCE information, and to apply for credit, please visit us at PeerView.com/PJA865. CME/MOC/NCPD/AAPA/IPCE credit will be available until May 27, 2026.Planting Roots for Next-Gen Bispecific Antibodies in Hematologic Cancers: Collaborative Principles to Extend the Reach of Immunotherapy in Myeloma and Lymphoma In support of improving patient care, PVI, PeerView Institute for Medical Education, is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.SupportThis activity is supported by an independent medical education grant from Regeneron Pharmaceuticals, Inc.Disclosure information is available at the beginning of the video presentation.
This content has been developed for healthcare professionals only. Patients who seek health information should consult with their physician or relevant patient advocacy groups.For the full presentation, downloadable Practice Aids, slides, and complete CME/MOC/NCPD/AAPA/IPCE information, and to apply for credit, please visit us at PeerView.com/PJA865. CME/MOC/NCPD/AAPA/IPCE credit will be available until May 27, 2026.Planting Roots for Next-Gen Bispecific Antibodies in Hematologic Cancers: Collaborative Principles to Extend the Reach of Immunotherapy in Myeloma and Lymphoma In support of improving patient care, PVI, PeerView Institute for Medical Education, is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.SupportThis activity is supported by an independent medical education grant from Regeneron Pharmaceuticals, Inc.Disclosure information is available at the beginning of the video presentation.
PeerView Immunology & Transplantation CME/CNE/CPE Audio Podcast
This content has been developed for healthcare professionals only. Patients who seek health information should consult with their physician or relevant patient advocacy groups.For the full presentation, downloadable Practice Aids, slides, and complete CME/MOC/NCPD/AAPA/IPCE information, and to apply for credit, please visit us at PeerView.com/PJA865. CME/MOC/NCPD/AAPA/IPCE credit will be available until May 27, 2026.Planting Roots for Next-Gen Bispecific Antibodies in Hematologic Cancers: Collaborative Principles to Extend the Reach of Immunotherapy in Myeloma and Lymphoma In support of improving patient care, PVI, PeerView Institute for Medical Education, is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.SupportThis activity is supported by an independent medical education grant from Regeneron Pharmaceuticals, Inc.Disclosure information is available at the beginning of the video presentation.
PeerView Immunology & Transplantation CME/CNE/CPE Video Podcast
This content has been developed for healthcare professionals only. Patients who seek health information should consult with their physician or relevant patient advocacy groups.For the full presentation, downloadable Practice Aids, slides, and complete CME/MOC/NCPD/AAPA/IPCE information, and to apply for credit, please visit us at PeerView.com/PJA865. CME/MOC/NCPD/AAPA/IPCE credit will be available until May 27, 2026.Planting Roots for Next-Gen Bispecific Antibodies in Hematologic Cancers: Collaborative Principles to Extend the Reach of Immunotherapy in Myeloma and Lymphoma In support of improving patient care, PVI, PeerView Institute for Medical Education, is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.SupportThis activity is supported by an independent medical education grant from Regeneron Pharmaceuticals, Inc.Disclosure information is available at the beginning of the video presentation.
CancerNetwork®, in collaboration with The American Society for Transplantation and Cellular Therapy (ASTCT), organized an X Space hosted by Rahul Banerjee, MD, FACP; Taha Al-Juhaishi, MD; and Muhammad Salman Faisal, MD. This expert panel convened to discuss key presentations and abstracts of interest at the 2025 American Society of Clinical Oncology (ASCO) Annual Meeting featuring noteworthy developments in modalities like CAR T-cell therapy and transplantation across multiple myeloma, lymphoma, and other disease types. Banerjee is an assistant professor in the Clinical Research Division at the Fred Hutchinson Cancer Center in Seattle, Washington. Al-Juhaishi is the associate director of the Hematopoietic Stem Cell Transplantation and Cell Therapy Program at Oklahoma University Health Stephenson Cancer Center and an assistant professor of medicine at the University of Oklahoma College of Medicine. Faisal is a hematologist/oncologist at Oklahoma University Health Stephenson Cancer Center and serves as an ambassador for ASCO. The group highlighted several late-breaking abstracts, plenary sessions, and poster presentations focused on significant clinical trial data and other findings across the hematologic oncology landscape. Topics of interest included the following: · Phase 1b/2 CARTITUDE-1 trial (NCT03548207, NCT05201781) o Long-term follow-up showed that approximately one-third (33%; n = 32) of patients with relapsed/refractory multiple myeloma maintained progression-free status for at least 5 years following a single infusion of ciltacabtagene autoleucel (cilta-cel; Carvykti). o An equal likelihood of progression-free survival occurred in patients with high-risk cytogenetics or extramedullary plasmacytomas. o With a median follow-up of 61.3 months, the median overall survival (OS) with cilta-cel was 60.7 months (95% CI, 41.9-not evaluable [NE]). · Real-world axicabtagene ciloleucel (axi-cel; Yescarta) use o Across inpatient and outpatient treatment settings, safety and efficacy outcomes were comparable for patients who received axi-cel for relapsed/refractory large B-cell lymphoma. o Multivariate analysis showed no associations between intended care setting and cytokine release syndrome or immune effector cell-associated neurotoxicity syndrome. o Investigators noted that these real-world data support the consideration of axi-cel in appropriate outpatient settings. · Phase 1b/2 NEXICART-2 trial (NCT06097832) o Investigators assessed NXC-201, a sterically optimized CAR T construct, as a treatment for patients with relapsed/refractory light chain amyloidosis, a population with no FDA-approved options. o Among 12 patients who received the agent at 450 x 106 cells, 100% achieved rapid and deep hematologic responses at a median time to first and best response of 7 and 26 days, respectively. o With a median follow-up of 121 days (range, 29-289), no hematologic relapses or progression had occurred. References 1. Voorhees P, Martin T, Lin Y, et al. Long-term (≥5 year) remission and survival after treatment with ciltacabtagene autoleucel (cilta-cel) in CARTITUDE-1 patients (pts) with relapsed/refractory multiple myeloma (RRMM). J Clin Oncol. 