Lisa Hatfield Archives

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The Importance of Telegenetics Consultations for MPN Patients from Patient Empowerment Network on Vimeo.

What role should telegenetics consultations take for myeloproliferative neoplasm (MPN) patients? Blood cancer patient Lisa Hatfield explains the rise of telegenetic consultations, how patients benefit from them, and how to learn more about access.

How MPN Patients Can Best Prepare for a Telemedicine Visit

Related Resources:

Using Telemedicine to Help MPN Clinical Trial Enrollment After COVID-19

Can Mobile Health Apps Lower the Burden of MPN Symptoms

Transcript:

Lisa Hatfield:

According to the National Library of Medicine, less than 300 genetic tests were available in the 1990s; at the end of 2012, almost 3,000 genetic tests were available and now in 2023, +76,000 tests are available to the general public. Some of those genetic tests can be used on MPN patients through telegenetic consultations. These are appointments done via telemedicine with genetic counselors to determine what gene mutations you might have. They can be done by telephone or video conferencing.

As you would imagine, this type of telemedicine became more common during the COVID-19 pandemic and should still remain in a patient’s tool box post-pandemic. While telegenetics consultations play an important role in a patient’s personalized care by determining if there are genetic mutations like JAK2 or MPL, the added benefit is that these online consultations protect the patient from exposure to viruses and potential infections as well as saves them valuable time, energy, and travel costs.

Telegenetic consultations are also beneficial for remote patients, including those in rural areas with limited or no access to genetic services. Be sure to talk to your doctor to see if you can benefit from telegenetic consults. This can be especially important or helpful to do at the beginning of your MPN journey or before switching treatments.

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How MPN Providers Want You to Prepare for Telemedicine Visits

April 27, 2023/in MPN Newly Diagnosed, MPN Programs, MPN TelemEDucation, MPN TelemEDucation Tool Box, MPN Treatments and Clinical Trials, MPN Videos ND, MPN Videos TC, Myeloproliferative Neoplasms /by Kara Rayburn

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How MPN Providers Want You to Prepare for Telemedicine Visits from Patient Empowerment Network on Vimeo.

What are some ways myeloproliferative neoplasm (MPN) providers want patients to prepare for telemedicine visits? MPN expert Dr. Jamile Shammo shares advice to avoid common obstacles to optimal telemedicine visits.

Pros and Cons of Telemedicine From an MPN Patient Perspective

Related Resources:

Using Telemedicine to Help MPN Clinical Trial Enrollment After COVID-19

Can Mobile Health Apps Lower the Burden of MPN Symptoms

Transcript:

Lisa Hatfield:

Do you ever wonder what your doctor wishes you would do before having a telemedicine appointment with them? After all, they are meeting with patients almost daily for telehealth visits so they know what makes a successful appointment. Listen as Dr. Jamile Shammo shares her advice on how to prep to make the most of your time together:

Dr. Jamile Shammo:

When preparing for a televisit, I think it’s so important to know whether or not you would have a connectivity issue. A lot of times, I’m trying to connect with the patient and then we realize that their phone isn’t equipped to handle the televisit and that is kind of disappointing to find that out a minute before you try to connect then that visit becomes a telephone encounter, which is again, less satisfying for some patients. I mean it does the job, but again, it doesn’t provide me with the exam…part of the exam that I’d like to do, at least in that way.

Lisa Hatfield:

If you are unsure on what platform to use for your appointment or if you have to download an application, it is worth asking your care team ahead of time as Dr. Shammo says. Most institutions have a person that can assist you with setup prior to the appointment, especially if it is your first virtual appointment.

Dr. Jamile Shammo:

It would be helpful to make sure that you have a blood draw or if your physician would like to have a blood draw in my case, I always like to have a CBC beforehand or perhaps a chemistry or maybe ion studies or what have you, to have that so that there will be something to discuss. Make sure that your physician has had those results before you have the visit. Sometimes it is also disappointing that the patient thinks I’ve received those results when I actually haven’t and I have no control over that, so that would be the other piece.

Lisa Hatfield:

Take control of your visit by asking staff ahead of time if you can have a blood draw or other testing and that those results are shared with the doctor prior to your visit, that way you can discuss them live. You can typically request this by calling or using a patient communication portal. Just like with in-person visits, have your questions ready or items you would like to talk about in order to utilize your time effectively.

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What MPN Patient Type Is a Good Candidate for Telemedicine Visits?

April 27, 2023/in MPN Newly Diagnosed, MPN Programs, MPN TelemEDucation, MPN TelemEDucation Tool Box, MPN Treatments and Clinical Trials, MPN Videos ND, MPN Videos TC, Myeloproliferative Neoplasms /by Kara Rayburn

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What MPN Patient Type Is a Good Candidate for Telemedicine Visits? from Patient Empowerment Network on Vimeo.

