ASH 2018 Daily Wrap: MPN News

Published on

Topics include: Treatment and Understanding

Patient Power founders Andrew and Esther Schorr are joined by a panel of experts, including, Dr. Robyn M. Scherber, from the Mays Cancer Center at UT Health San Antonio MD Anderson, Dr. Naveen Pemmaraju, from The University of Texas MD Anderson Cancer Center, and Dr. Larry Saltzman, from The Leukemia & Lymphoma Society (LLS),as they discuss research developments announced at the 2018 American Society of Hematology (ASH) meeting in San Diego. The panel shares clinical trial data, drug approvals and new therapies on the horizon with a focus on progress made in myeloproliferative neoplasms (MPN) and lymphomas. Watch day one of Patient Power’s daily wrap to hear the latest blood cancer-related treatment news.

View more programs featuring , , , and

Transcript

Please remember the opinions expressed on Patient Power are not necessarily the views of our sponsors, contributors, partners or Patient Power. Our discussions are not a substitute for seeking medical advice or care from your own doctor. That’s how you’ll get care that’s most appropriate for you.

Andrew Schorr:

And, greetings from San Diego in the American Society of Hematology meeting, more than 20,000 people here talking about blood-related conditions and blood-related cancers. Thank you for joining us for the first of three daily wrap-ups produced by Patient Power to bring you, around the world, news and to let you ask questions. I’m Andrew Schorr. Who’s this?

Esther Schorr: 

I’m Esther Schorr. I’m with him.

Andrew Schorr:           

Just like this. We have wonderful guests with us, and we invite your questions.

Esther Schorr: 

Yes, that’s right. If you have questions during the program, just write us at questions@patientpower.info, and our producer here will let us know, and we’ll try to get your questions answered.

Andrew Schorr:           

Okay. Remember, never too personal, so let’s have everybody get a benefit of what the answers are as we talk to our experts here, and also, remember, whatever you hear here—discuss it with your own healthcare team, so you get what’s right for you. Okay, who do we have?

Esther Schorr: 

Who do we have? Do you want me to introduce them?

Andrew Schorr:           

Please.

Esther Schorr: 

Okay. Well, the first guest here is Dr. Robyn Scherber, who’s an assistant professor of medicine at the Department of Hematology and Oncology—this is a mouthful—at the Mays Cancer Center at UT Health San Antonio MD Anderson. How did I do?

Dr. Scherber:   

That’s perfect. It’s my pleasure to be here.

Andrew Schorr:           

Thanks for being with us.

Esther Schorr: 

Yes, thank you.

Andrew Schorr:           

Is it safe to say, Robyn, that you’re a myeloid specialist?

Dr. Scherber:   

Yes, and lately, I’ve been seeing a lot of different things myeloid—everything from MDS to non-transplantable AML. My true is of myeloproliferative neoplasms.

Esther Schorr: 

And, am I write that you also focus—we’ll talk about it later—on the symptoms of all of that and how to manage those symptoms?

Dr. Scherber:   

We do, yeah.

Andrew Schorr:           

It’s diet we’re gonna talk about.

Dr. Scherber:   

Oh – this sounds awesome. I’m ready.

Andrew Schorr:           

What can you do? So, sitting next to Dr. Scherber is someone that you may have seen on many other Patient Power programs from the MD Anderson Cancer Center in Houston, Dr. Naveen Pemmaraju. What’s your title there now? Are you the president yet?

Dr. Pemmaraju:           

Not yet, Andrew, but Associate Professor.

Esther Schorr: 

And Chief Tweeter.

Dr. Pemmaraju:           

I need to go back with that. That’s good.

Andrew Schorr:           

If you happen to go on Twitter, this gentleman has lots of followers, and in the MPN area, you have a lot of followers. There’s the MPN social media, and also, Dr. – D-O-C-T-O-R—Pemm—P-E-M-M.

Dr. Pemmaraju:           
Right on, Andrew.

Andrew Schorr:           

Okay. And, thank you so much for using technology to help reach so many people. We have a lot to talk about, and you also are a myeloid specialist.

