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Which of these treatments has had the biggest impact on your patients with R/R FL?

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Bispecific antibodies
   
BTK inhibitors
   
CAR T-cell therapies
   
EZH2 inhibitors
   

Tutorial

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What do you use most often to guide your treatment sequencing decisions in R/R FL?

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Personal experience and/or guidance from colleague
   
Clinical or real-world evidence
   
Patient preference
   
Other
   

Tutorial

This icon indicates there is a poll question. Click it when you see it to interact with your peers.

Poll

What factor most frequently influences your patients’ treatment decisions in R/R FL?

Submit your answer to see the results

Distance to treatment centre
   
Availability of caregiver support
   
Treatment administration schedule
   
Potential impact of the treatment on quality of life/another factor
   
 
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Lymphoma, Haematological Malignancies, Haematology CE/CME accredited

touchPANEL DISCUSSION
A visually engaging discussion designed to emulate a ‘live’ panel experience and provide clinicians with practical expert insights to address their clinical challenges. Useful tips below will show how to navigate the activity. Close

Maximizing the possibilities in the evolving treatment paradigm for R/R follicular lymphoma: From optimal sequencing to shared decision-making

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Learning Objectives

After watching this activity, participants should be better able to

  • Analyse the evidence for novel approved therapies in relapsed/refractory follicular lymphoma and their potential impact on the evolving treatment paradigm
  • Practise shared decision-making when individualizing treatment selection for patients with relapsed/refractory follicular lymphoma, with a focus on bispecific antibody and CAR T-cell therapies
  • Evaluate the key considerations for treatment sequencing in relapsed/refractory follicular lymphoma
Overview

In this activity, three experts in haematological malignancies provide their perspectives on the latest evidence and clinical implications of recently approved treatments for relapsed/refractory follicular lymphoma (R/R FL), the importance of shared decision-making in treatment selection in the era of BsAb and CAR T-cell therapies, and the key considerations for treatment sequencing.

This activity is jointly provided by USF Health and touchIME. read more

Target Audience

Community and academic oncologists, haematologists and haemato-oncologists involved in the management of follicular lymphoma

Disclosures

USF Health adheres to the Standards for Integrity and Independence in Accredited Continuing Education. All individuals in a position to influence content have disclosed to USF Health any financial relationship with an ineligible organization. USF Health has reviewed and mitigated all relevant financial relationships related to the content of the activity. The relevant relationships are listed below. All individuals not listed have no relevant financial relationships.

Faculty

Dr Matthew Lunning discloses: Consultancy fees from AbbVie, Acrotech Biopharma, ADC Therapeutics, AstraZeneca, Bristol Myers Squibb, Caribou Biosciences, CRISPR Therapeutics, Daiichi Sankyo, Fate Therapeutics, Genentech, Genmab, Incyte Corporation, Ipsen, Janssen Pharmaceuticals, Kite Pharma, Loxo Oncology, Nurix, Recordati, Regeneron Pharmaceuticals, Sanofi, Seagen and Vittoria Biotherapeutics. Grants/Research support from Bristol Myers Squibb, Fate Therapeutics and Sana Biotechnology.

Prof. Charalambos Andreadis discloses: Advisory board or panel fees from AbbVie, AstraZeneca, Epizyme (an Ipsen company) and Gilead Sciences. Consultancy fees from Atara Biotherapeutics and Bristol Myers Squibb. Grants/Research support from Bristol Myers Squibb, Eli Lilly and Company, Genzyme, Merck, Novartis and Roche.

Dr Tara Graff discloses: Advisory board or panel fees from AbbVie, Adaptive Biotechnologies, AstraZeneca, Bristol Myers Squibb, BeiGene, Eli Lilly and Company, Genmab and Kite Pharma. Consultancy fees from AbbVie, Genentech and Genmab. Speaker’s bureau fees from AbbVie, Adaptive Biotechnologies, ADC Therapeutics, AstraZeneca, BeiGene, Eli Lilly and Company, Genmab and Kite Pharma.

Content reviewer

Danielle Walker, APRN has no financial interests/relationships or affiliations in relation to this activity.

Touch Medical Director

Sola Neunie has no financial interests/relationships or affiliations in relation to this activity.

USF Health Office of Continuing Professional Development and touchIME staff have no financial interests/relationships or affiliations in relation to this activity.

Requirements for Successful Completion

In order to receive credit for this activity, participants must review the content and complete the post-test and evaluation form. Statements of credit are awarded upon successful completion of the post-test and evaluation form.

If you have questions regarding credit please contact cpdsupport@usf.edu.

Accreditations

Physicians

This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education (ACCME) through a joint providership of USF Health and touchIME. USF Health is accredited by the ACCME to provide continuing medical education for physicians.

USF Health designates this enduring material for a maximum of 0.75 AMA PRA Category 1 CreditTM.  Physicians should claim only the credit commensurate with the extent of their participation in the activity.

The European Union of Medical Specialists (UEMS) – European Accreditation Council for Continuing Medical Education (EACCME) has an agreement of mutual recognition of continuing medical education (CME) credit with the American Medical Association (AMA). European physicians interested in converting AMA PRA Category 1 CreditTM into European CME credit (ECMEC) should contact the UEMS (www.uems.eu).

Advanced Practice Providers

Physician Assistants may claim a maximum of 0.75 Category 1 credits for completing this activity. NCCPA accepts AMA PRA Category 1 CreditTM from organizations accredited by ACCME or a recognized state medical society.

