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    Faculty & Disclosures
    Dr Matthew Matasar

    Rutgers Cancer Institute, New Brunswick, NJ, USA

    Dr Matthew Matasar is the chief of the Division of Blood Disorders at Rutgers Cancer Institute, New Brunswick, NJ, USA, and professor of medicine at Rutgers Robert Wood Johnson Medical School.read more

    He graduated from Harvard College and Harvard Medical School, Boston, MA, and moved to New York to train in medicine at the New York-Presbyterian Columbia University Irving Medical Center. After completing training in internal medicine, he served as a chief resident at Columbia-Presbyterian Medical Center while completing a master’s degree at the Mailman School of Public Health. Soon after, he joined Memorial Sloan Kettering Cancer Center to pursue advanced training in cancer medicine, and has been dedicated to caring for patients with lymphoma ever since. 

    In November 2022, Dr Matasar joined the Rutgers Cancer Institute of New Jersey and RWJBarnabas Health in New Brunswick. His research is focused on finding new and better ways to treat lymphoma, particularly high-risk aggressive lymphomas and certain uncommon non-Hodgkin lymphomas. Together with his research team, he wants to develop better strategies for protecting and preserving the health of survivors, through better understanding of the long-term impacts of treatments on patients.

    Dr Matasar contributes to the oncology community as a member of the board of the New Jersey chapter of the Leukemia and Lymphoma Society and as a member of the American Society of Hematology’s National Committee on Quality.

    Dr Matthew Matasar discloses: Advisory board or panel fees from Genentech and Merck. Consultancy fees from Bayer, Juno Therapeutics, Roche/Genentech, Seattle Genetics, Takeda and Teva. Grants/research support from Bayer, GM Biosciences, Immunovaccine Therapeutics, Janssen, Pharmacyclics, Roche/Genentech and Seagen. Stock/shareholder (self-managed) in Merck. Other financial or material support from ADC Therapeutics, AstraZeneca, Bayer, BMS, Celgene, Epizyme, Immunovaccine Therapeutics, IMV Therapeutics, Janssen, Kite Pharma, Pharmacyclics, Regeneron, Roche, Seagen and Takeda.
    Dr Amitkumar Mehta

    O'Neal Comprehensive Cancer Center, University of Alabama at Birmingham, Birmingham, AL, USA

    Dr Amitkumar Mehta is an associate professor at the O’Neal Comprehensive Cancer Center, University of Alabama at Birmingham (UAB), AL, USA. read more

    He received his medical degree from Baroda Medical College, India, and completed his internship and residency at the Providence Hospital-George Washington University, DC, USA, before accepting a fellowship position in haematology and oncology at the UAB. During his fellowship training, he focused on various translational projects, including the novel prognostic role of circulating free telomeres in patients with acute myeloid leukemia.

    Following his fellowship training, Dr Mehta joined the faculty at the UAB in 2014. His research now focuses on experimental therapeutics in haematological malignancies, especially lymphomas and chimeric antigen receptor (CAR) T-cell therapies. He has been a principal investigator on a number of clinical trials investigating the efficacy and safety of CAR T-cell therapy for treating lymphomas. He is currently the director of both the lymphoma and CAR-T cell therapy programmes at UAB, and associate director of the Phase I Program at O’Neal Comprehensive Cancer Center at UAB.

    Dr Mehta is a member of the American Society of Clinical Oncology and the American Society of Hematology, and board certified in medical oncology and haematology by the American Board of Internal Medicine.

    Dr Amitkumar Mehta discloses: Advisory board or panel fees from BeiGene, Gilead, Incyte, MorphoSys and Seagen. Consultancy fees from ADC Therapeutics, Kyowa Kirin, Roche/Genentech and TG Therapeutics. Grants/research support from Bristol Myers Squibb, Forty Seven Inc., Gilead, Incyte, Juno Therapeutics and Takeda. Speaker’s bureau fees from BeiGene, Incyte, Ipsen, Kyowa Kirin and MorphoSys. Other financial or material support from ADC Therapeutics, Affimed, Bristol Myers Squibb, Celgene, Gilead, Innate Pharma, Kite Pharma, Merck, Roche/Genentech, Seagen and TG Therapeutics. 
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    Tutorial

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    Poll

    The main barrier to CAR T-cell therapy access for your patients with B-cell NHL is:

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    Cost of therapy and the complex logistics of treatment access
       
    Length of waiting lists/lack of capacity
       
    Lack of knowledge about CAR T-cell therapy among HCPs in your region
       
    Other
       

    Tutorial

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    What salvage strategy for CAR T-cell therapy relapse do you use the most in R/R MCL?

