-
1 week ago | 
targetedonc.com | Catherine Lee |Michael Bishop |Paul Shaughnessy
May 26, 2025 By Panelists discuss how most clinicians prefer ruxolitinib over ibrutinib as second-line therapy due to better tolerability Ruxolitinib Data and Clinical Experience This segment focuses on the REACH-3 study data for ruxolitinib, demonstrating significant advantages over best available therapy: Median failure-free survival: 38 months vs 6 months 12-month failure-free survival probability: 64% vs 30% Duration of response was not reached in the ruxolitinib group vs 6.5 months in...
-
1 week ago | 
targetedonc.com | Catherine Lee |Michael Bishop |Paul Shaughnessy
May 26, 2025By Panelists discuss how FDA-approved therapies such as ibrutinib, ruxolitinib, belumosudil, and axatilimab provide treatment options for steroid-refractory chronic graft-vs-host disease (cGVHD).
-
2 weeks ago | 
targetedonc.com | Catherine Lee |Michael Bishop |Paul Shaughnessy
Steroid Management and ProphylaxisThis segment focuses on steroid management and prophylaxis in chronic GVHD patients. The panel discusses steroid tapering approaches (typically 10-mg reductions every 4 weeks, slowing at 20 mg daily) and addressing steroid complications.
-
2 weeks ago | 
targetedonc.com | Catherine Lee |Michael Bishop |Paul Shaughnessy
Clinical Case Continued (Part 2)In the clinical case, prednisone at 0.5 mg/kg/day was initiated with a 6-week taper. The patient initially improved but experienced progression during tapering. Steroids were increased again, but another taper was unsuccessful, leading to diagnosis of steroid-refractory cGVHD.
-
3 weeks ago | 
targetedonc.com | Catherine Lee |Michael Bishop |Paul Shaughnessy
Treatment Approaches (Part 1) For newly diagnosed moderate to severe cGVHD, the panel discussed: Initial steroid dosing: Dr Bishop: 1 mg/kg/day for severe cases, possibly split dosing Dr Shaughnessy: 0.5 mg/kg/day for many cases, 1 mg/kg/day for severe lung or liver involvement All agree on assessing response for at least 1-2 weeks before tapering Steroid taper considerations: Slow, cautious tapers, especially for cGVHD (unlike acute GVHD) Generally 10 mg every 1-2 weeks after stabilization,...
-
3 weeks ago | 
targetedonc.com | Catherine Lee |Michael Bishop |Paul Shaughnessy
Clinical Case Presentation (Part 1)A 50-year-old woman underwent allogeneic transplant with reduced-intensity conditioning from a matched unrelated donor for mesenchymal stromal cells. Her donor was a cytomegalovirus-negative 45-year-old man, and GVHD prophylaxis was tacrolimus and mycophenolate mofetil.
-
1 month ago | 
targetedonc.com | Catherine Lee |Michael Bishop |Paul Shaughnessy
Difficult-to-Diagnose Manifestations The panelists discussed challenging presentations: Pulmonary involvement is often insidious, requiring careful monitoring with serial PFTs Genital/gynecologic involvement is often underdiagnosed but impacts quality of life significantly Neuropathies are difficult to attribute to cGVHD due to multiple potential causes Peripheral edema can make assessment of skin thickening/sclerosis challenging Serositis (inflammation of tissue lining around heart, lungs,...
-
1 month ago | 
targetedonc.com | Catherine Lee |Michael Bishop |Paul Shaughnessy
Diagnosis and Clinical ChallengesFor diagnosis, the panel generally relies on clinical features rather than biopsies for typical presentations.
-
1 month ago | 
targetedonc.com | Catherine Lee |Michael Bishop |Paul Shaughnessy
Overview and Pathophysiology of cGVHDThe panel featured Dr Catherine Lee (Fred Hutch Cancer Center), Dr Michael Bishop (University of Chicago), and Dr Paul Shaughnessy (Sarah Cannon Transplant cellular therapy program).
-
1 month ago | 
targetedonc.com | Catherine Lee |Michael Bishop |Paul Shaughnessy
Clinical Prevalence and Risk Factors The panel discussed the frequency of cGVHD in clinical practice: Common risk factors include HLA disparity, donor characteristics, and GVHD prophylaxis regimen Post-transplant cyclophosphamide has reduced overall incidence of cGVHD, though severity remains similar when it does occur The panel still quotes patients approximately 50% risk of developing cGVHD Most common manifestations in practice are: Eyes, mouth, and skin (consensus among all panelists)...