The AANPCP accepts certificates of participation for educational activities approved for AMA PRA Category 1 CreditTM by ACCME-accredited providers. APRNs who participate will receive a certificate of completion commensurate with the extent of their participation.

Date of original release: 08 August 2024. Date credits expire: 08 August 2025.

If you have any questions regarding credit please contact cpdsupport@usf.edu.

This activity is CE/CME accredited

To obtain the CE/CME credit(s) from this activity, please complete this post-activity test.

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Topics covered in this activity

Lymphoma / Haematological Malignancies / Haematology
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touchPANEL DISCUSSION
Maximizing the possibilities in the evolving treatment paradigm for R/R follicular lymphoma: From optimal sequencing to shared decision-making
0.75 CE/CME credit

Question 1/4
Your 73-year-old patient with follicular lymphoma has experienced disease progression while on their third line of therapy. You are discussing next steps with them when they ask about epcoritamab, and how the response rate compares with therapies routinely used in this setting. Based on an analysis presented at EHA 2024 that compared the efficacy of epcoritamab in the EPCORE NHL-1 trial with usual-care records from the COTA EHR database, what would you tell them? “Compared with usual care, epcoritamab-treated patients…”

CR, complete response; EHA, European Hematology Association; EHR, electronic health record; ORR, overall response rate.

A comparison of individual patient data from the EPCORE NHL-1 trial (n=126) and records from the COTA EHR database (n=152) of patients with relapsed/refractory follicular lymphoma receiving treatment in the third- or later-line setting was presented at EHA 2024. Results showed that epcoritamab significantly improved the ORR (86% vs 70%, p=0.002) and CR rate (69% vs 23%, p<0.001) compared with usual care.

Abbreviations
CR, complete response; EHA, European Hematology Association; EHR, electronic health record; ORR, overall response rate.

Reference
Phillips T, et al. HemaSphere. 2024;8(Suppl.1):2063–4.

Question 2/4
You have been discussing initiating CAR T-cell therapy with your 58-year-old patient with relapsed/refractory follicular lymphoma. Which of these factors that you have identified during the shared decision-making process is likely to have the greatest influence on whether they choose this treatment?

CAR, chimeric antigen receptor.

Multiple factors influence treatment decisions in follicular lymphoma.1 Utilizing shared decision-making can help identify the patient’s priorities, needs, perceptions and expectations.1,2 Patients receiving CAR T-cell therapy require a caregiver to be available around-the-clock for 4–8 weeks after the infusion.3 The distance from the treatment centre, treatment-related side effects, administration schedule, convenience of administration, speed of access to therapy and the ability of the patient to tolerate therapy are also key factors influencing patient decisions.1,4,5

Abbreviation
CAR, chimeric antigen receptor.

References

  1. Qualls D, Salles G. Haematologica. 2022;107:19–34.
  2. Glatzer M, et al. Oncology. 2020;98:370–8.
  3. Cancer Support Community. CAR T Patient and Caregiver Guide. Available at: www.cancersupportcommunity.org/sites/default/files/fsac/CAR_T_Patient_and_Caregiver_Guide.pdf (accessed 02 July 2024).
  4. Skarbnik AZ, Patel K. Front Oncol. 2023;13:1120358.
  5. Gurumurthi A, et al. Blood Adv. 2023;7:5713–6.
Question 3/4
Which of the following factors are contributors to the challenge of determining the optimal treatment sequence in patients with relapsed/refractory follicular lymphoma?

Treatment sequencing can be challenging in relapsed/refractory follicular lymphoma.1 Key challenges include a wide variation in treatment accessibility,2 lack of published outcome data or limited follow-up availability1,2 and few biological insights or biomarkers to help guide patient selection.1-3 In addition, there is limited knowledge of how treatment affects disease biology and therefore response to the next class of agent.1 Importantly, few patients who have received bispecific antibodies or CAR T-cell therapy have been enrolled in trials for later lines of therapy2 and there are currently no head-to-head trial data available that compare recently approved agents.1–3

Abbreviation
CAR, chimeric antigen receptor.

References

  1. Qualls D, Salles G. Haematologica. 2022;107:19–34.
  2. Linton KM, et al. Hematol Oncol. 2023. DOI: 10.1002/hon.3205 (online ahead of print).
  3. Chen C-JJ, et al. Cancers (Basel). 2023;15:4483.
Question 4/4
You have a 63-year-old patient with follicular lymphoma who has relapsed following their second line of therapy. During discussions about their treatment options, they mention that their colleague at work had received an autologous stem cell transplant to treat his follicular lymphoma 5 years ago, and ask if this is a treatment option that they should consider. What would you tell them?

ASCT, autologous stem cell transplant; R/R FL, relapsed or refractory follicular lymphoma.

The NCCN guidelines for B-cell lymphomas state that autologous stem cell therapy can be used alongside high-dose therapy (HDT/ASCR) as consolidation therapy in the second line in patients with FL. This is not a preferred regimen and is optional.

Abbreviations
HDT/ASCR, high-dose therapy with autologous stem cell rescue; FL, follicular lymphoma; NCCN, National Comprehensive Cancer Network.

Reference
NCCN Clinical Practice Guidelines in Oncology. B-Cell Lymphomas Version 2.2024 – 30 April 2024. Available at: www.nccn.org (accessed 08 July 2024).

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