In this second episode, “Making the Right Selection: Expert Guidance on Treatment Sequencing of T-cell Mediated Therapies,” from the 4-part series Med Table Talk, “The Power of the Community: Translating Innovations into Care in NHL and HL,” learn from expert faculty on how to select CAR T-cell and bispecific antibody treatment regimens for NHL according to the latest clinical evidence including safety and efficacy data in accordance with clinical guidelines. Additionally, expert faculty will discuss how to best identify patients who are candidates for CAR T-cell or bispecific antibody therapies as well as how to evaluate the potential of bridging therapy in patients awaiting CAR T-cell therapy. Finally, expert faculty will review treatment-related toxicities with strategies and educational tools that can be used to prevent, monitor, and manage adverse events. This episode will conclude with a discussion between expert faculty and a special guest, Caitlin Murphy, DNP.
On May 15, 2024 (after the recording of this activity), the FDA has granted accelerated approval for lisocabtagene maraleucel, a CAR T-cell therapy, for the treatment of adult patients with R/R FL who have received two or more prior lines of systemic therapy.
On May 30, 2024 (after the recording of this activity), the FDA has granted accelerated approval for lisocabtagene maraleucel, a CAR T-cell therapy, for the treatment of adult patients with R/R MCL who have received after at least 2 lines of systemic therapy, including a BTK inhibitor
Speakers
Loretta Nastoupil, MD
Associate Professor
Director of Lymphoma Outcomes Database ad
Section Chief of New Drug Development
Department of Lymphoma – Myeloma, Division of Cancer Medicine
University of Texas MD Anderson Cancer Center
Houston, TX
Loretta J. Nastoupil, MD is an Associate Professor in the Department of Lymphoma/Myeloma at the University of Texas MD Anderson Cancer Center in Houston, TX USA. Dr. Nastoupil received her medical degree from the University of Texas Southwestern Medical School and completed her internal medicine training at Washington University and hematology/medical oncology fellowship at Emory University. She is currently Deputy Chair of the Lymphoma/Myeloma Department and Section Chief of the indolent lymphoma and new drug development teams which are in line with her research interests of designing and conducting prospective trials aimed at exploiting the immune system to eradicate B-cell lymphoma. She has led phase 1, 2, and 3 trials in follicular and diffuse large B-cell lymphoma. She is also interested in real world evidence and has been involved in exploring outcomes among patients treated with standard of care CAR T cell therapy and generating synthetic control arms for single arm phase 2 studies.
Amitkumar Mehta, MD
Director of Lymphoma and CAR T-cell Therapy Program,
University of Alabama at Birmingham
Birmingham, AL
Dr. Mehta is a board-certified hematologist and oncologist with a special interest in Lymphomas. A clinical investigator with a special interest in developing "no chemotherapy" approaches for the treatment of Lymphoma. "No chemotherapy" approaches include immunotherapy, CAR-T therapy, immune-modulating therapy, and targeted therapy. Dr. Mehta is a principal investigator of innovative clinical trials for the treatment of Lymphomas at UAB.
Ann S. LaCasce, MD, MMSc
Institute Physician, Dana-Farber Cancer Institute
Associate Professor of Medicine, Harvard Medical School
Boston, MA
Dr. Ann S. LaCasce earned her medical degree from Tufts University School of Medicine and has a Masters in Medical Science from Harvard/MIT Division of Health Sciences and Technology. She completed training in internal medicine at Brigham and Women's Hospital in Boston, where she later served as a Chief Medical Resident. Since 2003, she has been a member of the Lymphoma Program at Dana-Farber where she performs clinical research. She has a longstanding interest in medical education and is the Program Director of the Dana-Farber/Mass General Brigham Fellowship in hematology/oncology. In addition, she co-directs the Center for Adolescent and young Adult Oncology at Dana-Farber. She is an Associate Professor of Medicine at Harvard Medical School. She is the chair of the Lymphoma Research Foundation Scientific Advisory Board and serves on the ABIM Medical Oncology Board, the National Comprehensive Cancer Network's Lymphoma Guideline Panel, and the Alliance Lymphoma Committee,
Caitlin Murphy, DNP
Director of Advanced Practice Nursing
Clinical NP, section of Lymphoma
Dana Farber Cancer Institute
Boston, MA
Caitlin Murphy is a clinical nurse practitioner with over 15 years of heme-onc experience. She is currently practicing in the section of lymphoma at Dana Farber Cancer Institute; and a director of NP practice. She received her BSN from Saint Mary’ College (IN) and her DNP from Rush University College of Nursing
Accreditation and Disclosure Information
Target Audience
This educational activity is targeted to hematologic oncology clinicians, nurses, pharmacists, pathologists, and other members of the multi-disciplinary and interprofessional care team who care for individuals with NHL and HL.