What myeloproliferative neoplasm (MPN) patient type makes a good candidate for telemedicine visits? MPN expert Dr. Jamile Shammo shares her perspective of patient situations that work well for telemedicine and those who can benefit from in-person visits as part of ongoing care.

Using Telemedicine to Help MPN Clinical Trial Enrollment After COVID-19

Related Resources:

How MPN Providers Want You to Prepare for Telemedicine Visits

The Importance of Telegenetics Consultations for MPN Patients

Transcript:

Lisa Hatfield:

As more institutions start to have in-person visits instead of only telemedicine visits, you might be wondering if you should keep doing telemedicine visits or move back to seeing your physician in-person. Some people might want to continue doing telemedicine for a number of reasons, including convenience/no travel involved and limiting your exposure to colds/infection from other patients. There are certain MPN patients that could be seen with telemedicine visits or fewer in-person visits. Listen as Dr. Jamile Shammo explains.

Dr. Jamile Shammo:

So, when I think of the patient that might benefit most from seeing the physician via televisit, for example, it would be someone who perhaps has a stable disease, someone who I may want to monitor perhaps every three to six months, someone who may have stable counts, and we’re just talking to about their symptoms and monitoring those types of things every so often. And perhaps I look at the labs, and you can discuss their symptoms and whether or not they have splenomegaly and issues like that.

Lisa Hatfield:

As Dr. Shammo notes, if your MPN is considered stable and you typically only see your doctor every three to six months, it might be worth continuing telemedicine visits instead of going back to in-person visits.

Dr. Jamile Shammo:

Someone who may already be on a stable dose of medication and we don’t have to do any dose adjustments and even if we have to do those adjustments, perhaps we could do labs a little more frequently, so that would be all right too.

Lisa Hatfield:

If you are on a stable dose of your medication and don’t need any modifications or just have minor adjustments, you could consider staying with telemedicine visits.

But what patients should consider doing more in-person visits, now that COVID-19 precautions are lighter? Dr. Shammo goes on to explain THAT patient could be…

Dr. Jamile Shammo:

Someone in whom I would like to initiate in treatment, someone in whom the disease may be progressing a little too quickly, someone who I may want to do an exam and assess their spleen, I suppose you could send them to an ultrasound facility and obtain an MRI or a CT, or an ultrasound of the imaging study that is. But there’s nothing like an actual exam of the patient. You are thinking about the disease progression, so those sorts of patients in which the disease is actually changing its pace, you may want to take a look at it, the full smear look and examine the skin for certain TKI and signs and symptoms of low platelets and that sort of thing. Look in the mouth for ulcers and things of that nature.

Lisa Hatfield:

As always, please discuss with your health care team before deciding to switch to only telemedicine visits or going back to in-person visits. They know your history and can help decide what is best for you and your care at this particular time.

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Pros and Cons of Telemedicine From an MPN Patient Perspective

April 27, 2023/in MPN Newly Diagnosed, MPN Programs, MPN TelemEDucation, MPN TelemEDucation Tool Box, MPN Treatments and Clinical Trials, MPN Videos ND, MPN Videos TC, Myeloproliferative Neoplasms /by Kara Rayburn

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Pros and Cons of Telemedicine From an MPN Patient Perspective from Patient Empowerment Network on Vimeo.

What are the positives and negatives of telemedicine for myeloproliferative neoplasm (MPN) patients? MPN patient Debbie shares her perspective about benefits and drawbacks of telemedicine visits, and blood cancer patient Lisa Hatfield shares advice for preparing for telehealth visits and for staying connected with your healthcare team.

How MPN Patients Can Best Prepare for a Telemedicine Visit

Related Resources:

What MPN Patient Type Is a Good Candidate for Telemedicine Visits

How Can MPN Patients Continue to Use Telemedicine and Overcome Barriers

Transcript:

Debbie:

I think there is definitely a place for telemedicine in our care. It has enabled us to, or enable me to keep in touch with my hematologist and to understand where my blood counts currently are. What I would also say is, it’s…that there are positives and negatives. I think that the positive of it is the fact that I’ve got a regular update on what my blood counts actually are. I think the negatives of it can be, is that it is quite easy just to move the conversation quite quickly forward. It’s easier for me to just say, everything’s all okay. Thank you for updating me over the telephone, then it is perhaps if I was actually sat in front of somebody. I think that the challenges it presents is that personal touch, is that feeling of being able to have a one-to-one relationship with your consultant. I don’t think you have that over the telephone.

Lisa Hatfield:

You just heard from Debbie, who is living with an myeloproliferative neoplasm, share her positives and negatives of telemedicine but what can patients do so the positives outweigh the negatives? One suggestion is to treat a telehealth appointment the same way you would treat an in-person appointment, meaning you would write down all your questions ahead of time, make notes of the points you want to cover and keep information on your blood counts and medications handy. By looking at a telemedicine appointment with the same importance and preparedness as an in-person session, you will ensure you are making the most of the time. Another way to see the positives in telemedicine is to remember that telemedicine can be used beyond virtual visits. You can utilize telemedicine/telehealth technology to message and stay in contact with your care team and to share your records electronically with all the providers you see. Telemedicine can help us stay connected and informed of our health in this technology-heavy world!

