#amyloidosisJC Transcript

Healthcare social media transcript of the #amyloidosisJC hashtag.
().
See #amyloidosisJC Influencers/Analytics.

Sign up for FREE Symplur Account and Get
  • Create Transcripts with Custom Dates
  • Get Custom Influencer Lists
  • 3x Hashtag Search Results
Sign Up Now
ProfileTweet
Suresh Balasubramanian @malignantheme
Please join us for the last journal club session of "Untangling Amyloidosis 2019" before the ASH. 👉 "MRD in amyloidosis" tonight @9PM. https://t.co/8q0fEeTM6y. ✊🏼Moderators: @holly_dlduwls, me & @NB191186. 🙏🏽#amyloidosisjc @Amyloid_Planet
Dr. Jeffrey Zonder @Amyloid_Planet
RT @malignantheme: Please join us for the last journal club session of "Untangling Amyloidosis 2019" before the ASH. 👉 "MRD in amyloidosi…
Dr. Jeffrey Zonder @Amyloid_Planet
Join us for #amyloidosisjc this evening at 9 pm EST. We’ll be discussing if/when/how to use MRD testing for AL #amyloidosis. For a brief synopsis of the paper: https://t.co/pMFVa5dPaC @malignantheme @NB191186 @holly_dlduwls @Amyloidosisfdn @AmyloidosisSupp @Amyloidosis_ARC
Naresh Bumma @NB191186
RT @Amyloid_Planet: Join us for #amyloidosisjc this evening at 9 pm EST. We’ll be discussing if/when/how to use MRD testing for AL #amyloid
Raj Chakraborty @rajshekharucms
RT @Amyloid_Planet: Join us for #amyloidosisjc this evening at 9 pm EST. We’ll be discussing if/when/how to use MRD testing for AL #amyloid
Holly Lee @hollyleeYJ
RT @Amyloid_Planet: Join us for #amyloidosisjc this evening at 9 pm EST. We’ll be discussing if/when/how to use MRD testing for AL #amyloid
Suresh Balasubramanian @malignantheme
1 more hour to go for the last journal club session of "Untangling Amyloidosis 2019" before the ASH. 👉 "MRD in amyloidosis" @9PM. https://t.co/8q0fEfbmY6. ✊🏼Moderators: @holly_dlduwls, me & @NB191186. 🙏🏽#amyloidosisjc @Amyloid_Planet
Naresh Bumma @NB191186
RT @malignantheme: 1 more hour to go for the last journal club session of "Untangling Amyloidosis 2019" before the ASH. 👉 "MRD in amyloid…
Holly Lee @hollyleeYJ
Just 30 min until today's #AmyloidosisJC on "MRD in amyloidosis" @9pm - Join us! https://t.co/PIKsLAnvRt. ✊🏼Moderators: @malignantheme & @NB191186 & myself. 🙏🏽#Amyloidosisjc @Amyloid_Planet
Suresh Balasubramanian @malignantheme
Good evening everyone!! Welcome aboard!! We will be discussing the role of "MRD in AL amyloidosis". For a detailed synopsis 👉🏽https://t.co/65eOTf0zYe #amyloidosisjc @holly_dlduwls @NB191186 https://t.co/oVQjQffMUn
Suresh Balasubramanian @malignantheme
Please introduce yourself and relevant COI pertinent to the discussion tonight. Also please use the hashtag #amyloidosisJC for all your tweets here 🙏🏼
Naresh Bumma @NB191186
Welcome to this edition of #amyloidosisjc - I will be comoderating with Dr Balasubramanian @malignantheme and Dr Lee @holly_dlduwls #amyloidosisjc
Andrew Kin @Karmanos_DrAKin