Educational Objectives
After completing this CE activity, the participant should be better able to:
- Critically analyze the latest clinical evidence based on safety and efficacy in order to select appropriate treatment in accordance with clinical guideline recommendations
- Identify patients who are candidates for each of the approved CAR T cell therapies or bispecific antibodies.
- Evaluate the potential of bridging therapy regimens when utilizing CAR T cell therapy.
- Plan strategies to prevent, monitor, and manage adverse events related to treatment with CAR T cell therapy and bispecific antibody therapy to promote optimal patient outcomes and facilitate patient education.
Agenda
Analyze emerging safety and efficacy data for targeted therapies, including the sequencing of CART and bispecific antibodies in NHL, including highlights from recent conferences, and recently published clinical trial data from ASH 2023
- Awareness of current and emerging evidence of current and ongoing clinical trials/combination strategies that might implicate therapies in earlier lines of treatment
- Align treatment decision-making using T-cell mediated therapies with clinical guideline recommendations for treatment (eg, NCCN, etc) for optimal care in NHL, including DLBCL, MCL, FL, and MZL
- Identification of patients who might be eligible for both CART or bispecific treatment through the assessment of T-cell fitness (eg, expert guidance on treatment sequencing)
Apply the most appropriate data in regard to need for bridging strategies and identifying patients based on disease-characteristics who could benefit
- Expert guidance on use of bridging therapy for CART therapy
OCN/NP Guest: Implement best practices to prevent, monitor, and manage adverse events related to treatment with CAR T cell therapy and bispecific antibodies
- Adverse event mitigation and management, including prolonged cytopenias, infections, CRS, and delayed toxicities
- Step-up dosing for patients being administered with bispecific antibody therapy
- Initiating patient education and bridging gaps in health literacy to support a shared decision making model
Accreditation, Support and Credit
In support of improving patient care, Medical Learning Institute, Inc. is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.
Physician Continuing Medical Education
Medical Learning Institute, Inc. (MLI) designates this enduring material for a maximum of 0.5 AMA PRA Category 1 Credit™.
Physicians should claim only the credit commensurate with the extent of their participation in the activity.
MOC Statement
Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to 0.5 MOC point in the American Board of Internal Medicine’s (ABIM) Maintenance of Certification (MOC) program. It is the CME activity provider’s responsibility to submit participant completion information to ACCME for the purpose of granting ABIM MOC credit.
Participation information will be shared through the ACCME's Program and Activity Reporting System (PARS).
Through an agreement between the Accreditation Council for Continuing Medical Education and the Royal College of Physicians and Surgeons of Canada, medical practitioners participating in the Royal College MOC Program may record completion of accredited activities registered under the ACCME’s “CME in Support of MOC” program in Section 3 of the Royal College’s MOC Program.
Physician Associate
Medical Learning Institute, Inc. has been authorized by the American Academy of PAs (AAPA) to award AAPA Category 1 CME credit for activities planned in accordance with AAPA CME Criteria. This activity is designated for 0.5 AAPA Category 1 CME credit. Approval is valid until May 14, 2025. PAs should only claim credit commensurate with the extent of their participation.
