Panelists discuss how testing for specific changes in cancer cells, like ESR1 mutations, can help guide treatment choices for patients with hormone receptor-positive metastatic breast cancer.
Panelists discuss how belumosudil is particularly effective for patients with lung involvement due to its antifibrotic mechanism.
Panelists discuss how clinicians typically taper steroids slowly after starting second-line agents for chronic graft-vs-host disease (cGVHD).
Panelists discuss how the MAJIC-PV trial provides critical evidence that ruxolitinib offers more than symptomatic relief in polycythemia vera, demonstrating approximately 40% reduction in thromboembolic events and improved event-free survival while correlating these clinical benefits with molecular responses through JAK2 V617F allele burden reduction, suggesting ruxolitinib may be truly disease-modifying rather than merely a bandage treatment when comprehensive control of all 3 blood cell lineages (red cells, white cells, and platelets) is achieved.
A panelist discusses how treatment sequencing for neuroendocrine tumors (NETs) is less important than ensuring patients receive all available treatments, highlighting cabozantinib as a reasonable second- or third-line option with manageable adverse effects like hypertension and liver function abnormalities.
A panelist discusses how NCCN guidelines now include cabozantinib as a category 1 recommendation for gastrointestinal (GI) neuroendocrine tumors (NETs) after prior treatment with everolimus or lutetium-177 dotatate, with slightly different recommendations for pancreatic, lung, and thymic NETs.
Panelists discuss how ruxolitinib provides comprehensive benefits for polycythemia vera patients beyond count control, highlighting its remarkable ability to rapidly alleviate severe pruritus (often within 48 hours) and other constitutional symptoms that remain resistant to conventional therapies like hydroxyurea and interferon while also effectively managing cytokine-driven and spleen-related symptoms that significantly impact quality of life.
A panelist discusses how chronic graft-versus-host disease affects 30-70% of allogeneic transplant patients across eight cardinal organs (most commonly skin), presents with varying symptoms from rashes and joint stiffness to dry eyes and lung complications, and requires graded treatment approaches ranging from topical therapies for mild cases to systemic corticosteroids for moderate-to-severe disease, though 50% of patients ultimately need alternative treatments due to steroid dependency or resistance.
A panelist discusses how axatilimab is particularly effective for patients with bronchiolitis obliterans syndrome, showing response rates of almost 50% with 20% complete responses, and offers the advantage of reliable intravenous delivery despite logistical challenges of infusion center visits.
A panelist discusses how axatilimab demonstrated efficacy in a heavily pretreated patient population with predominantly severe chronic graft-vs-host disease (cGVHD) in the AGAVE-201 trial, with manageable adverse effects including infusion reactions and enzyme elevations that rarely required discontinuation of treatment.
Panelists discuss how most clinicians prefer ruxolitinib over ibrutinib as second-line therapy due to better tolerability
Panelists discuss how FDA-approved therapies such as ibrutinib, ruxolitinib, belumosudil, and axatilimab provide treatment options for steroid-refractory chronic graft-vs-host disease (cGVHD).
A panelist discusses how the CABINET trial showed significant progression-free survival benefits for cabozantinib compared with placebo (particularly in pancreatic neuroendocrine tumors (NETs), why progression-free survival (PFS) is a meaningful end point for NETs, and that safety findings revealed familiar adverse effects requiring dose reductions in about two-thirds of patients.
Panelists discuss how the CYTO-PV study provides compelling evidence for maintaining strict hematocrit control below 45% in polycythemia vera patients, demonstrating that even a 3% difference in hematocrit levels can lead to a fourfold increase in cardiovascular events and thrombosis risk while also emphasizing the independent importance of controlling white blood cell counts below 11 × 109/L to further reduce thrombotic complications.
A panelist discusses how the CABINET trial was a National Cancer Institute (NCI)–supported study conducted by the Alliance for Clinical Trials in Oncology that enrolled patients with well-differentiated grade 1 through 3 pancreatic or extrapancreatic neuroendocrine tumors who had progressed after somatostatin analogue therapy and at least 1 other FDA-approved therapy.
