Friday, August 12, 2016

Pan Pacific Lymphoma Conference: Videos

A couple of weeks ago, I wrote about a video from the Pan Pacific Lymphoma Conference on staging FL with PET scans. It turns out there are a few more videos available from that conference (all from ASCO Post). I thought about stretching them out into several posts, but it's probably easier to give links to all of them in a  single post.

So here are the videos from that conference that I found most interesting:

 John G. Gribben, MD, DSc, on Follicular Lymphoma: Still a Role for Transplant?
Dr. Gribben discusses Autologous Stem Cell Transplants (where the stem cells come from the patient herself) and Allogeneic Stem Cell Transplants (where the cells come from a donor), and the potential problems for each. As he points out, Follicular Lymphoma is especially challenging, because it is considered incurable, and because there is no course of treatment that oncologists agree on. And as new treatments are being developed, the question is whether or not transplants are worth considering. He thinks there is, especially for young patients with aggressive disease, who can handle aggressive chemo, and start with an Auto SCC and move to an Allo SCT if necessary. A nice summary of what goes into that decision.

Fredrick B. Hagemeister, Jr, MD, on Using Rituximab Maintenance
Dr. Hagemeister addresses the issues surrounding Rituxan Maintenance. And there are many, as I have been saying for a few years, as one study seems to say that RM is a great thing, and then another seems to say it's not worth it (and then this pattern is repeated). The issue, says Dr. Hagemeister, is Progression-Free Survival, and since most patients would say they would like to go as long as possible between treatments, Rituxan Maintenance should be considered. He was at the conference to speak in favor of RM, and thinks there is still a role for maintenance for certain patients. (Dr. Hagemeister gets extra points for saying that patients should have a voice in choosing treatments, as long as they have all of the information to make a good decision. And while he doesn't necessarily label it this way, I think he sees the importance of the emotional factor that goes into making this decision. Follicular Lymphoma is an emotional disease as well as a physical one -- I like to hear a doctor who recognizes that.)

Nathan Fowler, MD, and Sagar Lonial, MD, on Treating Follicular Lymphoma
This video has a pretty general title, but there really is more of a focus to it -- Dr. Fowler and Dr. Lonial discuss how to treat Follicular Lymphoma which is refractory or relapsed "early" (which they define as within 2 years after treatment). Dr. Fowler presented at the conference on the recent studies that showed that patients who relapsed within 2 years after receiving R-CHOP had shorter median Overall Survivals. He refers to Dr. Bruce Cheson's talk about PET scans -- a PET at diagnosis can offer a baseline to compare to, if a PET is then taken after treatment. PET scans after treatment can help determine if a patient is likely to be in that POD24 group. Dr. Fowler lists some of the choices that patients have if they are in that "early" group, including Bendamustine, Idilisib, and Obinituzimab. Still, the choice is tough. Dr. Fowler's own personal approach is to try Bendamustine if R-CHOP fails, and if Bendamustine fails within 18 months, he would seriously consider a transplant.

So, some interesting videos, mostly summarizing some of the recent advancements in the field.

Also, I love the ukulele music. I was so distracted by Dr. Cheson's cool shirt in the last video from two weeks ago that I didn't even notice the music.

My dream is to have a job that has conferences in Hawaii. Until that happens, I couldn't think of a group of people (oncologists and cancer researchers) that deserves it more.

Treating FL

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