Nursing Continuing Professional Development
Successful completion of this nursing continuing professional development activity will be awarded 0.5 contact hour and 0.5 contact hour in the area of pharmacology.
ILNA Coding
The program content has been reviewed by the Oncology Nursing Certification Corporation (ONCC) and is acceptable for recertification points in the following ILNA subject areas:
0.5 points: Care Continuum (OCN, CBCN, CPHON, AOCNP); Care of Pediatric Hematology and Oncology Patient (CPHON); Cellular Collection, Preparative Regimens, and Infusion (BMTCN); Disease Related Biology (CPHON); Early Post-Transplant Management and Education (BMTCN); Foundations of Transplant (BMTCN); Health Maintenance (CPHON); Late Post-Transplant Management and Education (BMTCN)
0.5 points: Oncologic Emergencies (OCN, CPHON, AOCNP); Oncology Nursing Practice (OCN); Pediatric Hematology and Oncology Nursing Practice (CPHON); Professional Practice/Performance (BMTCN, AOCNP); Psychosocial Dimensions of Care (AOCNP, CPHON, OCN, CBCN); Quality of Life (BMTCN); Roles of the APRN (AOCNP); Symptom Management, Palliative Care, Supportive Care (OCN, CPHON, AOCNP); Transplant Process and Infusion (BMTCN); Treatment (OCN, CBCN, AOCNP, CPHON)
The numerical value(s) indicated above is the maximum amount of points that can be claimed in each subject area domain. The total amount of points claimed may not exceed the total amount of nursing continuing professional development (NCPD) or CME awarded from this course and may only apply to the credential being renewed.
Continuing Pharmacy Education
Medical Learning Institute, Inc. designates this continuing education activity for 0.5 contact hour (.05 CEU) of the Accreditation Council for Pharmacy Education.
Universal Activity Number: JA0007322-0000-24-051-H01-P
Type of Activity: Knowledge
Interprofessional Continuing Education (IPCE) Statement
This activity was planned by and for the healthcare team, and learners will receive 0.5 Interprofessional Continuing Education (IPCE) credit for learning and change.
Support Statement
This activity is supported by an educational grant from Bristol Myers Squibb.
Disclosure & Conflict of Interest Policy
Medical Learning Institute, Inc. is committed to providing high quality continuing education to healthcare professionals, as individuals and teams, with a protected space to learn, teach, and engage in scientific discourse free from influence from ineligible companies that may have an incentive to insert commercial bias into education. To that end, MLI requires faculty, presenters, planners, staff, and other individuals who are in a position to control the content of this CE activity to disclose all financial relationships they have had in the past 24 months with ineligible companies as defined by the ACCME, as related to the content of this CE activity, regardless of the amount or their view of the relevance to the education. All identified COI will be thoroughly vetted and mitigated according to MLI policy. These disclosures will be provided to learners prior to the start of the CE activity.
Faculty Disclosures
Planner/Presenter
Loretta Nastoupil, MD (Chair)
Associate Professor
Director of Lymphoma Outcomes Database ad Section Chief of New Drug Development
Department of Lymphoma – Myeloma, Division of Cancer Medicine
University of Texas MD Anderson Cancer Center
Houston, TX
Loretta Nastoupil, MD, has a financial interest/relationship or affiliation in the form of:
Research Funding: Bristol Myers Squibb, Genentech, Daiichi Sankyo, Genmab, Gilead/Kite, Janssen, Ipsen, Merck, Novartis, Takeda
The following relationships have ended within the last 24 months:
Consultant/Advisor: AstraZeneca, AbbVie, Bristol Myers Squibb
Speakers’ Bureau: Gilead/Kite
Planner/Presenter
Amitkumar Mehta, MD
Director of Lymphoma and CAR T-cell Therapy Program
University of Alabama at Birmingham
Birmingham, AL
Amitkumar Mehta, MD, has a financial interest/relationship or affiliation in the form of:
Consultant/Advisor: Gilead, Seattle Genetics, Incyte, MorphoSys/Incyte, TG Therapeutics, Kyowa Kirin, BeiGene, Roche/Genentech, ADCT
Speakers’ Bureau: Incyte/MorphoSys, BeiGene, Ipsen, Kyowa Kirin
Planner/Presenter
Ann S. LaCasce, MD, MMSc
Institute Physician, Dana-Farber Cancer Institute
Associate Professor of Medicine
Harvard Medical School
Boston, MA
Ann S. LaCasce, MD, MMSc, has a financial interest/relationship or affiliation in the form of:
Consultant/Advisor: Kite Pharma, Seagen
Speakers’ Bureau: Research to Practice
Planner/Presenter
Caitlin Murphy, DNP, FNP-BC, AOCNP
Director of Advanced Practice Nursing
Clinical NP, section of Lymphoma
Dana Farber Cancer Institute
Boston, MA
Caitlin Murphy, DNP, FNP-BC, AOCNP, has a financial interest/relationship or affiliation in the form of:
The following relationships have ended within the last 24 months:
Consultant/Advisor: Genmab, Seagen
All of the relevant financial relationships of individuals for this activity have been mitigated.
