Unmet Needs in the First-Line Treatment of Diffuse Large B-cell Lymphoma: Expert Recommendations From the Asia-Pacific Region With a Focus on the Challenging Subtypes

Review

作者: Wudhikarn, Kitsada ; Chan, Jason Yongsheng ; Wong, Raymond Siu Ming ; Tan, Daryl ; Huang, Tai-Chung ; Poon, Limei ; Tse, Eric ; Norasetthada, Lalita

Diffuse large B-cell lymphoma (DLBCL) is the most common type of non-Hodgkin lymphoma, accounting for around 30-60% of all cases. The management of DLBCL in Asia has several unmet needs due to the diversity of the population, the heterogeneity of local clinical guidelines for DLBCL and the wide disparity in resources and healthcare systems across different regions. Rituximab combined with cyclophosphamide, doxorubicin, vincristine, and prednisone (RCHOP) is widely recognized as the standard first-line treatment for DLBCL; however, alternative regimens are required to improve patient outcomes in challenging subtypes, such as patients with high International Prognostic Index scores, old/frail patients, and patients with double-hit and double-expressor DLBCL or concurrent central nervous system disease. This review article draws from the expertise of practicing hematologists/oncologists in the region, with the aim of integrating data from current scientific evidence to address the unmet needs and unique socioeconomic challenges faced by challenging high risk patient groups in the Asia-Pacific region.

2024-09-01·Kidney International

Targeting APRIL in the treatment of glomerular diseases

Review

作者: Barratt, Jonathan ; Wong, Muh Geot ; Suzuki, Yusuke ; Trimarchi, Hernán ; Rizk, Dana V. ; Cheung, Chee Kay ; Lafayette, Richard ; Liew, Adrian ; Tesař, Vladimír ; Zhang, Hong ; Rizk, Dana V

A proliferation-inducing ligand (APRIL) is a key member of the tumor necrosis factor superfamily of cytokines and plays a central role in B-cell survival, proliferation, and Ig class switching. Recently, there has been increasing interest in the role of APRIL and the related cytokine B-cell activating factor in several glomerular diseases, because of their importance in the above processes. The therapeutic inhibition of APRIL represents a potentially attractive immunomodulatory approach that may abrogate deleterious host immune responses in autoimmune diseases while leaving other important functions of humoral immunity intact, such as memory B-cell function and responses to vaccination, in contrast to B-cell-depleting strategies. In this review, we describe the physiological roles of APRIL in B-cell development and their relevance to glomerular diseases, and outline emerging clinical trial data studying APRIL inhibition, with a focus on IgA nephropathy where the clinical development of APRIL inhibitors is in its most advanced stage.

2024-07-09·Circulation

Effect of Cangrelor on Infarct Size in ST-Segment–Elevation Myocardial Infarction Treated by Primary Percutaneous Coronary Intervention: A Randomized Controlled Trial (The PITRI Trial)