Andrew Kin, Amyloid & Myeloma faculty at Karmanos with @Amyloid_Planet . No relevant COI. #amyloidosisjc
Holly Lee @hollyleeYJ
Welcome to today's #AmyloidosisJC, a discussion on the role of MRD in AL amyloidosis based on this article👉https://t.co/PIKsLAnvRt. My name is Holly Lee, hematology fellow from University of Calgary, Canada. No COI
Suresh Balasubramanian @malignantheme
I am Suresh Kumar Balasubramanian from Wayne State University/ Karmanos Cancer Institute. No COI to declare. #amyloidosisJC
Naresh Bumma @NB191186
Naresh Bumma- multiple myeloma and amyloidosis doc @OSUCCC_James @OSUWexMed #amyloidosisjc
Vaishali Sanchorawala @vsanchorawala
Vaishali Sanchorawala from @BU_Amyloidosis No COI #amyloidosisjc
Naresh Bumma @NB191186
COI- Speaker bureau for Amgen
silva pregja @silvapregja
@malignantheme @holly_dlduwls @NB191186 Good evening, Silva Pregja, Karmanos Cancer Institute, looking forward to tonight’s discussion #AmyloidosisJC
Vijendra Singh @vijsinghmd
Vijendra Singh @karmanoscancer Hematology fellow, No COI #amyloidosisjc
Dr. Jeffrey Zonder @Amyloid_Planet
Jeffrey Zonder, Multidisciplinary Team Leader for Multiple Myeloma and #amyloidosis @karmanoscancer in Detroit MI. my COI are listed @ https://t.co/THV0rpamMW hi everybody #amyloidosisjc
Holly Lee @hollyleeYJ
#amyloidosisjc. Welcome to today's journal club, a discussion on the role of MRD in AL amyloidosis based on this article👉https://t.co/PIKsLAnvRt. My name is Holly Lee, hematology fellow from University of Calgary, Canada. No COI
AStaron (Amyloid Andrew) @a_staron
Andrew Staron, hematology fellow from @BUHemeOncFellow and @BU_Amyloidosis No COI. Keeping warm by my netflix fireplace and looking forward to the discussion tonight. #amyloidosisjc
Dr. Jeffrey Zonder @Amyloid_Planet
RT @holly_dlduwls: #amyloidosisjc. Welcome to today's journal club, a discussion on the role of MRD in AL amyloidosis based on this article…
Dr. Jeffrey Zonder @Amyloid_Planet
RT @NB191186: Naresh Bumma- multiple myeloma and amyloidosis doc @OSUCCC_James @OSUWexMed #amyloidosisjc
omar @omaralbanyan
Omar Albanyan. Heme/onc fellow @karmanoscancer #amyloidosisjc
Dr. Jeffrey Zonder @Amyloid_Planet
RT @malignantheme: I am Suresh Kumar Balasubramanian from Wayne State University/ Karmanos Cancer Institute. No COI to declare. #amyloidosi
Suresh Balasubramanian @malignantheme
Here is a visual abstract of tonight’s JC paper for a quick reference. ©️ ✋🏼 @holly_dlduwls #amyloidosisjc https://t.co/VlCJcWPOyQ
Naresh Bumma @NB191186
MRD has been an area of interest and debate in both MM and AL amyloidosis- re both methods of determining MRD and clinical application. #amyloidosisjc
Victor H Jimenez-Zepeda @vhugo8762
victor Jimenez Zepeda from TBCC, No COI #amyloidosisjc
Dr. Jeffrey Zonder @Amyloid_Planet
Nice summary of tonight's #amyloidosisjc article.
Susan Bal @SusanBal9
#amyloidosisjc Hello Susan Bal from UAB.
