Latest Conference Content

Taking aim at relapse rates and overall poor outcomes among adult patients with acute lymphoblastic leukemia (ALL) demands both new therapies and new ways of thinking, according to Anjali S. Advani, MD, of the Cleveland Clinic. Antibodies, which have produced success in treating other blood cancers, offer promise because in some cases the same antigens are involved.

Treating newly diagnosed patients even older ones with a combination of lenalidomide, marketed by Celgene as Revlimid, and low-dose dexamethasone, a steroid, seems likely to become the new treatment standard for multiple melanoma, based on the presentation of a mass vascular endothelial growth factor inhibitor, ive, multinational Phase III study presented Sunday at the 55th American Society of Hematology Meeting and Exhibition in New Orleans.

In recent years, overall progress in treating acute lymphoblastic leukemia (ALL), in which malignant white cells multiply in the bone marrow, has been tempered by this fact: Survival rates among children far outstrip those of adults, with childhood rates reaching 85% and adults registering at 45%.

Progress in treating multiple myeloma, or cancer of the plasma cells in bone marrow, has advanced significantly over the past decade. Today, questions about the disease often involve finding a treatment that balances the goal of putting a patient into remission especially if stem cell transplantation is a possibility against the toxicity of the treatment itself.

With grants from government sources looking less certain, partnerships between academic research center and pharmaceutical companies are more important than ever to keep breakthrough hematology therapies in the pipeline, said Burt Adelman, MD, a hematologist who serves as executive vice president and chief medical officer for Dyax Inc.

New therapies to treat chronic lymphocytic leukemia (CLL) will receive plenty of attention this week at the 55th American Society of Hematology Annual Meeting and Exposition in New Orleans. At an education session that opened the meeting Saturday, a physician with the Mayo Clinic made it clear that cost considerations are a reality for many older patients.

Ample evidence supports obesity as an independent risk factor for cardiovascular disease (CVD). Traditionally, obesity is defined by body mass index (BMI); however, recent data suggest metabolic syndrome and excess adipose tissue play more of a role than BMI in determining CVD risk. In this session, Jaime Armando, PhD, and colleagues from the University of Texas Southwestern Medical Center; and Amparo Figueroa, MD, MPH, from Massachusetts General Hospital, presented results from studies that examined the roles of metabolic syndrome and excess adipose tissue in determining CVD risk.

In a presentation titled Readmission for Stroke and Quality of Care Among Hospitalized Patients With Transient Ischemic Attack: Real World Delivery of Care, Emily C. O'Brian, PhD, from Duke University School of Medicine, presented results from the American Heart Association's Get With the Guidelines (GWTG)-Stroke program. GWTG is a hospital improvement program designed to improve adherence to evidence-based care.

In this session, data were presented from 3 separate trials that focused on potential ways to reduce the risk for bleeding in patients who require anticoagulation therapy, including the use of genetic tests to optimize warfarin dosing and the use of the factor Xa inhibitor edoxaban. Munir Pirmohamed, MD, PhD, from the University of Liverpool, discussed results from the EU-PACT trial; Stephen Kimmel, MD, from the University of Pennsylvania School of Medicine discussed results from the COAG trial; and Robert P. Giugliano, MD, SM, FAHA, FACC, from Brigham and Women's Hospital, discussed results from the ENGAGE TIMI-AF 48 trial.

In this session, the efficacy and safety profiles of novel alternatives to warfarin were discussed by Jeffrey Weitz, MD, FACP, from McMaster University. Also discussed was the selection of the right anticoagulant for the right patient.

In this session, Denise Bonds, MD, MPH, from the National Heart, Lung, and Blood Institute, discussed the limitations of outcomes research conducted using claims or registry data. According to Dr Bonds, the trend is to use new data, big data, and patient-powered data. In another presentation, Catarina Kiefe, PhD, MD, from the University of Massachusetts Medical School, provided preliminary findings from her research in patients with acute coronary syndrome as an example of how outcomes research is evolving.

Patients spend far more time in the home than with their healthcare providers, making the home an ideal and perhaps essential place to improve adherence and outcomes. In this session, Kathryn Donofrio, DNP, MBA, RN, from Swedish Covenant Hospital, and Debra Moser, DNSc, MN, RN, from the University of Kentucky, discussed home-based strategies for care improvements in patients with heart failure.

Accountable Care Organizations (ACOs) are designed to improve the quality and continuity of care, but it remains unclear how stakeholders can be successful in this new model and also how the shift in incentives will truly impact care. In this session, W. Douglas Weaver, MD, from the Henry Ford Heart and Vascular Institute and Henry Ford Hospital, and Karen E. Joynt, MD, MPH, from Brigham and Women's Hospital and Harvard Medical School, discussed the potential impact of ACOs on specialty care and the potential for ACOs to limit access to care.

Recently released guidelines from the American College of Cardiology and American Heart Association base treatment on a 10-year risk for atherosclerotic cardiovascular disease, a shift from the previous guidelines' overall emphasis on treat to target. In this session, C. Noel Bairey Mertz, MD, FACC, from the Cedars-Sinai Heart Institute; Jennifer G. Robinson, MD, MPH, from the University of Iowa; and Karol Watson, MD, PhD, FACC, from the University of Southern California, Los Angeles, discussed the evidence supporting cholesterol lowering in women, the elderly, and minorities.