Planning Committee and Content/Peer Reviewers
The planners and content/peer reviewers from Medical Learning Institute, Inc., the accredited provider, do not have any relevant financial relationships to disclose with ineligible companies unless listed below.
Disclosure of Unlabeled Use
This educational activity may contain discussions of published and/or investigational uses of agents that are not indicated by the FDA. The planners of this CE activity do not recommend the use of any agent outside of the labeled indications. The opinions expressed in the CE activity are those of the presenters and do not necessarily represent the views of the planners. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings.
Disclaimer
Participants have an implied responsibility to use the newly acquired information to enhance patient outcomes and their own professional development. The information presented in this CE activity is not meant to serve as a guideline for patient management. Any procedures, medications, or other courses of diagnosis or treatment discussed or suggested in this CE activity should not be used by clinicians without evaluation of their patient's conditions and possible contraindications and/or dangers in use, review of any applicable manufacturer's product information, and comparison with recommendations of other authorities.
ONCC review is only for designating content to be used for ILNA points and is not for NCPD accreditation. NCPD programs must be formally approved for contact hours by an acceptable accreditor/approver of nursing NCPD to be used for recertification by ONCC. If the NCPD provider fails to obtain formal approval to award contact hours by an acceptable accrediting/approval body, no information related to ONCC recertification or ILNA categories may be used in relation to the program.
Method of Participation
There are no fees for participating in or receiving credit for this CE activity. In order to receive credit, learners must participate in the entire CE activity, complete the activity evaluation form and your certificate of credit will be generated. You will receive your certificate from Medical Learning Institute, Inc.
For information on applicability and acceptance of continuing education credit for this CE activity, please consult your professional licensing board.
If you have questions regarding your certificate, please contact MLI at mvu@mlieducation.org.
For Physician, If requesting MOC/CC credit, the post-test and evaluation are required in their entirety as well as your Board Unique ID number, DOB (MM/DD), and a score of 70% or higher is needed to obtain MOC credit (75% is required for ABS).
For Pharmacists, MLI will accept your completed evaluation form for up to 30 days post-activity and will report your participation to the NABP only if you provide your NABP e-Profile number and DOB (MM/DD). Within 6 weeks, you can view your participation record at the NABP website: https://nabp.pharmacy/.
About This Activity
Medical Learning Institute, Inc. is responsible for the selection of this activity’s topics, the preparation of editorial content, and the distribution of this CE activity. Our activities may contain references to unapproved products or uses of these products in certain jurisdictions. The preparation of this activity is supported by educational grants subject to written agreements that clearly stipulate and enforce the editorial independence of Medical Learning Institute, Inc.
The materials presented here are used with the permission of the authors and/or other sources. These materials do not necessarily reflect the views of Medical Learning Institute, Inc. or any of its partners, providers, and/or supporters.
Copyright © 2024 Medical Learning Institute, Inc | All Rights Reserved