0:00
Hello everyone.
My name is Nishitha Reddy
and I'm the Associate Professor
of Medicine
at Vanderbilt University Medical Center
and the Director
of the Lymphoma Program here.
Today we'll be discussing
the novel treatment options
that are available for lymphoma
and leukemia treatments.
0:19
So in the last decade, we have seen
an emergence of several new drugs
that have been approved for both Hodgkin
and non-Hodgkin lymphoma,
and most of these agents
are targeted therapies
that were designed
to alter a specific pathway
or antibodies
that bind to a particular site.
As we can see here,
several novel agents have been approved
since 2008 up until now.
Starting in 2008,
bendamustine was approved
for relapsed indolent lymphomas.
And following that,
several new agents have been
approved specifically obinutuzumab,
which is one of the novel
monoclonal antibody therapies
for approval in CLL
and relapsed follicular lymphoma
in combination with bendamustine.
Another agent is brentuximab,
which was approved in 2011
for Hodgkin lymphoma.
And more recently
some of the novel agents
such as PD-1 inhibitors,
specifically nivolumab and pembrolizumab
have been given accelerated approval
for Hodgkin lymphoma.
So in the next several slides,
we will be discussing the mechanisms
of action of these agents,
the current indications,
the side effects of novel agents
used in the treatment of lymphomas
and leukemias.
1:38
Here's an example of several new drugs
that are in the development of lymphoma
for various indications.
Although, this slide does not cover
all the novel targeted drugs,
it at least gives us an idea
to where we stand in drug development,
and how these agents will shape
in the future of therapy for lymphoma.
For, example, some of the newer
monoclonal antibodies directed
towards CD20 are obinutuzumab
and ofatumumab.
And brentuximab is a CD30 antibody
which has been recently approved
for Hodgkin lymphoma.
We will go further
in detail of these drugs
as we move further into the slides.
Proteasome inhibitors are
specifically targeting the NFkB pathway,
and one such drug is bortezomib,
that's been approved
for mantle cell lymphoma.
Other second generation
proteasome inhibitors
are also currently under development
such as carfilzomib and ixazomib.
HDAC inhibitors
which are histone deacetylase
inhibitors,
romidepsin, vorinostat, and belinostat
have also been approved
in T-cell lymphomas.
Another exciting area
are Burton's kinase inhibitors
such as ibrutinib, and acalibrutinib.
While discussing
tyrosine kinase inhibitors,
we would also like to mention
PI3kinase inhibitors
which specifically inhibit
the PI3kinase pathway
and the mTOR pathway are the idelalisib,
duvelisib, and copanilisib.
Currently, idelalisib is the drug
that's approved for treatment
in indolent non-Hodgkin lymphoma.
More recently, BCL2 inhibitors
have been gaining interest.
Specifically, the BCL2
inhibit the BCL2 pathway,
and an example
in that area is venetoclax.
Immune checkpoint inhibitors
which are mostly of interest
in solid tumor oncology
such as lung cancer and melanoma
have recently gained interest
in lymphomas as well.
Nivolumab, and pembrolizumab
are such examples,
they are PD1 and PDL1 inhibitors,
specifically.
Fostamatinib is a splenic
tyrosine kinase inhibitor,
and second generation
splenic tyrosine kinase inhibitors
are currently underway.
Certain drugs
that are called immune modulators
which really don't have
any specific single mechanism of action
but have a varied mechanism of action
and are also anti-angiogenic
are lenalidomide,
and pomalidomide approved
in multiple myeloma
but also seem to have activity
in lymphomas as well.