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How MPN Patients Can Best Prepare for a Telemedicine Visit

April 27, 2023/in MPN Newly Diagnosed, MPN Programs, MPN TelemEDucation, MPN TelemEDucation Tool Box, MPN Treatments and Clinical Trials, MPN Videos ND, MPN Videos TC, Myeloproliferative Neoplasms /by Kara Rayburn

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How MPN Patients Can Best Prepare for a Telemedicine Visit from Patient Empowerment Network on Vimeo.

What are some ways that myeloproliferative neoplasm (MPN) patients can best prepare for telemedicine visits? Lisa Hatfield shares information about telemedicine, and MPN patient Summer Golden and care partner Jeff Bushnell share their tips for telemedicine best practices.

Pros and Cons of Telemedicine From an MPN Patient Perspective

Related Resources:

How MPN Providers Want You to Prepare for Telemedicine Visits

The Importance of Telegenetics Consultations for MPN Patients

Transcript:

Lisa Hatfield:

After the extensive use of it during the COVID-19 pandemic, it seems like telemedicine will be here to stay. It’s another technological advantage that people living with MPNs can put in their toolbox. Since MPNs are classified as a rare disease, and there might be a lack of doctors knowledgeable on how to treat it near you, telemedicine has made it easier to connect with MPN specialists via online consults. Telemedicine can include video or audio only, and you should receive instructions how to set up and what to expect prior to your appointment.

Listen as MPN patient, Jeff Bushnell and his care partner, Summer Golden, share how they prepare for telemedicine visits

Summer Golden and Jeff Bushnell:

A top tip I think, it’s sort of logical, but is to have the questions and issues written out because it’s a limited matter of time and to specifically jot down the answers. Another tip would be to ensure that you have the appropriate stuff on whatever device you’re using to talk to the doctor on. We’ve used about three or four different apps, as it were, on our phone to communicate with different doctors, and you need to make sure that that works ahead of time.

Usually, the way they do it is they set up the appointment, they contact you ahead of time, and make sure that it’s going to work before they put the doctor online. But that’s very important that you have the technical ability to ensure that your equipment can support telemedicine. They’re making it pretty easy, but you still have to do it.

Lisa Hatfield:

Follow these two tips from Summer and Jeff as part of what YOU do to be ready for your next telemedicine visit. If you are having trouble with the technology needed for telemedicine, be sure to reach out to your doctor, nurse, or care partner for assistance.

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[ACT]IVATED DLBCL Resource Guide en español

April 21, 2023/in Diffuse Large B-Cell Lymphoma (DLBCL), DLBCL Activated, DLBCL Activated Resources, DLBCL Newly Diagnosed, DLBCL Programs, DLBCL Resource ND, DLBCL Resource TC, DLBCL Treatments and Clinical Trials /by Kara Rayburn

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How Are Bispecific Antibodies Being Used in Diffuse Large B-Cell Lymphoma Treatment?

April 20, 2023/in Diffuse Large B-Cell Lymphoma (DLBCL), DLBCL Activated, DLBCL Activated Expert, DLBCL Newly Diagnosed, DLBCL Programs, DLBCL Treatments and Clinical Trials, DLBCL Videos ND, DLBCL Videos TC /by Kara Rayburn

How Are Bispecific Antibodies Being Used in Diffuse Large B-Cell Lymphoma Treatment? from Patient Empowerment Network on Vimeo.

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How can diffuse large B-cell lymphoma (DLBCL) patients be helped with bispecific antibodies? Expert Dr. Nirav Shah from the Medical College of Wisconsin shares an explanation of bispecific antibodies and his perspective on potential approvals and how the treatment could serve additional DLBCL patients in the future.

Dr. Nirav Shah is an Associate Professor at the Medical College of Wisconsin. Learn more about Dr. Shah.

What Promising Treatments Are Available for Diffuse Large B-Cell Lymphoma Patients

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How Can Patients Overcome Noted Diffuse Large B-Cell Lymphoma Disparities

Will Newer Therapies Be Curative for Diffuse Large B Cell Lymphoma Patients

Transcript:

Lisa Hatfield:

In addition to things like CAR-T therapy, blood cancer, there’s a lot of progress being made in something called bispecific antibodies. Can you talk about that a little bit, how that’s being looked at with DLBCL?

Dr. Nirav N. Shah:

Yeah, so bispecific antibodies in a way are a drug-ish form of CAR T. So CAR T is complex, it involves collecting your immune system cells, reprogramming them, and often that involves sending them to a third party manufacturing site, that can sometimes take several weeks to manufacture, and the other issue with CAR T is that it’s limited in accessibility because it’s often only available in these larger regional centers, which often means a big city, and not everybody has access to that. Bispecific antibodies, I think are going to be really, really important therapies in diffuse large B-cell lymphoma, and I think other cancers as well.

