Hodgkin Lymphoma – Page 3 – New Developments in Lymphoma

A Reflection on National Cancer Survivor Day: “I’m Cancer-Free, But I Don’t Like the Word ‘Survivor’”

By Katie DeMasi

Today, June 4th, is National Cancer Survivor Day. Personally, I’m not totally in love with the word “survivor.” Maybe it’s because I’m new to this whole thing. It’s only been a little less than two months since I was told I’m cancer free. When I think about survivors, I think about plane crashes or that show on TV. I think about luck. I didn’t beat cancer because I was lucky or because no one decided to vote me off the island. I beat cancer with the help of my healthcare team, especially everyone at Weill Cornell Medicine and NewYork-Presbyterian Hospital, modern day medicine, and positivity.

KatieDeMasi_lastchemo — Here I am on my last day of chemotherapy.

This is all just my opinion, and maybe as I get older and time goes on, I will understand survivorship in the face of cancer. Nonetheless, today is a day to commemorate those who have won their battles and to remember those who aren’t with us. It is a day of not only celebration, but also reflection.

I often think about what my life was supposed to be before I was diagnosed with Hodgkin lymphoma last August. I was supposed to be starting a job as a new nurse in New York City. I was supposed to move out of my childhood home. I was supposed to be living my life like any normal post-graduate. But to be honest, I’m kind of sick of talking about that. I’m more interested in what my life is and will be. I like to think about how my experience with cancer has changed me as a person. I think about what I have overcome and just how I did it.

I have learned the true meaning of the expression “YOLO” (You only live once.) and have included the word “yes” a lot more in my day-to-day life. And not just in the instances where it’s like, “Do you want to get ice cream?” or “Do you want to leave work early?” because those answers always have been and always will be “yes.”

I’m talking more about attitude and experiences. I can say with my whole heart that I have become a more positive person because of what I’ve been through, which might sound weird to some people. Why would something that was pretty awful cause me to have a better outlook on life? Well, it’s because I’m still here. Duh.

Chemo is bad. It is not fun. It is the enemy. But you know what they say: “Keep your friends close and your enemies closer.” So instead of complaining about having to wake up early to sit in traffic just to get to the hospital, and then get chemo dumped into my body, and then feel like a zombie for the next couple of days, I said “yes.” Yes, I can do this. Yes, I can get through this. Yes, I will take that Ativan before I leave the hospital so I can sleep in the car on the way home.

And now that chemo is done and has left me with a taste aversion to cranberry turkey wraps (I know, specific, but I ate one while getting chemo once and just the thought of it is making me gag.), I have carried over my “yes” attitude into my every day life.

I love sitting on the couch in my sweatpants binge-watching Netflix as much as the next girl, but there is a lot to do and see in this world. In this life. I’m not saying I plan on never working again and travelling the world (even though if I won the lottery today, I would probably be on a plane to somewhere new tomorrow); I’m talking about taking advantage of a beautiful day. Spending it outside instead of being cooped up all day. Doing something I’ve never done before, like going to a music festival or paddle boarding. Trying a new menu item at a restaurant I’ve been to a million times. Trying a new restaurant all together. Meeting new people. Spending time with family and friends and really being present.

KatieDeMasi_hotdog — Here I am outside of NYP after I got my clear scan results, eating my first hot dog in six months. Again, it’s the little things.

It’s the little things that I am saying yes to now. Things that maybe I would have ignored or pushed off before. I have stopped thinking about what the plan for my life was and started to think about what the plan is. Life threw me lemons even though I planned on making orange juice. So what did I do? I took those lemons and made a lot of lemonade during chemo because it really seemed to help with the nausea.

I can wish I never had cancer all I want, but that’s not going to change the fact that I had it. So, I have changed my attitude and learned to appreciate what I have now, turkey wrap taste aversion, lemons, and all.

New Immunotherapy Treatment Approved for Children and Adults with Hodgkin Lymphoma

On March 14, 2017, the Food and Drug Administration (FDA) approved pembrolizumab for the treatment of refractory Hodgkin lymphoma in children and adults who have been treated with at least three prior therapies.