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    Clinical trials (e.g. with a bispecific antibody)
       
    Lenalidomide monotherapy
       
    Lenalidomide + rituximab
       
    Other
       

    Tutorial

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    Which of these oncology settings do you predominantly work in?

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    Community oncology
       
    Academic oncology/oncology research
       
    Other
       

    Tutorial

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    How many patients do you typically refer/treat with CAR T-cell therapy in 1 month?

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    0–2
       
    3–5
       
    >5
       
     
    Exploring current treatment strategies for R/R MCL and the role of CAR T-cell therapy
    Practicalities of CAR T-cell therapy for MCL in the clinic: Focus on toxicities and salvage therapy
    Future considerations for optimizing the use of CAR T-cell therapies in patients with MCL
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    Lymphoma, Haematological Malignancies, Haematology CE/CME accredited

    touchIN CONVERSATION
    A relaxed discussion between two faculty focussed on real world clinical issues. Useful tips below will show how to navigate the activity. Join the conversation. Close

    Managing the practicalities of CAR T-cell therapies in patients with R/R MCL: Current considerations and future strategies

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    Learning Objectives

    After watching this activity, participants should be better able to:

    • Review current treatment strategies for relapsed/refractory mantle cell lymphoma, including the role of CAR T-cell therapy
    • Formulate practical strategies for the management of CAR T-cell-associated toxicities and treatment failure in patients with relapsed/refractory mantle cell lymphoma
    • Discuss future considerations for optimizing CAR T-cell therapy in relapsed/refractory mantle cell lymphoma
    Overview

    In this activity, haemato-oncologists with expertise in mantle cell lymphoma (MCL) and chimeric antigen receptor (CAR) T-cell therapy respond to questions from the community oncology, haematology and haemato-oncology communities on current treatment strategies for relapsed or refractory MCL and the role of CAR T-cell therapy, managing the toxicities of treatment with CAR T-cells, and future considerations for optimizing the use of CAR T-cell therapies in MCL.

    This activity is jointly provided by USF Health and touchIME. read more

    Target Audience

    Haematologists, haemato-oncologists (including CAR T-cell therapy specialists) and oncologists (including community oncologists) involved in the management of mantle cell lymphoma.

    Disclosures

    USF Health adheres to the Standards for Integrity and Independence in Accredited Continuing Education. All individuals in a position to influence content have disclosed to USF Health any financial relationship with an ineligible organization. USF Health has reviewed and mitigated all relevant financial relationships related to the content of the activity. The relevant relationships are listed below. All individuals not listed have no relevant financial relationships.

    Faculty

    Dr Matthew Matasar discloses: Advisory board or panel fees from Genentech and Merck. Consultancy fees from Bayer, Juno Therapeutics, Roche/Genentech, Seattle Genetics, Takeda and Teva. Grants/research support from Bayer, GM Biosciences, Immunovaccine Therapeutics, Janssen, Pharmacyclics, Roche/Genentech and Seagen. Stock/shareholder (self-managed) in Merck. Other financial or material support from ADC Therapeutics, AstraZeneca, Bayer, Bristol Myers Squibb, Celgene, Epizyme, Immunovaccine Therapeutics, IMV Therapeutics, Janssen, Kite Pharma, Pharmacyclics, Regeneron, Roche, Seagen and Takeda. 

    Dr Amitkumar Mehta discloses: Advisory board or panel fees from BeiGene, Gilead, Incyte, MorphoSys and Seagen. Consultancy fees from ADC Therapeutics, Kyowa Kirin, Roche/Genentech and TG Therapeutics. Grants/research support from Bristol Myers Squibb, Forty Seven Inc., Gilead, Incyte, Juno Therapeutics and Takeda. Speaker’s bureau fees from BeiGene, Incyte, Ipsen and Kyowa Kirin and MorphoSys. Other financial or material support from ADC Therapeutics, Affimed, Bristol Myers Squibb, Celgene, Gilead, Innate Pharma, Kite Pharma, Merck, Roche/Genentech, Seagen and TG Therapeutics. 

    Content Reviewer

    Alicia Canalejo, APRN has no financial interests/relationships or affiliations in relation to this activity.

    Touch Medical Contributors

    Sola Neunie has no financial interests/relationships or affiliations in relation to this activity.

    USF Health Office of Continuing Professional Development and touchIME staff have no financial interests/relationships or affiliations in relation to this activity.

    Requirements for Successful Completion

    In order to receive credit for this activity, participants must review the content and complete the post-test and evaluation form. Statements of credit are awarded upon successful completion of the post-test and evaluation form.