Ahmad Masri @MasriAhmadMD
RT @malignantheme: Here is a visual abstract of tonight’s JC paper for a quick reference. ©️ ✋🏼 @holly_dlduwls #amyloidosisjc https://t.co/…
AStaron (Amyloid Andrew) @a_staron
@NB191186 What are the 3 different modalities for assessing for MRD? #amyloidosisjc
Ahmad Masri @MasriAhmadMD
Ahmad Masri Cardiologist No COI #amyloidosisjc
Naresh Bumma @NB191186
Paper in blood in 2017 showed MRD was predictive of disease progression https://t.co/IQ50JWlk7O #amyloidosisjc
Naresh Bumma @NB191186
RT @malignantheme: Here is a visual abstract of tonight’s JC paper for a quick reference. ©️ ✋🏼 @holly_dlduwls #amyloidosisjc https://t.co/…
Suresh Balasubramanian @malignantheme
There is a bit of lag in the tweets. Please refresh your screen now and then #amyloidosisjc
Holly Lee @hollyleeYJ
Here is the link to the 2019 paper👉Survival impact of achieving minimal residual negativity by multi-parametric flow cytometry in AL amyloidosis by Muchtar et al. https://t.co/xoeNp6S58X. #amyloidosisjc
Dr. Jeffrey Zonder @Amyloid_Planet
@holly_dlduwls (or others) can u comment on relative sensitivity of different methods for assessing MRD status? #amyloidosisjc
Holly Lee @hollyleeYJ
Design: retrospective observation study, Objective: assess the impact of undetectable clonal plasma cells at end of first line therapy (EOT) on overall survival of AL amyloidosis patients. #amyloidosisjc
Holly Lee @hollyleeYJ
Inclusion: among the original 173 patients with newly diagnosed AL amyloidosis patients (from the previous 2017 study), 82 patients who had MFC based MRD testing at EOT were included in the current study (2019). #amyloidosisjc
Suresh Balasubramanian @malignantheme
@Amyloid_Planet @holly_dlduwls @holly_dlduwls will be elaborating that in the next tweet #amyloidosisjc
Holly Lee @hollyleeYJ
Link to the 2017 paper👉The prognostic value of multiparametric flow cytometry in AL amyloidosis at diagnosis and at the end of first-line treatment. Muchtar E et al. https://t.co/cqYraWYRlu. #amyloidosisjc
Holly Lee @hollyleeYJ
MRD assessment by MFC: single 7-color tube MFC analysis (sensitivity 1x10^-4 to 2x10^-5) with median gated events 489,922. #amyloidosisjc
Ibrahim Azar, MD @ibrahimazaronc
Ibrahim Azar, @karmanoscancer Hem/Onc fellow #amyloidosisjc
AStaron (Amyloid Andrew) @a_staron
@Amyloid_Planet @holly_dlduwls ASO RQ-PCR = 10^-5; NGS = 10^-6; dPCR = 10^-5; MFC = 10^-4 or 10^-5; NGF = 10^-6. #amyloidosisjc
Vaishali Sanchorawala @vsanchorawala
RT @a_staron: @Amyloid_Planet @holly_dlduwls ASO RQ-PCR = 10^-5; NGS = 10^-6; dPCR = 10^-5; MFC = 10^-4 or 10^-5; NGF = 10^-6. #amyloidosis
AStaron (Amyloid Andrew) @a_staron
@Amyloid_Planet @holly_dlduwls These are different modalities tested in MM. #amyloidosisjc
Suresh Balasubramanian @malignantheme
RT @a_staron: @Amyloid_Planet @holly_dlduwls ASO RQ-PCR = 10^-5; NGS = 10^-6; dPCR = 10^-5; MFC = 10^-4 or 10^-5; NGF = 10^-6. #amyloidosis
Dr. Jeffrey Zonder @Amyloid_Planet
RT @holly_dlduwls: Link to the 2017 paper👉The prognostic value of multiparametric flow cytometry in AL amyloidosis at diagnosis and at the…
omar @omaralbanyan
RT @a_staron: @Amyloid_Planet @holly_dlduwls ASO RQ-PCR = 10^-5; NGS = 10^-6; dPCR = 10^-5; MFC = 10^-4 or 10^-5; NGF = 10^-6. #amyloidosis
Ahmad Masri @MasriAhmadMD
RT @a_staron: @Amyloid_Planet @holly_dlduwls ASO RQ-PCR = 10^-5; NGS = 10^-6; dPCR = 10^-5; MFC = 10^-4 or 10^-5; NGF = 10^-6. #amyloidosis