2025;43(suppl 16):7507. doi: 10.1200/JCO.2025.43.16_suppl.7507 2. Furqan F, Hemmer M, Tees M, et al. Trends and outcomes by inpatient and outpatient infusion of axicabtagene ciloleucel (axi-cel) in the US for patients (pts) with relapsed/refractory large B-cell lymphoma (R/R LBCL). J Clin Oncol. 2025;43(suppl 16):7023. doi:10.1200/JCO.2025.43.16_suppl.7023 3. Landau H, Hughes C, Rosenberg A, et al. Safety and efficacy data from Nexicart-2, the first US trial of CAR-T in R/R light chain (AL) amyloidosis, Nxc-201. J Clin Oncol. 2025;43(suppl 16):7508. doi:10.1200/JCO.2025.43.16_suppl.7508
Join Howard and Janeen Arbuckle for this discussion of pediatric and adolescent gynecology essentials. Pediatric and adolescent gynecology is a newer discipline bringing specialized care to young women with unique gynecologic needs, with a focus on counseling, education, and age-appropriate interventions. • Abnormal uterine bleeding in adolescents is rarely caused by structural problems (unlike in adults) and typically relates to immaturity of the hypothalamic-pituitary-ovarian axis• Hematologic workup should be considered for adolescents with heavy menstrual bleeding as this may be the first time their clotting system is challenged• Hormonal therapies are safe to use once menarche has occurred, with no impact on bone growth• Long-acting reversible contraceptives offer superior pregnancy prevention (1 in 10,000 for implants vs 8 in 100 for typical pill use) but require thoughtful counseling• Private interviews with adolescent patients create trust while preparing them for independent healthcare navigation• Tranexamic acid is effective for heavy menstrual bleeding in adolescents but pill size and frequency can limit compliance• Most ovarian cysts in adolescents represent normal physiologic function and rarely require intervention• Preservation of reproductive organs should be prioritized in adolescent surgery, including leaving ovaries after torsion when possible• Vaginal bleeding in pre-pubertal girls requires assessment for secondary sexual characteristics to distinguish precocious puberty from other causes00:00:00 Introduction to Pediatric Gynecology00:07:20 Abnormal Uterine Bleeding in Adolescents00:19:36 Contraception Choices for Young Patients00:29:40 Managing Difficult Patient-Parent Conversations00:38:04 Pelvic Pain and Endometriosis00:46:58 Adnexal Pathology and Ovarian Issues00:50:51 Congenital Anomalies and Vaginal BleedingFollow us on Instagram @thinkingaboutobgyn.
CME credits: 0.50 Valid until: 28-02-2026 Claim your CME credit at https://reachmd.com/programs/cme/diagnosis-and-treatment-of-systemic-mastocytosis-with-an-associated-hematologic-neoplasm/32715/ The identification of KIT D816V mutation as a key driver for the expansion and accumulation of neoplastic mast cells in systemic mastocytosis (SM) has significantly improved the diagnosis, subclassification, and management of SM. Moreover, the advent of novel targeted therapies has dramatically changed the treatment landscape. However, challenges persist for community clinicians due to the low prevalence of SM and its vague and wide spectrum of clinical features. Expanded knowledge of the recommended pathology and laboratory evaluation for the diagnosis and subclassification of the disease is needed to shorten delays in diagnosis and delivery of optimal care. Tune in and find out more about the management of SM and the latest clinical evidence and guideline recommendations for the use of tyrosine kinase inhibitors (TKIs) and learn about the role played by pathologists in the identification and diagnosis of SM, which ultimately guides treatment selection.
Commentary by Dr. Jian'an Wang
Shira Dinner, MD, Northwestern University, Chicago, IL and Tom Martin, MD, University of California San Francisco, San Francisco, CA Recorded on September 9, 2024 Join us for this special episode, recorded at the Twelfth Annual Meeting of the Society of Hematologic Oncology in Houston, TX! Guest host and conference attendee, Lauren Berger, Senior Director of Professional Education and Engagement at The Leukemia & Lymphoma Society, speaks with Dr. Shira Dinner, from Northwestern University, and Dr. Tom Martin, from University of California San Francisco, about their insights and key takeaways from the conference. Learn more by tuning in here! Shira Dinner, MD Associate Professor Robert H. Lurie Comprehensive Cancer Center Northwestern University Chicago, IL Tom Martin, MDClinical Professor of Medicine, Division of Hematology/Oncology Director, Clinical Research, Hematologic Malignancies Program Co-Leader, Cancer Immunology and Immunotherapy Associate Director, Myeloma Program University of California San Francisco San Francisco, CA
In today's VETgirl podcast, we discuss a study by Dohany et al. assessing phenobarbital-induced hematologic changes in 69 cats. As we know, phenobarbital is a widely prescribed anti-epileptic medication used in veterinary medicine. But how aware are you of the cytopenias that can be associated with chronic phenobarbital administration?
Ximena Jordan-Bruno, MD, University of Pennsylvania, Philadelphia, PA Recorded on June 4, 2024 Ximena Jordan-Bruno, MD Assistant Professor, Division of Hematology/Oncology University of Pennsylvania Philadelphia, PA Join us for this fascinating episode, where Dr. Ximena Jordan-Bruno from the University of Pennsylvania explores hereditary myeloid and hematologic disorders, covering their classifications, mutations, and related germline predisposition syndromes. Learn about key clinical features, diagnostic approaches, the role of genetic counseling, and future research directions. Tune in today for valuable updates to enhance your understanding and practice!
