Dr Lai on NCCN Guideline Updates in AML Maintenance Therapy

Catherine E. Lai, MD, MPH, associate professor, physician leader, the Leukemia Clinical Research Unit, University of Pennsylvania Perelman Center for Advanced Medicine, discusses recent updates to the National Comprehensive Cancer Network (NCCN) Clinical Practice Guidelines in Oncology for acute myeloid leukemia (AML) maintenance treatment, highlighting how these updates may influence treatment decisions for this population.

Lai begins by stating that the 2024 NCCN guidelines have expanded their recommendation for the use of oral azacitidine maintenance therapy. Previously, this treatment was primarily for patients with intermediate- or adverse-risk disease who had completed consolidation therapy and were not eligible for a transplant, she explains. However, the 2024 guidelines for azacitidine maintenance therapy now also include patients with favorable-risk profiles who do not exhibit core binding factors, Lai reports. This recommendation is based on data from a small subset of patients in the phase 3, double-blind, placebo-controlled QUAZAR AML-001 trial (NCT01757535), she states.

The decision to use oral azacitidine for maintenance therapy should be individualized and tailored to specific patients’ needs, Lai continues. Several factors must be considered, such as whether a patient is likely to benefit from this treatment, she notes. It’s essential to consider patients’ bothshort-term and long-term goals, as well as the number of cycles of consolidation therapy they have received, Lai emphasizes, adding that these factors can play a critical role in determining whether azacitidine maintenance therapy is appropriate.

Having oral azacitidine as an option in the maintenance setting is beneficial, especially when the use of this agent aligns with patients’ specific circumstances and treatment objectives, she continues. These expanded guidelines provide a valuable alternative for maintenance therapy, ensuring that each patient receives a treatment plan that is best suited to their individual health needs, Lai states. Therefore, careful assessment and personalized decision-making are crucial in determining the most suitable maintenance therapy for each patient, she concludes.

Videos

Catherine E. Lai, MD, MPH, discusses NCCN guideline updates regarding AML maintenance therapy, sharing how these updates influence treatment decisions.

Catherine E. Lai, MD, MPH, an associate professor and physician leader of the Leukemia Clinical Research Unit at the University of Pennsylvania Perelman Center for Advanced Medicine, moderates a discussion with Selina M. Luger, MD, FRCPC; Gail J. Roboz, MD; and Wendy Stock, MD, on how they turned leukemia career “lemons” into “lemonade.”

Luger is an attending physician, professor of medicine, and interim director of the Penn-Vinmec Oncology Center of Excellence at the Hospital of the University of Pennsylvania. Roboz is a professor of medicine and the director of the Clinical and Translational Leukemia Program at the Weill Medical College of Cornell University and the NewYork-Presbyterian Hospital. Stock is the Anjuli Seth Nayak Professor of Medicine and a professor in the Comprehensive Cancer Research Center at the University of Chicago Medicine.

In this episode, Luger, Roboz, and Stock discuss times when their plans veered in directions different from what they expected, such as the challenges of spearheading a leukemia program, designing a trial that never happened, and developing a well-researched regimen that nevertheless fell short. In highlighting their most memorable roadblocks, they share how they turned these obstacles into inspirations for further advancement in the field of leukemia treatment.

The 3 experts also reflect on what they learned from each of these experiences, including the details of designing studies, the value of research that leads to networking, and how leaving one institution opens other doors and is a catalyst for gaining the necessary confidence for effective leadership. Additionally, they express their gratitude that moments like these helped them speak up about their work and develop their authoritative voices.

Selina M. Luger, MD, FRCPC; Gail J. Roboz, MD; and Wendy Stock, MD, discuss how they turned their leukemia career “lemons” into “lemonade.”

Women in Oncology: Resilience That Leads to Innovation

Catherine E. Lai, MD, MPH, an associate professor and physician leader of the Leukemia Clinical Research Unit at the University of Pennsylvania Perelman Center for Advanced Medicine, moderates a discussion with Judith Karp, MD; Azra Raza, MD; and Michelle M. Le Beau, PhD, on the leukemia treatment legacies they hope to be remembered for.

