Mar 16, 2020

Proceedings from a roundtable discussion with Drs Courtney D DiNardo, Keith W Pratz, Richard M Stone and a group of 20 general medical oncologists and nurse practitioners on the optimal management of acute myeloid leukemia within a community-based setting.

• Initial Workup and Determination of Eligibility for Intensive Treatment; Integrating Venetoclax into the Treatment of Acute Myeloid Leukemia (AML)
• • Faculty presentation — Dr DiNardo: Exploring the current management paradigm for AML in patients not eligible for intensive therapy (00:00)
  • Case (Dr Marte): A woman in her early 80s who presented 7 years ago with t(8;21) AML is in complete remission 7 years after treatment with 7+3 chemotherapy (09:13)
  • Therapeutic options for older patients with AML without targetable mutations (11:02)
  • Genetic testing for patients with AML (16:21)
  • Assessment of minimal residual disease status in patients undergoing treatment for AML; selection of patients who are eligible for intensive chemotherapy (19:40)
  • Choice of therapy for a patient with AML and multiple comorbidities (23:36)
  • Prophylaxis for patients receiving venetoclax in combination with azacitidine (26:57)
  • Optimal duration of venetoclax therapy (29:05)
  • Prevention and management of tumor lysis syndrome associated with venetoclax (30:58)
  • Selection of therapy for a patient with AML with complex karyotype and a TP53 mutation (34:58)
  • Case (Dr Dandamudi): A woman in her early 80s with AML attains an excellent response to venetoclax and azacitidine (38:11)
  • Case (Dr Choksi): A woman in her late 70s with myelodysplastic syndrome (MDS)/myeloproliferative neoplasm develops neutropenia after treatment with venetoclax and azacitidine (43:13)
  • Case (Dr Hussein): A man in his early 80s develops persistent neutropenia after receiving azacitidine for MDS, which resolves after treatment with pembrolizumab for metastatic melanoma (51:14)
  • Choice of hypomethylating agent for patients with AML (52:42)
  • Case (Dr Gandhi): A man in his mid-70s with AML receives venetoclax/decitabine (55:34)
  • Perspective on the use of GCSF for the management of neutropenia associated with venetoclax/azacitidine for AML (57:49)
• Management of AML with FLT3 and IDH Mutations
• • Faculty presentation — Dr Stone: Management of AML with a FLT3 mutation in older patients who are not eligible for intensive treatment (1:00:36)
  • Therapeutic approach for elderly patients with FLT3-ITD AML and high allelic burden (1:08:08)
  • Case (Ms Sanchez): A woman in her mid-60s with FLT3-ITD AML is enrolled on a clinical trial evaluating gilteritinib as maintenance therapy after allogeneic transplant (1:11:48)
  • Activity and tolerability of gilteritinib and sorafenib in patients with AML (1:16:39)
  • Ongoing investigation of venetoclax in combination with a hypomethylating agent for younger/fit patients with AML (1:19:26)
  • Duration of response to therapy with venetoclax and a hypomethylating agent; investigation of approaches to overcome resistance (1:22:31)
  • Case (Dr Sullivan): A man in his mid-30s with AML with mutations in FLT3, MPN1 and ROS1 experiences disease progression after chemotherapy and FLT3 inhibitors (1:24:46)
  • Case (Dr Dandamudi): A man in his early 70s receives venetoclax and azacitidine for AML (1:32:43)
  • Faculty presentation — Dr Pratz:Therapeutic approach for older patients with AML with IDH1/2 mutations who are not eligible for intensive treatment (1:35:52)
  • Selection of first-line therapy for patients with AML with an IDH mutation (1:45:08)
  • Side effects associated with ivosidenib; management of differentiation syndrome related to IDH inhibitors (1:48:41)
  • Case (Dr Shah): A man in his late 80s with AML with an IDH2 mutation and multiple comorbidities receives enasidenib (1:54:41)
  • Case (Dr Malhotra): A man in his early 60s with AML with an IDH2 mutation receives enasidenib (1:57:56)

CME information and select publications