Advancing Global Care with Emerging BTKi in Relapsed/Refractory CLL: Connecting Hematology Leaders to Worldwide Learners

Guest: Caron A. Jacobson, MD

CD19-directed chimeric antigen receptor (CAR) T-cell therapies are revolutionizing the treatment of aggressive non-Hodgkin lymphoma (NHL), offering patients with refractory/relapsed disease the chance for a potential cure after a single infusion. However, the widespread use of CAR T-cell therapies faces several challenges, from the production of the therapies to the management of toxicities to issues of inpatient vs outpatient administration. While CAR T-cell therapies have historically been given in the inpatient setting, interest in outpatient delivery is growing, and this option may become more feasible if logistical issues and lack of multidisciplinary collaboration between the community provider and the CAR-T cell therapy center can be overcome.

AXIS routinely collects and analyzes data gathered from participants in our live activities. These questions provide incredible insight regarding the persistent challenges that clinicians face when trying to optimize treatment and management of patients with cancer, helping to verify where clinical practice gaps exist. This activity will provide expert answers to questions asked during a recent educational series on CAR T-cell therapies in large B-cell lymphoma regarding practical considerations for CAR T-cell therapies.

Guest: Joyce O'Shaughnessy, MD

By 2040, the global breast cancer burden is expected to increase by 40%, resulting in more than 3 million new cases and 1 million deaths per year. Approximately 65% of cases among women less than 50 years of age and 75% of cases among women over 50 years of age are classified as HR+/HER2-. Although endocrine therapy is employed as standard-of-care treatment for many patients with HR+/HER2- breast cancer, not all such patients respond to endocrine therapy, and many who do initially respond will relapse. CDK 4/6 inhibitors can help overcome mechanisms of endocrine resistance, decrease tumor cell growth, and act synergistically with anti-estrogens. Clinicians are faced with constant change in the breast cancer treatment landscape. Disease heterogeneity, drug resistance, and incorporation of genetic testing into the treatment formula for HR+/HER2- breast cancer patients are all things they must contend with. Understanding practice guideline recommendations and the evidence behind them will allow clinicians to better integrate CDK 4/6 inhibitors into their clinical practice.

This Chairman’s Perspective activity features a highlight summary from a nationally recognized expert with relevant and timely information on HR+/HER2- BC, including the latest trial results and accumulating real-world evidence that demonstrates the efficacy and overall safety …

Guest: Neeraj Agarwal, MD, FASCO
Guest: Elena Castro, MD, PhD
Guest: Neal Shore, MD, FACS
Guest: Axel S. Merseburger, MD

While the development of advanced prostate cancers is largely influenced by androgen receptor (AR) signaling, DNA-damage response (DDR) pathways also contribute to disease progression. AR axis-targeted therapies (ARATs) have been the standard of care for first-line mCRPC. Inhibiting PARP activity is an effective strategy for targeting malignant cells with limited DNA repair capacity due to DDR gene mutations, leading to synthetic lethality. There may be a synergy between ARATs and PARP inhibitors (PARPi), as ARATs can induce HRR deficiencies and PARP inhibitors can increase the activity of ARATs through AR-dependent transcription. Recent clinical trial results have demonstrated that the combination of PARPi with ARATs is safe and effective for the first-line treatment of patients with mCRPC, with 3 combinations now FDA-approved: olaparib + abiraterone, talazoparib + enzalutamide, and niraparib + abiraterone.

This activity will provide expert contextualization of evidence from first-line mCRPC clinical trials exploring these combinations, including insights about the differentiation of both treatment and patient selection, as well as management of treatment-related toxicities. Given the differences in approvals and guidelines between the US and European context, this Ryder Cup themed Expert Panel Discussion will compare and contrast the approach in both regions, giving participants comprehensive education on …

Host: Paul P. Doghramji, MD, FAAFP
Guest: Rami Komrokji, MD
Guest: Allan Platt, PA-C, MMSc

Low-risk myelodysplastic syndrome (LR-MDS) is an acquired bone marrow disorder that manifests with symptomatic anemia. Many patients become dependent on red blood cell transfusions. Erythropoiesis-stimulating agents (ESAs) are the first-line treatment, but not all patients with LR-MDS respond to ESAs, and many become refractory to ESAs over time. Although advances have been made in the treatment of anemia in patients with MDS, there remains a significant unmet need for new and better treatment options for patients with ESA-refractory, transfusion-dependent MDS.

