Hematology Oncology | Oncology Today with Dr Neil Love: Waldenström Macroglobulinemia Edition


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By Dr Neil Love. Discovered by Player FM and our community — copyright is owned by the publisher, not Player FM, and audio is streamed directly from their servers. Hit the Subscribe button to track updates in Player FM, or paste the feed URL into other podcast apps.

A virtual roundtable discussion with noted investigators Prof Meletios A Dimopoulos and Dr Steven P Treon for a review of recent innovations in the treatment of Waldenström Macroglobulinemia.

  • Pathophysiology, symptoms and common genetic mutations associated with Waldenström macroglobulinemia (WM) (00:00)
  • Somatic mutations in MYD88 (L265P) and CXCR4 and implications for prognosis and therapy (1:46)
  • Diagnostic criteria for WM (7:12)
  • Case (Dr Treon): A man in his late 60s with WM experiences an IgM flare and worsening peripheral neuropathy during first-line treatment with rituximab (8:55)
  • Indications for the initiation of therapy for patients with WM (12:02)
  • Management approach for patients with WM experiencing IgM flare after treatment with rituximab (13:40)
  • Activity of the Bruton tyrosine kinase (BTK) inhibitor ibrutinib alone or in combination with rituximab in patients with WM (15:35)
  • Perspective on the use of ibrutinib with or without rituximab as front-line therapy for WM (17:51)
  • Symptoms and management of hyperviscosity syndrome associated with WM (21:07)
  • Role of obinutuzumab in the management of WM (23:58)
  • Case (Prof Dimopoulos): A man in his early 50s with WM and a MYD88 L265P mutation attains a very good partial response to first-line therapy with bortezomib/dexamethasone/rituximab (25:24)
  • Selection of therapy for patients with WM in the first-line setting (27:50)
  • Efficacy and tolerability of proteasome inhibitors for WM (31:42)
  • Peripheral neuropathy associated with WM and implications for therapy (34:39)
  • Duration of ibrutinib therapy for WM and impact of treatment holidays (37:27)
  • Side effects associated with ibrutinib; monitoring and management of atrial fibrillation (39:44)
  • Case (Dr Treon): A woman in her mid-60s diagnosed with WM and a MYD88 L265P mutation experiences a dramatic response after receiving ibrutinib as first-line therapy (44:44)
  • Response and tolerability with ibrutinib in the front-line setting (46:56)
  • Case (Prof Dimopoulos): A woman in her early 80s with a history of hypertension and atrial fibrillation is diagnosed with WM with a MYD88 L265P mutation and receives ibrutinib and anticoagulation therapy (49:39)
  • Perspective on the use of ibrutinib for elderly patients and those with a history of atrial fibrillation (51:37)
  • Activity of the BTK inhibitor zanubrutinib in patients with WM (54:36)
  • Results of the Phase III iNNOVATE trial evaluating ibrutinib with rituximab versus rituximab alone for patients with previously untreated or relapsed/refractory WM (56:19)
  • Ongoing investigation of CXCR4 inhibitors and the Bcl-2 inhibitor venetoclax for WM (57:59)
  • Biologic rationale and role for venetoclax in WM (1:00:28)
  • Tumor lysis syndrome associated with venetoclax (1:04:11)
  • Novel agents and approaches under investigation for WM (1:05:26)
  • Therapeutic options for patients with WM after disease progression on ibrutinib (1:06:56)

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