ASH News Daily - Sunday, December 11, 2011 - (Page A-14)

Page A–14 ® ® NON-HODGKIN ALL What’s New in Aggressive Non-Hodgkin Lymphomas? Efficacy and Toxicity — Is There a Sweet Spot in ALL? By BaRBaRa PRo, Md By BarBara pro, Md New Agents and Current Management,” attend the repeat session today at 7:30 a.m. in Room 20AB, San Diego Convention Center, to learn about the latest developments in the diagnosis and treatment of aggressive lymphomas. Dr. Elaine Jaffe, National Cancer Institute, will open this session with a review that will highlight the most recent updates in lymphoma classification. As the list of lymphoma subtypes gets longer, I T Meth Lab «« From Page A-12 Education Program session titled “Updates on Treatment Strategies in Myelodysplastic Syndromes,” which emphasized the advances that had been made in our understanding of the biology of MDS, that survival has increased dramati particularly has cused on how this ing changed hypomethylating our approaches with the approval of health issues, agents treatment such potion. Thus, moving away from standard “kill-all” drugs to “spareme” targeted agents have been most of the focus of cancer research in the last few decades. Also, as patients live longer, we struggle with a number of issues due to treatment-related short- and long-term toxicities and look back and ask ourselves: How can we make it better? Is there a sweet spot of increased efficacy and minimal toxicity? This morning at 7:30 a.m. and again at 2:00 p.m. in Elizabeth Ballroom EFGH, Manchester Grand Hyatt San Diego, Dr. Adele Fielding, University College London, will chair an Education Program session titled “Current Management Issues in Acute Lymphocytic Leukemia,” outlining the most current and pressing issues in the treatment of ALL. For pediatric ALL the good news is methylation, and fo- f you missed yesterday’s Education Program session, “Update on Aggressive Lymphomas – cally with five-year rates exceeding understand90 percent. The bad news is that success has come with a price. Chronic secondary cancers, as and significant emotional hurdles othy Graubert, Washington University, St. Louis, shared with the audience some recently discovered genetic abnormalities in MDS, with a particular emphasis on genes coding for proteins involved in epigenetic modifications, as many of them may have prognostic value, including in response to hypomethylating agents. During his presentation, Dr. Graubert reviewed the hot topic of RNA splicing, highlighting the SF3B1 mutations and their relations to What about adult ALL? The good refractory anemia with ringed sideroblasts. Dr. Steven Gore, Johns Hopkins University, then reviewed the AZA001 study and how it has JAK2 plantation news is that there are many new therapies; the bad news is that none of them are fully effective at controlfirmly established azacitidine as the treatment of choice for patients with high-risk MDS who are not allogeneic hematopoietic stem cell transcandidates. «« From Page A-12 Dr. Gore emphasized that it is important to be patient in the administration of this agent, as it may take several cycles before evidence of hematologic responses. Dr. Pierre Fenaux’s portion of the session focused primarily on results obtained with lenalidomide in low-risk MDS with 5q deletion. He also shared some new data on the use of lenalidomide in lower-risk MDS without 5q deletion. the eosinophilic disorders, molecularly defined as PDGFRA, PDGFRB, and FGFR1-associated neoplasms. Dr. James W. Vardiman from the University of Chicago, indicates that the promise of future targeted therapies akin to imatinib played a role in devising the 2008 WHO Classification system. While JAK2 mutations were at once enlightening, they likely represent just the first piece of a very elaborate mosaic. Dr. Bishop indicated no relevant conflicts of interest. Dr. Landau indicated no relevant conflicts of interest. 003192_sgn35_adc_and_fa2.indd 1 azacitidine and decitabine. Dr. Timfor both patients and caregivers are only a few of the many issues we are left to deal with. Dr. Leslie Robinson, St. Jude Children’s Research Hospital, will present the most current in formation on key issues associated with early morbidity and mortality in childhood ALL survivors. Most importantly, based on recent findings, she will provide recommendations for screening and new directions for interventions to improve long-term outcomes. he goal of our fight against cancer is finding the MELTing (most-effective-least-toxic) it is a must for the practicing clinician to become familiar with some of the new challenges in the classification of these neoplasms and get to know the new kids on the block. Be prepared, as some of these new ones can “double hit.” Dr. Jaffe will summarize what is new in the WHO classification regarding aggressive B-cell lymphoma and in particular how we subdivide this heterogeneous group based on cell of origin, clinical and etiologic factors, and pathogenesis. An entity ling this challenging disease. The development of monoclonal antibodies represents one of the greatest success stories in the treatment of hematologic malignancies as it is the ideal targeted therapy. Dr. Dieter Hoelzer, University of Frankfurt, will discuss how the introduction of antibodybased therapies is changing the outcome for patients with ALL. In addition to providing the most current data on the use of traditional antibodies, Dr. Hoelzer will discuss the use of the newer humanized anti-CD20 and bi-specific an- that is particularly challenging for both pathologists and clinicians is double hit B-cell lymphoma, which has features intermediate between diffuse large B-cell lymphoma (DLBCL) and Burkitt lymphoma (BL). Patients with this disease have a poor prognosis when treated with conventional therapy and most cases carry a Myc translocation. Dr. Jaffe will also address important questions regarding the impact of c-Myc translocation in other subtypes of aggressive B-cell lymphoma. tibodies in the treatment of ALL. Some of the challenges related to the use of antibody-based therapies in different clinical settings will also be addressed. Dr. Fielding will conclude the ses- sion with an update on the treatment of Philadelphia-positive (Ph+) ALL. The Philadelphia chromosome is the most common cytogenetic abnormality associated with adult ALL. Before the introduction of tyrosine kinase inhibitors (TKIs), Ph+ ALL carried a poor prognosis with poor response to chemotherapy and short survival Following Dr. Jaffe, Dr. Jonathan Friedberg, University of Rochester, will present the most recent data on treatment of relapsed disease. He will address the importance of using prognostic markers to identify newly diagnosed patients at highest risk of relapse and who therefore may be offered more aggressive therapies. The majority of patients with relapsed DLBCL have primary refractory disease but late relapses flicts of interest. »» NON-HODGKIN Page A-19 rates. Treatment with BCR-ABLspecific TKIs has resulted not only in higher complete remission rate and better long-term outcome but also in minimal toxicity. Dr. Fielding will review a number of important issues such as the role of monotherapy with TKIs in select patients, the role of allogeneic stem cell transplantation, and mechanisms of resistance. Results of ongoing studies with novel agents will also be presented. Dr. Pro indicated no relevant conASH NEWS DAILY AIL Sunday, December 11, 2011 Saturday, December 10, 2011 E N G I N E E R I N G T H E N E X T G E N E R AT I O N O F A N T I B O D Y - D R U G C O N J U G AT E S To learn more about our ADC technology, see our medical affairs representatives at booth 129

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ASH News Daily - Sunday, December 11, 2011

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