Article

作者: Ong, Marcus Eng Hock ; Mahadi, Tasha ; Chua, Terrance ; Ong, Paul ; Poay Huan, Loh ; Hua Chong, Jun ; Teo, Tina ; Soo Teik, Lim ; Ping Ting, Boon ; Pung, Xuan Ming ; Chee Yang, Chin ; Priyalatha, S. ; Maverick Rubillar, Felix ; Teo, Lynette ; Thon Hon, Yong ; Tan, Jack W.C. ; Ching Hui, Sia ; Lee, Audry ; Chi, Chee-Tang ; Xucong, Ruan ; Khung Keong, Yeo ; Rui Yi, Pang ; Song, Junda ; Tay, Julian Cheong Kiat ; Lim Zhan Yun, Patrick ; Chin, Chee Yang ; Chua, Jia-Mei ; Ho, Andrew ; Keong, Yeo Khung ; Atiqa Binte Rahmat, Syamimi ; Xuyan, Teoh ; Houdmont, Marie ; Ng, Perryn ; Chawla, Ashish ; Wah Liew, Boon ; Venkataraman, Anantharaman ; Ning Yan, Wong ; Chan, Mervyn ; Joo Hor, Tan ; Fatt Hoe Adrian, Low ; Ahmad Hatib Muhammad Alimi, Bin ; Han Lim, Swee ; Chung, Yiu-Cho ; Chong Keat, Tan ; Rilong, Hong ; Ke Xuan Jessica, Ng ; Watson, Timothy ; Bryant, Jennifer ; Ang, Florence ; Kyaw, Min-Tun ; Shu Qi Benita, Chiang ; Chan, Michelle ; Wanshan, Leow ; Chin, Calvin ; Saqib Imran, Syed ; Tan, Jack ; Yue Ting, Ho ; Lee Jin Hyun, Deborah ; Xia Yen, Shen ; Ping, Chai ; Chew, Nicholas ; Shiane, Lim ; Dalakoti, Mayank ; Ru San, Tan ; Yann San, Keh ; Imran, Syed Saqib ; Jian Ming, Fam ; Jia Min, Chua ; Hoe, John ; Choon Peng Jeffrey, Wee ; Ching Ong, Ching ; Shalini, Nair ; Fang Yi, Lim ; Yan Tan, Shi ; Jiamin, Siew ; Sim Wen Jun, Eran ; Bulluck, Heerajnarain ; Kay Woon, Ho ; Tan Boon Kiat, Kenneth ; Fatimah, Lateef ; Hak Chiaw, Tang ; Yi-Ting Laureen, Wang ; Liew, Boon Wah ; Lee, Rosalind ; Zhe Yan, Ng ; Bahru, Leong ; Yar Chze, Gan ; Chan, Mark Y. ; An Shing, Ang ; Lee, Chi-Hang ; Yip, Alfred ; Zhengfeng Jason, Chen ; Raudha, Siti ; Zhi Lin Deanna, Khoo ; Wong, Aaron ; Kuang Low, Choong ; Koo Hui, Chan ; Ki Fung Cliff, Li ; Lim, Swee Han ; Chew, Kenneth ; Wei Sheng Jonathan, Ong ; Xuan Ming, Pung ; Tan, Alvin ; Xin Ni, Koo ; Chook, Shaun ; Hartanto Djohan, Andie ; Anbalakan, Kamalesh ; Annathurai, Annitha ; Ting, Boon Ping ; Jin Hyun, Lee ; Chai, Ping ; Ong Eng Hock, Marcus ; Ho, Hee-Hwa ; Low Jun Bang, Randal ; Tay, Julian ; Zhan Yun, Patrick Lim ; Yap, Jonathan ; Jia-ling Stephanie, Quek ; Yang Chin, Chee ; Paradies, Valeria ; Lim, Soo Teik ; Wong, Evelyn ; Cai, James ; Oh, Katherina ; Ho, Hee Hwa ; Ng, Faclin ; Swee Leng, Kui ; Gao, Fei ; Francis Prabath, Joseph ; Ho, Andrew Fu Wah ; Pei Yi, Ho ; Yip, Deborah ; Chai Jun Hui, Tony ; Lim, Benji ; Hausenloy, Derek J. ; Chong, Jun Hua ; Shonda, Ng