Pedro Graziano Sanchez @wikimagen
RT @malignantheme: Here is a visual abstract of tonight’s JC paper for a quick reference. ©️ ✋🏼 @holly_dlduwls #amyloidosisjc https://t.co/…
Holly Lee @hollyleeYJ
Moving on to Results 👉 Result 1. Baseline patient characteristics (n=82):❗84% of patients had ASCT as 1st line therapy – selection bias❓primarily transplant eligible patients, generally fit and do not have extensive organ involvement. #amyloidosisjc https://t.co/d0S1jbjpnJ
Victor H Jimenez-Zepeda @vhugo8762
Vaishali is presenting at ASH this year their experience withNGS/clonoseq.https://t.co/LnQNhRHMaa NGS was successful at identifying the clone in 27 out of 37, thus, the method matters as the clone in AL amyloid is smaller. Also proper timing for assessment is key. #amyloidosisjc
Suresh Balasubramanian @malignantheme
@a_staron @Amyloid_Planet @holly_dlduwls That was helpful! Definitely this will be pinned from tonight's JC #amyloidosisjc
Dr. Jeffrey Zonder @Amyloid_Planet
and no consensus re: optimal method in either #myeloma ar #amyloidosis #amyloidosisjc
Vaishali Sanchorawala @vsanchorawala
@vhugo8762 We will present data in 10 patients post treatment with NGS. #amyloidosisjc
Holly Lee @hollyleeYJ
Result 2: 29% (24) had MRD➖ and 71% (58) had MRD➕ at EOT. 19.5% (16) CR, 46.3% (38) VGPR, and 34.1% (28) <VGPR. Median time from diagnosis to EOT MFC was 6 months, longer for non-ASCT vs ASCT patients (median 11 vs 6 months, P = 0.002). #amyloidosisjc https://t.co/QsENHcSug6
Suresh Balasubramanian @malignantheme
@Amyloid_Planet @a_staron NGF seems to be more reproducible and deep? It will be great if you can highlight the panel of genes that are tested in NGS #amyloidosisjc
Holly Lee @hollyleeYJ
Result 3. Patient outcome (median 4.6 year follow up): MRD➖ was associated with improved PFS compared to MRD➕ (3-year PFS 88% vs. 28%, p<0.001). No difference in OS (3-year OS 96% vs. 84%, p=0.17). #amyloidosisjc https://t.co/vrHrh9SMrF
Vijendra Singh @vijsinghmd
For NGS MRD testing here, do we need pt sample prior to treatment as we need them in ALL or other diseases @Amyloid_Planet #amyloidosisjc
Naresh Bumma @NB191186
84% had ASCT as first line... Would the group say this is usual in their practice? #amyloidosisjc
Vaishali Sanchorawala @vsanchorawala
@DrSinghvij @Amyloid_Planet Yes, absolutely. #amyloidosisjc
Suresh Balasubramanian @malignantheme
@DrSinghvij @Amyloid_Planet That's the great question! atleast in myeloid neoplasms, yes! So as well here i believe. Is there a standard panel atleast in clinical trials? 🤔 #amyloidosisjc
AStaron (Amyloid Andrew) @a_staron
@Amyloid_Planet IMWG put out consensus criteria for MRD in MM (https://t.co/air18M03Pf) which for flow includes processing technique guidelines and minimum sensitivity 10^-5. #amyloidosisjc
Vaishali Sanchorawala @vsanchorawala
@BU_Amyloidosis #amyloidosisjc
Naresh Bumma @NB191186
The pfs curves are spread apart ( can drive a truck through them). but there is no difference in OS.. is that mostly driven by salvage therapy? #amyloidosisjc
Vijendra Singh @vijsinghmd
@malignantheme @Amyloid_Planet common sense says the ones which are mutated and not germ line should be used for MRD testing. Waiting from experts #amyloidosisjc
Holly Lee @hollyleeYJ
