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Oncology On The Go

By: CancerNetwork
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  • Summary

  • Oncology On The Go is a biweekly podcast that talks to authors and experts to thoroughly examine featured articles in the journal ONCOLOGY. Each episode, you'll hear from one of the authors of our featured article to summarize the important takeaways from that piece. Then, an outside expert will give their perspective on the details of that article. As the home of the journal ONCOLOGY, CancerNetwork offers different perspectives on oncology/hematology through review articles, news, podcasts, blogs, and more. To learn more, you can also visit us on Facebook, Twitter, and LinkedIn!
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Episodes
  • S1 Ep120: Improving CAR T-Cell Therapy Monitoring Strategies and Access in Lymphoma

    S1 Ep120: Improving CAR T-Cell Therapy Monitoring Strategies and Access in Lymphoma
    Jul 29 2024
    In a conversation with CancerNetwork®, Nausheen Ahmed, MD, spoke about optimizing monitoring strategies for patients with B-cell non-Hodgkin lymphoma who undergo treatment with CAR T-cell therapy.


    Ahmed, an associate professor in the Division of Hematologic Malignancies and Cellular Therapeutics at the University of Kansas Medical Center, discussed the possibility of offering more flexible monitoring periods for patients in the context of findings from a real-world study published in Blood Advances.1 Data from her study showed that the occurrence of new onset cytokine release syndrome (CRS) and immune effector cell-associated neurotoxicity syndrome (ICANS) was rare at more than 2 weeks following CAR T-cell therapy infusion. Additionally, late non-relapse mortality generally resulted from infectious complications.


    The FDA implemented a Risk Evaluation and Mitigation Strategy (REMS) to help manage the risk of severe CRS and ICANS by requiring patients to reside within 2 hours of an authorized treatment center for 4 weeks following CAR T-cell therapy infusion.2 According to the study authors, this mitigation strategy may create significant barriers to CAR T-cell therapy access among certain patients and caregivers who need to relocate as part of a treatment plan.


    Findings from Ahmed’s study supported the development of individualized monitoring strategies depending on the stability of the patient. She and her coauthors proposed a 2-week monitoring period for patients while allowing for an optional increase to 4 weeks based on factors such as physician comfort and availability of local community oncology support. As Ahmed emphasized during the discussion, having flexibility in these monitoring periods could help mitigate financial and geographic obstacles preventing adequate access to CAR T-cell therapy among patients.


    “There has to be more of a hybrid model of care. There has to be more involvement of our referring doctors or community doctors in detecting and managing these infections or working with the specialized center in order to bypass the [emergency room] and other strategies to help these patients,” Ahmed said. “If there is enough data to say that the patients do not need extra restrictions beyond 2 weeks, which is what our studies show, then reconsidering the requirements will be one step towards decreasing disparities in access.”


    References


    1. Ahmed N, Wesson W, Lutfi F, et al. Optimizing the post-CAR T monitoring period in recipients of axicabtagene ciloleucel, tisagenlecleucel, and lisocabtagene maraleucel. Blood Advances. Published online July 24, 2024. doi:10.1182/bloodadvances.2023012549

    2. Risk Evaluation and Mitigation Strategies (REMS) for autologous chimeric antigen receptor (CAR) T cell immunotherapies modified to minimize burden on healthcare delivery system. FDA. June 26, 2024. Accessed July 23, 2024. https://tinyurl.com/2m284rjy
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    16 mins
  • S1 Ep119: Exploring New Possibilities in Kidney Cancer Detection and Therapy

    S1 Ep119: Exploring New Possibilities in Kidney Cancer Detection and Therapy
    Jul 22 2024
    At the 2024 Kidney Cancer Research Summit (KCRS), CancerNetwork® spoke with various experts in the kidney cancer field about potential advancements in disease detection and updated efficacy data on immunotherapy and other treatment strategies in patients with renal cell carcinoma (RCC).


    Karl Semaan, MD, MSc, a postdoctoral oncology research fellow at Dana-Farber Cancer Institute, discussed the implications of findings related to the use of an investigational tissue-informed liquid biopsy epigenomic profiling tool for detecting sarcomatoid differentiation in RCC.1 According to Semaan, this method may avoid the sampling errors and spatial heterogeneity challenges associated with traditional biopsy strategies.


    Additionally, Neil J. Shah, MBBS, an assistant attending physician from Memorial Sloan Kettering Cancer Center, spoke about data from a real-world study evaluating treatment patterns and outcomes in those with metastatic RCC following prior receipt of immunotherapy and tyrosine kinase inhibitors (TKIs).2 Data showed no differences in overall survival (OS) outcomes across different immunotherapy- and TKI-containing regimens. Based on these findings, Shah emphasized a need for additional novel therapeutic approaches to help improve outcomes in later-line settings of treatment.


