ANNUAL HAIRY CELL LEUKEMIA FOUNDATION CONFERENCE RAISES AWARENESS OF HCL RESEARCH AND EMERGING THERAPIES
Each year, our annual scientific conference brings together leading hairy cell leukemia researchers and experts. Over two days, conference attendees present research and difficult cases, and discuss strategies for collaborative study and consensus building in approaches to treatment. More than 50 doctors from 10 countries representing HCL Centers of Excellence were invited to attend our conference on October 24-25, 2019 in Rome. Many of these doctors are past or current recipients of research grants funded by the Hairy Cell Leukemia Foundation in partnership with other foundations. During the conference, these investigators shared exciting updates on their research and clinical trials. The conference featured high-caliber scientific presentations and discussion about optimal therapies for patients, as well as thoughtful conversations about opportunities for future research to further improve patient outcomes.
OncologyLive interviewed several attendees during our conference and published excerpts of these interviews after the meeting.
MINIMAL RESIDUAL DISEASE (MRD) IN MANAGEMENT OF HAIRY CELL LEUKEMIA
Both Dr. Robert Kreitman and Dr. Farhad Ravandi sat down with OncLive to discuss the role of minimal residual disease (MRD) in HCL management.
Dr. Robert Kreitman, National Cancer Institute, NIH
In his comments, Dr. Kreitman said that MRD appears to cause relapse in some patients and affects the length of a patient’s remission. “If you can get rid of MRD, you can have a longer complete remission duration,” he said. Dr. Kreitman also discussed the effectiveness of moxetumomab pasudotox during the phase I and phase II trials “in not only achieving [complete remission], but eliminating MRD.” He said, “We have patients who still have MRD-negative disease more than 8.5 years after moxetumomab pasudotox. It is tempting to say that those patients have permanent elimination of MRD, but it is still too early to say.”
Read Dr. Kreitman’s interview with OncLive. >>
Dr. Farhad Ravandi, The University of Texas – MD Anderson Cancer Center
Dr. Ravandi also discussed MRD in hairy cell leukemia: “In more indolent leukemias, such as hairy cell leukemia, the value of MRD assessment is somewhat controversial. However, there have been studies that have shown that if you have persistent disease at a time of remission, you are probably more likely to relapse. The original study used immunohistochemistry showing that patients who are in remission and still had evidence of disease in their bone marrows, they are more likely to relapse.“ He added, “but there are also some publications that have shown that in indolent diseases such as hairy cell leukemia, you can have a few hairy cells in your bone marrow 10, 15, or 17 years after achieving remission and still not have a full-blown relapse.”
Read Dr. Ravandi’s interview. >>
EXAMINING NON-CHEMOTHERAPY OPTIONS FOR PATIENTS WITH HAIRY CELL LEUKEMIA
During our conference, Dr. Justin Taylor from Memorial Sloan Kettering Cancer presented updates on his institution’s phase II clinical trial in combining vemurafenib plus obinutuzumab for previously untreated patients. He said, “This is the first trial in hairy cell leukemia looking at targeted agents as a frontline treatment. The rationale is to see if treating the patients upfront before they relapse might have better outcomes.”
Dr. Taylor says that early results from the trial are encouraging. This research is being supported by a jointly funded grant from the Hairy Cell Leukemia Foundation, Leukemia & Lymphoma Society and SASS Foundation for Medical Research.
Read Dr. Taylor’s interview. >>
CELL FREE DNA AS A BIOMARKER FOR HAIRY CELL LEUKEMIA
Dr. James Blachly from The Ohio State University Comprehensive Cancer-The James is a 2017/2018 Research Grantee of the Hairy Cell Leukemia Foundation and SASS Foundation for Medical Research. During our conference, he presented an update on his work assessing cell free DNA (cfDNA/ctDNA) in patients with HCL, which could improve the way that HCL patients are monitored and evaluated for residual and relapsed disease.
View a video excerpt of Dr. Blachly’s interview with OncLive. >>
IBRUTINIB IN HCL TREATMENT
Dr. Kerry Rogers from The Ohio State University Comprehensive Cancer Center-The James discussed data from an ongoing trial using ibrutinib to treat patients with both classic and variant forms of hairy cell leukemia. BTK inhibitors such as ibrutinib have been approved by the FDA to treat other B-cell malignancies. “Since ibrutinib is available and potentially effective (especially for patients who might not benefit from chemotherapy), we decided to evaluate it in hairy cell leukemia,” said Dr. Rogers. Regarding results from the study, Dr. Rogers said, “It is showing that patients who weren’t benefiting from standard therapies like pentostatin or cladribine are able to benefit from ibrutinib in terms of stable disease control for a good duration.”
Dr. Rogers was a member of our inaugural cohort of fellowship awardees in 2017, supporting her research in ibrutinib to treat HCL. The fellowship award program is jointly funded by the Hairy Cell Leukemia Foundation and SASS Foundation for Medical Research.
Read Dr. Rogers’ interview. >>
MOXETUMOMAB PASUDOTOX IN HCL TREATMENT
Dr. Agnieszka Janus from Copernicus Memorial Hospital in Poland discussed her experience in treating patients with moxetumomab pasudotox, which was approved by the FDA in 2018 for relapsed or refractory patients. She said, “The efficacy is great because it works even if the patient is heavily treated. We are very happy to have early access to this drug" for our patients.
During our conference, Dr. Janus shared case studies where patients who didn’t respond to moxetumomab pasudotox were treated with vemurafenib.
STANDARD OF CARE FOR HCL
Dr. Enrico Tiacci of the University of Perugia, Italy discussed the effectiveness of pentostatin and cladribine in HCL treatment, noting the strong responses among 80 to 90% of patients treated with these purine analogs.