Result 4. Subgroup analysis: Among patients with VGPR or CR, MRD➖ was associated with better PFS compared MRD➕ (3-year PFS 88% vs. 46%, p=0.003), particularly among patients who achieved CR (3-year PFS 100% vs. 33%, p=0.001). #amyloidosisjc https://t.co/3Kd3vozojr
Holly Lee @hollyleeYJ
In contrast, difference in PFS advantage in VGPR MRD➖patients compared to VGPR MRD➕patients was not statistically significant (p=0.14). #amyloidosisjc
AStaron (Amyloid Andrew) @a_staron
@malignantheme @Amyloid_Planet I believe typically IGH-VDJH, IGH-DJH, or IGK. #amyloidosisjc
Dr. Jeffrey Zonder @Amyloid_Planet
RT @holly_dlduwls: Result 3. Patient outcome (median 4.6 year follow up): MRD➖ was associated with improved PFS compared to MRD➕ (3-year PF…
Victor H Jimenez-Zepeda @vhugo8762
The rate of CR seems to be lower of that expected for this population of patients mainly treated with autoSCT #amyloidosisjc
AStaron (Amyloid Andrew) @a_staron
@NB191186 I believe so, good outcomes with next lines of therapy. #amyloidosisjc
Vijendra Singh @vijsinghmd
A Layman question: What is so unique about these plasma cell disorders that even after MRD negativity we do not have cure ? @malignantheme #amyloidosisjc
Holly Lee @hollyleeYJ
Result 5: MRD➖ compared with MRD➕ among deep responders was associated with lower level of iFLC (median 1.1 vs. 1.7mg/dL, p=0.02) and higher frequency of renal response (100% vs. 68%; p=0.005). #amyloidosisjc
Victor H Jimenez-Zepeda @vhugo8762
we are now debating the use of CR or dFLC<10 as predictors and/or therapy goals, correlation of the above and MRD status might also be interested to see #amyloidosisjc
Naresh Bumma @NB191186
@vhugo8762 yes it is a little lower #amyloidosisjc
Holly Lee @hollyleeYJ
@vhugo8762 Also, interesting report by Muchtar et al. 2019, looked at the depth of response by nadir iFLC <2mg/d #amyloidosisjc. https://t.co/sHvPxX4S3k
AStaron (Amyloid Andrew) @a_staron
@DrSinghvij @malignantheme Plasma cells can resist treatments and can be patchy, even our best techniques for MRD testing have their limitations. #amyloidosisjc
Vijendra Singh @vijsinghmd
@SusanBal9 @malignantheme But that should be the case in other diseases as well. #amyloidosisjc @SusanBal9
Naresh Bumma @NB191186
@vhugo8762 hopefully future studies, similar to MM, will incorporate MRD.. esp questions about post-ASCT maintenance #amyloidosisjc
Holly Lee @hollyleeYJ
When assessing independent organ response, this difference was not found in cardiac response. 20 patients available for cardiac response assessment, all patients with MRD➖ (n = 8) had cardiac response (100%), compared to 10/12 (83%) in MRD➕ patients (p=0 .13). #amyloidosisjc
Suresh Balasubramanian @malignantheme
@DrSinghvij
Suresh Balasubramanian @malignantheme
@DrSinghvij #amyloidosisjc
Naresh Bumma @NB191186
@DrSinghvij @SusanBal9 @malignantheme It also has to do with the polyclonality and heterogeneity of plasma cell disorders + high levels of mutations..#amyloidosisjc
Holly Lee @hollyleeYJ
@a_staron @DrSinghvij @malignantheme Also, the MRD neg by one method might not be MRD neg by another: with next gen flow for MRD assessment, Kastritis et al. found that 5 out of 12 MRD➕ cases had very low residual tumor burden (<3x10^-5), which would have been undetected with lower sensitivity assays.#amyloidosisjc
Vaishali Sanchorawala @vsanchorawala
@vhugo8762 Me too! #amyloidosisJC
Dr. Jeffrey Zonder @Amyloid_Planet