Dr. Pemmaraju:           

Right, correct.

Andrew Schorr:           

Okay, and a researcher. Who’s that?

Esther Schorr: 

That is Dr. Larry Saltzman, who is the Executive Research Director of The Leukemia & Lymphoma Society, and also, you are a CLL survivor, correct?

Larry Saltzman:           

Yes, I am.

Andrew Schorr:           

How long has that been, Larry?

Larry Saltzman:           

It is going on nine years come January.

Andrew Schorr:           

And, you’re a marathoner.

Larry Saltzman:           

I have run marathons, yes. Many.

Andrew Schorr:           

A retired physician living in Sacramento.

Larry Saltzman:           

Yes, I am.

Esther Schorr: 

Nowhere near fires, right?

Larry Saltzman:           

Yes. Well, we’re 100 miles away from the Paradise fire, so it was raining ash on us for about 10 days. Not comfortable.

Andrew Schorr:           

Well, we are here in what was rainy Southern California the other day, but it’s cleared up. Here’s the thing: There is a lot of news going on, so I would—sayand, I wanted to get Larry’s take for a second—for me as a CLL patient for 22 years and a myelofibrosis patient for seven, I guess, it continues to offer a lot of hope that there are more treatments in development or treatments being approved.

We’ll hear a lot about acute myeloid leukemia. And also, more precise testing and just a buzz—Larry, do you feel positive?

Larry Saltzman:           

Oh, it’s amazing. Andrew, when I was diagnosed eight-plus years ago, I was told that I had an eight-year prognosis because the drugs that I’m now taking, which are keeping me healthy, were not even available or in a mind’s eye at that time, and so, there were very few treatments, but now, here we are, attending sessions, and there are multitudes of treatments now for CLL, and they’re not all chemo-based intravenous treatments. Many are oral, and it’s very exciting because they’re showing survival rates that were unheard of a decade ago.

Esther Schorr: 

It’s not too different than your story because you started out in a clinical trial that included some chemotherapy, and then you were just retreated with non-chemotherapy. It’s amazing.

Andrew Schorr:           

Right, with monoclonal antibodies targeted therapies, so all that’s been happening while we’ve been—patients have been living.

Larry Saltzman:           

Absolutely.

Andrew Schorr:           

So, we have chronic lymphocytic leukemia—a lymphoid condition, right? And then, I developed myelofibrosis, which is a myeloid condition, right? So, here we have two myeloid specialists. So, Robyn, what are you excited about or are you excited about, and let’s start with the MPNs, the myeloproliferative neoplasms. That’s essential thrombocythemia, polycythemia vera, myelofibrosis. So, are you feeling encouraged here?

Dr. Scherber:   

We have a breadth of new therapies at an unprecedented rate that we’ve never seen before. Right before this, I was looking back through again at all the FDA approvals from November alone. In the last month, there have been nine FDA approvals for cancer, six of which have been for blood cancers.

It’s unbelievable, and three of those have been for a special type of myeloid cancers—acute myelogenous leuke. So, in this way, we are just growing at an unprecedented rate.

Andrew Schorr:           

So, I wanted to ask you just as a follow-up about lines of therapy. So, some of us with polycythemia vera and some with myelofibrosis are on a drug called ruxolitinib, or Jakafi, or Jakavi, if you’re outside the country, and it’s been working for me. It doesn’t always work for some people, but then you say, “How long will it last and will there be something else coming?” So, you get to go to advisory board meetings and things like that. Is there hope coming?

Dr. Scherber:   

From what I can tell you—and, most of this stuff is about things that are openly published—we have a whole bunch of new therapies that are on the horizon.

I feel very fortunate—recently, we had the Society of Hemoncology in September, and we have now here at ASH—more than ever, we’re actually trying to find either alternative therapies or, even in combination with ruxolitinib, newer therapies to optimize the treatment.

We also have new JAK inhibitors that are on the horizon that have really taken another second wind. There’s been that little bit of a struggle getting new JAK inhibitor therapies other than ruxolitinib on the market, but these efforts have recently been renewed, and I think there’s a lot of enthusiasm that we’ll have a second-line, FDA-approved treatment in the setting of people who can’t tolerate or, for whatever reason, have progressed on ruxolitinib.

