Thursday, June 19, 2014

Dr. Bruce Cheson on Indolent Lymphoma (Video)

Hot off the press, just posted this morning -- so new that there are only 7 views, as I write this:

A video featuring Lymphoma Rock Star Dr. Bruce Cheson of Georetown,  presenting the keynote address at the International Waldenstrom Macroglobulinemia Foundation Educational Forum in May, in Tampa. (Waldenstrom Macroglobulinemia is a type of indolent NHL like Follicular Lymphoma.)

Dr. Cheson's talk is called "Progress in Indolent Lymphoma: Is Chemotherapy Dead?"

So while this isn't about Follicular Lymphoma specifically, it is about current and future ways of treating indolent lymphomas, and the treatments he discusses are already in the Follicular arsenal. As the title suggests, his focus is on lymphoma treatments that he believes will replace chemotherapy very soon, since they are more focused and potentially personalizable than traditional chemo.

I'm linking the talk above, and embedding it below, but here are some highlights:

First off, after the introduction, Dr. Cheson walks to the podium carrying a glass of red wine. He keeps it with him throughout the talk. Am I joking when I call him a Lymphoma Rock Star? Hell no. Total Rock Star move.

To the meat of his entertaining and informative talk:

He gives a nice (and brief) historical overview on indolent lymphomas and the use of chemotherapy, particularly CHOP, in treating lymphoma.

He then discusses the alternatives: Antibodies (like Rituxan) that target the surface of the cancer cell.
Treatments that target pathways, like Ibrutinib and Idelalisib, which disrupt the processes that keep cancer cells alive.
And combinations like Lenalidomide (a.k.a. Revlimid) + Rituxan, now being studied in the RELEVANCE Study. Dr. Cheson believes the R squared combination "could very well change how we approach patients with indolent lymphomas."

He also makes clear that cancer cells are tricky, and one of these types probably won't be The Answer. Instead, he can see some combination of, say, and monoclonal antibody with a kinase inhibitor or two, with a dash of anti-PD1 added for good measure, to take care of the microenvironment. As we learn more about the way cancer cells work,we also learn about how all of these various targets interact with one another.

W still have lots of questions to answer, though, like How do we match a patient with an effective treatment, and truly personalize the therapy? And when we treat Indolent NHL, like Follicular Lymphoma, do we treat it as a chronic disease, controlled by a daily pill forever? Or do we go for a cure? (Incidentally, Dr. Cheson would rather go for a cure.)

But none of this happens without patients being willing to participate in clinical trials. Dang few of us do that now (myself included).

(How do you participate in a clinical trial? Well, for starters, has some good advice.)

One final thought: Dr. Cheson says that lymphoma is presentable. He cites an article from his favorite journal that shows how. But you'll have to watch the video to the end to find out how.

But it's definitely worth 28 minutes of your time to see a Lymphoma Rock Star describe the state of the art in Indolent Lymphoma treatments.



Anonymous said...

Really enjoy your blog! And I especially liked this video.

Lymphomaniac said...

Yeah, Dr. Cheson is pretty awesome, and he's at his best here.
And thanks for reading.

Virginia Miller said...

Loved the info and the video!

Naturalherbs Solutions said...
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