What they do is they give you a drug molecule, an antibody that on one end binds the T-cell, which is sort of that immune effector cell, and on the other end, targets the cancer cell, which in this case is a B cell, so in a way, it sort of works like CAR T. Now, it is not CAR T, and I wouldn’t necessarily compare those two, but the exciting thing is that we’ve seen really, really nice outcomes with bispecific antibodies, and while we don’t have one approved in diffuse large B-cell lymphoma today, I anticipate that those drugs are going to be available and approved in the very near future.

And why is that important? Because these drugs can now be given anywhere because they’re a drug molecule. Again, sites will have to do some training and learn how to give them, but there’s a potential for them to be really administered at regional sites and at locations that don’t require patients to travel long distances to get access to CAR T. Now, I’m not saying that we should use one therapy in lieu of the other, we should always do the best therapy for the patient, but thinking about accessibility, it’ll be great to have another option available. And not only that, these drugs also have been shown to have efficacy in patients that have failed CAR T. So that gives us another sort of tool in our tool basket to use, while I mentioned that we’re giving more and more CAR T in the second line, as this therapy got approved in that setting, we now have another option with bispecific antibodies for patients that don’t respond to CAR T, and, unfortunately, not everybody does respond to CAR T-cell therapy. So very excited. I hope, and I think there’ll be an approval in diffuse large B-cell lymphoma later this year.

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Will Newer Therapies Be Curative for Diffuse Large B-Cell Lymphoma Patients?

April 20, 2023/in Diffuse Large B-Cell Lymphoma (DLBCL), DLBCL Activated, DLBCL Activated Expert, DLBCL Newly Diagnosed, DLBCL Programs, DLBCL Treatments and Clinical Trials, DLBCL Videos ND, DLBCL Videos TC /by Kara Rayburn

Will Newer Therapies Be Curative for Diffuse Large B Cell Lymphoma Patients? from Patient Empowerment Network on Vimeo.

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Will newer diffuse large B-cell lymphoma (DLBCL) therapies be curative for patients? Expert Dr. Nirav Shah from the Medical College of Wisconsin shares his perspective on advances in DLBCL treatments and his hopes for the future of DLBCL care.

Dr. Nirav Shah is an Associate Professor at the Medical College of Wisconsin. Learn more about Dr. Shah.

What Is the Ann Arbor Staging System for Diffuse Large B-Cell Lymphoma

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How Are Bispecific Antibodies Being Used in Diffuse Large B-Cell Lymphoma Treatment?

Transcript:

Lisa Hatfield:

Dr. Shah, can you give all DLBCL patients a little bit of hope, even those who are relapsed and refractory in the future sometime, can you see any of these newer therapies being curative for all diffuse large B-cell lymphoma patients?

Dr. Nirav N. Shah:

Yeah, so that’s the hope. And that’s a goal. I can tell you that in my time in practice, which is about 10 years now as a lymphoma provider, I’ve seen improvements that almost blow my mind. What’s happened in this decade, it almost seems more consequential than what happened in the 20 years prior, there have just been incredible advances, not just in chemotherapy, but immune therapy and targeted therapy, and so the goal is to keep getting better. I see a future where more and more patients with diffuse large B-cell lymphoma are cured in the front line, and more and more patients are cured in the second line.

I think it’s very, very hard, unfortunately, to say that every single patient with diffuse large B-cell lymphoma will be cured even 20 to 30 years from now, because cancer is tricky and cancer is hard, and each patient, again, is also an individual, and how they react to these treatments can also be challenging and hard. But I can tell you that my goal and the goal of so many other people like me, who not only treat lymphoma but also participating in clinical trials and do research, is to do better. And so I hope that we see a day where the great majority of patients with DLBCL are cured and able to move on and live their lives without this cancer.

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Is Stem Cell Transplantation Still a Treatment Option for Some DLBCL Patients

April 20, 2023/in Diffuse Large B-Cell Lymphoma (DLBCL), DLBCL Activated, DLBCL Activated Expert, DLBCL Newly Diagnosed, DLBCL Programs, DLBCL Treatments and Clinical Trials, DLBCL Videos ND, DLBCL Videos TC /by Kara Rayburn

Is Stem Cell Transplantation Still a Treatment Option for Some DLBCL Patients? from Patient Empowerment Network on Vimeo.

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Can diffuse large B-cell lymphoma (DLBCL) patients expect to undergo stem cell transplant? Expert Dr. Nirav Shah from the Medical College of Wisconsin explains some alternatives to stem cell transplant in specific situations and shares his perspective about how the use of stem cell transplants may evolve in the future.