Andrew Schorr:           

Naveen, what do you think? Also, I know for some people, they also have interferons or other treatments—some have been around for 40 years.

Dr. Pemmaraju:           

Yeah, there’s a lot of buzz at ASH this year—exactly what you guys are both talking about. So, for example, our colleague Jean Jacques Kiladjian from France will be presenting results for RUXOpeg, a combination of ruxolitinib with interferon—so, something old, something new, something borrowed. So, exactly right, and number two is, as Robyn was mentioning, combinations of JAK inhibitor with other novel non-JAK inhibitors—hypomethylated, or azacitidine (Vidaza), or decitabine (Dacogen), as our group has shown, and other novel agents.

And then, there’s this whole group of drugs that I helped to research in, which are non-JAK inhibitors or beyond JAK inhibitors—so, drugs with completely different mechanisms of action that go through different pathways outside of the JAK-STAT pathway, so you’ll hear a lot about that at ASH this year as well.

Esther Schorr: 

I have a question. All of this—it seems in parallel with all these new drugs coming out. We hear as patients and care partners about genetic testing, and subtypes and all this.

So, is this increase in all of these options because there’s so much more knowledge and information coming from genetic testing? Is that why this is happening at the rate that it is, because you have those insights?

Dr. Pemmaraju:           

I absolutely think so. You’re right. I think about before JAK2 V617F—so, that was 2005 when we found out about that, and then, CALR was 2013, MPL somewhere in between—you’re right. Since then, there’s been an explosion of research. Non-JAK, non-CALR—the so-called non-driver mutations—ASXL1, all of these things.

And, to match your question, there’s a scoring system that comes out every week, I think. One of our colleagues—one of us comes out to try to make sense of all this. How do you fit in the clinical factors, the patient at the bedside, the genetic information, the chromosomes?

So, there is a lot of that going on, and that increased knowledge is helping to propel new drug targets. For example, if there’s another pathway that you find in your research, perhaps, maybe possibly, that can be targeted to help a patient with a certain…

Andrew Schorr:           

…so, I went to see my myeloid doctor—I have a lymphoid doctor and a myeloid doctor – I went to see Catriona Jamieson a week ago, and she is now gonna do a test for, I don’t know, several hundred genes. Now, you guys don’t know what all those genes mean. It may say Andrew has this gene or that gene, but you won’t necessarily know what’s significant yet.

Dr. Pemmaraju:           

That’s right on. So, a lot of these gene panels—we have to talk about it here—23 and Me, a lot of our listeners and viewers have heard about foundation medicine, in-house panels at all of our major academic centers, sometimes anywhere from 100 to 400 genes being tested. Andrew’s right. We know some of them, we have a hunch about some of them, but some of them are the great unknown.

So, as patients and doctors, we have to go into a partnership saying, “Let’s go for this testing, but let’s also go with the understanding that we may not know now, but maybe five to 15 years from now, we may know what to do with this information.”

Related Programs

What Treatments Are Available If Myelofibrosis Progresses to AML?

How many MPN patients go on to develop secondary AML? What medicines are offered to treat it? Dedicated researcher Dr. Naval Daver explains what percentage of myelofibrosis patients typically progress to AML, treatment options and patient response. Watch now to find out more.

Published:

Regulating the Course of MPNs: What Are Inhibitors and How Do They Work?

Can modern MPN treatments disrupt the abnormal molecular signaling in cancerous cells? A panel of MPN experts discuss pathway inhibitors and their effect on proliferative activity and disease course. Watch now to learn more.

Published:

An Expert’s Perspective on the Expanded Approval of Venetoclax

Dr. Susan O’Brien discusses the exciting new data propelling the recent approval for the expanded use of venetoclax and the impact it will have on those living with CLL.

Published:

Advertisement
Join Our Community Register for Events Read Our Latest Blog
Advertisement

Page last updated on January 30, 2019