Karp is Professor Emerita of Oncology and Medicine at Johns Hopkins University School of Medicine, where she was a professor of oncology and the director of the Adult Leukemia Program in the Division of Hematologic Malignancies at the Sidney Kimmel Comprehensive Cancer Center, until her retirement in 2013. Raza is a professor of medicine and the director of the MDS Center at Columbia University. Le Beau is the Arthur and Marian Edelstein Professor of Medicine and the director of the University of Chicago Medicine Comprehensive Cancer Center.

In this episode, Karp, Raza, and LeBeau discuss their proudest career accomplishments, including the investigation of potential treatments using a patient’s first cancerous cell, advances in cytogenetics, and a rational design for clinical trials involving cell cytokinetics, all of which have ultimately contributed to improved leukemia treatment.

Additionally, the 3 experts share their thoughts on inspiring fresh faces in leadership positions and upholding integrity in their work. They also emphasize the importance of developing therapies using human cells and the crucial nature of treating patients with empathy and understanding during every step of their disease.

Judith Karp, MD, Azra Raza, MD, and Michelle M. Le Beau, PhD, discuss their proudest career accomplishments, including the investigation of potential treatments using a patient’s first cancerous cell, advances in cytogenetics, and a rational design for clinical trials involving cell cytokinetics.. 

Women in Oncology: Leukemia Therapies in Humans, for Humans 

Catherine E. Lai, MD, MPH, an associate professor and physician leader of the Leukemia Clinical Research Unit at the University of Pennsylvania Perelman Center for Advanced Medicine, moderates a discussion with Judith Karp, MD; Azra Raza, MD; and Michelle M. Le Beau, PhD, on what it’s like to be a woman working in the oncology field.

In this episode, Karp, Raza, and LeBeau discuss how their gender has shaped their professional lives, from working as some of the only female clinical faculty at their institutions to being compared to their male colleagues and denied opportunities and fair pay when working independently from men. They also highlight the ways their careers impacted their personal lives, including the external challenges they faced when making family-oriented decisions and the encouragement they felt when recognized as valued members of their communities.

Additionally, the 3 experts reflect on the strides they made to be taken seriously by their peers, the difficulty of navigating stereotypes and discrimination, and the patient-focused advice they have for future generations of female oncologists.

Judith Karp, MD, Azra Raza, MD,, and Michelle M. Le Beau, PhD, discuss how their gender has shaped their professional lives, from working as some of the only female clinical faculty at their institutions to being compared to their male colleagues and denied opportunities when working independently from men.

Women in Oncology: Finding Strength and Support in Community 

Catherine Lai, MD, MPH, director of Leukemia at MedStar Georgetown University Hospital’s Lombardi Comprehensive Cancer Center, discusses ​the potential benefits of venetoclax (Venclexta) in acute myeloid leukemia (AML). 

Many advances have been made in the AML armamentarium, and chief among them is venetoclax, explains says Lai. 

The drug plays a significant role in the treatment of patients with newly diagnosed AML who are older and are unfit for intensive chemotherapy​, Lai explains.

Although the response rates with venetoclax are similar to several induction chemotherapy regimens, the toxicity profile is improved with the BCL-2 inhibitor. ​Additionally, venetoclax can be given in the outpatient setting, which is of critical importance for older, high-risk patients during the coronavirus disease 2019 pandemic, Lai concludes. 

Catherine Lai, MD, MPH, discusses ​the potential benefits of venetoclax in acute myeloid leukemia. 

Catherine Lai, MD, MPH,

Articles

Dr Lai on NCCN Guideline Updates in AML Maintenance Therapy

Women in Oncology: Resilience That Leads to Innovation

Women in Oncology: Leukemia Therapies in Humans, for Humans

Women in Oncology: Finding Strength and Support in Community

Dr. Lai on the Potential Benefits of Venetoclax in AML