May 2019 ALLG Scientific Meeting Highlights
The Australasian Leukaemia & Lymphoma Group (ALLG) held its May 2019 Scientific Meeting (SM) in Sydney with over 300 members, associate members, professional staff and affiliated guests in attendance.
A key objective with the Scientific Meetings is to promote engagement among our members. Along with the normal activities such as ‘Meet the Chief & ALLG Leaders’ and scientific networking events, this year we included a fundraising drive with the ‘I Support ALLG’ coffee cup sleeves and a Photo Booth for professional headshots.
Another new initiative was the Lymphoma Australia Patient Education Day, hosted in collaboration with Lymphoma Australia.
We would especially like to thank the 16 sponsors for their support. The May meeting sponsors included Janssen, Amgen, Celgene, Novartis, Roche, AbbVie, Astellas, Bristol-Myers Squibb, Gilead, MSD, Mundipharma, Pfizer, Phebra, Servier, Specialised Therapeutics and Takeda.
The highlights of the meeting included:
- Chaired by Judith Trotman and Eliza Hawkes, the Tuesday Haematology Education Day focused on Lymphoma and offered a wide breadth of information on the diagnosis, treatment and current research. The highlights of the day included an in-depth discussion regarding the differences in high-grade, and low-grade lymphoma by Adam Bryant; Diffuse Large Cell Lymphoma by Emma Verner, and Waldenström Macroglobulinemia and Marginal Zone Lymphoma by Ibrahim Tohidi-Esfahani. A highlight of the session was Kenneth Micklethwaite’s introduction to CAR T-Cell therapy for lymphoma, what happens when a genetically modified CAR T-cell encounters a tumour, and CAR T-Cell toxicity including major syndromes and side effects. Eliza Hawkes continued the session with Mantle Cell Lymphoma, while the last presentation on Aggressive T-Cell Non-Hodgkin Lymphoma was by Robin Gasiorowski. Out of the 68 participants, the feedback from the sessions was overwhelmingly positive, and we thank the speakers for their time and expertise.
- The Wednesday Clinical Trials Operations Meeting was chaired by Chrissie Risteski. During the session, the participants heard about all the new and exciting trials that are taking place at the ALLG. It was interesting to hear from Nicola Venn, a specialist in MRD testing as many new trials have introduced this technology. QOL measure is an important aspect when developing trials, Madeleine King gave a fantastic presentation about the importance of QOL and how it can be incorporated into a protocol at the design concept stage. Thank you also to Angela Bayley for sharing with us how different trials are managed at their site, as well as some insight into the life of a site study coordinator.
- The Lymphoma Clinical Research Workshop on Wednesday focused on the current TCL landscape, non-interventional research activities and new trial concepts. Open to full members, the session was chaired by Eliza Hawkes and Judith Trotman and attended by 39 members. During the session Dejan Radeski spoke about the exciting collaboration ALLG has formed with the Global T-cell lymphoma clinical trials consortium, Australia is now the 4th arm for global research, and this will enable us to participate in many more international clinical trials. This will provide a forum to propose new local investigator-initiated trial proposals to the group.
- Andrew Wei chaired the ALL, AML & MDS Clinical Research Workshop on Wednesday with 29 full members in attendance. The speakers included William Stevenson, Shaun Fleming, Greg Corboy, Ing Soo Tiong, Anoop Enjeti, Carolyn Grove, Andrew Wei, Devendra Hiwase, and Ashish Bajel. Discussion was robust and centred on molecular genetics in AML starting with an overview of genomics accreditation and funding structures, prospective validation of new recursive partitioning model, a national molecular data repository, and harmonisation of INTERCEPT, the maintenance platform and cryopreservation activities. The new trial concepts included MDS proposal-AZA-GILT, TKI priming for relapsed/refractory AML, TIM3 targeting as a new maintenance domain, and EVOLVE AML study collaborations.
- During Wednesday’s session, we had the pleasure of thanking our 2018 ‘Janey Stone Perpetual Award‘ and ‘Anne Lenton Memorial Scholarship‘ award winners Amie Connor (Site Development Project at Sir Charles Gairdner Hospital WA) for being awarded the Janey Stone Perpetual Award; and Lorraine King (Point of Care Use of Mobile Device Project at St George Hospital NSW) for being awarded the Anne Lenton Memorial Scholarship for their inspiring work performed as a result of the award opportunities. We look forward to announcing the 2019 award recipients and their exciting projects at the next Scientific Meeting in November.