Dr. Nirav Shah is an Associate Professor at the Medical College of Wisconsin. Learn more about Dr. Shah.

[ACT]IVATION TIP:

“…don’t discard transplantation because it’s an older therapy, it’s just one that needs to be used in the right scenario for each patient.”

What Promising Treatments Are Available for Diffuse Large B-Cell Lymphoma Patients

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$When Should CAR-T Therapy Be Considered for Relapsed_Refractory DLBCL Patients$

When Should CAR-T Therapy Be Considered for Relapsed/Refractory DLBCL Patients

How Can Diffuse Large B-Cell Lymphoma Treatment Symptoms Be Managed

Transcript:

Lisa Hatfield:

So in light of all of these newer therapies, there’s still a place for stem cell transplantation with the DLBCL patients?

Dr. Nirav N. Shah:

Yeah, great question. So the goal is always to do better. And so we have this new exciting therapy called CAR T, that for a lot of patients is going to replace the role of the stem cell transplant. However, there still is a role for transplant in patients that have later relapse, so those patients who relapse one to two years, transplant is still a standard of care and an option that I would consider for my patients, and there’s more than one type of stem cell transplant out there. So we often think about autologous transplants in diffuse large B-cell lymphoma, where we use our own immune system to rebuild it after giving a high intensity chemotherapy treatment to eliminate the cancer. But there’s a second type of transplant called allogeneic stem cell transplant, and that is where we actually replace your whole immune system with one from a healthy donor.

Our group, actually, for patients that fail CAR T-cell therapy, which is one of our better treatment options that we have, but again, not 100 percent effective, we’ve used allogeneic stem cell transplant to try and cure those patients and offer them something where we replace their immune system with one from a healthy donor to be able to get rid of the cancer where other treatments have failed.

So I think that how we use transplant is going to be redefined with newer therapies and immune therapies like CAR , immune T or bispecific antibodies. But I do think that either auto or allogeneic transplant is still going to be part of the treatment algorithms, especially for those patients who have failed other options. So my activation point is don’t discard transplantation because it’s an older therapy, it’s just one that needs to be used in the right scenario for each patient.

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How Can Diffuse Large B-Cell Lymphoma Treatment Symptoms Be Managed?

April 20, 2023/in Diffuse Large B-Cell Lymphoma (DLBCL), DLBCL Activated, DLBCL Activated Expert, DLBCL Newly Diagnosed, DLBCL Programs, DLBCL Treatments and Clinical Trials, DLBCL Videos ND, DLBCL Videos TC /by Kara Rayburn

How Can Diffuse Large B-Cell Lymphoma Patients Manage Treatment Symptoms? from Patient Empowerment Network on Vimeo.

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How can diffuse large B-cell lymphoma (DLBCL) treatment symptoms be managed? Expert Dr. Nirav Shah from the Medical College of Wisconsin explains common symptoms and side effects that patients experience and how they can help in managing their care along with their team.

Dr. Nirav Shah is an Associate Professor at the Medical College of Wisconsin. Learn more about Dr. Shah.

[ACT]IVATION TIP:

“…call us. Let us know what’s going on. We can’t help you with your symptoms if we’re not aware, and we don’t mind those phone calls because we want to help patients through that journey.”

How Is Diffuse Large B-Cell Lymphoma Explained to a Newly Diagnosed Patient?

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$When Should CAR-T Therapy Be Considered for Relapsed_Refractory DLBCL Patients$

When Should CAR-T Therapy Be Considered for Relapsed/Refractory DLBCL Patients

Is Stem Cell Transplantation Still a Treatment Option for Some DLBCL Patients

Transcript:

Lisa Hatfield:

So, Dr. Shah, newly diagnosed DLBCL patients, they come in and typically, you would most likely prescribe a chemotherapy regimen, and then maybe down the road they may see something like CAR-T therapy. Can you explain what type of symptoms they may or may not have, and how they can manage those symptoms and maybe even a tip on who to call when they experience symptoms?

Dr. Nirav N. Shah:

Yeah, it’s a great question, Lisa. So the front-line regimen for diffuse large B-cell lymphoma in 2023 is a combination chemotherapy regimen. The good news is we’ve gotten so much better at delivering these drugs in a safe and efficacious manner, we’re really good at preventing those horrible things that we think about when we watch movies of people vomiting all the time and being nauseous and losing weight. We have really good antiemetics, we develop a program to deal with nausea or vomiting should it occur, and escalate our treatments to prevent it in those patients that are more sensitive to the chemotherapy drugs.

That being said, it’s still chemotherapy. And so people do feel the side effects. I think the hardest side effect for a lot of people to endure is hair loss, these combination chemotherapy do cause hair loss, and then that often is even a little bit harder for women, just given the stigma for hair and how important that is to some of our female patients, and so these are challenges that I try to discuss with patients to help them anticipate. Again, we have lots of different services at our institution, we have a wig service, a place for people to go to find options on how to deal with that.

