WolverHeme Happy Hour
By Bernard Marini, Anthony Perissinotti, et al.
Disclaimer: The views and opinions expressed on this podcast are solely those of the podcasters and guests and do not reflect the views or opinions of our employers or other affiliations.
WolverHeme Happy HourDec 21, 2022
Episode 17: The Hemophilia Eras Tour
In this episode, we are joined by classical hematology experts, Madeleine Ochs, PharmD, BCOP and Justin Arnall, PharmD, BCOP, to teach us hemophilia 101!
In this T-Swift themed, episode, we discuss the history of hemophilia treatment (through the "eras") and how new agents may change the management of hemophilia patients.
Common Sense Oncology: Outcomes That Matter
In this episode, Anthony and Bernie chat with Chris Booth, MD, and Aaron "Papa Heme" Goodman, MD, to talk about the Common Sense Oncology movement!
Join the Common Sense Oncology movement at this link (it's free!): https://commonsenseoncology.org/
Lancet Oncol paper: https://www.thelancet.com/journals/lanonc/article/PIIS1470-2045(23)00319-4/fulltext
All too well: the reality of leukemia treatment
In this episode, Anthony, Bernie, and Lydia are joined by a former patient, Madeline B, to talk about her ALL treatment journey. Drawing inspiration from Taylor Swift's upcoming concert and heartfelt ballad ("All Too Well"), this episode tackles some of the unique challenges, emotions, and considerations that come with helping adolescents and young adults (AYA) with treatment for acute leukemia. This is a must-listen for anyone taking care of AYA patients!
Episode 14: A Quantum Leap in AML Treatment? Dissecting Quizartinib Data with Dr. Dale Bixby
In this episode, Anthony and Bernie are joined once again by special guest and hematology expert, Dr. Dale Bixby, to discuss the recent publication of the QUANTUM-First study of quizartinib in newly diagnosed AML. Should this study change practice in FLT3-ITD+ AML? Have we made a "Quantum Leap" in the treatment of these patients? Listen for a fun-filled discussion of the data!
Notable References:
- QUANTUM-First Study: https://pubmed.ncbi.nlm.nih.gov/37116523/
- WolverHeme Episode 8 (Pulling the Goalie on FLT3 Inhibitor Use in AML): https://podcasters.spotify.com/pod/show/wolverheme/episodes/Episode-8-Pulling-the-Goalie-on-FLT3-Inhibitor-Use-in-AML---A-Discussion-with-Dr--Dale-Bixby-e1r6tqt/a-a8tthkc
Episode 13: You get blinatumomab! You get blinatumomab!
Blinatumomab - it's Oprah's new favorite drug!
On this episode, Anthony and Bernie are joined by special guests Dr. Lydia Benitez and Dr. Patrick Burke to discuss the ECOG1910 trial of blinatumomab in adult ALL. Is this trial practice changing? Listen and find out!
- ECOG1910 Late-Breaking Abstract: https://ash.confex.com/ash/2022/webprogram/Paper171751.html
Episode 12: Tinder for T Cells - Bispecifics in DLBCL
In this episode, we are joined by two lymphoma experts - Victoria Nachar, PharmD, BCOP and Tycel Phillips MD - to discuss the use of bispecific antibodies in Diffuse Large B-Cell Lymphoma (DLBCL)! Stay tuned for an exciting episode where we discuss the data, their possible role in therapy, and what questions and controversies remain.
Relevant Articles:
Review on Design of Bispecifics - https://pubmed.ncbi.nlm.nih.gov/25728220/
Epcoritamab - https://pubmed.ncbi.nlm.nih.gov/36548927/
Glofitamab - https://pubmed.ncbi.nlm.nih.gov/36507690/
Mosunetuzumab - https://pubmed.ncbi.nlm.nih.gov/34914545/
Odronextamab - https://pubmed.ncbi.nlm.nih.gov/35366963/
CRS and ICANS grading - https://pubmed.ncbi.nlm.nih.gov/30592986/
Episode 11: "Olu the Drunk Snowman" - IDH inhibitors in R/R AML with Dr. Jill Lykon
In this episode, we are joined by Dr. Jill Lykon, Clinical Pharmacist Specialist in Hematology at the University of Miami, to discuss the use of IDH inhibitors in relapsed/refractory AML. How do we choose between IDH inhibitors? Is "Olu" the new standard IDH inhibitor in R/R AML, or just the name of a drunk snowman? What about ivosidenib?