Pembrolizumab is a type of immunotherapy called a checkpoint inhibitor. This drug consists of an antibody that binds to programmed death receptor-1 (PD-1), preventing the cancer cells from evading detection by the body’s immune system. Treatment with pembrolizumab allows T-cells (the fighter cells) to mount an immune response against the malignant cells.

Since 2014, Pembrolizumab has been FDA approved for the treatment of unresectable or metastatic melanoma, metastatic non-small-cell lung cancer, and recurrent or metastatic head and neck squamous cell carcinoma. The approval of pembrolizumab for the treatment of relapsed Hodgkin lymphoma was made under the FDA’s accelerated approval process.

This approval was based on data from a clinical trial of pembrolizumab in 210 adult patients with Hodgkin lymphoma who had relapsed or refractory disease after autologous stem cell transplant and/or treatment with brentuximab vedotin. With a median follow up of 9.4 months, the overall response rate was 69%, including partial responses in 47% and complete responses in 22% of patients. The approval in pediatrics was based on known safety data and extrapolated efficacy based on the adult trial.

The most common adverse events in the trial were fatigue, fever, cough, musculoskeletal pain, diarrhea, and rash. Among 40 pediatric patients with advanced melanoma, PD-L1 positive tumors, or lymphoma, the side effects and overall safety profile was similar to adults. A “warning and precaution” was added to the label describing the potential complications of graft-versus-host disease (GVHD) in patients undergoing allogeneic stem cell transplant after treatment with pembrolizumab. Death related to GVHD has occurred and physicians are advised to monitor for hepatic veno-occlusive disease and grade 3-4 acute GVHD including hyperacute GVHD.

The recommended dose of pembrolizumab for patients with Hodgkin lymphoma is 200mg every 3 weeks in adults and 2mg/kg (up to 200mg) every 3 weeks in children.

At the Weill Cornell and NewYork-Presbyterian Lymphoma Program, we offer pembrolizumab as one of many treatment choices available for people with Hodgkin lymphoma.

Weill Cornell Medicine – 2016 ASH Abstracts

2016 has been another productive year for research in the Lymphoma Program at Weill Cornell Medicine. Listed below are the abstracts we were involved in whole or in part to be presented at this year’s 58th Annual Meeting of the American Society of Hematology (ASH).

Look to this space for more information about developments during the ASH meetings this December 3-6.

CLL/SLL

60 – Acalabrutinib Monotherapy in Patients with Richter Transformation from the Phase 1/2 ACE-CL-001 Clinical Study

188 – The Landscape of Dynamic Genetic Changes in Ibrutinib-Treated CLL

192 – Outcome of Patients with Complex Karyotype in a Phase 3 Randomized Study of Idelalisib Plus Rituximab for Relapsed Chronic Lymphocytic Leukemia

233 – Five-Year Experience with Single-Agent Ibrutinib in Patients with Previously Untreated and Relapsed/Refractory Chronic Lymphocytic Leukemia/Small Lymphocytic Leukemia

304 – Targeting Cellular Metabolism and Survival in Chronic Lymphocytic Leukemia and Richter Syndrome Cells By a Novel NF-Kb Inhibitor

621 – Phase 1 Study of REGN1979, an Anti-CD20 x Anti-CD3 Bispecific Monoclonal Antibody, in Patients with CD20+ B-Cell Malignancies Previously Treated with CD20-Directed Antibody Therapy

638 – Acalabrutinib Monotherapy in Patients with Ibrutinib Intolerance: Results from the Phase 1/2 ACE-CL-001 Clinical Study

642 – Venetoclax (VEN) Monotherapy for Patients with Chronic Lymphocytic Leukemia (CLL) Who Relapsed after or Were Refractory to Ibrutinib or Idelalisib

969 – Mutations in NOTCH1 PEST Domain Orchestrate CCL19-Driven Homing of Chronic Lymphocytic Leukemia (CLL) Cells By Modulating the Tumor Suppressor Gene DUSP22

1047 – Single Cell Bisulfite Sequencing Defines Epigenetic Diversification in Chronic Lymphocytic Leukemia