@NB191186 this is obviously not a typical cross-section of patients - perhaps a third of AL #amyloidosis patients are ASCT-eligible. #amyloidosisjc
Holly Lee @hollyleeYJ
@a_staron @DrSinghvij @malignantheme With next gen flow, reported median sensitivity level was 2.3 x 10^−6 (range: 2 × 10^−6–3.1 × 10^-6). https://t.co/w2pgTPuXwr. #amyloidosisjc
AStaron (Amyloid Andrew) @a_staron
@NB191186 @vhugo8762 We still need to better understand the clinical relevance of MRD for AL amyloidosis in my opinion. #amyloidosisjc
Suresh Balasubramanian @malignantheme
Some concluding points from this JC paper! 1. There may be value in bone marrow biopsy/ aspirate at end of therapy in AL amyloidosis patients who achieve VGPR/CR. MRD➕ is associated with 👎PFS in this group of patients. #amyloidosisjc @Amyloid_Planet @NB191186 @vsanchorawala
Naresh Bumma @NB191186
@a_staron @vhugo8762 Agree- we need more data before using it to make clinical decisions...#amyloidosisjc
Suresh Balasubramanian @malignantheme
Conclusion #2: MRD negativity is a robust surrogate endpoint for the design of clinical trials, and for optimizing individual patients’ treatment. #amyloidosisjc
Vaishali Sanchorawala @vsanchorawala
@a_staron @NB191186 @vhugo8762 I agree! See results of @a_staron from @BU_Amyloidosis at ISA 2020! #amyloidosisJC
Suresh Balasubramanian @malignantheme
Conclusion #3: The sensitivity of the current standard assay for sFLC detection does not discern between MRD➕ vs MRD➖ among VGPR/CR patients. #amyloidosisjc
Dr. Jeffrey Zonder @Amyloid_Planet
@NB191186 presumably - suspect dara. #amyloidosisjc
Naresh Bumma @NB191186
Just to poll the group- how many of incorporating MRD testing in clinical practice? #amyloidosisjc
Dr. Jeffrey Zonder @Amyloid_Planet
@holly_dlduwls struggled to understand this. thoughts? #amyloidosisjc
AStaron (Amyloid Andrew) @a_staron
@holly_dlduwls @DrSinghvij @malignantheme The study we are discussing used MFC at minimum sensitivity 10^-4, which may be not sensitive enough in AL amyloidosis. According to detection levels reported by Kastritis et al. (https://t.co/sQI3rMQYGV) up to 42% of patients were MRD-positive at 10^-5 and 10^-6. #amyloidosisjc
Dr. Jeffrey Zonder @Amyloid_Planet
@holly_dlduwls no statistical power with these numbers. But also, all these pts had excellent hematologic responses, whether they were MRD(-) or not. #amyloidosisjc
Vaishali Sanchorawala @vsanchorawala
@NB191186 Incorporating into clinical practice for AL amyloidosis only when in Hem CR, however, not changing or directing therapy based on results. #amyloidosisjc
AStaron (Amyloid Andrew) @a_staron
RT @vsanchorawala: @NB191186 Incorporating into clinical practice for AL amyloidosis only when in Hem CR, however, not changing or directin…
Naresh Bumma @NB191186
if pt is post-ASCT and in heme CR but MRD +, would you change anything? monitor more closely? #amyloidosisjc
Vaishali Sanchorawala @vsanchorawala
@a_staron @holly_dlduwls @DrSinghvij @malignantheme minimum sensitvity of 10^-5 needed per IMWG consensus report in myeloma. #amyloidosisJC
Suresh Balasubramanian @malignantheme
@NB191186 on the same note 🤔❓Currently no studies inform us how best to manage/ monitor patients in deep hematological response based on their MRD status. #amyloidosisjc
Holly Lee @hollyleeYJ
@Amyloid_Planet @NB191186 Yes in their original 2017 study of total 173 patients, 38% underwent ASCT #amyloidosisjc. https://t.co/cqYraWYRlu.