The biggest medical symptoms that I tell people that everybody experiences is just fatigue. We’re putting poison in your body to kill a cancer. We’re doing it for a good reason, but that just wipes people out. Most patients will not have the energy, the appetite, the drive that they normally have when they’re feeling well. And again, for the most part, that’s short-lived, but for some patients that can even last three to six months after completing their chemotherapy regimen. There’s lots of individual side effects that I warn them about, the one that I am most concerned about for my patients is infection, because chemotherapy doesn’t only kill the part of the immune system, the lymphoma, it can also weaken the immune system, a part of the immune system that is there to protect you from infection.

And so we tell them to monitor for fevers, and if they’re not feeling well to call us in. We provide our patients numbers for 24/7 contact. So we have a number that they can call to, and no matter when they call, they’ll be able to get either an on-call provider or the team if it’s during the daytime, to be able to help them with whatever issue or symptoms that they’re having. And so my activation point to my patients is, call us. Let us know what’s going on. We can’t help you with your symptoms if we’re not aware, and we don’t mind those phone calls because we want to help patients through that journey.

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Why Is Clinical Trial Participation Vital for Diffuse Large B-Cell Lymphoma Patients?

April 20, 2023/in Diffuse Large B-Cell Lymphoma (DLBCL), DLBCL Activated, DLBCL Activated Expert, DLBCL Newly Diagnosed, DLBCL Programs, DLBCL Treatments and Clinical Trials, DLBCL Videos ND, DLBCL Videos TC /by Kara Rayburn

Why Is Clinical Trial Participation Vital for Diffuse Large B-Cell Lymphoma Patients? from Patient Empowerment Network on Vimeo.

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Why is it vital for diffuse large B-cell lymphoma (DLBCL) patients to participate in clinical trials? Expert Dr. Nirav Shah from the Medical College of Wisconsin shares his perspective on the benefits of clinical trial participation and advice for patients who are considering joining a trial.

Dr. Nirav Shah is an Associate Professor at the Medical College of Wisconsin. Learn more about Dr. Shah.

[ACT]IVATION TIP:

“…for clinical trials is, consider them. They may not be right for you, and that’s okay.”

What Promising Treatments Are Available for Diffuse Large B-Cell Lymphoma Patients

Related Resources:

How Can Patients Overcome Noted Diffuse Large B-Cell Lymphoma Disparities

Will Newer Therapies Be Curative for Diffuse Large B Cell Lymphoma Patients

Transcript:

Lisa Hatfield:

Okay, Dr. Shah, why is clinical trial participation so important with DLBCL patients, and what advice do you have for those patients considering a clinical trial?

Dr. Nirav N. Shah:

Yeah, so number one, I always tell my patients one thing is it’s, clinical trials are an opportunity or an option, not a mandate. And so I never want a patient thinking that they have to participate in the clinical trial, participating in a clinical trial is an opportunity to help define potentially, the next treatment. Every treatment we’ve talked about up until this point was because kind, courageous people were willing to participate in a clinical trial. We wouldn’t have CAR T if hundreds of patients didn’t go on these clinical trials and be willing to be a subject and go through a treatment that was at the time undefined and without knowing how efficacious it was going to be.

And so clinical trials are important because without patients participating in clinical trials, how can we do better? That being said, a clinical trial is not right for every patient, and so it’s a value, it’s a judgment that each individual has to make. But I know that I really value my patients that are willing to participate because they all become part of that story about how to improve outcomes for diffuse large B-cell lymphoma for that patient who’s diagnosed five years from today or 10 years from today. And their participation, again, may not be recognized in the time that they’re participating, but what they did helps define the future of how we treat this disease. So my activation point for clinical trials is, consider them. They may not be right for you, and that’s okay.

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When Should CAR-T Therapy Be Considered for Relapsed/Refractory DLBCL Patients?

April 20, 2023/in Diffuse Large B-Cell Lymphoma (DLBCL), DLBCL Activated, DLBCL Activated Expert, DLBCL Newly Diagnosed, DLBCL Programs, DLBCL Treatments and Clinical Trials, DLBCL Videos ND, DLBCL Videos TC /by Kara Rayburn

When Should CAR-T Therapy Be Considered for Relapsed/Refractory DLBCL Patients? from Patient Empowerment Network on Vimeo.

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When can relapsed/refractory diffuse large B-cell lymphoma (DLBCL) patients benefit from CAR T-cell therapy? Expert Dr. Nirav Shah from the Medical College of Wisconsin explains study results that compared chemo versus CAR T-cell therapy in relapsed DLBCL patients and the importance of looking at the timing of relapse.

Dr. Nirav Shah is an Associate Professor at the Medical College of Wisconsin. Learn more about Dr. Shah.

[ACT]IVATION TIP:

“…for people thinking about what is the best treatment for CAR T is think about how the disease is behaving, and did you relapse early or did you relapse late?”

