[ Inglês] The Latest in Mantle Cell Lymphoma From ASH 2017

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Topics include: Treatments and Understanding

What’s the latest in mantle cell lymphoma research? Esther Schorr, on location at the 2017 American Society of Hematology (ASH) meeting, discusses new developments in treatment for mantle cell lymphoma with expert, Dr. Peter Martin from Weill Cornell Medicine. Tune in to find out what exciting advances in research have been made and how it will impact mantle cell lymphoma patients. 

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Please remember the opinions expressed on Patient Power are not necessarily the views of our sponsors, contributors, partners or Patient Power. Our discussions are not a substitute for seeking medical advice or care from your own doctor. That’s how you’ll get care that’s most appropriate for you.

Esther Schorr:

Hi there from Patient Power.  This is Esther Schorr.  I'm here at the American Society of Hematology annual conference in Atlanta, and it's a very, very exciting year here.  This is the largest gathering of physicians and researchers that look at hematological cancers, blood cancers.  And today I'm with a very special guest.  Why don't you introduce yourself?

Dr. Martin:

Thanks.  I'm Peter Martin.  I'm an Associate Professor of Medicine at Weill Cornell Medicine, and I'm chief of the lymphoma program. 

Esther Schorr:

That's a mouthful.  Thank you.  And what we wanted to talk about today is some of the findings that have come out at ASH specifically related to mantle cell lymphoma. 

Dr. Martin:

Yeah, it's been a really interesting meeting.  We have a few interesting projects that I think are worth discussing.  One of them, we recently had approval of an acalabrutinib (Calquence) for treatment of previously treated mantle cell lymphoma.  Acalabrutinib is a BTK inhibitor that's pretty specific for the BTK enzyme, and in data that was presented just yesterday by Michael Wong we saw a pretty high response rate, 80 percent response rate with 40 percent complete responses, and these responses appear pretty durable. 

Not only that, it seems to be a pretty well-tolerated BTK inhibitor.  So that was a pretty exciting paper that he presented.  But more importantly it resulted in approval of the drug.  Having more options for patients is always great, and that trial did that for us. 

Esther Schorr:

Now, am I right that with mantle cell lymphoma often people are diagnosed later than some of the other lymphomas and that some of this research and what's being found is going to help some of the patients that may be farther along in progression?  Is that correct? 

Dr. Martin:

Mantle cell lymphoma is often a pretty tricky disease to treat.  I'm not sure it matters so much how much of it there is.  Really what we depend on understanding is the biology of the lymphoma, and sometimes the biology is pretty aggressive.  Sometimes it's less aggressive.  Where it is, how long it's been there I think is a little bit less relevant than whether it goes away when you treat it. 

Esther Schorr:

And the findings that are happening with mantle cell lymphoma, are any of them transferable to some of the other lymphomas, or is this very specific to mantle cell? 

Dr. Martin:

Yeah, mantle cell lymphoma in a lot of ways is an interesting model for other cancers.  So we know that BTK inhibition is important in chronic lymphocytic leukemia.  We know that there is some role for BTK for follicular lymphoma and diffuse large B-cell lymphoma. 

In mantle cell lymphoma because we often have accessible tissue in the blood and because events tend to happen pretty quickly we have the opportunity to study really mechanisms of response and resistance, and what we learn there may help us translate some of those findings to other kinds of lymphoma and leukemia, sure. 

Esther Schorr:

So if we—we probably have some patients in our audience who are dealing with mantle cell lymphoma.  Based on what you've just—what you just told us about, how should patients or what should patients be talking to their medical team about if this is an issue for them? 

Dr. Martin:

First of all, they should feel encouraged that we have more options than we've ever had before.  Also I think it's worthwhile discussing really what the goal of therapy always is, right?  So there are people with mantle cell lymphoma who may not have a lot of symptoms, who may have a very slowly progressive disease, and it may not always be necessary to jump on them right away with treatment.  A lot of people can do fine for months or years just observing it.  Some people might require more intensive therapy, some people might do very well with less intensive therapy, and it can sometimes be a little bit challenging to try to parse that out.  But these things can be figured out, and taking the time to do it is really the key, right? 

And so I think when we're—when I see a patient with mantle cell lymphoma collect a lot of information and we talk about it, they go away, they come back, we talk about it again, right?  It's not a discussion that needs to be rushed.  Most of the time, we can take a little bit of time, think about it, and then come up with a conclusion that meets the goals of those patients that I think are integrated with my understanding of the biology and their life situation.  And so the key is really not to rush the decision, I think. 

Esther Schorr:

I have just one other question.  I know that with a lot of the research that's going on it's really important for patients and their medical team to know the genetic profile, to understand fully what genetic abnormalities there may be.  Is that true with mantle cell as well?  Is there something specific that needs to be looked for? 

Dr. Martin:

I think you read my mind.  So in solid tumors, you're right that it's become increasingly common to sequence several genes and decide on therapy based on that.  That's less true in most hematologic malignancies.  It's becoming more true in acute myeloid leukemia.  It's becoming more true in chronic lymphocytic leukemia. 

In mantle cell lymphoma, over the past year we've learned that mutations in the TP53 gene, which is a tumor-suppressor gene that's responsible for helping cells to die when exposed to chemotherapy, mutations in that gene that results in TP53 not working well means that patients don't respond as well to chemotherapy.  We've known this for a long time with chronic lymphocytic leukemia, and we've adjusted our therapies accordingly.  In mantle cell lymphoma, we now have I think sufficient data to say, okay, if that mutation is present, we need to be thinking along different lines than we had been in the past. 

Esther Schorr:

So little pieces of a puzzle coming together genetically.

Dr. Martin:

Exactly. 

Esther Schorr:

Okay.  Well, thank you very much, Dr. Martin, for being here.  This is Esther Schorr from ASH 2017 in Atlanta and lots more news to come.  So stay with us, and this along with a lot of other good interviews from ASH will be posted on Patient Power over the next couple of weeks.  Thank you for being with us.  And remember, knowledge can be the best medicine of all. 

Please remember the opinions expressed on Patient Power are not necessarily the views of our sponsors, contributors, partners or Patient Power. Our discussions are not a substitute for seeking medical advice or care from your own doctor. That’s how you’ll get care that’s most appropriate for you.

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Page last updated on January 5, 2018