    If you have questions regarding credit please contact cpdsupport@usf.edu.

    Accreditations

    Physicians

    This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education (ACCME) through a joint providership of USF Health and touchIME. USF Health is accredited by the ACCME to provide continuing medical education for physicians.

    USF Health designates this enduring material for a maximum of 1.0 AMA PRA Category 1 CreditTM.  Physicians should claim only the credit commensurate with the extent of their participation in the activity.

    The European Union of Medical Specialists (UEMS) – European Accreditation Council for Continuing Medical Education (EACCME) has an agreement of mutual recognition of continuing medical education (CME) credit with the American Medical Association (AMA). European physicians interested in converting AMA PRA Category 1 CreditTM into European CME credit (ECMEC) should contact the UEMS (www.uems.eu).

    Advanced Practice Providers

    Physician Assistants may claim a maximum of 1.0 Category 1 credits for completing this activity. NCCPA accepts AMA PRA Category 1 CreditTM from organizations accredited by ACCME or a recognized state medical society.

    The AANPCP accepts certificates of participation for educational activities approved for AMA PRA Category 1 CreditTM by ACCME-accredited providers. APRNs who participate will receive a certificate of completion commensurate with the extent of their participation.

    Date of original release: 11 January 2024. Date credits expire: 11 January 2025.

    If you have any questions regarding credit please contact cpdsupport@usf.edu.

    This activity is CE/CME accredited

    To obtain the CE/CME credit(s) from this activity, please complete this post-activity test.

    Claim Credit
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    Topics covered in this activity

    Lymphoma / Haematological Malignancies / Haematology
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    This activity is funded by:

    An independent medical education grant from Bristol Myers Squibb, and is jointly provided by USF Health and touchIME.

    The information provided by this CME activity is for continuing education purposes only and is not meant to substitute for the independent medical/clinical judgment of a healthcare provider relative to diagnostic and treatment options of a specific patient’s medical condition.

    USF is an Equal Opportunity / Affirmative Action / Equal Access Institution.

    USF Health is accredited by the Accreditation Council for Continuing Medical Education, the American Nurses Credentialing Center and the Accreditation Council for Pharmacy Education to provide continuing education to healthcare professionals. As an accredited provider, USF Health is required to disclose personal information to relevant accredited bodies that certify CME to process credits/contact hours, comply with reporting requirements, and for internal recordkeeping and regulatory purposes. USF Health does not share or sell any individual’s contact information or unique identifiers to any commercial supporter, advertiser, or third party without the specific permission of the individual.

    Unapproved products or unapproved uses of approved products may be discussed by the faculty; these situations may reflect the approval status in one or more jurisdictions. The presenting faculty have been advised by touchIME and USF Health to ensure that they disclose any such references made to unlabelled or unapproved use. No endorsement by touchIME or USF Health of any unapproved products or unapproved uses is either made or implied by mention of these products or uses in touchIME or USF Health activities. touchIME and USF Health accept no responsibility for errors or omissions.

    This content is intended for healthcare professionals.

    Date of original release: 11 January 2024. Date credits expire: 11 January 2025.

     

    Claim Credit
    touchIN CONVERSATION
    Managing the practicalities of CAR T-cell therapies in patients with R/R MCL: Current considerations and future strategies
    1.0 CE/CME credit
    Question 1/4
    What overall and complete response rates were observed in patients with R/R MCL treated with brexu-cel in the pivotal ZUMA-2 clinical trial?

    Brexu-cel, brexucabtagene autoleucel; CR, complete response; ORR, overall response rate; R/R MCL, relapsed or refractory mantle cell lymphoma.

    In the ZUMA-2 clinical trial, an ORR of 91% and a CR of 68% was observed for 68 patients with R/R MCL who were treated with brexu-cel, at a median follow-up of 35.6 months.

    Abbreviations

    Brexu-cel, brexucabtagene autoleucel; CR, complete response; ORR, overall response rate; R/R MCL, relapsed or refractory mantle cell lymphoma.

    Reference

    Wang M, et al. J Clin Oncol. 2023;41:555–67.

    Question 2/4
    Your 70-year-old male patient with R/R MCL has relapsed while on second-line acalabrutinib, and is now awaiting CAR T-cell therapy. He has an aggressive disease presentation with a high disease burden and evidence of CNS involvement. What bridging therapy would you choose to help optimize his outcomes with CAR T-cell therapy?

    CAR, chimeric antigen receptor; CNS, central nervous system; R/R MCL, relapsed or refractory mantle cell lymphoma.

