Hematologic Malignancies - Siteman Cancer Center

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Hematologic MalignanciesLeukemia, Lymphoma, Myelomaand Stem Cell TransplantationFor patients with refractory DLBCL, we are evaluating the drug YM155 in aPhase II multi-institution trial. YM155 is a survivin inhibitor which demonstratedactivity in the Phase I setting and was well-tolerated. Patients with relapsed/refractory DLBCL, and who are not candidates for SCT, are also eligible forSGN-40 in combination with rituximab and gemcitabine. The combinationof rituximab and gemcitabine has demonstrated clinical efficacy and goodtolerability. Toxicity from SGN-40 appears to be most associated with the firstinfusion. The addition of SGN-40 may increase efficacy without significantoverlapping toxicity.Follicular LymphomaMost patients with low-grade lymphomas eventually relapse. In the era priorto rituximab, the average survival was 7 years. While the survival is improving,research is being directed to augment the activity of rituximab. One suchapproach is a Phase II randomized CALGB study, in which we will be evaluatinglenalidomide vs. lenalidomide plus rituximab for patients with relapsedfollicular lymphoma (FL) following a rituximab containing regimen. Patientsmust not be refractory to rituximab. Similarly, in patients who have progressedfollowing previous rituximab therapy, we are also evaluating a Phase IIrandomized, double-blind, placebo-controlled study of Apomab administeredin combination with rituximab. All patients will receive rituximab 375 mg/m2weekly for eight doses with or without 6 cycles of Apomab administered every 3weeks. Apomab is a fully humanized monoclonal antibody that induces apoptosisby engaging death receptors on cancer cells, specifically via the Apo2 ligand/TNFrelatedapoptosis-inducing ligand (Apo2L/TRAIL) death receptor. Our thirdtrial aimed at improving upon rituximab, is a Phase II study of bendamustinein combination with bortezomib and rituximab. Eligible patients must havepreviously received 4 or more doses of rituximab.T-cell lymphomaAlk-1 negative anaplastic large cell lymphoma (ALCL) has a poor prognosis,with most patients relapsing after primary therapy. The anti-CD30 antibody,SGN-30 showed activity in relapsed ALCL (RR 25-30%) and these patientsare now included in the ongoing SGN-35/gemcitabine trial as described aboveunder relapsed HL. Praletrexate, an anti-folate and methotrexate analog hasdemonstrated significant activity against relapsed and refractory aggressive T-celllymphomas (RR 30%). We are currently participating in a multi-center Phase I/IItrial of Praletrexate plus gemcitabine.Relapsed Lymphoma- All HistologiesWe are participating in a multi-center Phase I/II dose-escalation study of PCI-24781, an oral pan-HDAC inhibitor. In pre-clincial studies PCI-24781 hadmore activity than vorinostat, an HDAC inhibitor approved for cutaneous T-celllymphoma. Previously treated patients with most subtypes of lymphoma will beeligible for enrollment.Patients with relapsed lymphoma should be strongly encouraged to participate inclinical trials in efforts to gain understanding of how best to treat this complex disease.If you have any questions or have a patient who may be appropriate for these studies,please feel free to contact Dr. Nancy Bartlett or Dr. Nina Wagner-Johnston at(314) 362-5654. We truly appreciate your referrals and support of these studies.2
WelcomeThe Alvin J. Siteman Cancer Center at Barnes-Jewish Hospital and Washington University School ofMedicine is pleased to announce the addition of Kenneth Carson, M.D. and Nina Wagner-Johnston, M.D.to its hematologic malignancies team.Kenneth Carson, M.D.Dr. Carson received his medical degree from the University of SouthernCalifornia and completed a residency in internal medicine at Duke University.Prior to joining the Washington University faculty, he completed a clinicalfellowship in hematology and oncology and a postdoctoral researchfellowship in health services at Northwestern University in Chicago.Dr. Carson will be seeing patients with hematologic malignancies atSiteman’s main campus and west county location. His research focuses onissues of cost, quality, and access to oncology care. Dr. Carson joins theWashington University faculty as an Instructor of Medicine.Kenneth Carson, M.D.Nina Wagner-Johnston, M.D.Dr. Wagner-Johnston graduated from the University of Chicago School ofMedicine, where she also received residency training in internal medicine.She completed a fellowship in medical oncology at Johns Hopkins Universityin Baltimore. During her fellowship training, she evaluated clonal Ig DNAin plasma from patients with AIDS-related lymphomas. Her interestsinclude prognostic biomarkers and clinical trial development for patientswith lymphoma and AIDS-related malignancies. Dr. Wagner-Johnston seesnontransplant lymphoma patients at Siteman’s main campus and joins theWashington University faculty as an Assistant Professor of Medicine.Nina Wagner-Johnston, M.D.Continuing Medical Education:Advances in Diagnosis and Treatment of Hematologic MalignanciesSeptember 20, 2008Four Seasons Hotel, St. Louis, MissouriSiteman Cancer Center at Barnes-Jewish Hospital and Washington University School of Medicine is hosting an educational symposiumentitled “Advances in Diagnosis and Treatment of Hematologic Malignancies”. The symposium will take place on Saturday, September20 at the Four Seasons Hotel in St. Louis, Missouri.The annual symposium provides the audience with updated information on cancer treatment and diagnosis through discussions onhematological malignancies, and to host a guest speaker, Dr. Dennis Confer who is the Chief Medical Officer for the National MarrowDonor Program.In addition to the conference, we are hosting our 15th Annual Bone Marrow Transplant Patient Celebration on Saturday, September20, in the ballroom of the St. Louis Four Seasons Hotel. You and a guest are invited to attend this event and honor our survivors.Please join us for a private physician reception an hour prior to the patient celebration, in the “Gateway Room” of the hotel.If you are interested in attending the symposium, please register at http://cme.wustl.edu. Also, please RSVP for the patientcelebration and private physician reception by calling 314-747-7222 or 800-600-3606 by September 10.3
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Hematologic Malignancies - Siteman Cancer Center

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