TARGET AUDIENCE
This activity is intended for medical oncologists, hematologists-oncologists, hematology-oncology fellows and other healthcare providers involved in the treatment of Waldenström macroglobulinemia (WM).

OVERVIEW OF ACTIVITY
WM is a rare, incurable hematologic disorder characterized by infiltration of the bone marrow and often extramedullary sites by a lymphoplasmacytic infiltrate and an immunoglobulin M (IgM) monoclonal gammopathy. Despite the usually indolent course of WM, a significant proportion of patients require treatment because of hypersecretion of IgM and the invasion of bone marrow and peripheral organs by neoplastic lymphoplasmacytic lymphoma cells. Historically a dearth of research and therapeutic advancements has persisted in the field, but a recent increase in dedicated research to better explain the pathobiology of WM has identified several clinical and genetic markers that serve to prognosticate disease course and patient outcomes. This work has led to dedicated clinical trials and the development of novel drugs and regimens, including the first FDA-approved agent for this diagnosis, ibrutinib monotherapy. The rapid emergence of treatment options, and the unique toxicities and practical nuances associated with their use, has complicated traditional therapeutic decision-making. Although several consensus- and evidence-based treatment guidelines are available to assist clinicians with making management recommendations in this dynamic clinical and research environment, the rarity of the disease means that community oncologists are likely to have limited experience caring for patients with WM.

To bridge the gap between research and patient care, this program features a joint discussion with 2 leading hematology-oncology clinical investigators. By providing access to the latest scientific developments and the perspectives of experts in the field, this CME activity will assist medical oncologists with the formulation of up-to-date clinical management strategies.

LEARNING OBJECTIVES

• Understand the criteria for diagnosis and initiation of therapy for patients with WM, and use this information to guide initial workup and treatment decision-making.
• Recall published efficacy and safety data supporting the recent FDA approval of ibrutinib/rituximab for patients with untreated WM, and use this information to identify individuals for whom this combination may be appropriate.
• Appreciate the frequency and significance of the molecular biomarkers MYD88 L265P and CXCR4, and determine how this information should be used to guide protocol and nonresearch decision-making for patients with newly diagnosed and relapsed/refractory WM.
• Formulate an evidence-based approach to the sequence and selection of therapy for patients with progressive WM, considering age and performance status, symptomatology, prior therapeutic exposure and other disease-related factors.
• Assess emerging research data on the efficacy of proteasome inhibitors, Bcl-2 inhibitors and CXCR4 antagonists in the management of WM.

ACCREDITATION STATEMENT
Research To Practice is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

CREDIT DESIGNATION STATEMENT
CME credit is no longer available for this issue

AMERICAN BOARD OF INTERNAL MEDICINE (ABIM) — MAINTENANCE OF CERTIFICATION (MOC)
CME credit is no longer available for this issue

HOW TO USE THIS CME ACTIVITY
This CME activity consists of an audio component.
CME credit is no longer available for this issue

This CME activity consists of a video component.
CME credit is no longer available for this issue

CONTENT VALIDATION AND DISCLOSURES
Research To Practice (RTP) is committed to providing its participants with high-quality, unbiased and state-of-the-art education. We assess conflicts of interest with faculty, planners and managers of CME activities. Conflicts of interest are identified and resolved through a conflict of interest resolution process. In addition, all activity content is reviewed by both a member of the RTP scientific staff and an external, independent physician reviewer for fair balance, scientific objectivity of studies referenced and patient care recommendations.

FACULTY — The following faculty (and their spouses/partners) reported relevant conflicts of interest, which have been resolved through a conflict of interest resolution process:

Meletios A Dimopoulos, MD
Department of Medical Therapeutics
School of Medicine
National and Kapodistrian University of Athens
Athens, Greece

Honoraria: Amgen Inc, Bristol-Myers Squibb Company, Celgene Corporation, Janssen Biotech Inc, Takeda Oncology.

Steven P Treon, MD, PhD
Professor, Harvard Medical School
Lead Physician, Dana-Farber Cancer Institute
Director, Bing Center for Waldenström’s Macroglobulinemia
Boston, Massachusetts

Consulting Agreement: Janssen Biotech Inc.

MODERATOR — Dr Love is president and CEO of Research To Practice. Research To Practice receives funds in the form of educational grants to develop CME activities from the following commercial interests: AbbVie Inc, Acerta Pharma — A member of the AstraZeneca Group, Adaptive Biotechnologies, Agendia Inc, Agios Pharmaceuticals Inc, Amgen Inc, Ariad Pharmaceuticals Inc, Array BioPharma Inc, Astellas Pharma Global Development Inc, AstraZeneca Pharmaceuticals LP, Bayer HealthCare Pharmaceuticals, Biodesix Inc, bioTheranostics Inc, Boehringer Ingelheim Pharmaceuticals Inc, Boston Biomedical Inc, Bristol-Myers Squibb Company, Celgene Corporation, Clovis Oncology, Daiichi Sankyo Inc, Dendreon Pharmaceuticals Inc, Eisai Inc, Exelixis Inc, Foundation Medicine, Genentech, Genmab, Genomic Health Inc, Gilead Sciences Inc, Guardant Health, Halozyme Inc, ImmunoGen Inc, Incyte Corporation, Infinity Pharmaceuticals Inc, Ipsen Biopharmaceuticals Inc, Janssen Biotech Inc, administered by Janssen Scientific Affairs LLC, Jazz Pharmaceuticals Inc, Kite Pharma Inc, Lexicon Pharmaceuticals Inc, Lilly, Loxo Oncology Inc, a wholly owned subsidiary of Eli Lilly & Company, Merck, Merrimack Pharmaceuticals Inc, Myriad Genetic Laboratories Inc, Natera Inc, Novartis, Oncopeptides, Pfizer Inc, Pharmacyclics LLC, an AbbVie Company, Prometheus Laboratories Inc, Puma Biotechnology Inc, Regeneron Pharmaceuticals Inc, Sandoz Inc, a Novartis Division, Sanofi Genzyme, Seattle Genetics, Sirtex Medical Ltd, Spectrum Pharmaceuticals Inc, Taiho Oncology Inc, Takeda Oncology, Tesaro, Teva Oncology, Tokai Pharmaceuticals Inc and Tolero Pharmaceuticals.

RESEARCH TO PRACTICE CME PLANNING COMMITTEE MEMBERS, STAFF AND REVIEWERS — Planners, scientific staff and independent reviewers for Research To Practice have no relevant conflicts of interest to disclose.

This educational activity contains discussion of published and/or investigational uses of agents that are not indicated by the Food and Drug Administration. Research To Practice does not recommend the use of any agent outside of the labeled indications. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications and warnings. The opinions expressed are those of the presenters and are not to be construed as those of the publisher or grantors.

This activity is supported by educational grants from AbbVie Inc, Janssen Biotech Inc, administered by Janssen Scientific Affairs LLC, and Pharmacyclics LLC, an AbbVie Company.

Hardware/Software Requirements:
A high-speed Internet connection
A monitor set to 1280 x 1024 pixels or more
Internet Explorer 11 or later, Firefox 56 or later, Chrome 61 or later, Safari 11 or later, Opera 48 or later
Adobe Flash Player 27 plug-in or later
Adobe Acrobat Reader
(Optional) Sound card and speakers for audio

Release date: July 2019
Expiration date: July 2020