At the 2024 European Hematology Association (EHA) Congress, CancerNetwork® spoke with a variety of experts in the hematologic oncology space about optimizing outcomes across different patient populations and subgroups based on updated research they presented at the meeting. Manali Kamdar, MD, an associate professor of medicine-hematology and clinical director of Lymphoma Services at the University of Colorado Anschutz Medical Campus, in Colorado, spoke about data from the phase 1 TRANSCEND NHL 001 trial (NCT02631044) supporting the use of lisocabtagene maraleucel (liso-cel; Breyanzi) in earlier lines of therapy for patients with relapsed/refractory mantle cell lymphoma (MCL).1 Specifically, Kamdar highlighted how research should continue to focus on the potential utility of liso-cel in MCL subgroups such as those with TP53 mutations or blastoid morphology. Additionally, she stated that liso-cel may need to be further tested in earlier lines of therapy for patients with diffuse large B-cell lymphoma, including those with double-hit lymphoma. Michael R. Grunwald, MD, chief of the Leukemia Division and director of the Transplantation and Cellular Therapy Program at Atrium Health's Levine Cancer Institute, in North Carolina, discussed findings from the Prospective Observational Study of Patients With Polycythemia Vera (PV) in US Clinical Practices Trial (REVEAL) exploring risk factors for disease progression in patients with polycythemia vera (PV).2 According to Grunwald, a history of thromboembolic events, elevated white blood cell counts, and higher variant allele frequencies may contribute to a patient's likelihood of experiencing progression to myelofibrosis or acute myeloid leukemia (AML). Additionally, he highlighted ongoing research into the potential molecular factors that may prognosticate disease transformation in PV among a small cohort of patients enrolled on the REVEAL trial.3 Harry P. Erba, MD, PhD, a professor of medicine in the Division of Hematologic Malignancies and Cellular Therapy and the director of the Leukemia Program and Phase I Development in Hematologic Malignancies at Duke Cancer Institute, in North Carolina, discussed the clinical implications of data from the phase 3 QuANTUM-First study (NCT02668653).4 Specifically, findings demonstrated that continuation therapy with quizartinib (Vanflyta) elicited a more pronounced survival benefit vs placebo in patients with newly diagnosed FLT3-ITD–positive AML who did not undergo allogeneic hematopoietic stem cell transplant (allo-HSCT). However, Erba noted that survival outcomes were not significantly different in the quizartinib and placebo arms among patients who received allo-HSCT. References 1. Palomba ML, Siddiqi T, Gordon LI, et al. Subgroup analyses in patients with R/R MCL treated with lisocabtagene maraleucel by prior lines of therapy and response to Bruton tyrosine kinase inhibitor from the TRANSCEND NHL 001 MCL cohort. Presented at the European Hematology Association (EHA) 2024 Congress; Madrid, Spain; June 13-16, 2024. P1126. 2. Grunwald M, Zwicker J, Gerds A, et al. A real-world evaluation of risk factors for disease progression in patients with polycythemia vera (PV) enrolled in REVEAL. Presented at the 2024 European Hematology Association (EHA) Congress; June 13-16, 2024; Madrid, Spain. Abstract P1047. 3. Crowgey E, Timmers C, Xue Z, et al. Analysis of molecular mechanisms and predictive biomarkers of disease transformation in polycythemia vera. Presented at the 2024 European Hematology Association (EHA) Congress; June 13-16, 2024; Madrid, Spain. Abstract S217. 4. Sekeres MA, Erba H, Montesinos P, et al. QuANTUM-First: efficacy in newly diagnosed patients with FMS-like tyrosine kinase 3-internal tandem duplication–positive (FLT3-ITD+) acute myeloid leukemia (AML) who received continuation therapy. Presented at the 2024 European Hematology Association (EHA) Congress; June 13-16, 2024; Madrid, Spain. Abstract S142.
Welcome to this Hematology Round Up from #EHA24WE have focused on on Hematologic malignancies with abstracts presented on June 15nd, 2024The first presentation was abstract s100 This Phase 3 study results of isatuximab, bortezomib, lenalidomide, and dexamethasone (Isa-VRd) versus VRd for transplant-ineligible patients with newly diagnosed multiple myeloma (IMROZ) . Presented by Dr. FaconThis trial presentation had a concomitant publication on the @NEJMat #ASCO24 last weekhttps://lnkd.in/d2dRh6HpThe Second presentation was abstract S101THE LANDSCAPE OF TP53 MUTATIONS AND THEIR PROGNOSTIC IMPACT IN CHRONIC LYMPHOCYTIC LEUKEMIAhttps://lnkd.in/dYg6DqPTThe Next presentation was abstract S102FIRST RESULTS OF THE APOLLO TRIAL: A RANDOMIZED PHASE III STUDY TO COMPARE ATO COMBINED WITH ATRA VERSUS STANDARD AIDA REGIMEN FOR PATIENTS WITH NEWLY DIAGNOSED, HIGH-RISK ACUTE PROMYELOCYTIC LEUKEMIAhttps://lnkd.in/d2ZM6Z4QThe Next presentation is abstract S103ASCIMINIB (ASC) PROVIDES SUPERIOR EFFICACY AND EXCELLENT SAFETY AND TOLERABILITY VS TYROSINE KINASE INHIBITORS (TKI) IN NEWLY DIAGNOSED CHRONIC MYELOID LEUKEMIA (CML) IN THE PIVOTAL ASC4FIRST STUDYhttps://lnkd.in/dxiets8mOur final Presentation is Late breaking abstract 3438GLOFITAMAB PLUS GEMCITABINE AND OXALIPLATIN (GLOFIT-GEMOX) FOR RELAPSED/REFRACTORY (R/R) DIFFUSE LARGE B-CELL LYMPHOMA (DLBCL): RESULTS OF A GLOBAL RANDOMIZED PHASE III TRIAL (STARGLO)https://lnkd.in/dMWxnyF4Thank you for your attention and enjoy #EHA24Disclosure: This Hematology Round Up was supported by Sanofi