AStaron (Amyloid Andrew) @a_staron
@Amyloid_Planet @holly_dlduwls MRD-negative cohort with VGPR may have had a residual clonal PC population that wasn't detected by this particular technique at this sensitivity level. #amyloidosisjc
Vaishali Sanchorawala @vsanchorawala
@NB191186 Not changing anything at this time if deep hemCR with MRD positive. #amyloidosisjc
Suresh Balasubramanian @malignantheme
To the group on closing remarks🤔❓How does MRD status guide frequency of follow up of patients after therapy? If a patient initially achieves MRD-CR but then progresses to MRD➕ CR on repeat follow up, does this indicate progression/ requirement for treatment? #amyloidosisjc
Naresh Bumma @NB191186
RT @vsanchorawala: @NB191186 Not changing anything at this time if deep hemCR with MRD positive. #amyloidosisjc
Dr. Jeffrey Zonder @Amyloid_Planet
@NB191186 @DrSinghvij @SusanBal9 @malignantheme clarify? #amyloidosisjc
Naresh Bumma @NB191186
I would agree... This could be underlying MGUS clone..#amyloidosisjc
Victor H Jimenez-Zepeda @vhugo8762
MRD and mass spect are great tools to assess for AL amyloid and I agree there is lots to learn about them. Particularly, if there is potential to guide therapy or predict organ responses and survival outcomes #amyloidosisjc
AStaron (Amyloid Andrew) @a_staron
@malignantheme Need to better understand how MRD status correlates with clinically important parameters/morbidity/organ response and OS in my opinion. Would not treat based on MRD-positivity alone otherwise. #amyloidosisJC
Dr. Jeffrey Zonder @Amyloid_Planet
@malignantheme @NB191186 @vsanchorawala what we do not know is whether there is benefit to extension and/or switching therapy in pts who remain MRD(+) at the end of planned induction therapy for AL #amyloidosis in order to try and attain MRD (-) status. #amyloidosisjc thoughts anyone?
Naresh Bumma @NB191186
So, heme CR is still the goal as of now for AL amyloidosis, until we have more data from clinical trials about what to do if pts are MRD+ #amyloidosisjc
Suresh Balasubramanian @malignantheme
@Amyloid_Planet @NB191186 @DrSinghvij @SusanBal9 My belief is that though MRD negative by currently available modalities, they are not deep enough for a cure? #amyloidosisjc @Amyloid_Planet @NB191186 @holly_dlduwls @DrSinghvij
Vaishali Sanchorawala @vsanchorawala
@BU_Amyloidosis
Dr. Jeffrey Zonder @Amyloid_Planet
@vsanchorawala @a_staron @NB191186 @vhugo8762 @BU_Amyloidosis any hints? #amyloidosisjc
Naresh Bumma @NB191186
maybe we could extrapolate from some of the MM trials...#amyloidosisjc
Dr. Jeffrey Zonder @Amyloid_Planet
@vsanchorawala @NB191186 if not making any clinical decisions based on it, how are you incorporating it into clinical practice? #amyloidosisjc
Suresh Balasubramanian @malignantheme
@Amyloid_Planet @NB191186 @vsanchorawala Definitely a good stimulus for considering MRD based clinical trials for extending treatment in AL amyloidosis as in MRD guided ALL clinical trials using blinatumumab #amyloidosisjc @Amyloid_Planet
Naresh Bumma @NB191186
@Amyloid_Planet @vsanchorawala that's the challenge.. would be a very interesting trial for post-induction pts, treatment based on MRD status #amyloidosisjc
Dr. Jeffrey Zonder @Amyloid_Planet
@malignantheme it does not affect my usual frequency of clinical monitoring, nor would i change anything for shfit from MRD(-) to MRD(+) if usual clinical hematologic parameters remain unchanged #amyloidosisjc
Vijendra Singh @vijsinghmd
@malignantheme @Amyloid_Planet @NB191186 @SusanBal9 @holly_dlduwls 2/2 MGUS course after MRD negativity. #amyloidosisjc @malignantheme
Vaishali Sanchorawala @vsanchorawala
Great discussion #amyloidosisjc. Thank you.