The participants in this session noted that the medical record of the future will likely include a prognostic genetic component that will have short- and long-term implications. Panelists included Jennifer Hall, PhD, FACC, FAHA, from the University of Minnesota; Dan Roden, MD, from Vanderbilt University; Gary H. Gibbons, MD, from the National Heart, Lung, and Blood Institute; and Christopher Cannon, MD, from Brigham and Women's Hospital.

The fourth session of the FDA Town Hall Meeting at the Transcatheter Cardiovascular Therapeutics (TCT) conference was titled Regulation and Reimbursement: Global Imperatives and Trends. It began with the keynote address, The Intersection of Innovation, Payment and Regulatory Approval in the Future of Interventional Cardiology, delivered by Jack L. Lewin, MD, CEO of the Cardiovascular Research Foundation. He discussed 5 critical trends affecting innovation: progression of science, information technology and big data, changing politics and public scrutiny of healthcare quality and costs, regulatory expansion, and healthcare payment reform.

FDA Town Hall Meeting is a multi-part session held yearly at the Transcatheter Cardiovascular Therapeutics (TCT) conference. At this year's conference, the first portion, titled The Year in Review: A Year in Transition, was introduced by Martin B. Leon, MD, and Bram D. Zuckerman, MD. The Town Hall Meeting is meant to be dynamic and inclusive of key forces from the regulatory environment, clinical scientists, and representatives from industry.

The multi-part session, On Deck: Next Generation Biologics, was part of a larger session at the Transcatheter Cardiovascular Therapeutics (TCT) conference, called Strategies for Cardiovascular Repair: Stem Cells and Beyond. The first portion on extracellular matrices and related products was presented by Karen Christman, PhD, associate professor of bioengineering at the University of California San Diego. Dr Christman discussed the use biomaterials for treating the extracellular matrix of the heart after MI.

A multi-part session titled Stroke in Atrial Fibrillation: A Preventable Condition was begun by Michael D. Ezekowitz, MB, ChB, DPhil, of the Lankenau Institute for Medical Research. In his presentation titled All Novel Agents are Preferred to Warfarin, he discussed the benefits of novel anticoagulant agents.

Atrial Fibrillation, the Epidemic of Our Time was the first portion of a multi-part session titled Pharmacological and Interventional Options for Stroke Prevention in Atrial Fibrillation. The introduction, titled Multifaceted Approaches to Atrial Fibrillation: From Drugs to Ablation to Left Atrial Appendage Closure, was delivered by Vivek Y. Reddy, MD, professor of medicine in cardiology at Mount Sinai Medical Center.

The first part of the session titled Innovation in Transition: Models, Global Trends, Regulatory Challenges, and Funding Opportunities started with a presentation from John B. Simpson, MD, PhD, chief executive officer at Avinger, Inc, called Individual-Based Innovation. Dr Simpson briefly described the lumivascular approach to treatment of cardiovascular disease, which is image-guided atherectomy.

This multi-part presentation was begun with Then and Now: The Evolution of Translational Science, Clinical Evidence-Based Medicine, and Socioeconomic Considerations, delivered by Elazer R. Edelman, MD, PhD, physician at Brigham and Women's Hospital and professor at Harvard Medical School and MIT. He began by discussing the history of innovation in biomedical research and then outlining a current problem in US innovation.

The first presentation in this multi-part session, Current Status of Lipid Lowering Therapy in CAD, PAD, and CKD, was delivered by Rita Redberg, MD, professor of medicine and director women's cardiovascular services, University of California, San Francisco. According to Dr Redberg, a heart-healthy diet, regular physical activity, weight management, medications, and smoking cessation are mainstays of prevention.

The multi-part session at the Transcatheter Cardiovascular Therapeutics (TCT) conference was moderated by Roxana Mehran, MD, professor of medicine at Icahn School of Medicine at Mount Sinai in New York, NY. Dr Mehran began by emphasizing the importance of clinical research in interventional cardiology. She then described the session's speakers as premier investigators.

For Douglas Long, MBA, vice president, industry relations, IMS Health, Inc, keeping up-to-date on the trends and forecasts of the evolving managed care arena is crucial to remaining competitive.

Michael Fischer, MD, associate professor of medicine, Harvard Medical School, associate physician, Division of Pharmacoepidemiology and Pharmacoeconomics, Brigham and Women's Hospital, said that the complexity of the healthcare system is part of the challenge of managing adherence.

Dual eligibles-the class of Americans that qualify for both Medicaid and Medicare coverage-are mostly older adults with low incomes and tend to be the sickest beneficiaries covered by either Medicaid or Medicare.

Almost all pharmacy and therapeutic committees have a unique process for evidence-based formulary decision making, said Steven Pearson, MD, founder & president, Institute for Clinical and Economic Review.

The dynamic landscape of healthcare and managed care pharmacy will be deeply impacted by new and emerging specialty medications. The ever-spiraling costs of specialty medications have led many experts to question whether these treatments translate into true improvements in health outcomes or patients' quality of life.

Not surprisingly, Thomas Merrill, lead researcher, Center for Accountable Care Intelligence, Leavitt Partners, LLC, said that cost is a major work flow challenge associated with Accountable Care Organizations.