Medical Roundtable: Hodgkin Lymphoma - Discussing Recent Evidence & Practice Options

October 19, 2015|Non-Hodgkin Lymphoma Hub

Moderated by: Stephen Ansell, MD, PhD1

Discussants: Craig Moskowitz, MD2; Catherine Diefenbach, MD3; Andrew M. Evens, DO, MSc4

From Mayo Clinic, Rochester, MN¹; Memorial Sloan Kettering Cancer Center and Weill Medical College of Cornell University, New York, NY²; NYU School of Medicine and NYU Perlmutter Cancer Center, New York, NY³; Tufts University School of Medicine and Tufts Medical Center, Boston, MA⁴

Address for correspondence: Stephen Ansell, MD, PhD, Mayo Clinic, 200 First Street SW #W10, Rochester, MN 55905

E-mail: ansell.stephen@mayo.edu

Biographical sketch:

From Weill Medical College of Cornell University:

Dr. Craig Moskowitz received his MD degree from Wayne State University School of Medicine in Detroit in 1988. He completed his residency in Internal Medicine in 1991 and served as Chief Resident in 1992. He completed a Fellowship in Hematology/Oncology at Memorial Sloan Kettering Cancer Center (MSKCC) in 1995 and served as the Chief Fellow from 1993–1994. Dr. Moskowitz is currently the Steven A. Greenberg Chair in Lymphoma Research as well as the Clinical Director of the Hematologic Oncology Division at Memorial Hospital. He is also a Member at Memorial Sloan Kettering Cancer Center, Attending Physician on the Lymphoma and Adult Bone Marrow Transplant Services; and a Professor of Medicine at Cornell University Medical College.

Dr. Moskowitz serves as principal investigator and co-investigator for a number of clinical trials aimed at improving the care of patients with lymphoma. His research has focused on improving the outcome of patients with poor-risk diffuse large B-cell lymphoma (DLBCL) and Hodgkin lymphoma (HL). This effort has been conducted along two tracks. One effort is focused on improving therapy for patients with disease that has returned or is not responding to standard therapy (refractory disease), through the use of high-dose therapy and autologous stem cell transplantation as well as new agents that can be incorporated into such "salvage" therapy. The second is aimed at developing risk-adapted strategies to optimize the treatment of newly diagnosed DLBCL by using what we have learned in the relapsed and refractory setting.

Dr. Moskowitz has been recognized for his research on a national level through multiple awards. He has lectured worldwide on lymphoma and stem cell transplantation. In addition, he is a member of the research council at MSKCC, and on the steering committees for the bi-annual international lymphoma conference in Lugano and international Hodgkin lymphoma conference in Cologne.

From NYU School of Medicine and NYU Perlmutter Cancer Center:

Dr. Catherine S. Diefenbach is an Assistant Professor of Medicine in the Department of Hematology/Oncology at NYU Langone Medical Center and a member of its Laura and Isaac Perlmutter Cancer Center. She is a translational physician-scientist specializing in the care of patients with Hodgkin and non-Hodgkin lymphoma.

An alumna of the University of Pennsylvania School of Medicine, Dr. Diefenbach completed her internship and residency at the Johns Hopkins Hospital and her oncology fellowship at Memorial Sloan-Kettering Cancer Center, where she spent an additional year focusing on translational immunology.

Her scientific research focuses on the relationship between lymphoma and immunity; on developing novel and immune based treatment strategies for patients with relapsed lymphoma; and on biomarker discovery. She is currently leading a national clinical trial for relapsed Hodgkin lymphoma investigating the combination of the antibody drug conjugate brentuximab with the immune activating agents ipilimumab and nivolumab.

Dr. Diefenbach directs the lymphoma clinical research within the Hematology/ Oncology Division at the Perlmutter Cancer Center. She is a member of the ECOG Lymphoma Committee, the NCI Lymphoma Steering Committee Clinical Trials Planning Meeting, and the Editorial Board of Clinical Cancer Research. Her research is supported by the Lymphoma Research Foundation, the American Cancer Society and the National Cancer Institute (NCI).

From Tufts University School of Medicine and Tufts Medical Center:

Dr. Andrew M. Evens is an expert in the biology, prognosis, and treatment of Non-Hodgkin’s lymphoma and Hodgkin’s disease/lymphoma. Over the past 15 years, Dr. Evens has been the principal investigator for >75 lymphoma clinical trials that have included phase I, II, and III studies, a number of which have been investigator-initiated clinical trials studying novel therapeutic agents for the treatment of lymphoma. He also maintains an active NIH funded translational lymphoma laboratory studying lymphoma biology, signal transduction pathways, free radical-mediated biology, and the development of novel targeted agents for the treatment of lymphoma. His work has been funded by the National Cancer Institutes, including a prior K23 grant and a currently funded R01 entitled 'MAP Kinase Signaling in Lymphoma: A Novel Therapeutic Paradigm'. Dr. Evens is also involved in collaborations with investigators throughout New England, nationally, and internationally that include lymphoma research in epidemiology, pharmacovigilance, and health outcomes. Additionally, he is an Associate Editor for the British Journal of Haematology and he chairs the Hematology Panel for the VA R01 Scientific Merit Review committee. At Tufts Medical Center, Dr. Evens is Chief of the Division of Hematology/Oncology and Director of the Tufts Cancer Center

DR. ANSELL: My name is Stephen Ansell, from Mayo Clinic, Rochester, Minnesota. I’m joined by Drs. Craig Moskowitz, Attending Physician at Memorial Sloan Kettering Cancer Center and Professor of Medicine at Weill Medical College of Cornell University, Catherine Diefenbach, Assistant Professor of Medicine at the NYU School of Medicine and the NYU Perlmutter Cancer Center, and Andy Evens, Professor of Medicine at Tufts University School of Medicine, and Faculty Member at Tufts Medical Center in Boston.

Welcome to all of you and thank you for participating in this medical roundtable discussion. The focus today is going to be on practical management of Hodgkin lymphoma. This is a very experienced group of roundtable participants whom I hope will give us valuable insights into some of the questions relating to managing Hodgkin lymphoma.

Let’s talk about patients with early stage Hodgkin lymphoma and discuss what we feel the standard management might be and how we would use positron emission tomographic (PET) scans to direct therapy. Craig, I’m going to ask you to start. Please discuss what your standard management of early stage Hodgkin lymphoma is and how you use PET scans to direct your treatment.

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