Panelists discuss how multiple pivotal clinical trials inform polycythemia vera management strategies, highlighting key findings from CYTO-PV (strict hematocrit control <45% reduces thrombosis risk fourfold), RESPONSE (ruxolitinib’s superiority over best available therapy for controlling both hematocrit and splenomegaly), MAJIC-PV (demonstrating improved event-free survival with ruxolitinib), and PROUD-PV/CONTINUATION-PV (showing ropeginterferon’s durable molecular responses compared with hydroxyurea’s diminishing effect over time).
Panelists discuss how JAK inhibitor therapy, while effective in treating myelofibrosis and other hematologic disorders, increases the risk of skin cancers, particularly non-melanoma skin cancers, and emphasize the importance of regular screening, patient education, and preventive measures to manage this risk.
Panelists discuss how the evolution of myelofibrosis care has led to advancements in pharmacotherapy, risk stratification, and emerging therapies while highlighting ongoing unmet needs such as long-term disease control, treatment resistance, anemia and thrombocytopenia management, and the need for personalized treatment approaches.
Panelists discuss how prophylaxis against opportunistic infections is essential for patients on immunosuppressive therapy for chronic graft-vs-host disease (cGVHD).
Panelists discuss how specialists balance controlling chronic graft-vs-host disease (cGVHD) symptoms while minimizing steroid exposure when patients fail initial therapy.
A panelist discusses how axatilimab, a humanized IgG4 monoclonal antibody targeting CSF-1 receptors on monocytes and macrophages, showed promising results in the AGAVE-201 trial for treatment-resistant chronic graft-vs-host disease (cGVHD), with high response rates, durable responses, and tolerable adverse effects at the FDA-approved dose of 0.3 mg/kg every 2 weeks.
A panelist discusses how chronic graft-vs-host disease (cGVHD) is a common posttransplant complication with increasing incidence due to peripheral blood stem cell grafts, older patients, and more unrelated donor transplants, which can manifest in multiple organs and is typically treated with corticosteroids as first-line therapy.
Panelists discuss how managing advanced polycythemia vera requires tailored approaches beyond hydroxyurea when patients show resistance (persistent hematocrit >45%, elevated white blood cell counts, ongoing symptoms), with experts advocating for either second-line ruxolitinib for rapid symptom and hematologic control or interferons (particularly in younger patients), while emphasizing the importance of addressing modifiable cardiovascular risk factors like smoking cessation.
A panelist discusses how first-line treatment options for neuroendocrine tumors depend on tumor grade, disease extent, and symptoms, ranging from observation for asymptomatic cases to somatostatin analogues, chemotherapy, and the newly approved cabozantinib.
Panelists discuss how polycythemia vera treatment follows a risk-stratified approach, with all patients receiving daily aspirin and phlebotomies to maintain hematocrit below 45%, while high-risk patients (aged >60 years or history of thromboembolism) additionally require cytoreductive therapy with options including hydroxyurea, pegylated interferon alfa-2a, ropeginterferon alfa-2b, or second-line ruxolitinib, with treatment modifications based on response, tolerance, and disease progression.
A panelist discusses how neuroendocrine tumors are defined by World Health Organization (WHO) classification, graded based on Ki-67 proliferative index, diagnosed through imaging (often incidentally), and most commonly found in the small bowel, lungs, and pancreas.
Panelists discuss how important end points for evaluating new myelofibrosis therapies include overall survival, symptom improvement, splenic volume reduction, hematologic parameters, disease modification, safety, and patient-reported outcomes, all of which help assess the impact of treatment on both clinical outcomes and quality of life.
Panelists discuss how investigational therapies beyond Janus kinase (JAK) inhibition, including epigenetic modulation, telomerase inhibition, PI3K/AKT/mTOR pathway inhibition, immune modulation, TGF-β inhibition, and novel anti-fibrotic agents, are showing promise in improving efficacy and targeting different disease pathways in myelofibrosis.
Panelists discuss how steroid dosing for chronic graft-vs-host disease (cGVHD) typically starts at 0.5-1 mg/kg/day depending on severity, with careful tapering to avoid flares.