NCI-CCC Tumor Board Question
These are questions being discussed by academics at NCI-Cancer Centers
Questions discussed in this category
Most would argue that gain(1q) in combination with another high-risk feature constitutes ultra-high-risk multiple myeloma, and most would argue (with ...
The OS benefit with Zometa was seen only in patients with myeloma bone disease achieving less than or equal to a partial response. SRE risk reduction ...
For many clinical trials, a screening bone marrow biopsy is necessary to get a new baseline. Do you do the same in real-world practice?
Previous questions have focused on the newly diagnosed setting and choice of bisphosphonate versus denosumab. IMWG guidelines do recommend resuming zo...
For example - minimum number of months of therapy, driving distance to clinic, at least a CR with or without MRD negativity?
Would you continue R-CHOP or would you switch therapy?
Please assume that IVIG is fine (as it is for many Jehovah's Witness patients, since IgG is often not considered a blood product per se).
Specifically, do you offer closer follow-up for certain patients after local radiation?
Would you consider this de novo DLBCL (unable to assess for clonality)? How would you handle prior anthracycline exposure?
Is the therapeutic purpose of the proteasome inhibitor to maximize total dosage per week or number of infusions per week?
Would you do a 24-hour urine and echocardiogram in all of these patients? Cardiac biomarkers, PT/PTT, or any other such blood tests?
Specifically, in the setting of patients that have had a PR or VGPR and are not actively progressing.
This question seems quite specific but happens quite often. Multi-drug chemotherapy runs the risk of profound cytopenias and infections, while bispeci...
I.e. dosing regimen frequency, side effect profile, duration of follow up, etc.
Modified HyperCVAD? V(R)D-PACE? DCEP? Are there any data to favor one over the other?
Do you utilize rituximab or any other specific management strategies?
Would you prefer CAR-T or bi-specific or neither? If CAR-T, how do you approach lymphodepletion?
Which PI and at what dosing intervals? Dexamethasone or not?
Emory has now published data with VRd consolidation as well as KPd consolidation, while ...
i.e., 60+% bone marrow plasmacytosis, light chain ratio >100, and/or >1 MRI lesion
240-300 mg/m2 prior exposure. How would your management change in young fit/older individuals with comorbidities? Would you obtain interval TTE during...
Would your approach differ for a 30 year old and a 70 year old?
Do you incorporate PEG-asparaginase or brentuximab vedotin (for CD30-expressing malignant cells) into anthracycline-based induction regimens? Do you c...
Are you adding ibrutinib? Should we add ibrutinib to NORDIC? Still referring to transplant?
How do you choose between CAR-T and autoSCT, for example?
In addition to reversing hypercalcemia, initiating myeloma therapy, etc.
Would you still go to auto or consider allo?
Would you intercalate HD-MTX with her CHOEP?
Ide-cel? Cilta-cel? Teclistamab?
For example, would you use a tool like the Hydrashift assay? Would this change your management?
If tolerated through Cycle #1, how aggressively do you try to titrate the selinexor dose up toward 100mg weekly or 80mg twice-weekly?
And does your a...
How much weight do you give to a hgb/hct threshold versus symptoms?
In this case, the patient had received daratumumab/lenalidomide/dexamethasone as part of a cooperative group trial. Would you say that the patient had...
Would you consider Dara-CyBorD or a MM triplet/quadruplet such as VRd or Dara-VRd?
Does a progressing kappa/lambda ratio > 100 at any point in time warrant treatment, or does one wait to treat patients in the setting of a slowly i...
Would you give R-CHOP without knowing if there was use of prior anthracycline?
For pts w/ eGFR between 30-60
Frailty Index per Palumbo et al. PMID 25628469Is it practical to apply in clinics? Have you made decision changes based on it?
Venetoclax has demonstrated efficacy in patients harboring t(11;14) mutations but is not FDA approved for MM. Can you expand on what situations you ma...
For example: shorten IMiD duration each cycle, add scheduled G-CSF, add antibacterial prophylaxis, etc.
CAR-T (any specific preference of product?) vs bispecific antibodies vs any other specific agents not previously utilized?
Is a repeatedly abnormal serum immunofixation all it takes for MGUS?
Would you continue with daratumumab maintenance per ANDROMEDA or switch regimen?
Ki67 = 90% with multiple small nodes on PET scan and normal CBC
Patient in mid-30s with no major medical history presented with isolated left neck swelling. Incisional biopsy w/ HTLV1/2 associated ATLL, Ki67 of >...
What about multiple anaplastic plasmacytoma without bone marrow involvement?