    Bradley A. McGregor, MD, director of Clinical Research for the Lank Center of Genitourinary Oncology and medical oncologist specializing in genitourinary malignancies at Dana-Farber Cancer Institute, highlighted findings from his presentation on a phase 1b study (NCT04627064) evaluating treatment with abemaciclib (Verzenio) in a pretreated metastatic clear cell RCC population.3 Among 11 patients who received abemaciclib, 1 had stable disease, 8 had progressive disease, and 2 were not evaluable for response. Additionally, the median progression-free survival (PFS) and overall survival (OS), respectively, was 1.8 months (95% CI, 1.5-1.9) and 9.1 months (95% CI, 2.1-15.3).


    Although abemaciclib monotherapy yielded no responses in the study, McGregor highlighted the potential clinical utility of administering the agent in combination with other therapies. Findings from his presentation suggested that CDK4/6 inhibitors may demonstrate a synergistic effect when combined with HIF-2α inhibitors, which is a potential strategy that investigators are evaluating with belzutifan (Welireg) and palbociclib (Ibrance) combination therapy as part of the phase 1/2 LITESPARK-024 trial (NCT05468697).



    References


    1. Semaan K, Zarif TE, Eid M, et al. Liquid biopsy epigenomic profiling for the detection of sarcomatoid renal cell carcinoma. Presented at the 2024 Kidney Cancer Research Summit; July 11-12, 2023; Boston, MA. Abstract 44.

    2. Shah N, Sura S, Shinde R, et al. Real-world treatment patterns and clinical outcomes of metastatic renal cell carcinoma patients post immune-oncology (IO) and Vascular Endothelial Growth Factor (VEGF) receptor targeted therapies. Presented at the 2024 Kidney Cancer Research Summit; July 11-12, 2023; Boston, MA. Abstract 36.

    3. McGregor BA, Xie W, Xu W, et al. Phase IB trial of abemaciclib in advanced renal cell carcinoma. Presented at: 2024 Kidney Cancer Research Summit; July 11-12, 2024. Boston, MA.
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    10 mins
  • S1 Ep118: Overcoming Physical and Social Barriers in the Lymphoma Field

    S1 Ep118: Overcoming Physical and Social Barriers in the Lymphoma Field
    Jul 15 2024
    As part of the Breaking Barriers: Women in Oncology program, CancerNetwork® spoke with Julie M. Vose, MD, MBA, and Avyakta Kallam, MD, about the evolution of their careers in the hematology-oncology space, including some of the critical advances and challenges associated with their work in the lymphoma field.


    Vose is division chief, Neumann M. and Mildred E. Harris Professor at the University of Nebraska Medical Center, and co-editor-in-chief of ONCOLOGY®. Kallam is an assistant professor in the Division of Lymphoma and Department of Hematology & Hematopoietic Cell Transplantation from City of Hope in Duarte, California.


    Vose and Kallam discussed how they first developed a passion for researching lymphoma, which led them to become involved in various breakthroughs related to the use of treatment strategies such as autologous stem cell transplantation, bispecific antibodies, and CAR T-cell therapy. The conversation highlighted how this evolution of therapy options has helped improve patient outcomes while reducing hospitalization periods and minimizing toxicity.


    The discussion also extended to the topic of overcoming various physical and social barriers while trying to advance in the lymphoma field. For example, Kallam described her experience with moving to the United States from India to complete her medical training, which involved adapting to a new culture and a new style of approaching treatment.


    In the early stages of Vose’s career, there were far fewer women involved in oncology and medicine in general, contributing to the challenge of needing to work extremely hard to prove that she was equal to her male colleagues. Vose noted in the early days, she was considered a rarity in the field as one of very few women.


    Vose and Kallam also brought up how their mentors have given them key pieces of advice from mentors that have stuck with them throughout their careers. They, in turn, offered wisdom to any woman looking to advance in the hematology-oncology space.


    “The biggest piece of advice [I received] is to see the patient as a person—not just as a patient—to be able to get to know them and their families understand some of their struggles so that you can relate to them as a person,” Vose said.


    The conversation also focused on the challenge of achieving work/life balance while making advances in the lymphoma space. Dedicating time to hobbies and finding support from friends and family members emerged as potential strategies for balancing professional responsibilities with one’s personal life.


    “Life is too unpredictable to not do things that you enjoy doing,” Kallam said, recounting a bit of advice she had received from one of her mentors. “What we’re doing is important; we are impacting lives. We’re doing a lot of research, but at the same time, keep in mind to have fun along the way.”
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    19 mins
Science
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