Medical Oncology
Physician insights on cancer treatment protocols, immunotherapy, targeted therapies, and clinical trial updates.
Recent Discussions
What are your top takeaways in Hematologic Malignancies from ASCO 2023?
There was a time when those of us in the myeloma field could focus on ASH each year as our main source of updated practice-changing abstracts. No longer! Many exciting oral and poster abstracts were presented around multiple myeloma at the 2023 ASCO meeting in Chicago. Here are the top three that st...
Are there biomarkers or other factors to help predict which patients with MCL are most likely to benefit, or not, from pirtobrutinib following a prior covalent BTKi?
In the phase I/II BRUIN trial, responses with pirtobrutinib occurred across prespecified subgroups regardless of demographics, number of prior lines of therapy, or prior therapy. Responses were seen in patients with blastoid and pleomorphic histology, regardless of the number of prior lines of thera...
What subsequent therapies did patients receive after progressing on pirtobrutinib in the mantle cell BRUIN trial population?
Not all post-protocol therapy was reported; however, nearly 20% of patients who were treated with pirtobrutinib on trial went on to receive CAR-T therapy. Pirtobrutinib’s ideal use is dependent on patient and disease characteristics. In the BRUIN trial, the median PFS, DOR, and OS of MCL patients wa...
In light of the TRIANGLE data at ASH, how should we now approach a transplant-eligible patient with a new diagnosis of aggressive mantle cell lymphoma?
The TRIANGLE data presented by Dr. Dreyling on behalf of the European Mantle Cell Network are certainly provocative. Adding ibrutinib to induction pre-BEAM and maintenance post-BEAM (A+I) led to improved FFS compared to standard-of-care induction and maintenance (A). Not surprising, and doesn't tell...
What are your top takeaways in Hematologic Malignancies from ASCO 2023?
There was a time when those of us in the myeloma field could focus on ASH each year as our main source of updated practice-changing abstracts. No longer! Many exciting oral and poster abstracts were presented around multiple myeloma at the 2023 ASCO meeting in Chicago. Here are the top three that st...
Are there biomarkers or other factors to help predict which patients with MCL are most likely to benefit, or not, from pirtobrutinib following a prior covalent BTKi?
In the phase I/II BRUIN trial, responses with pirtobrutinib occurred across prespecified subgroups regardless of demographics, number of prior lines of therapy, or prior therapy. Responses were seen in patients with blastoid and pleomorphic histology, regardless of the number of prior lines of thera...
What subsequent therapies did patients receive after progressing on pirtobrutinib in the mantle cell BRUIN trial population?
Not all post-protocol therapy was reported; however, nearly 20% of patients who were treated with pirtobrutinib on trial went on to receive CAR-T therapy. Pirtobrutinib’s ideal use is dependent on patient and disease characteristics. In the BRUIN trial, the median PFS, DOR, and OS of MCL patients wa...
When would you consider treating an asymptomatic patient with follicular lymphoma?
The decision of when to initiate treatment of low-grade follicular lymphoma is, of course, part art and part science. It largely remains the standard of care to defer initiation of treatment when not required, but when is it required? The question identifies symptoms attributed to disease as a clear...
Would you consider replacing ibrutinib with acalabrutinib or zanubrutinib in the TRIANGLE regimen for MCL in a patient with atrial fibrillation or high risk coronary syndromes who is otherwise fit for aggressive induction therapy?
Generally, if a patient is significantly symptomatic or intolerant due to atrial fibrillation, or other arrhythmia or even heart failure, it is reasonable to consider a next generation BTKI (acalabrutinib or zanubrutinib). As a cardiologist, I will defer to my cancer colleagues on efficacy across ad...
When would you consider treating an asymptomatic patient with follicular lymphoma?
The decision of when to initiate treatment of low-grade follicular lymphoma is, of course, part art and part science. It largely remains the standard of care to defer initiation of treatment when not required, but when is it required? The question identifies symptoms attributed to disease as a clear...