The 11th Annual Canadian Conference on Lymphoproliferative Disorders provided valuable insights into disease approaches and treatment advances. The conference was divided into sessions in chronic leukemia, lymphomas and multiple myeloma. As a hematology pharmacist working in an ambulatory chemotherapy unit, these conference topics fill my world every day.
Key discussions talked about how we can sequence therapy and novel treatments in our Canadian landscape. In the Multiple Myeloma sessions, for example, we contrasted that induction regimens are often Imid-based in the US but often proteasome inhibitor-based in Canada. In the relapsed setting we need to select combination therapies while taking the patients’ previous therapies into consideration. Much research is being done in Canada to answer sequencing questions with a Canadian perspective.
Another discussion point that came up time and time again was that now is a time of novel anticancer agents. How do classic prognostic factors derived from chemotherapy-based trials or how do indicators of treatment efficacy e.g. minimum residual disease, measure in this era of oral anticancer therapy or immunotherapy? We can now measure deeper disease response beyond CR. Perhaps the bar of treatment success needs to be raised to ensure the disease can stay away longer and longer for our patients. What are the implications for success in the relapsed setting in CLL as we move these agents more and more into front line therapy? Can we adopt time limited therapy with these novel agents so that patients do not need to monitor adverse effects and financial toxicity on a lifelong basis? If we can treat a disease well enough the first time around, perhaps in the future, relapsed treatment options would no longer be needed.
Lastly, this conference brought together hematology nurses and pharmacists to share best practices in the Allied Health Sessions. Approaches to adherence, persistence of therapy: key components to treatment success and key areas in which nurses and pharmacists can make a difference. Alternative or complementary medicine use while on chemotherapy: heme-onc pharmacists have these discussions with their patients on a regular basis. During the Allied Health session we reviewed the evidence behind the most commonly requested products and how to have productive, judgement-neutral conversations about these products while on lymphoma therapy.
I would like to thank CAPhO for the support to attend this valuable conference. My notebook was filled with key takeaways and ideas to modify my practice once I returned home.