Suresh Balasubramanian @malignantheme
@Amyloid_Planet Interesting report by Muchtar et al. 2019, looked at not only the depth of response (in this case nadir iFLC <2mg/dL) but also the impact of time to nadir iFLC on patient outcomes. #AmyloidosisJC @Amyloid_Planet
Dr. Jeffrey Zonder @Amyloid_Planet
@malignantheme @NB191186 @vsanchorawala it would be interesting to see if maintenance improves PFS in MRD(+) pts, but need data to justify outside of a trial #amyloidosisjc
Suresh Balasubramanian @malignantheme
@Amyloid_Planet Patients whose nadir iFLC occurred after 12 months from EOT had significantly longer PFS and OS compared to patients who reached nadir before 12 months. #amyloidosisjc (https://t.co/FKZ6ou7vwK)
Naresh Bumma @NB191186
Great discussion! thank you all for your insights. Great job by @malignantheme and @holly_dlduwls #amyloidosisjc
Suresh Balasubramanian @malignantheme
@Amyloid_Planet is there a role for MRD assessment not only at EOT but also, further out from EOT to inform patient outcomes? #amyloidosisjc @Amyloid_Planet
Holly Lee @hollyleeYJ
@a_staron @NB191186 @vhugo8762 Yes, and also standardize the modality/sensitivity for MRD studies #amyloidosisjc
Victor H Jimenez-Zepeda @vhugo8762
Great discussion! Have a great night everyone! #amyloidosisjc @holly_diduwis
AStaron (Amyloid Andrew) @a_staron
@Amyloid_Planet @vsanchorawala @NB191186 @vhugo8762 @BU_Amyloidosis Not all light chains are equally pathologic in my opinion; MRD may matter for a subset of patients. Data can have different interpretations. #amyloidosisjc
Suresh Balasubramanian @malignantheme
@a_staron @Amyloid_Planet @vsanchorawala @NB191186 @vhugo8762 @BU_Amyloidosis can't agree more! #amyloidosisjc
Dr. Jeffrey Zonder @Amyloid_Planet
RT @NB191186: Great discussion! thank you all for your insights. Great job by @malignantheme and @holly_dlduwls #amyloidosisjc
Suresh Balasubramanian @malignantheme
Thank you all for being part of this excellent thought provoking discussion on MRD in amyloidosis! Hope to see you all at ASH 2019 "Untangling Amyloidosis" Symposium on Dec 6 @ Orlando Convention Center @7AM. #amyloidosisjc Thank you @holly_dlduwls @NB191186 @Amyloid_Planet
Vijendra Singh @vijsinghmd
RT @malignantheme: Thank you all for being part of this excellent thought provoking discussion on MRD in amyloidosis! Hope to see you all a…
Holly Lee @hollyleeYJ
Thank you for the discussion everyone! #amyloidosisjc Thank you - @malignantheme @NB191186 @Amyloid_Planet
Dr. Jeffrey Zonder @Amyloid_Planet
thanks all for interesting #amyloidosisjc discussion this evening. will post link to transcript soon @ https://t.co/myWHYQYT8p
#amyloidosisJC content from Twitter.