- Olutasidenib Phase I - Watts, et al. Lancet. 2023: https://pubmed.ncbi.nlm.nih.gov/36370742/
- Olutasidenib Phase II ASH Abstract: https://ash.confex.com/ash/2022/webprogram/Paper167330.html
- Ivosidenib Phase I escalation/expansion - Dinardo, et al. NEJM. 2018: https://pubmed.ncbi.nlm.nih.gov/29860938/
- Design of olutasidenib and other IDH inhibitors: https://pubmed.ncbi.nlm.nih.gov/31971798/ and https://pubmed.ncbi.nlm.nih.gov/36091829/
- Episode 5 of WolverHeme Happy Hour (for background on IDH Inhibitors and frontline data): https://open.spotify.com/episode/4eNXjuGEFFRWTFJF0zsuMw?si=9bd0ae0a488e44ba
Episode 10: ASH Recap Part 2 - Papa Heme + WolverHeme
In this episode, we are joined by the legendary hematologist and rock star - Dr. Aaron Goodman - aka "Papa Heme"! We discuss which ASH abstracts might be practice changing and which simply don't make the cut. Stay tuned for an entertaining and very educational episode!
Episode 9: ASH Recap Part 1 - Dauno-Double Trouble
In this episode, Anthony and Bernie begin to recap some interesting studies presented at ASH, starting with a discussion the results of the "Dauno-Double" Trial. Should it change practice?
Dauno-Double Trial: https://ash.confex.com/ash/2022/webprogram/Paper157126.html
Dr. Todd Lee breaking down the non-inferiority numbers: https://twitter.com/DrToddLee/status/1600662377250586627?s=20&t=RdIhJJpMG-G_oPUSH2u2mw
Episode 8: Pulling the Goalie on FLT3 Inhibitor Use in AML - A Discussion with Dr. Dale Bixby
In this enlightening episode, Anthony and Bernie chat about FLT3+ AML with Dr. Dale Bixby, Clinical Professor and expert in leukemia at the University of Michigan. We use two clinical cases to take a deep dive into the biology and prognostic implications of FLT3+ AML, pitfalls and controversies of variant allele frequency and allelic ratio testing, and the data that informs the use of FLT3 inhibitors in AML. Watch out for some possibly heretical views!
REFERENCES
Schlenk and Dohner (Impact of AML prognostic markers)l: https://pubmed.ncbi.nlm.nih.gov/19468271/
RATIFY Trial: https://www.nejm.org/doi/full/10.1056/nejmoa1614359
ODAC Review of Quantum-R (quizartinib): https://www.fda.gov/media/124896/download
ELN 2022: https://pubmed.ncbi.nlm.nih.gov/35797463/
WHO Myeloid 2022: https://pubmed.ncbi.nlm.nih.gov/35732831/
Sorafenib Maintenance (RCT China): https://pubmed.ncbi.nlm.nih.gov/32791048/
SorMAIN: https://pubmed.ncbi.nlm.nih.gov/32673171/
RADIUS (midostaurin maintenance): https://pubmed.ncbi.nlm.nih.gov/33288862/
LACEWING Trial: https://pubmed.ncbi.nlm.nih.gov/35917453/
HMA/Ven pooled FLT3: https://pubmed.ncbi.nlm.nih.gov/35063965/
Ven/Aza/Gilteritinib ASH 2022: https://ash.confex.com/ash/2022/webprogram/Paper157210.html
UK NCRI AML 17 Flt3 analysis: https://pubmed.ncbi.nlm.nih.gov/27268085/
Episode (3+)7: Straight Outta Roswell - OG AML Data
Finally back from a much needed vacation, in this episode, Anthony and Bernie discuss some of the "OG" data and pharmacology behind key AML therapies.
Episode 6: Dr. StrangeDrug or: How I Learned to Stop Worrying and Love the Asparaginase
In this episode, Bernie and Anthony do an in-depth dive into the pharmacology, toxicity management, and clinical conundrums with asparaginase therapy, including how and when to monitor asparaginase activity levels (per Papa Heme request!). For those who don't know (and maybe aren't as nerdy as we are), the title is a reference to the 1964 film Dr. Strangelove!