Dear Colleagues,Welcome to this Hematology Round Up from hashtag#ASCO24 . WE have focused on Hematologic malignancies with 3 presentations which were presented on June 2nd, 2024The first presentation was the Phase 3 study results of isatuximab, bortezomib, lenalidomide, and dexamethasone (Isa-VRd) versus VRd for transplant-ineligible patients with newly diagnosed multiple myeloma (IMROZ) . Presented by Dr. FaconThis trial presentation came with a concomitant publication on the New England Journal of Medicine (NEJM).https://lnkd.in/d2dRh6HpThe Second Presentation was the Phase 3 randomized BENEFIT study of isatuximab (Isa) plus lenalidomide and dexamethasone (Rd) with bortezomib versus isard in patients with newly diagnosed transplant ineligible multiple myeloma (NDMM TI). Presented by Dr. LeleuThis trial presentation came with a concomitant publication on Nature Medicinehttps://lnkd.in/dSjVvk7XThe final presentation was Daratumumab (DARA) + bortezomib/lenalidomide/dexamethasone (VRd) in transplant-eligible (TE) patients (pts) with newly diagnosed multiple myeloma (NDMM): Analysis of minimal residual disease (MRD) in the PERSEUS trial. Presented by Dr Rodriguez-OteroDr. Landgren discussed how quadruple therapies showed higher rates of minimal residual disease (MRD) and longer progression-free survival compared to triplets, regardless of age and transplant eligibility, potentially making them a new standard of care for newly diagnosed Multiple Myeloma.He emphasized the importance of minimal residual disease as an endpoint in newly diagnosed multiple myeloma, suggesting that having it as an early endpoint for accelerated approval could give patients faster access to new therapies. However, he also highlighted that bortezomib increases the rate of peripheral neuropathy.Dr. Landgren pointed out that CD38 monoclonal antibodies narrow the gap between transplant-eligible, younger, and fit patients, and transplant-ineligible, older, and less fit patients with multiple myeloma.Thank you for your attention and enjoy ASCODisclosure: This Hematology Round Up was supported by Sanofi
CME credits: 1.00 Valid until: 19-03-2025 Claim your CME credit at https://reachmd.com/programs/cme/adc-related-hematologic-adverse-events/18169/ "Mastering the AEs of ADCs to Unlock Their Full Potential in Breast, Lung, and Gynecologic Cancer” is a multiepisodic CME series that delves into the treatment-emergent adverse events related to antibody-drug conjugates. Join expert faculty as they assess these toxicities and provide guidance on the optimal management of these side effects. On April 5, 2024, the FDA granted accelerated approval to fam-trastuzumab deruxtecan-nxki (Enhertu, Daiichi Sankyo, Inc.) for adult patients with unresectable or metastatic HER2-positive (IHC3+) solid tumors who have received prior systemic treatment and have no satisfactory alternative treatment options. . To learn more about this approval, please visit: https://www.fda.gov/drugs/resources-information-approved-drugs/fda-grants-accelerated-approval-fam-trastuzumab-deruxtecan-nxki-unresectable-or-metastatic-her2
CME credits: 1.00 Valid until: 19-03-2025 Claim your CME credit at https://reachmd.com/programs/cme/hematologic-adverse-events-with-adcs-in-breast-cancer-optimal-management-strategies/18165/ "Mastering the AEs of ADCs to Unlock Their Full Potential in Breast, Lung, and Gynecologic Cancer” is a multiepisodic CME series that delves into the treatment-emergent adverse events related to antibody-drug conjugates. Join expert faculty as they assess these toxicities and provide guidance on the optimal management of these side effects. On April 5, 2024, the FDA granted accelerated approval to fam-trastuzumab deruxtecan-nxki (Enhertu, Daiichi Sankyo, Inc.) for adult patients with unresectable or metastatic HER2-positive (IHC3+) solid tumors who have received prior systemic treatment and have no satisfactory alternative treatment options. . To learn more about this approval, please visit: https://www.fda.gov/drugs/resources-information-approved-drugs/fda-grants-accelerated-approval-fam-trastuzumab-deruxtecan-nxki-unresectable-or-metastatic-her2
CME credits: 1.00 Valid until: 19-03-2025 Claim your CME credit at https://reachmd.com/programs/cme/gastrointestinal-and-hematologic-teaes-related-to-adc-therapy-in-gynecologic-cancers/18172/ "Mastering the AEs of ADCs to Unlock Their Full Potential in Breast, Lung, and Gynecologic Cancer” is a multiepisodic CME series that delves into the treatment-emergent adverse events related to antibody-drug conjugates. Join expert faculty as they assess these toxicities and provide guidance on the optimal management of these side effects. On April 5, 2024, the FDA granted accelerated approval to fam-trastuzumab deruxtecan-nxki (Enhertu, Daiichi Sankyo, Inc.) for adult patients with unresectable or metastatic HER2-positive (IHC3+) solid tumors who have received prior systemic treatment and have no satisfactory alternative treatment options. . To learn more about this approval, please visit: https://www.fda.gov/drugs/resources-information-approved-drugs/fda-grants-accelerated-approval-fam-trastuzumab-deruxtecan-nxki-unresectable-or-metastatic-her2