The last two days of the meeting provided an opportunity for clinicians to discuss new concepts of clinical trials, collaborate, share ideas, engage in robust scientific scrutiny of local and international studies, present updates of current, open to accrual studies, and present published data.
- The Network Breakfast event offered the opportunity for engagement between members, staff, partners and sponsors. We welcomed more than 50 people to the event which, offered attendees the opportunity to discuss different ways we can collaborate on projects together.
- Eliza Hawkes chaired the first session on High Grade NHL and Hodgkins Lymphoma. A definite highlight was the discussion led by guest speaker Andrei Shustov (Seattle Cancer Care Alliance, United States), who spoke about the latest insights in T-cell Lymphomas – new knowledge and treatment approaches with clinical outcomes in PTCL and recent advances in CTCL therapy. The remainder of the session focused on new trial concepts for NHL32, NHL33, RADAR, CLARIFY and ongoing collaborative studies in T-Cell Lymphoma, with studies in progress including HD10, NHL29 with a much anticipated discussion centered on Maher Gandhi’s NHL31 trial that offers new treatments for patients with specific T cells and immunosuppression related EBV-positive brain and/or systematic B cell Lymphoma, that are relapsed/refractory or unsuitable for standard first-line treatments. The trial is set to be open for 5.5 years and will be the only trial of its kind in Australia offering this innovative new treatment for patients with brain lymphoma.
- The Low-Grade Non-Hodgkin Lymphoma/Chronic Lymphocytic Leukaemia session was chaired by Judith Trotman and Stephen Mulligan and featured presentations by Ian Bilmon, Anna Johnston, Judith Trotman and Stephen Mulligan. The session started with an update on what’s new in LG NHL & CLL signalling out Indolent Non-Hodgkin Lymphoma, Cutaneous T cell lymphoma and Chronic Lymphocytic Leukaemia; plus what’s new in indolent NHL and CLL with new drugs such as Alternate BTKi (acalabrutinib, zanubrutinib, etc.), Alternate PI3k inhibitors to idelalisib, EZH2 inhibitors, and Checkpoint inhibitors (antiCD47). Also presented were updates on proposed study LS21, and studies in progress NHL26 (REPLY), NHL30 (PETReA), CLL5, CLL6 and CLL7. Interesting to note was the update on NHL30 (PETReA), outlining progress to date with funding being secured from Snowdome, Leukaemia Foundation and Rare Cancers Rare Diseases Unmet Need (RCRDUN) Medical Research Futures Fund grant. Two sites have been activated in Australia with the first patient enrolled at Concord. This is an important International trial with the UK, Dutch and German groups all currently recruiting.
- Peter Mollee (SAC Chair) offered an informative session on the ALLG Scientific and Research Directions which included an update on the SAC introducing the current SAC members, what their function is in relation to scientific research and how to become involved in the SAC. He outline five specific scientific objectives including to lead research into blood cancer via multisite, multistate, investigator-initiated trials; enable our patients to access new drugs; support research capability with data and samples (trials and NBCR); improving care for rural, regional and remote communities; and lastly, develop partnerships with other who share our vision.
- Cancer Australia Quality of Life Technical Service (CA QOL) was presented by Madeleine King and featured a discussion around what CA QOL could do for ALLG Members. This included resources to aid creation of high-quality PRO evidence, specific workshops and webinars, education and training opportunities, technical services, offer guidelines for inclusion of patient-reported outcomes in clinical trial protocols.
- Thursday’s final session was the Acute Leukaemia & Myelodysplasia chaired by Andrew Wei and Andrew Grigg. The session was broken up into six sub-sessions and featured updates on the NBCR AML/ALL linked studies, current and future priorities, proposed studies, studies in progress and completed studies. Some of the highlights included Andrew Wei’s discussion surrounding molecular risk stratification strategy, off-trial standard chemotherapy backbone and NPM1 management. Ing Soo Tiong presented the findings and publications for the NBCR: AML first 1,000 patients with future goals included issuing the first registry publication. Also, presented, by Paula Marlton, was the introduction of AMLM23 (HOVON) study, and an update on the current status of Daunorubicin as it is not PBS listed for AML. Also presented were updates on current studies including AMLM22, ALL08, ALL06, ALL09, APML5, AMLM21, and AMLM16. Matthew Greenwood presented the interim results for ALL06. These findings have been submitted and accepted to EHA and we wish Mathew every success in presenting the findings. The session finished with an overview of completed studies outlining the findings for AMLM15, AMLM17, and MDS4.