Would you use MRD status to guide your decision making?
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Papers discussed in this category
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J Clin Oncol, 2020 Feb 21
J Clin Oncol, 2020 Oct 06
Journal of clinical pathology, 2017-09
Leukemia, 2018-06
Haematologica, 2021 Jun 01
Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2009-03-10
The New England journal of medicine, 2015-11-05
Haematologica, 2018 May 24
Blood,
Leukemia, 2011 Jul 01
Haematologica, 2019 Sep 19
Blood, 2017 Aug 17
Blood, 2015 May 28
Clin Lymphoma Myeloma Leuk, 2020 Mar 07
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Blood Cancer J, 2021 Jan 11
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British journal of haematology, 2014-06
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Blood, 2018-07-05
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J Clin Oncol, 2021 Jun 25
Blood, 2011-09-15
Haematologica, 2011 Dec 01
Cancer Chemother Pharmacol, 2016 Jun 10
Clin Cancer Res, 2020 Aug 17
British journal of haematology, 2017-11
J Clin Oncol, 2016 Feb 29
Lancet Haematol, 2016 Dec 05
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Lancet Oncol, 2020 Oct 29
J Clin Oncol, 2021 Aug 13
Blood Adv, 2021 Sep 01
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Clin Lymphoma Myeloma Leuk, 2019 Oct 09
JCO Oncol Pract, 2019 Nov 25
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Leukemia, 2020 Jul 21
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Blood cancer journal, 2016-07-29
Leukemia, 2022 Apr 11
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Blood Adv, 2022 May 10
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Blood, 2016 Mar 21
Amyloid, 2017 Apr 23
Leukemia, 2015 Oct 07
British journal of haematology, 2017-10
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Blood Cancer J, 2018 May 24
Amyloid, 2019 Jan 20
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Ann Oncol, 2009 Jul 01
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Br J Haematol, 2021 Aug 15
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J Clin Oncol, 2022 Jun 04
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Leukemia, 2019-03
Journal of the American Society of Nephrology : JASN, 2007-03
Lancet Haematol, 2019 Mar 11
Blood Cancer J, 2022 Sep 02
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J Hematol Oncol, 2021 Oct 30
Blood, 2022 Mar 03
Lancet,
N Engl J Med, 2021 Dec 11
Cancer, 2021 Jun 28
Leukemia, 2022 Feb 21
Cancer cell, 2017-06-12
J Neurooncol, 2022 Jun 20
Lancet Oncol, 2020 Jun 05
Lancet Oncol, 2022 Jul 12
Lancet, 2021 Jun 24
N Engl J Med, 2023 Jun 05
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Lancet Oncol, 2021 Dec 03
Lancet, 2021 Jun 04
Blood, 2022 Oct 20
J Clin Oncol, 2017 Jan 17
Br J Haematol, 2023 Jun 07
Experimental hematology & oncology, 2022 Feb 28
The Lancet. Oncology, 2011 Dec 13
American journal of hematology, 2022 Jul 05
Blood advances, 2023 Oct 24
Blood, 2018 Aug 14
American journal of hematology, 2016-09
Blood, 2017 Jun 13
Haematologica, 2013-01
The Lancet. Haematology, 2015 May 06
European respiratory review : an official journal of the European Respiratory Society, 2017 Sep 06
Mayo Clinic proceedings, 2017-06
Blood Cancer J, 2022 Sep 14
The Lancet. Haematology, 2023 Sep 11
The Lancet. Oncology, 2021 Sep 13
The New England journal of medicine, 2019-05-30
JAMA, 2023 Aug 8
Blood, 2017 Jan 31
Blood, 2023 Nov 30
Cancer, 2011-10-01
BMC Cancer, 2006 May 05
International journal of radiation oncology, biology, physics, 1998-07-15
International journal of radiation oncology, biology, physics, 2006-01-01
Blood, 2014 May 29
Blood, 2014 Jun 17
International journal of radiation oncology, biology, physics, 2011 Jan 27
Leukemia & lymphoma, 2021 Feb 03
Dominion law reports, 1990 Mar 30
Blood, 2020 Apr 09
American journal of hematology, 2019-04
Blood advances, 2023 Mar 28
American journal of hematology, 2023 Jul 08
Blood, 2013-10-24
The Lancet. Oncology, 2018-03
Blood cancer journal, 2024 Apr 15
Blood cancer journal, 2019 Nov 25
British journal of haematology, 2019 Dec 09
The New England journal of medicine, 2023 Dec 12
Blood cancer journal, 2024 Apr 22