59 episodes

Highlights and interviews from the 2015 ASH conference.

ASH 2015 ecancer

    • Medicine

Highlights and interviews from the 2015 ASH conference.

    • video
    Cancer-associated thrombosis: Switching patients to warfarin after 6-month completion of anticoagulant treatment

    Cancer-associated thrombosis: Switching patients to warfarin after 6-month completion of anticoagulant treatment

    Dr Chai-Adisaksopha talks to ecancertv at ASH 2015 about his study that looked at the efficacy and safety of switching patients with cancer-related thrombosis to warfarin after completing 6 months of anticoagulant treatment.

    Extended (3–6 months) anticoagulant treatment with low-molecular-weight heparin (LMWH) is now generally recommended for patients who develop venous thromboembolism (VTE) secondary to their cancer, but not all patients tolerate this in the long term, Dr Chai-Adisaksopha says in the interview.

    His research suggests, however, that switching to the old standard of warfarin is just as good as continuing LMWH for preventing recurrent VTE (7.2% vs 6.0%, p = NS) with no increase in major bleeding (2.6% versus 2.7%, p = NS).

    Dr Chai-Adisaksopha acknowledges that this was a retrospective study and so a prospective study is needed, but the results suggest that switching to warfarin may be an option for some patients.

    • 2 min
    • video
    Promising new strategy for treating children with acute lymphocytic leukaemia

    Promising new strategy for treating children with acute lymphocytic leukaemia

    Dr Raetz talks to ecancertv about results from a Children's Oncology Group study that looked at using a real-time disease classification protocol based on clinical, biologic and early disease response measures for childhood B-lymphoblastic leukaemia (ALL).

    The study involved over 10,000 children of whom around 5,000 met National Cancer Institute criteria for standard risk ALL and 2,700 were deemed high risk at the end of induction therapy. A large subset of children was identified who had favourable cytogenetic profiles and rapid responses to treatment resulting in high overall survival at 5 years. This suggests that there could be some children who would not benefit from further chemotherapy intensification.

    • 2 min
    • video
    Engineered cells to target multiple myeloma

    Engineered cells to target multiple myeloma

    Dr Kochenderfer talks to ecancertv at ASH 2015 about the promising results of a phase I clinical trial that provides evidence that adoptive T cell therapy may work in patients with advanced multiple myeloma.

    Multiple myeloma is an currently an incurable malignancy of plasma cells and in this study patients’ T cells were obtained and genetically modified to target the B-cell maturation antigen (BCMA), a protein that is preferentially expressed by plasma cells.

    Although only 12 patients have been treated to date, very good responses have been seen with some of the higher doses used, Dr Kochenderfer say in the interview. This includes a few patients who remain in complete remission.

    • 3 min
    • video
    Guidance for anticoagulation management in the setting of thrombocytopenia in cancer patients

    Guidance for anticoagulation management in the setting of thrombocytopenia in cancer patients

    Dr Soff talks to ecancertv at ASH 2015 about the results of a study that prospectively assessed the efficacy and safety of an algorithm for reducing the dose of low molecular weight heparin (LMWH) in patients with cancer-associated thrombosis who develop chemotherapy-induced thrombocytopenia (CIT).

    CIT is a common problem in anticoagulated cancer patients and the current recommendation on how to amend LMWH is based on expert opinion rather published evidence, Dr Soff explains. The present study therefore aimed to address this knowledge gap and considered all 15,000 cancer patients treated with LMWH (enoxaparin) at Memorial Sloan Kettering Cancer Center over a 3-year period.

    There were 143 patients who developed CIT and results showed that holding anticoagulant therapy was an appropriate approach if platelet levels fell below 25,000/mcL. Halving the dose of LMWH was appropriate if the platelet count was 25,000/mcL to 50,000/mcL and continuing LMWH at full dose if the platelet count was more than 50,000/mcL.

    • 4 min
    • video
    Quality assessment looking at rivaroxaban for cancer-related thrombosis

    Quality assessment looking at rivaroxaban for cancer-related thrombosis

    Dr Soff talks to ecancertv at ASH 2015 about a quality assessment initiative that looked at the use of the oral anticoagulant rivaroxaban for treating cancer-related thrombosis.

    The current standard of care for treating patients with cancer who develop venous thromboembolism (VTE) is injected low molecular weight heparin. Rivaroxaban has been approved in the United States for the treatment for VTE since the end of 2012 but clinical trials did not specifically look at its use in cancer patients, Dr Soff explains in the interview.

    It was therefore decided to take a look at patients being treated with rivaroxaban for VTE according to the product’s label and make note of which of these patients also had cancer and what effects could be seen.
    The risk of major bleeding, which is always a concern with anticoagulant therapy, was found to be low (1.6% of patients) and recurrent thrombosis occurred in 4.4% of patients.

    A randomized trial is the optimal approach to establish non-inferiority or superiority of rivaroxaban to LMWH for cancer-associated thrombosis but results of the quality assessment provide guidance and reassurance for rivaroxaban use in cancer patients.

    • 4 min
    • video
    Tosedostat for elderly acute myeloid leukaemia

    Tosedostat for elderly acute myeloid leukaemia

    Dr Visani talks to ecancertv at ASH 2015 about the use of the investigational drug tosedostat in the setting of elderly acute myeloid leukaemia (AML).

    Patients with AML aged 60 years and older can be a difficult population to treat as they are often resistant to or cannot tolerate intensive chemotherapy. As a result they generally have poorer outcomes than their younger counterparts with shorter overall survival.

    Tosedostat is a new, orally bioavailable inhibitor of members of the M1 and M17 classes of aminopeptidases that has shown efficacy in both de novo and relapsed AML.

    In the interview, Dr Visani talks about the results of a prospective phase II multicenter study that looked at combining tosedostat with low-dose cytarabine versus the chemotherapy alone in 33 elderly patients with AML.

    Dr Visani highlights that 45% of patients achieved complete remission with the combination versus 25% of those who had the chemotherapy alone. The duration of remission was also lengthened by the addition of tosedostat.

    • 6 min

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