Saturday, May 23, 2015

ASCO Preview

Medscape has a brief (5 minute) video previewing the ASCO conference sessions on blood cancers. The video features Lymphoma Rock Star Dr. Bruce Cheson of Georgetown University.

Dr. Cheson mentions a couple of sessions related top lymphomas of various types, including including two that will be of interest to Follicular Lymphoma patients. The first will be results from the GADOLIN trial, which features Bendamutine plus Obinutuzumab (a monoclonal antibody that targets CD20, like Rituxan, but which is humanized, unlike Rituxan, which is mouse-icized).

The other is a report on a study of Polatuzumab Vedotin. This is a very cool treatment. It consists of a toxic substance that can't be administered directly because it is too toxic. So it is attached to an anti-CD79b molecule. Follicular Lymphoma cells express CD79b, so this molecule attaches to them. The cell then kind of sucks the whole thing into itself, and then it breaks apart, releasing the toxin, which disrupts some processes and kills them cell from the inside. You can watch a short video of how it works by clicking here.

 Dr. Cheson's video mentions some other blood-cancer-related sessions, but those two seem most relevant to those of us with Follicular Lymphoma. I found a few others, too, that I plan to describe in the next few days.

In case the link for the Medscape video doesn't work, they included a helpful transcript, which I am copying below.

So maybe not a huge amount of Follicular Lymphoma stuff at ASCO this year, but what is there looks pretty good.

This is Bruce Cheson from Georgetown University Hospital, the Lombardi Comprehensive Cancer Center, for Medscape Hematology.
It's that time again. The end of May is rolling around and the American Society of Clinical Oncology (ASCO) 2015 annual meeting is coming up. If you are an aficionado of hematologic malignancies, you will find one session each for lymphoma (Hodgkin's and non-Hodgkin's), leukemia (acute and chronic), and multiple myeloma. These will be spread out over 4 days.
What can we expect? Some interesting abstracts will be presented. In lymphoma, we will hear about the GADOLIN trial.[1] This is a randomized phase 3 trial in rituximab-refractory patients, of bendamustine plus or minus obinutuzumab (the other anti-CD20 agent). Interesting data will be presented.
There will be some information on polatuzumab vedotin, the anti-CD79B antibody-drug conjugate, in combination with rituximab.[2] In these compounds, an antibody is bound to a toxin, which becomes internalized within the malignant cell and kills those cells. They really work.
Additional data[3] will be presented on the combination of what I call "A2VD" (Adcetris® [brentuximab vedotin], Adriamycin® [doxorubicin], vinblastine, and dacarbazine) in early-stage Hodgkin's lymphoma. The same antibody-drug conjugate (brentuximab vedotin) will be combined with R-CHOP for patients with diffuse large B-cell lymphoma.[4] There is a lot of interest, and a lot of data are coming out with the antibody-drug conjugates.
In the leukemia field, we will see the first offering of bendamustine/rituximab with or without ibrutinib in chronic lymphocytic leukemia.[5] The treatment that has many of my patients curious and excited—CART-19 therapy—will be presented in a study of patients with acute lymphoblastic leukemia of the B-cell variety.[6] We will see data from a triplet of biologic agents—ublituximab (another anti-CD20 agent), TGR1202 (a PI3-kinase inhibitor), and ibrutinib—in lymphoma.[7]
For those of you interested in myeloma, you are going to have to wait until Tuesday, when you will hear the results of the ELOQUENT trial.[8] This is lenalidomide/dexamethasone with or without elotuzumab, which is a signaling lymphocyte activation molecule number 7 (SLAM 7). You will also see the ENDEAVOR trial[9] which is carfilzomib/dexamethasone vs bortezomib/dexamethasone duking it out to see which is the better proteasome inhibitor. Data[10] will be presented on a monoclonal antibody—CD38 daratumumab—for lymphoma, which is very promising. Finally, there will be some data on a combination of panobinostat, the HDAC inhibitor, and carfilzomib.[11]
Those are just some of the studies that should capture your interest and get you going to those sessions at the ASCO meeting. For those of us who would like to see a little more lymphoma, don't forget the International Conference on Malignant Lymphoma (ICML) coming up in the middle of June in Lugano, Switzerland. I like Chicago a lot, but then there is Lugano, Switzerland.
This is Bruce Cheson, signing off with a little teaser about the upcoming ASCO meeting. Hope to see you there and I hope you'll enjoy the various hematologic oncology sessions.

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