    A 2021 review of bridging therapy options prior to CAR T-cell therapy indicated that rituximab ± cytarabine was suitable for patients with a non-Hodgkin lymphoma and a high disease burden. Blinatumomab and hydroxyurea ± steroids were indicated as suitable bridging therapies for patients with B-cell acute lymphoblastic leukaemia and a high disease burden. Belantamab mafodotin was indicated as a possible bridging therapy for patients with multiple myeloma and a high disease burden.

    Abbreviation

    CAR, chimeric antigen receptor.

    Reference

    Bhaskar ST, et al. EJHaem. 2021;3(Suppl. 1):39–45.

    Question 3/4
    Your patient with R/R MCL has been experiencing recurrent mild infections following treatment with brexu-cel. After routine monitoring, you find that their IgG level is 290 mg/dL. What would you do next?

    Brexu-cel, brexucabtagene autoleucel; G-CSF, granulocyte colony-stimulating factor; IgG, immunoglobulin G; IVIG, intravenous immunoglobulin; R/R MCL, relapsed or refractory mantle cell lymphoma.

    It is recommended that patients who develop hypogammaglobulinaemia following brexu-cel therapy receive IVIG replacement therapy.1,2 Tocilizumab and corticosteroids are used to manage CRS.1 G-CSF support is used to manage prolonged cytopenias.1 Vaccination with live virus vaccines is not recommended following treatment with brexu-cel, until the immune system has recovered.2

    Abbreviations

    Brexu-cel, brexucabtagene autoleucel; CRS, cytokine release syndrome; G-CSF, granulocyte colony-stimulating factor; IVIG, intravenous immunoglobulin.

    References

    1. Thompson JA, et al. J Natl Compr Canc Netw. 2022;20:387–405.

    2. FDA. Brexucabtagene autoleucel PI. Available at: www.fda.gov/media/140409/download?attachment (accessed 17 November 2023).

    Question 4/4
    Off-the-shelf, allogeneic CAR T-cell therapy is currently being investigated to further improve accessibility of the treatment. What is a primary challenge that must be overcome versus autologous CAR T-cell therapy before these therapies can be used in practice?

    CAR, chimeric antigen receptor; CRS, cytokine release syndrome; ICANS, immune effector cell-associated neurotoxicity syndrome.

    A number of strategies for manufacturing allogeneic CAR T-cell therapies are being investigated. In addition to the risk of GvHD, many production strategies have problems with in vivo T-cell persistence, which negatively impacts efficacy.1 Against these disadvantages, allogeneic CAR-T cell therapy offers the possibilities of large-scale manufacturing and the consequent potential cost reduction, greater standardization of the product, better quality of the therapeutic cells, as well as immediate availability of the product to treat the patients.1 The risk of CRS or ICANS is specific to the patient or their disease characteristics.2

    Abbreviations

    CAR, chimeric antigen receptor; CRS, cytokine release syndrome; GvHD, graft-versus-host disease; ICANS, immune effector cell-associated neurotoxicity syndrome.

    References

    1. Aparicio C, et al. Exp Hematol Oncol. 2023;12:73.

    2. Thompson JA, et al. J Natl Compr Canc Netw. 2022;20:387–405.

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    This activity is funded by:

    An independent medical education grant from Bristol Myers Squibb, and is jointly provided by USF Health and touchIME.

    The information provided by this CME activity is for continuing education purposes only and is not meant to substitute for the independent medical/clinical judgment of a healthcare provider relative to diagnostic and treatment options of a specific patient’s medical condition.

    USF is an Equal Opportunity / Affirmative Action / Equal Access Institution.

    USF Health is accredited by the Accreditation Council for Continuing Medical Education, the American Nurses Credentialing Center and the Accreditation Council for Pharmacy Education to provide continuing education to healthcare professionals. As an accredited provider, USF Health is required to disclose personal information to relevant accredited bodies that certify CME to process credits/contact hours, comply with reporting requirements, and for internal recordkeeping and regulatory purposes. USF Health does not share or sell any individual’s contact information or unique identifiers to any commercial supporter, advertiser, or third party without the specific permission of the individual.

    Unapproved products or unapproved uses of approved products may be discussed by the faculty; these situations may reflect the approval status in one or more jurisdictions. The presenting faculty have been advised by touchIME and USF Health to ensure that they disclose any such references made to unlabelled or unapproved use. No endorsement by touchIME or USF Health of any unapproved products or unapproved uses is either made or implied by mention of these products or uses in touchIME or USF Health activities. touchIME and USF Health accept no responsibility for errors or omissions.

    This content is intended for healthcare professionals.

    Date of original release: 11 January 2024. Date credits expire: 11 January 2025.

     

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