BACKGROUND:The administration of intravenous cangrelor at reperfusion achieves faster onset of platelet P2Y12 inhibition than oral ticagrelor and has been shown to reduce myocardial infarction (MI) size in the preclinical setting. We hypothesized that the administration of cangrelor at reperfusion will reduce MI size and prevent microvascular obstruction in patients with ST-segment–elevation MI undergoing primary percutaneous coronary intervention.METHODS: This was a phase 2, multicenter, randomized, double-blind, placebo-controlled clinical trial conducted between November 2017 to November 2021 in 6 cardiac centers in Singapore. Patients were randomized to receive either cangrelor or placebo initiated before the primary percutaneous coronary intervention procedure on top of oral ticagrelor. The key exclusion criteria included presenting <6 hours of symptom onset; previous MI and stroke or transient ischemic attack; on concomitant oral anticoagulants; and a contraindication for cardiovascular magnetic resonance. The primary efficacy end point was acute MI size by cardiovascular magnetic resonance within the first week expressed as percentage of the left ventricle mass (%LVmass). Microvascular obstruction was identified as areas of dark core of hypoenhancement within areas of late gadolinium enhancement. The primary safety end point was Bleeding Academic Research Consortium–defined major bleeding in the first 48 hours. Continuous variables were compared by Mann-Whitney U test (reported as median [first quartile–third quartile]), and categorical variables were compared by Fisher exact test. A 2-sided P <0.05 was considered statistically significant. RESULTS: Of 209 recruited patients, 164 patients (78%) completed the acute cardiovascular magnetic resonance scan. There were no significant differences in acute MI size (placebo, 14.9% [7.3–22.6] %LVmass versus cangrelor, 16.3 [9.9–24.4] %LVmass; P =0.40) or the incidence (placebo, 48% versus cangrelor, 47%; P =0.99) and extent of microvascular obstruction (placebo, 1.63 [0.60–4.65] %LVmass versus cangrelor, 1.18 [0.53–3.37] %LVmass; P =0.46) between placebo and cangrelor despite a 2-fold decrease in platelet reactivity with cangrelor. There were no Bleeding Academic Research Consortium–defined major bleeding events in either group in the first 48 hours. CONCLUSIONS:Cangrelor administered at the time of primary percutaneous coronary intervention did not reduce acute MI size or prevent microvascular obstruction in patients with ST-segment–elevation MI given oral ticagrelor despite a significant reduction of platelet reactivity during the percutaneous coronary intervention procedure.REGISTRATION: URL: https://www.clinicaltrials.gov ; Unique identifier: NCT03102723.

项与 Mount Elizabeth Novena Hospital 相关的新闻（医药）

2023-07-13

·GlobeNewswire-Health Care

International Myeloma Foundation (IMF) to Hold In-Person 2023 Patient and Family Seminar in Los Angeles in August