How Can Your Diffuse Large B-Cell Lymphoma Care Team Help in Treatment Decisions

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$What DLBCL Treatment Options Are There for Relapsed/Refractory Patients$

What DLBCL Treatment Options Are There for Relapsed/Refractory Patients

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Transcript:

Lisa Hatfield:

When do you say that CAR-T therapy should be used for relapsed/refractory patients? Is it after the first line of therapy has failed, or when do you tell your patients to consider that?

Dr. Nirav N. Shah:

Yeah, so there was a large clinical trial that compared outcomes for those patients who had early relapse of diffuse large B-cell lymphoma. So within 12 months of finishing their R-CHOP chemotherapy, and they compared that to what was our historical standard, was to get more chemotherapy and then consider a stem cell transplant. And CAR T did better, and CAR T had better outcomes. And then recently, they just actually demonstrated that those patients that got CAR T early as a second-line therapy actually had better survival. For patients with early relapse in diffuse large B-cell lymphoma, the standard of care is to go right to CAR T-cell therapy as long as you’re a candidate, which means you have to be healthy enough, have the social support and the resources to be able to go through that therapy, which does require you to be within 45 minutes of a CAR-T center for about a month.

And again, we talked about, again, there’s issues with accessibility, which limits it sometimes, the availability to CAR T to all of our patients. Now, for those patients who relapse later, and we see that, patients who relapse a year-and-a-half, two years or even three or four years after their initial treatment, for those patients, the standard of care is to give a second-line chemotherapy, and then based on how well you respond to that, you would consider either doing a stem cell transplant if you had a very nice response to that second-line therapy, or if you were refractory to that second-line therapy, then getting CAR T as sort of a third-line therapy.

So again, there are lots of caveats here. The main distinction I think about is, when did you relapse? Did you relapse earlier or late? And based on that, choosing the treatment that’s most appropriate for that situation. So my activation tip for people thinking about what is the best treatment for CAR T is think about how the disease is behaving, and did you relapse early or did you relapse late?

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What DLBCL Treatment Options Are There for Relapsed/Refractory Patients?

April 20, 2023/in Diffuse Large B-Cell Lymphoma (DLBCL), DLBCL Activated, DLBCL Activated Expert, DLBCL Newly Diagnosed, DLBCL Programs, DLBCL Treatments and Clinical Trials, DLBCL Videos ND, DLBCL Videos TC /by Kara Rayburn

What DLBCL Treatment Options Are There for Relapsed/Refractory Patients? from Patient Empowerment Network on Vimeo.

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What can relapsed/refractory diffuse large B-cell lymphoma (DLBCL) patients look to for treatment options? Expert Dr. Nirav Shah from the Medical College of Wisconsin shares research updates for relapsed/refractory DLBCL patients and his perspective about advances in DLBCL care.

Dr. Nirav Shah is an Associate Professor at the Medical College of Wisconsin. Learn more about Dr. Shah.

[ACT]IVATION TIP:

“…for those patients who have relapsed DLBCL, is learn your options and make the decision that is best that fits your personal needs, your ability to handle the treatment with your doctor.”

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$When Should CAR-T Therapy Be Considered for Relapsed_Refractory DLBCL Patients$

When Should CAR-T Therapy Be Considered for Relapsed/Refractory DLBCL Patients

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Transcript:

Lisa Hatfield:

What treatment options are available for patients who have either relapsed with DLBCL or are refractory to certain treatment options, meaning that they are no longer responding to those treatment options?

Dr. Nirav N. Shah:

Yeah, so the good news is, is for DLBCL, even in the relapsed setting, we have lots of options available, and that’s really exciting. The way that I look at a patient is how quickly did they relapse and then are they eligible for a higher intensity treatment or not. We know that patients who relapse early, within the first 12 months, that for that group of patients, the best therapy based on clinical trials is to get them to a CAR T-cell therapy type treatment, which has high efficacy and the potential to cure patients with diffuse large B-cell lymphoma. We now have patients who are more than five years out after CAR T with relapsed disease and an ongoing remission.

Now, for some patients who relapse later, we still consider things like stem cell transplantation, which was sort of the standard of care for 20 plus years until recent data showed that CAR T might be a better option in those patients who relapse early. Now, we have a group of patients that often aren’t candidates for high intensity treatment because they’re older because they have medical problems, or because they live too far away, and they can’t commit to the three to four weeks that it takes to be able to get a therapy like CAR T or stem cell transplant at a larger community or a larger academic hospital.

And the good news is that we even have options for them, so there’s new chemotherapy regimens, new antibody-based treatments that again, I like to think of those medications as more disease control rather than disease cure, but for some patients, disease control is often adequate. It allows him to be functional, go to work, with the milder therapy that sort of meets their, again, personal and individualized needs. And so my activation tip for those patients who have relapsed DLBCL, is learn your options and make the decision that is best that fits your personal needs, your ability to handle the treatment with your doctor.