In this episode we discuss the management of newly diagnosed AL amyloidosis with Dr. Angela Dispenzieri from the Mayo Clinic. Here are the key articles discussed:1. Optimal use of tissue biopsy in AL amyloidosis: https://pubmed.ncbi.nlm.nih.gov/28271734/ 2. Mayo 2004 staging: https://pubmed.ncbi.nlm.nih.gov/15365071/ 3. Mayo 2012 staging: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3675680/ 4. Renal staging: https://pubmed.ncbi.nlm.nih.gov/25115890/ 5. Hematologic and cardiac response criteria in AL amyloidosis: https://pubmed.ncbi.nlm.nih.gov/23091105/ 6. ANDROMEDA Trial: Dara-VCD vs VCD in newly diagnosed AL amyloidosis: https://pubmed.ncbi.nlm.nih.gov/34192431/ 7. How I Treat AL Amyloidosis: https://pubmed.ncbi.nlm.nih.gov/34517412/ 8. Venetoclax in AL amyloidosis (largest retrospective study till date): https://pubmed.ncbi.nlm.nih.gov/33431806/
Kathy Ford is the Chief Operating Officer (COO) at Kura Oncology. She has over 30 years experience in biopharmaceuticals. She is equally passionate about the work she does bringing treatment to cancer patients and as a mom and grandmother. Kathy earned her R.N. from Massachusetts General Hospital School of Nursing and her B.S.N. from Fitchburg State College.What do we talk about in this episode?Kathy's journey from nursing, being a stay at home mom, and back into the job market and into executive management in biopharmaceuticals.The changes she has seen for women in medicine and STEM fields over the past several decades.The importance of family in her life. Grandmotherhood is her greatest joy!Her passion for working for a company working to treat and cure cancer.The importance of women, especially in higher positions, using their voice to support other women.What does a COO do?Music used in the podcast: Higher Up, Silverman Sound StudioYou can support my podcast on Patreon here: https://patreon.com/user?u=72701887ResourcesHematologic cancers begin in blood-forming tissue, such as the bone marrow, or in the cells of the immune system. Examples of hematologic cancer include leukemia, lymphoma, and multiple myeloma. It's also referred to as blood cancer. (https://www.summitcancercenters.com/cancers-we-treat/hematologic-cancer/#:~:text=Hematologic%20cancers%20begin%20in%20blood,referred%20to%20as%20blood%20cancer.)Some 37% of active physicians in the U.S. were women in 2021, up from about 36% in 2019, and about 47% of residents and fellows were women, according to the AAMC report.Large gender pay gaps still exist, however. A 2021 report from the Rand Corporation published in Health Affairs found female physicians earn $2 million less than men over the course of their career, with the largest gaps in male-dominated specialties. (https://www.healthcaredive.com/news/AAMC-us-physician-workforce-women-specialties/640621/#:~:text=Some%2037%25%20of%20active%20physicians,according%20to%20the%20AAMC%20report.)
Featuring perspectives from Dr Nicole Lamanna and Dr William G Wierda, including the following topics: Introduction: Mentoring Fellows (0:00) Case: A woman in her mid 50s with multiple cardiovascular comorbidities and relapsed/refractory (R/R) chronic lymphocytic leukemia (CLL) receives bendamustine/rituximab induction followed by venetoclax/rituximab consolidation in a clinical trial — Spencer Henick Bachow, MD (11:47) Case: A man in his late 70s with relapsed del(11q) CLL develops atrial fibrillation while receiving ibrutinib — Warren S Brenner, MD (18:15) Case: A man in his early 70s with CLL develops rash and bruising while receiving ibrutinib — Gigi Chen, MD (27:02) Case: A man in his late 80s with CLL receives acalabrutinib as initial therapy and experiences thrombocytopenia — Kapisthalam (KS) Kumar, MD (31:42) Case: A woman in her mid 80s with relapsed CLL (TP53 mutation) discontinues ibrutinib due to bruising — Dr Brenner (40:08) Case: A man in his early 80s with R/R mantle cell lymphoma discontinues ibrutinib due to bleeding risks after a traumatic head injury — Dr Bachow (49:01) Case: A man in his late 50s with CLL and response to acalabrutinib develops worsening myalgias a year later — Eric H Lee, MD, PhD (58:36) CME information and select publications
“It's really important to look at where your target is and what the toxicities are associated with hitting that target. Make sure you include that thinking when you're talking about bispecifics,” ONS member Rowena (Moe) Schwartz, PharmD, BCOP, professor of pharmacy practice at the James L. Winkle College of Pharmacy at the University of Cincinnati in Ohio, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager of oncology nursing practice at ONS, during a discussion about the use of bispecific monoclonal antibodies in hematologic cancers and solid tumors. You can earn free NCPD contact hours after listening to this episode and completing the evaluation linked below. Music Credit: “Fireflies and Stardust” by Kevin MacLeod Licensed under Creative Commons by Attribution 3.0 Earn 0.5 contact hours of nursing continuing professional development (NCPD), which may be applied to the treatment ILNA category, by listening to the full recording and completing an evaluation at myoutcomes.ons.org by September 1, 2025. The planners and faculty for this episode have no relevant financial relationships with ineligible companies to disclose. ONS is accredited as a provider of NCPD by the American Nurses Credentialing Center's Commission on Accreditation. Learning outcome: The learner will report an increase in knowledge related to bispecific monoclonal antibodies in hematologic cancers and solid tumors. Episode Notes Complete this evaluation for free