LOS ANGELES, July 13, 2023 (GLOBE NEWSWIRE) -- The International Myeloma Foundation (IMF) today announced that a 2023 IMF Patient and Family Seminar (PFS) will take place in-person from August 18-19 at the Sofitel Los Angeles at Beverly Hills on 8555 Beverly Blvd., Los Angeles, CA 90048. For those who are unable to attend, there will be a livestream of the seminar for remote viewing. This is the second in-person IMF Patient and Family Seminar to be held this year, with the first one conducted in Boca Raton, FL last March after a 3-year hiatus due to COVID-19. The event aims to help patients and their families learn from world-renowned myeloma experts face-to-face while bonding with others in the community. In 1993, after noticing a need to educate patients and their families, IMF Founder & Director of Global Patient Initiatives Susie Novis Durie initiated the first IMF Patient and Family Seminar. “I was attending a large medical conference, and I thought, 'Where are the patients? Why are they not meeting with these myeloma experts?' After this, the IMF team and I decided to host our first Patient and Family Seminar,” said Susie, on the reason behind its inception. IMF Patient and Family Seminars gather doctors, patients, and families to share stories and connect with those going through similar journeys. These seminars present a unique opportunity for attendees to learn from leading global myeloma researchers, free of charge. Participants gain vital information and a deeper understanding of the newest treatment options and the latest clinical trials from multiple myeloma experts. By creating a venue for leading myeloma experts to interact directly with members of the myeloma community, the IMF facilitated better outcomes for patients and their family members. A Media Snippet accompanying this announcement is available by clicking on the image or link below: “Patient and Family Seminars are informative, fun, inspirational, and hopeful. You can connect with others going through the same journey, find the playbook you want to adopt on your own path, and ask the difficult questions you have been unable to ask in a safe environment. Whether I join a Patient and Family Seminar as ‘just a patient’ or in my role as President and CEO, I always find them invigorating and educational,” shared IMF Patient, President & CEO Yelak Biru. “What the IMF means to me is help, support, friendship,” said myeloma patient and support group leader Sheri Baker. “Sure, nobody wants to have cancer, but it has brought people into my life that never would have come into my life before that. A lot of that is through the IMF. All the people at the IMF – the people who run the Patient and Family Seminars, the people who run our support groups, and the support group leaders that I've met through the IMF – they [have become my] friends.” “Whether you are new in your myeloma journey or a seasoned veteran, once you attend a Patient and Family Seminar, I know you cannot wait until the IMF returns to your area with another program,” said Yelak. The 2023 IMF Los Angeles Patient and Family Seminar will include presentations tackling a variety of topics, to be conducted by esteemed myeloma researchers from all over the world: • Ask-the-Experts - Open Forum Discussion• Taking the Reins of Your Multiple Myeloma Care• Testing and AI• Myeloma 101: What Patients Need to Know• Frontline Therapy• Myeloma.org Presentation• Patient support group programs in Asia• Approaches to Relapse Therapy• Immune Therapy Options• Care Partner Breakout Session Speakers at the PFS in Los Angeles include: Brian G.M. Durie, MD (IMF Chairman of the Board and Chief Scientific Officer)Yelak Biru, MSc (IMF Patient, President & CEO)Robin Tuohy (IMF Vice President, Patient Support)Rafat Abonour, MD (University of Indiana—Indianapolis, IN)Donna D. Catamero, ANP-BC, OCN, CCRC (Icahn School of Medicine at Mount Sinai—New York, NY)Ajai Chari, MD (The Mount Sinai Hospital—New York, NY)Noopur S. Raje, MD (Massachusetts General Hospital—Boston, MA)Daryl Tan, MBBS, M Med, MRCP, FAMS (Mount Elizabeth Novena Hospital—Singapore)Robert A. Vescio, MD (Cedars-Sinai Samuel Oschin Comprehensive Cancer Institute—Los Angeles, CA) Registration is NOW OPEN for the Patient and Family Seminar in Los Angeles, CA. Date: August 18-19, 2023 Venue: Sofitel Los Angeles at Beverly Hills Location: 8555 Beverly Blvd., Los Angeles, CA 90048 The 2023 IMF Los Angeles Patient & Family Seminar is FREE of charge. Register today to reserve your spot and do not forget to book your hotel room by August 2, 2023. If you are unable to attend in person, you may also catch a livestream of the seminar by registering here. ABOUT MULTIPLE MYELOMA Multiple myeloma is a cancer of the bone marrow plasma cells — white blood cells that make antibodies. A cancerous or malignant plasma cell is called a myeloma cell. Myeloma is called "multiple" because there are frequently multiple patches or areas in bone where it grows. It can appear as both a tumor and/or an area of bone loss, and it affects the places where bone marrow is active in an adult: the hollow area within the bones of the spine, skull, pelvis, rib cage, and the areas around the shoulders and hips. ABOUT THE INTERNATIONAL MYELOMA FOUNDATION  Founded in 1990, the International Myeloma Foundation (IMF) is the first and largest global foundation focusing specifically on multiple myeloma. The Foundation's reach extends to more than 525,000 members in 140 countries worldwide. The IMF is dedicated to improving the quality of life of myeloma patients while working toward prevention and a cure by focusing on four key areas: research, education, support, and advocacy. The IMF has conducted more than 250 educational seminars worldwide, maintains a world-renowned InfoLine, and in 2001, established the International Myeloma Working Group (IMWG), a collaborative research initiative focused on improving myeloma treatment options for patients. In 2012, the IMF launched the Black Swan Research Initiative®, a groundbreaking research project aimed at curing myeloma. The IMF can be reached at (800) 452-CURE (2873). The global website is www.myeloma.org. Follow the IMF On:Twitter: @IMFmyelomaInstagram: @imfmyelomaFacebook: @myelomaLinkedIn: International Myeloma Foundation Media Contacts: Peter AntonPanton@myeloma.orgJason LondonJlondon@myeloma.org

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