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How Can Your Diffuse Large B-Cell Lymphoma Care Team Help in Treatment Decisions?

April 20, 2023/in Diffuse Large B-Cell Lymphoma (DLBCL), DLBCL Activated, DLBCL Activated Expert, DLBCL Newly Diagnosed, DLBCL Programs, DLBCL Treatments and Clinical Trials, DLBCL Videos ND, DLBCL Videos TC /by Kara Rayburn

How Can Your Diffuse Large B-Cell Lymphoma Care Team Help in Treatment Decisions? from Patient Empowerment Network on Vimeo.

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How can diffuse large B-cell lymphoma (DLBCL) treatment decisions be aided by your care team? Expert Dr. Nirav Shah from the Medical College of Wisconsin explains key factors that help guide treatment decisions and how some patient characteristics may alter dosing and treatment approaches.

Dr. Nirav Shah is an Associate Professor at the Medical College of Wisconsin. Learn more about Dr. Shah.

[ACT]IVATION TIP:

“..try to come up with an individualized treatment plan that meets the needs of your disease and your situation.”

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$When Should CAR-T Therapy Be Considered for Relapsed_Refractory DLBCL Patients$

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Transcript:

Lisa Hatfield:

So, Dr. Shah, how do you work with your DLBCL patients in helping them make treatment decisions, and what should they consider when they are making their treatment decisions?

Dr. Nirav N. Shah:

It’s a great question, Lisa. I think that in the current area that we’re practicing, the term I use is one size doesn’t fit all. I really try to meet with the patient, understand number one, their disease, so the biology of their disease, what subtype or phenotype is it, what stage is it presenting in. Then I try to think about the actual patient characteristics, what are their goals of care, what is their age, and what are their comorbid conditions that may impact our ability to treat them and other factors, social factors. Do they have a support system? What is the distance that they’re driving to come here to be able to get treated here, and so I take all of this information together and try to come up with the best treatment option that is available for that patient.

Now again, the majority of people are going to get common regimen such as R-CHOP chemotherapy, which is one of the standard of care for diffuse large B-cell lymphoma, but even within them, there are different ways you can administer it if you’re a particularly older patient or have a lot of medical problems. And so I really believe in trying to individualize the treatment plan for the patient, because each one of us are different, and how we tolerate things and what our body has been through in the past is going to impact how we’re going to be able to handle a specific treatment. And so my activation tip to patients about this is to try to come up with an individualized treatment plan that meets the needs of your disease and your situation.

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How Do Different Diffuse Large B-Cell Lymphoma Subtypes Impact Treatment Options?

April 20, 2023/in Diffuse Large B-Cell Lymphoma (DLBCL), DLBCL Activated, DLBCL Activated Expert, DLBCL Newly Diagnosed, DLBCL Programs, DLBCL Treatments and Clinical Trials, DLBCL Videos ND, DLBCL Videos TC /by Kara Rayburn

How Do Different Diffuse Large B-Cell Lymphoma Subtypes Impact Treatment Options? from Patient Empowerment Network on Vimeo.

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How are diffuse large B-cell lymphoma (DLBCL) subtypes impacting treatment options? Expert Dr. Nirav Shah from the Medical College of Wisconsin explains key factors that help determine DLBCL subtype and the importance of knowing your subtype for optimal care.

Dr. Nirav Shah is an Associate Professor at the Medical College of Wisconsin. Learn more about Dr. Shah.

[ACT]IVATION TIP:

“…know your subtype of diffuse large B-cell lymphoma, so you can understand what treatment is best for that variant.”

What Promising Treatments Are Available for Diffuse Large B-Cell Lymphoma Patients

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Transcript:

Lisa Hatfield:

What are the subtypes of DLBCL, and how does that impact treatment options?

Dr. Nirav N. Shah:

Yeah, so I think I may have talked about that a little bit earlier. So we call it diffuse large B-cell lymphoma, but it’s really not one disease, there are multiple subtypes, so one thing is a cell of origin, and this sort of says what part of the lymph node does this diffuse large B-cell lymphoma originate from. And so there’s something called the germinal center phenotype. The other one is called the activated B-cell phenotype and prognostically, these sort of behave differently. Currently, we’re treating them the same, but we’re hoping that in the future, we’ll actually have algorithms that are more refined so that they are giving the best treatment for each subtype.

I mentioned earlier that there’s a variant called double-hit lymphoma that we think is particularly aggressive, and for that variant, I would actually consider clinical trials as an option if they’re available to you, but outside of a clinical trial, we do give higher intensity chemotherapy regimens, there’s more than one standard of care in that setting. But, again, important to understand what is your DLBCL type and what are some of these other molecular mutations that might be there that would impact that frontline treatment. So my activation tip for this is to know your subtype of diffuse large B-cell lymphoma, so you can understand what treatment is best for that variant.

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