The HemOnc Pulse

What It Takes to Harmonize the World’s Hodgkin Lymphoma Data

The first episode of The HemOnc Pulse of the new year features an in-depth discussion by the leading researchers of the Hodgkin Lymphoma International Study for Individual Care (HoLISTIC) consortium.
Principal investigators Susan Parsons, MD, MRP; and Andrew Evans, DO, MBA, MSc; are joined by Matthew Maurer, DMSc; to share the story behind harmonizing the world's Hodgkin lymphoma data, and what the effort means for both clinicians and patients.

Dr. Usmani Discusses Perseus, IsKia, Data Plus More Myeloma Updates

Saad Usmani, MD, MBA, FACP, Chief of the Myeloma Service at the Memorial Sloan Kettering Cancer Center, joins Chadi Nabhan, MD, MBA, FACP, on The HemOnc Pulse to chat about the latest research in multiple myeloma from the 65th American Society of Hematology (ASH) Annual Meeting and Exposition.
Dr. Usmani shares insights on the evolution in myeloma treatment since he first started practicing in the hematologic oncology space. He also reflects on the Perseus and IsKia trials, which were presented at ASH 2023.

Dr. Venugopal Offers Her Thoughts on the Latest MDS News

Sangeetha Venugopal, MD, of the University of Miami Sylvester Comprehensive Cancer Center, offers her thoughts on the investigational drug KER-050 in lower-risk myelodysplastic syndromes (MDS), the COMMANDS trial, and if she believes MDS is a distinct disease.
She also highlights the latest research in MDS at the 65th American Society of Hematology Annual Meeting and Exposition.

Jerald Radich, MD: AML Abstracts to Keep an Eye on at ASH 2023

In this episode of The HemOnc Pulse, Jerald Radich, MD, of the Fred Hutchinson Cancer Center, joins Chadi Nabhan, MD, MBA, FACP, to discuss various abstracts on acute myeloid leukemia (AML) presented at the 2023 American Society of Hematology (ASH) Annual Meeting & Exposition. The conversation centered around menin inhibitors for the treatment of AML, the effect of measurable residual disease-positivity on transplantation outcomes, and whether age plays a role in transplantation.

Inside the FDA ODAC ’Yes’ Vote to Polivy

In this episode of The HemOnc Pulse, Grzegorz Nowakowski MD, a Professor of Oncology and Medicine in the Division of Hematology at the Mayo Clinic, recounts his experience serving on the FDA Oncologic Drugs Advisory Committee that reviewed and evaluated data from the POLARIX study and polatuzumab vedotin-piiq (Polivy)for patients with previously untreated LBCL.

Kami Maddocks, MD, on the Shocking Ibrutinib Withdrawal

In this episode of The HemOnc Pulse, Dr. Maddocks, Professor of Clinical Internal Medicine in the Division of Hematology at The Ohio State University, charts the treatment evolution of mantle cell lymphoma (MCL) from frontline therapy to future directions. She also explains her initial shock, and subsequent bittersweet reaction to the withdrawal of ibrutinib.

Jorge Cortes, MD, on Why Balance Is Key in CML Therapy

Dr. Cortes, who serves as Director of the Georgia Cancer Center at Augusta University, joins host Chadi Nabhan, MD, MBA, FACP, to chat about the “boom” in treatments for chronic myeloid leukemia (CML), and where he sees a need for balance.
Dr. Cortes discussed the evolution of tyrosine kinase inhibitors (TKIs) and the multiple generations of TKIs that are now available. Second-generation TKIs can lead to earlier and deeper responses than first-generation TKIs, he said, noting that this means patients receiving second-generation TKIs are more likely to be able to discontinue treatment.
“If I was diagnosed with CML, I would take a second-generation TKI,” Dr. Cortes said.
However, Dr. Cortes emphasized that the first-generation TKI imatinib comes with a lower risk of serious side effects than second-generation TKIs. This is an important consideration because “most people are going to do well and have a normal life expectancy” on imatinib, he said.
It is critical to evaluate multiple factors when choosing between a first-generation TKI and a second-generation TKI. This means involving patients in the decisions about treatment to ensure they are comfortable with the balance of efficacy and safety, he said.
“I certainly would rather have more bags under my eyes than a heart attack,” Dr. Cortes said. “So, we need to balance that, and I think that sometimes we've been a little too obsessed on [obtaining] the lowest possible [polymerase chain reaction] value, and we lose the context of other elements that are important, such as risks, and comorbidities and side effects.”
He also discussed a population of patients who remain challenging to treat despite the evolution of therapies for CML.
“The most difficult patient is one without a mutation,” Dr. Cortes said, noting this is because response rates are lowest for those without a mutation and “you don’t know why they are not responding.”

What Are the Top Questions in ALL?

Elias Jabbour, MD, of the University of MD Anderson Cancer Center stops by The HemOnc Pulse for a live show at the Eleventh Annual Meeting of the Society of Hematologic Oncology in Houston, Texas.
In this episode, Dr. Jabbour, who is also an Associate Editor of Blood Cancers Today, the home of The HemOnc Pulse, discusses the most burning questions in acute lymphoblastic leukemia (ALL).

The ABCs of MM Treatment According to Rafael Fonseca, MD

Dr. Fonseca offers his thoughts on the future of multiple myeloma (MM) treatment, the ongoing debate between chimeric antigen receptor (CAR)-T therapies and bispecifics, and the latest treatment news on bispecifics, including elranatamab, which had yet to be approved at the time of this recording.
The conversation also covers the role of measurable residual disease (MRD), the potential for bispecific therapies to democratize access to advanced treatments, and the intriguing prospect of CAR-T cells potentially replacing hematopoietic stem cell transplants in the first relapse—a scenario reminiscent of lymphoma care.
"I don't think it's far-fetched to think that there's going to be a good number of patients with multiple myeloma that will be proposed as CAR T-cell candidates now at the time of first relapse, you know, similar to what has been seen in lymphoma," Dr. Fonseca said.
Additionally, the conversation touches on the paradigm shift toward prioritizing deeper responses, including MRD negativity, as a potential avenue to achieve long-term cure for some myeloma patients.
"I think the debate of cure versus control in myeloma is pretty much very clear that for those that are capable and those that are fit, the intention should be to try to lead to the deepest responses," he said.

The Post-POLARIX Trial Era: Polatuzumab Vedotin Shifts DLBCL Treatment

On this episode of The HemOnc Pulse, guest Jonathan Friedberg, MD, MMSc, a hematologic oncologist at the University of Rochester Medicine – Wilmot Cancer Institute, chats with host Dr. Chadi Nabhan on the subtle but important shift in the treatment landscape of diffuse large B-cell lymphoma (DLBCL)in the post-POLARIX trial era.
The POLARIX trial, which was designed to improve upon the standard R-CHOP regimen for DLBCL treatment, investigated the potential of polatuzumab vedotin. The phase III trial ultimately resulted in the US Food and Drug Administration approving the treatment in previously untreated DLBCL, not otherwise specified, or high-grade B-cell lymphoma. The approval is for patients with an International Prognostic Index (IPI) score of two or greater.
"I think that this was a robustly done randomized placebo-controlled trial that showed a small but clinically significant benefit as far as progression-free survival in patients with IPI score of two and above [in] large B cell lymphoma," he said.