NCPD. ONS Voice drug reference sheets and FDA announcements about bispecific anticancer therapies ONS resources for cytokine release syndrome Oncology Nursing Podcast Episode 176: Oncologic Emergencies 101: Cytokine Release Syndrome Clinical Journal of Oncology Nursing article: STAT: Cytokine Release Syndrome Clinical Practice Resource Clinical Practice Video Huddle Card™ Cancer article: The BiTE (Bispecific T-Cell Engager) Platform: Development and Future Potential of a Targeted Immuno-Oncology Therapy Across Tumor Types Pharmaceutics article: Bispecific Antibodies in Cancer Immunotherapy: A Novel Response to an Old Question U.S. Food and Drug Administration label search for package inserts To discuss the information in this episode with other oncology nurses, visit the ONS Communities. To find resources for creating an ONS Podcast Club in your chapter or nursing community, visit the ONS Podcast Library. To provide feedback or otherwise reach ONS about the podcast, email pubONSVoice@ons.org. Highlights From Today's Episode “When we talk about bispecifics, we need to really pay attention to both the target on the cancer and the target for T-cell engaging, because that impacts both efficacy but also toxicity.” TS 4:20 “If you really look deep into the clinical trials, often the patients that are receiving these agents in clinical trials have had more than the required three or four lines of treatment. They may have had five or more lines of treatment. So it's really important to kind of look at where it sits right now, knowing, of course, that that's an evolving target.” TS 7:13 “One of the things I think can be missed, at times, is the fact that you need to consider the toxicities associated with your target on the cancer cell.” TS 10:06 “In terms of mitigating risk, there's been two major ways that have been done. One is a step-up dose schedule, and so one of the key things I would say: If you're not familiar with an agent that you're going to be administering, it's really important to review the entire step-up scheme because it's different for each agent. In some cases, patients need to be admitted to the hospital for the entire step-up strategy. Other times it's just the first dose. So it's really important to look at that.” TS 11:58 “I think we're going to get to the point where our teaching strategy is going to have to be somewhat tailored to the agent we're giving. So, how the drug is given during the step-up, what the subsequent cycling is going to be, whether it's going to be a Q21-day cycle or a weekly dosing administration or every-two-week administration after a certain point. So, I think some understanding of what to expect going forward because these are drugs that are given continually in most situations and so it's important for people to know what to expect.” TS 14:25 “I think we're going to see bispecifics that perhaps engage other aspects of the immune system besides CD3. In fact, those are in clinical trials. And I do believe that we're going to see these more and more developed for cancers beyond the hematologic malignancies. There's a lot of work being done at looking at targets that we know are helpful targets in certain cancers. And I think we'll see more drugs approved beyond the myeloma and the lymphoma and the leukemia space.” TS 20:42
In this episode, Dr. Zanotti discusses the management of acute-on-chronic liver failure (ACLF) in the ICU. He is joined by Dr. Nanchal, a practicing critical care physician with an interest in liver disease. He is a Professor in the Division of Pulmonary and Critical Care Medicine, at the Medical College of Wisconsin, in Milwaukee. Dr. Nanchal is also the lead author of the Society of Critical Care Medicine's Guideline for the Management of Adult Acute and Acute-on-Chronic Liver Failure in the ICU. Additional Resources Executive Summary for Guideline for the Management of Adult Acute and Acute-on-Chronic Liver Failure in the ICU: Neurology, Peri-transplant Medicine, Infectious Disease, and Gastroenterology Considerations: https://journals.lww.com/ccmjournal/pages/articleviewer.aspx?year=2023&issue=05000&article=00010&type=Fulltext Guideline for the Management of Adult Acute and Acute-on-Chronic Liver Failure in the ICU: Neurology, Peri-transplant Medicine, Infectious Disease, and Gastroenterology Considerations: https://journals.lww.com/ccmjournal/pages/articleviewer.aspx?year=2023&issue=05000&article=00011&type=Fulltext Guideline for the Management of Adult Acute and Acute-on-Chronic Liver Failure in the ICU: Cardiovascular, Endocrine, Hematologic, Pulmonary, and Renal Considerations: https://journals.lww.com/ccmjournal/Fulltext/2020/03000/Guidelines_for_the_Management_of_Adult_Acute_and.29.aspx Previous Episodes of Critical Matters on the Topic of Acute-on-Chronic Liver Failure: https://soundphysicians.com/podcast-episode/?podcast_id=342&track_id=953807698 https://soundphysicians.com/podcast-episode/?podcast_id=342&track_id=965563996 Books Mentioned in this Episode: Noise: A Flaw in Human Judgement. By Daniel Kahneman, et al: https://bit.ly/3sqfRin Seven Brief Lessons on Physics. By Carlo Rovelli: https://bit.ly/45jv82N Anaximander: And the Birth of Science. By Carlo Rovelli: https://bit.ly/3sqgqbZ
Understanding Your Complete Blood Count: Hematologic Cancers | On Call with the Prairie Doc® | May 11, 2023 | Prairie Doc® host Dr. Andrew Ellsworth is joined by Dr. Xavier Andrade Gonzalez from Avera.
