18th Annual Advances in Oncology - 2017

Treatment of Non-Hodgkin’s Lymphoma: State of the Art and Home

Brewed Approaches

The Magic of Fermentation

An Enlightening Case• ND, a 77 y/o male with Stage IV mantle cell lymphoma

– extensive bulky disease in nearly all nodal stations – adamantly opposed to chemotherapy– over a 2-3yr period had tried a number of alternative treatment approaches.

• presented to consultation– bilateral pleural effusions– left chest wall mass– bulky inguinal adenopathy– dyspneic and appeared cachectic

• continued to refuse chemotherapy and insisted on initiating therapy with fermented wheat germ extract (also known as MSC).

Follow-up of ND

BC

FWGE Pre-clinical Efficacy in Burkit’s Xenograft Model

Protein fraction resuspended in saline

Protein pellet freeze-dried

Soluble fraction precipitated with ethanol

Wheat germ + Saccharomyces cerevisiae

In-house Production of Fermented Wheat Germ

Table 1: IC50s for FWGP

Cell line Human tumor IC50 (µg/ml)HCT-15 Colon 12SNU-16 Gastric 12DG-75 Burkitt’s lymphoma 20

HCT-116 Colon 23DLD-11 Colon 27

Raji NHL 39Chevalier NHL 40WSU-WM NHL/Waldenstrom 42

Ramos NHL 70Sudhl4 NHL 70A549 Lung 70BM35 NHL 71

Granta519 NHL 80H1650 Lung 144DoHH2 NHL 171HepG2 Hepatic 245MCF-7 Breast 639

FWGPIn vivo efficacy

Mastewal Abuhay/Tuscano Lab

Figure 4: NK cell depletion abrogates FWGP activity in vivo

���Relevant financial relationships in the past twelve months by presenter or spouse/partner. � �Grant/Research Support: Celgene, Novartis, Takeda�Speakers Bureau: Celgene, Amgen, Seattle Genetics�   ����The speaker will directly disclosure the use of products for which are not labeled (e.g., off label use) or if the product is still investigational.Slide Number 2Slide Number 3Slide Number 4Slide Number 5Slide Number 6Slide Number 7Slide Number 8Slide Number 9Slide Number 10Slide Number 11CR Rates in Relapsed/Refractory Aggressive B-NHL Treated�With the CD19-Directed CAR T-Cell Product JCAR017�(TRANSCEND NHL 001)Slide Number 13Slide Number 14Alpha and Delta PI3K IsoformsCHRONOS-1�Phase 2 Study of Copanlisib in R/R NHLCHRONOS-1�MethodsCHRONOS-1�ResultsCHRONOS-1�SafetyDoes classification by “cell or origin (COO)” guide therapeutic decisions?Slide Number 21Slide Number 22Slide Number 23Slide Number 24Clinical Impact of the Cell-of-Origin Classification and the MYC/BCL2 Dual Expresser Status in Diffuse Large B-Cell Lymphoma Treated Within Prospective Clinical Trials of the German High-Grade Non-Hodgkin's Lymphoma Study Group Slide Number 26Slide Number 27Bispecific T-Cell Engager (BiTE) Antibody Construct�Blinatumomab for the Treatment of Patients With�Relapsed/Refractory Non-Hodgkin Lymphoma: Final�Results From a Phase I Study���Maria-Elisabeth Goebeler, Stefan Knop, Andreas Viardot, Peter Kufer, Max S. Topp, Hermann Einsele,�Richard Noppeney, Georg Hess, Stefan Kallert, Andreas Mackensen, Kathrin Rupertus, Lothar Kanz,�Martin Libicher, Dirk Nagorsen, Gerhard Zugmaier, Matthias Klinger, Andreas Wolf, Brigitte Dorsch,�Beate D. Quednau, Margit Schmidt, J¨urgen Scheele, Patrick A. Baeuerle, Eugen Leo, and Ralf C. Bargou��J Clin Oncol 34:1104-1111. © 2016Slide Number 29Slide Number 30A Taste of Locally Brewed Clinical ResearchPleiotropic Effects of LenalidomideAbstract 249�Correlative Analysis and Clinical Update of a Phase 2 Study Using Lenalidomide and Rituximab in Patients With Indolent �Non-Hodgkin Lymphoma�Slide Number 34Slide Number 35Slide Number 36Slide Number 37Case ReportCase report - imagingCase report – Patient APPatient APSlide Number 42Slide Number 43Slide Number 44Slide Number 45California Cancer Consortium Protocol 9197Slide Number 47A Phase I Trial of the Combination of Lenalidomide and Blinatumomab in Patients with Relapsed or Refractory Non-Hodgkins Lymphoma (NHL)�NCI Protocol # 9924First Patient to Complete Therapy on 9924The Magic of FermentationAn Enlightening CaseFollow-up of NDSlide Number 53Slide Number 54Slide Number 55FWGP�In vivo efficacyFigure 4: NK cell depletion abrogates FWGP activity in vivo