- At the End of Day Networking Event we welcomed 20 new members to the ALLG. David Kipp presented a wonderful speech about the ALLG and what new members can expect and look forward to as part of the ALLG.
- The Laboratory Scientific Committee kicked off Friday’s sessions and was chaired by Jake Shortt. The presentations included ‘what’s new’ in Laboratory Science, with updates on LS17 REGALLIA, Molecular testing in MPN’s, and improved measurement of MRD by PCR in ALL and CLL. Gohar Maqbool (for Dipti Talaulikar) presented an overview of the LS22: Identifying resistant clones in cellular compartments post chemoimmunotherapy in Waldenström Macroglobulinaemia (WM). This pilot study aims to investigate the impact of chemoimmunotherapy on bone marrow compartments (i.e. lymphoplasmacytic and plasma cell compartments) in eradicating malignant clones in WM as they may be differentially affected. We look forward to learning the outcomes of this pilot study.
- During the Supportive Care session, we learnt about ‘what’s new’ and was given an overview of the progress of the REDDS-2 study, a feasibility trial of weekly-interval red cell transfusion in MDS by Allison Mo. Further to this, Zoe McQuilten covered non-ALLG studies RATIONAL and RATIONALISE, while Robert Weinkove gave a thought-provoking presentation on the PaSCC RAPID Pharmacovigilance Study Tranexamic acid for bleeding in Palliative Care.
- It was a pleasure and honour to have Professor Anne Kelso AO FAA (CEO of the National Health and Medical Research Council) address our membership. Her keynote address featured an outline of the future directions in Australian health and medical research including factors that may affect future directions, current health challenges, future health challenges and the changing burden of disease. Professor Kelso’s slide on the NHMRC strategies and priorities sparked quite a few questions form the floor and prompted insights into future funding goals for the NHMRC.
- A highlight of the Bone Marrow Transplant session chaired by David Ritchie, was an update on BM12 study using using Cyclophosphamide After Sibling-donor allogeneic stem-cell Transplantation (CAST) in patients with acute leukaemia and myelodysplasia. The presentation by David Ritchie (for David Curtis) featured strategies to enhance the GVL Effect, novel non-chemo conditioning and allogenic transplants being a platform for innovation. Cell therapy and BMT updates was presented by David Ritchie (for David Bishop & Siok Tey) and introduced the CARTELL trial which is the first-in-human phase I trial of piggyBac CAR19 T cells, with an update on cell therapy approaches to tackle GVHD.
- Chaired by David Yeung and David Ross, the Chronic Myeloid Leukaemia/Myeloproliferative Neoplasms session focused on ‘what’s new’ in CML and MPN including an update on the data outcomes from study MPN01. Proposed studies SATURN, and new concept studies TIDELL-III, and CML treatment free remission registry were discussed along with updates on CML12, CML9 and CML11. Peter Browett introduced the membership to the Auckland Kinase Inhibition with Sprycel Start-up study hypothesising ‘that imatinib is safe and effective in maintaining a major molecular remission (MR3.0) in patients with chronic myeloid leukaemia who are in MMR / MR3.0 at 12 months following initial induction therapy with dasatinib‘.
- The sessions ended with Myeloma, chaired by Peter Mollee, and featured updates by Joy Ho and Anna Kalff (for Andrew Spencer) on MM16, MM17, MM19, MM20 and MM21. New concept MM22 (FRAIL-M), a frailty-stratified, randomised controlled Bayesian adaptive trial of bortezomib vs lenalidomide in transplant-ineligible myeloma, was presented by Zoe McQuilten. We learnt about a number of outcomes of the study particularly the identification of the optimal doses of Revlimid and Velcade within each frailty category of TI-NDMM.
- Marketing and Communications continued with the distribution of the welcome card which has been well received by members, and the development of the ALLG 2018 Research Report outlining the ALLG’s scientific achievements for the past year. Another initiative was the inclusion of a dedicated Fundraising area complete coffee cup sleeves that were given out with a gold coin donation. Thank you to all those that donated to support the ALLG. We were also fortunate enough to secure a photo booth for professional headshots and dedicated areas for Meet the Chief and ALLG Leaders. We are excited to grow and develop both marketing and fundraising initiatives in the coming meetings.
For those who were unable to attend or would like to receive the presentation slides, the sessions are now available in the members’ area on the ALLG website under ‘Meetings & Events’ page.
Also, if you have any direct questions to current members, you can find their contact details in the members’ area on the ALLG website under ‘Current Members’ page.
The next Scientific Meeting will be held in 12-15 November 2019 at Hilton Adelaide.
We hope to see you all there.