Timely identification of patients who become ESA refractory is critical for primary care physicians to promptly request referral to hematology specialists. Delays in referral can contribute to increased disease burden and lower quality of life (QoL) for patients. To achieve optimal patient outcomes requires multi-disciplinary team-based management and collaboration among primary care and hematology specialty care providers. With recent FDA approvals and emerging positive trial data, the multi-disciplinary care teams are faced with learning how to integrate new treatment options and associated guidelines into real-world clinical practice thus making clinical decision-making much more complex.

This educational activity, featuring an expert panel discussion, will review the identification of ESA failure in patients with LR-MDS and the importance of timely referral to …

Host: Mark Socinski, MD

Host: Richard S. Finn, MD

Evidence supports the notion that adding targeted agents that have a different mechanism of action than those that cause estrogen receptor interference can improve the benefits and outcomes seen with endocrine therapies alone in HR+/HER2- metastatic breast cancer (mBC). Clinical trial and real-world evidence show that CDK 4/6 inhibitors are safe and effective treatments for HR+/HER2- mBC. Real-world evidence can supplement clinical trial evidence and be more applicable to relevant community-based populations and clinical practice settings.

Optimal care of mBC involves the use of effective therapies that are supported by the latest evidence and guidelines, selected through a shared decision-making process, and individualized to each patient’s needs. The educational Oncology Clinic features an up-to-date review of real-world evidence surrounding CDK 4/6 inhibitors in mBC that expands on available clinical trial evidence. Through case vignettes that model best practices in shared decision-making, expert faculty will demonstrate how to translate clinical trial and real-world evidence into discussions with patients.

Host: Anthony Mato, MD, MSCE
Guest: Toby A. Eyre, MD, MBChB
Guest: Talha Munir, PhD

The validation of targeted agent classes, driven by the emergence of BTK inhibitors as a highly effective therapeutic tool, has transformed the medical management of CLL/SLL and led to similar advances for other B-cell malignancies. Although this transformation has substantially improved outcomes, challenges remain and are centered on the problem of devising truly individualized sequential care in the relapsed/refractory disease setting, where outcomes to date have not improved as dramatically as those for newly diagnosed/treatment-naïve disease. Therapeutic intolerance and challenges involving adverse event management, BTK inhibitor resistance, and double-refractory status contribute to therapy interruption or discontinuation and abrogate clinical benefits associated with continued BTK inhibitor therapy, leading to subsequent care that is suboptimal due to a dearth of effective treatment options.

The educational activity, featuring an expert panel discussion comprised of 1 US and 2 international faculty thought leaders, will provide an evaluation of the most recent clinical data and expert insights on the current and emerging evidence supporting the clinical utility of BTK inhibitors in relapsed/refractory CLL/SLL.

Host: Eric H. Kraut, MD

Hemophilia A is a rare bleeding disorder caused by deficiency of clotting factor VIII. The current standard of care for patients with severe hemophilia A centers on replacement therapy with factor VIII concentrate, either on demand when bleeding occurs or prophylactically (replacement therapy). Potential complications from replacement therapy include the development of inhibitory antibodies that attack the clotting factor in approximately one-fourth of patients, viral infections from human clotting factors, and bleeding in joints and muscles resulting from treatment delays. According to treatment guidelines from the Medical and Scientific Advisory Council (MASAC), “Inhibitor development is the most severe complication of treatment for patients with inherited hemophilia A.” In addition, the high cost and frequency of infusing factor VIII concentrates can increase the potential for side effects, thereby negatively affecting patient quality of life.

Fortunately, several unique agents have been newly approved or are currently under development. These agents promise to reduce morbidity and improve quality of life for patients. Clinicians will be challenged to integrate these new agents into their clinical practices.

AXIS routinely collects and analyzes data gathered from participants in our live grand rounds programs. These questions provide incredible insight regarding the persistent challenges that clinicians face when …