“When someone is faced with a cancer diagnosis, you want to really try to work to make that patient an active part of their care team. Understand that there are things out of their control, but there are also things that are within their control. You can teach them how to manage fatigue associated with anemia, or how to prevent falls. These are the things you can do to prevent infection; these are the nutrition things you should focus on to help you feel your best,” ONS member Kimberly Miller, BSN, RN, BMTCN®, transplant case manager at Nebraska Medicine in Omaha, and member of the Metro Omaha ONS Chapter, told Jaime Weimer, MSN, RN, AGCNS-BC, AOCNS®, oncology clinical specialist at ONS, during a conversation about nursing management of cancer-related hematologic complications. This episode is part of a series about cancer symptom management basics. The others are linked in the episode notes. You can earn free NCPD contact hours after listening to this episode and completing the evaluation linked below. Music Credit: “Fireflies and Stardust” by Kevin MacLeod Licensed under Creative Commons by Attribution 3.0 Earn 0.5 contact hours of nursing continuing professional development (NCPD) by listening to the full recording and completing an evaluation at myoutcomes.ons.org by April 21, 2025. The planners and faculty for this episode have no relevant financial relationships with ineligible companies to disclose. ONS is accredited as a provider of NCPD by the American Nurses Credentialing Center's Commission on Accreditation. Learning outcome: The learner will report an increase in knowledge related to hematologic complications. Episode Notes Complete this evaluation for free NCPD. Previous Oncology Nursing Podcast episodes on cancer symptom management basics Additional Oncology Nursing Podcast episodes: Episode 181: Oncologic Emergencies 101: Febrile Neutropenia Episode 196: Oncologic Emergencies 101: Bleeding and Thrombosis Episode 220: Oncologic Emergencies 101: Febrile Neutropenia and Sepsis Episode 234: Oncologic Emergencies 101: Thrombotic Thrombocytopenia Purpura ONS book: Cancer Basics (third edition) ONS course: Cancer Basics ONS Symptom Interventions for Prevention of Bleeding American Cancer Society patient education handouts: Low Red Blood Cell Counts (Anemia) Low Platelet Count (Bleeding) Low White Blood Cell Counts (Neutropenia) American Society of Clinical Oncology Answers fact sheets Centers for Disease Control and Prevention patient education on neutropenia Leukemia and Lymphoma Society patient education To discuss the information in this episode with other oncology nurses, visit the ONS Communities. To provide feedback or otherwise reach ONS about the podcast, email pubONSVoice@ons.org. Highlights From Today's Episode “The biggest complication is infection. You do not have the ability to present with the normal signs and symptoms of infection. You're not going to have redness and swelling and drainage. You're going to have more fever, hypertension, dysuria, shortness of breath, or cough.” Timestamp (TS) 07:22 “Some patients get really nervous if their blood counts get to a certain point. I find that we just try to explain to them, ‘We're watching your labs very frequently, we see you several times a week, these are the complications that can happen,' and talk them through the rationale for not giving a lot of maybe not necessary transfusions.” TS 15:15 “In general, the guidelines are if you expect a patient to have severe prolonged neutropenia, lasting greater than seven days, then you would want to consider giving them an antibiotic to help prevent neutropenic fever. . . . A high-risk patient would benefit from that.” TS 17:23 “Myelosuppression can delay chemotherapy, so patients who are getting treatment for their cancer may experience delays in their next cycle, they may have dose reduction, they may have to discontinue that chemotherapy if they have severe myelosuppression. That could affect their outcomes as far as their cancer treatment goes. Patients who are anemic—if you are fatigued and your legs feel heavy and you feel dizzy when you get up and you fall and your platelets are low as well, that leads to an increased risk of bleeding, and really a decrease in quality of life.” TS 23:30 “Myelosuppresion and cancer treatment in general does carry other toxicities besides the physical: emotional, mental, financial, and social.” TS 25:33 “For a patient with cancer, from diagnosis on, there's a lot that they can't control. When you're faced with that diagnosis, you want to really try to work to make that patient an active part of their care team. So, I think it's important to talk with a patient—understand that there are things out of their control, but there are things that are within their control. You can teach them how to manage fatigue associated with anemia or how to prevent falls. These are the things you can do to prevent infection; these are the nutrition things you should focus on to help you feel your best. Anything that you can let the patient have control over because their life has just changed dramatically.” TS 29:03 “Oncology nurses are wonderful at looking at the patient as a whole person. Keep in mind that there are financial toxicities as well as physical, emotional, and mental. So, it might create a bigger team of people that need to step in and help the patient find the resources that they need to be successful. Also, don't forget about the caregivers.” TS 33:47
Howie and Harlan are joined by Megan Ranney, who will become the dean of the newly independent Yale School of Public Health later this year. Harlan reflects on the research that is helping us understand aging at a cellular level; Howie discusses a new study that he co-authored which examines the costs that make it harder for many mothers to breastfeed. Links: “Accelerated Epigenetic Aging Is Associated with Multiple Cardiometabolic, Hematologic, and Renal Abnormalities: A Project Baseline Health Substudy” Outlive by Peter Attia with Bill Gifford “Megan Ranney named dean of Yale School of Public Health” “Yale School of Public Health to become self-supporting, independent school” Megan Ranney: “To prevent gun injury, build better research” Megan Ranney: “We need more research on guns. Here are 5 questions we can answer.” Howard Forman: “No such thing as a free lunch: The direct marginal costs of breastfeeding” Learn more about the MBA for Executives program at Yale SOM. Email Howie and Harlan comments or questions.
In this bonus episode Associate Editor, Dr. Mario Cazzola discusses the review series on Germline predisposition to hematologic malignancies with authors, Dr. Lucy Godley, Dr. Anna Brown, and Dr. Dennis Hickstein.
Mike Goldstein is a fourth year medical student in the Uniform Services University School of Medicine, and he plans to go into Obstetrics and Gynecology. Mike was the recipient of both the Gibbons award for medical students to attend the armed forces district annual meeting for American Congress of Obstetricians and Gynecologists, and the Chairman's award for the top manuscript at the annual conference. In this episode, Mike provides insights on shoulder dystocia, the risks to mom and baby, and the maneuvers to relieve it. *Mike Goldstein is also the creator of the logo for this podcast! Coaching offerSupport the showConnect with Kelly Hof at kellyhof.comMedical Disclaimer:This podcast is intended as a safe space for women to share their birth experiences. It is not intended to provide medical advice. Each woman's medical course of action is individual and may not appropriately transfer to another similar situation. Please speak to your medical provider before making any medical decisions. Additionally, it is important to keep in mind that evidence based practice evolves as our knowledge of science improves. To the best of my ability I will attempt to present the most current ACOG and AWHONN recommendations at the time the podcast is recorded, but that may not necessarily reflect the best practices at the time the podcast is heard. Additionally, guests sharing their stories have the right to autonomy in their medical decisions, and may share their choice to go against current practice recommendations. I intend to hold space for people to share their decisions. I will attempt to share the current recommendations so that my audience is informed, but it is up to each individual to choose what is best for them.