Episode 5: IDH Inhibitors in AML: not so AGILE
In this episode, Bernie Marini and Anthony Perissinotti chat with special guest Charles Foucar, MD, a hematology specialist and expert in the field. We discuss the controversial FDA approval of ivosidenib in combination with azacitidine in newly diagnosed IDH1+ AML, based on the results of the AGILE study: https://www.nejm.org/doi/full/10.1056/NEJMoa2117344
Episode 4: All Aboard the Oncology StewardSHIP
In this episode, Bernie Marini and Anthony Perissinotti are joined by two special guest hematology experts - Lydia Benitez, PharmD, BCOP, and Madeleine Ochs, PharmD, BCOP. Maddy and Lydia help us dive into the topic of Oncology Stewardship, including how we can incorporate Oncology Stewardship into practice to improve outcomes for patients.
Learn more about Oncology Stewardship in AML patients in our hot off the press paper in Annals of Hematology, written by Maddy (first author), Lydia (senior author), and the rest of our leukemia team:
https://link.springer.com/article/10.1007/s00277-022-04872-1
Episode 3.2: Ranting About Rituximab in Acute Lymphoblastic Leukemia
In part two of this two-part episode, Bernie Marini and Anthony Perissinotti discuss the use of rituximab in acute lymphoblastic leukemia (ALL), based on the recent publication of the UKALL14 study (Marks, et al. Lancet Haematol, 2022): https://pubmed.ncbi.nlm.nih.gov/35358441/. We also discuss the previously published GRAALL study that evaluated rituximab in ALL (Maury, et al. NEJM, 2016, https://pubmed.ncbi.nlm.nih.gov/27626518/), and what we can conclude from the literature to date. The data surprises us, and makes us question our own practices!
Episode 3.1: History of Acute Lymphoblastic Leukemia Treatment and Building the BFM Backbone
In part one of a two-part episode, Bernie Marini and Anthony Perissinotti take a journey through the history of acute lymphoblastic leukemia treatment throughout the decades and explain how we got to our current standard of care treatment of ALL patients. In part 2 we tackle the UKALL14 study evaluating the addition of rituximab to acute lymphoblastic leukemia therapy.
Some important historical articles that we reference:
- Nitrogen mustard therapy: https://pubmed.ncbi.nlm.nih.gov/20997191/
- Methotrexate/Aminopterin: https://www.nejm.org/doi/full/10.1056/nejm194806032382301
- Vincristine: https://pubmed.ncbi.nlm.nih.gov/13627916/ and https://pubmed.ncbi.nlm.nih.gov/2085431/ and https://www.utpjournals.press/doi/pdf/10.3138/cbmh.17.1.155
- 6-MP: https://pubmed.ncbi.nlm.nih.gov/13105700/
- Total Therapy: https://pubmed.ncbi.nlm.nih.gov/5237796/ and https://pubmed.ncbi.nlm.nih.gov/5279904/
- BFM: https://pubmed.ncbi.nlm.nih.gov/320377/ and https://pubmed.ncbi.nlm.nih.gov/23700050/
This episode is dedicated to the late Don Pinkel (9/7/1927 - 3/9/2022), a pioneer in the treatment of childhood ALL. Read more about his legacy here: https://cancerletter.com/obituary/20220318_4/ and https://www.nature.com/articles/s41375-022-01562-9.pdf and https://www.smithsonianmag.com/innovation/childhood-leukemia-untreatable-dr-don-pinkel-st-jude-180959501/
Episode 2: We Don't Talk About Rylaze
Bernie Marini and Anthony Perissinotti discuss asparaginase, the data (or lack thereof) behind the FDA approval of Rylaze (Erwinia asparaginase), and concerning trends regarding switches between asparaginase products in clinical practice!
Episode 1: Surrogate Endpoints in AML
Bernie Marini and Anthony Perissinotti discuss the following paper on whether or not event-free survival (EFS) is an appropriate surrogate endpoint for overall survival (OS) in AML:
Norsworthy KJ, et al. Response Rate, Event-Free Survival, and Overall Survival in Newly Diagnosed Acute Myeloid Leukemia: US Food and Drug Administration Trial-Level and Patient-Level Analyses. J Clin Oncol. 2022 Mar 10;40(8):847-854. PMID: 34890212.