Exclusive content and support: https://www.patreon.com/theemttutor The EMT student will have an understanding of diabetes, sickle cell disease, clotting disorders, and the complications associated with each. EMT students should be able to understand the characteristics of type 1 and type 2 diabetes and be able to list the appropriate steps for assessment and prehospital treatment of diabetic emergencies. Students should also be able to discuss hematologic emergencies, and describe sickle cell disease, hemophilia, thrombophilia, and deep vein thrombosis. Knowledge Domains Describe the anatomy and physiology of the endocrine system and its main function in the body and discuss the role of glucose as a major source of energy for the body as well as its relationship to insulin. Define the terms diabetes mellitus, hyperglycemia, and hypoglycemia and understand the differences between hypo and hyperglycemia to include the signs and symptoms of both. Understand the interventions for providing emergency medical care to both a conscious and unconscious patient with an altered mental status and a history of diabetes who is having symptomatic hyperglycemia or hypoglycemia. Identify the steps the EMT should follow when conducting a primary and secondary assessment of a patient with an altered mental status who is a suspected of having diabetes. Know the indications, and contraindications for giving oral glucose to a patient with a decreased level of consciousness who has a history of diabetes. Know the composition and functions of blood as well as describing the pathophysiology of sickle cell disease, complications, and management of sickle cell disease. Describe two types of blood clotting disorders, and the risk factors, characteristics, and management of each. --- Send in a voice message: https://anchor.fm/thepublicsafetyguru/message
Hematologic cancer patients have the benefit of many new oral medications to manage their conditions; however, those medications may create or worsen cardiovascular comorbidities. Nurse Practitioners Courtney Estes (Cardio-Oncology Program) and Ellen Lazarre (Hematology Oncology Division) discuss the balancing act of managing risks while attacking cancer, which is only possible with an interdisciplinary team. They discuss the most common cardiovascular comorbidities (e.g., AFib, hypertension) and alternative treatments that may address them without interfering with effective cancer treatments.
Featuring perspectives from Drs Ajai Chari, Ian Flinn, Nikhil Munshi and Laurie Sehn, including the following topics: Part 1: Case Presentations and Clinical Decision-Making (0:00) Case: A man in his early 70s with diffuse large B-cell lymphoma (DLBCL) arising from follicular lymphoma — Ian W Flinn, MD, PhD (3:46) Case: A man in his late 50s with nongerminal center B-cell-like subtype DLBCL — Laurie H Sehn, MD, MPH (15:57) Case: CAR-T therapy during the pandemic — Nikhil C Munshi, MD (22:16) Case: Anti-BCMC bispecific in triple-class and penta-drug refractory disease — Ajai Chari, MD (33:54) CAR-T therapy for non-Hodgkin lymphoma — Dr Flinn (37:09) Bispecifics for non-Hodgkin lymphoma — Dr Sehn (51:48) CAR-T therapy for multiple myeloma — Dr Munshi (1:13:23) Bispecifics for multiple myeloma — Dr Chari (1:26:14) CME information and select publications
Proceedings from an educational event held in partnership with the 2022 Pan Pacific Lymphoma Conference, featuring perspectives from Drs Ajai Chari, Ian Flinn, Nikhil Munshi and Laurie Sehn, moderated by Dr Neil Love.
On this week's episode of Fast Facts - Perio Edition, Katrina Sanders, wraps up the series on Periodontitis as a Manifestation of Systemic Disease, finishing by educating us on hematologic disorders! Quotes: “Now, we know hematologic diseases are disorders of the blood or can be disorders of blood forming organs and this affects millions of Americans.” “When we take a look at some of these different types of diseases, we are looking at things like blood cell cancers, hematologic diseases, including rare genetic disorders, anemias, conditions that can be related to HIV, sickle cell disease, or even in some cases, complications affiliated with chemotherapy or transfusions.” “Recent studies that have demonstrated that bacteria like Porphomonas gingivalis does govern aspects of osteoclast differentiation, meaning that the way that our own cells, our own bone cells, are able to break down bone is readily influenced by the presence of this Gram Negative anaerobic bacteria.” Resources: DentistRX: https://www.dentistrx.com More Fast Facts: https://www.ataleoftwohygienists.com/fast-facts/ Katrina Sanders Website: https://www.katrinasanders.com Katrina Sanders Instagram: https://www.instagram.com/thedentalwinegenist/ Papapanou, P. N., Sanz, M., Buduneli, N., Dietrich, T., Feres, M., Fine, D. H., ... & Tonetti, M. S. (2018). Jepsen S, Caton JG, Albandar JM, Bissada NF, Bouchard P, Cortellini P, Demirel K, de Sanctis M, Ercoli C, Fan J, Geurs NC, Hughes FJ, Jin L, Kantarci A, Lalla E, Madianos PN, Matthews D, McGuire MK, Mills MP, Preshaw PM, Reynolds MA, Sculean A, Susin C, West NX, Yamazaki K. Periodontal manifestations of systemic diseases and developmental and acquired conditions: Consensus report of workgroup 3 of the 2017 World Workshop on the Classification of Periodontal and Peri-Implant Diseases and Conditions. J Periodontol. 2018 Jun;89 Suppl 1:S237-S248. doi: 10.1002/JPER.17-0733. PMID: 29926943. Botelho, J., Machado, V. & Mendes, J.J. Periodontal Health and Blood Disorders. Curr Oral Health Rep 8, 107–116 (2021). https://doi.org/10.1007/s40496-021-00301-w