Research Report Summer 2014 | Volume 12 | Number 2 About the Research Report Research Report is a publication of the Lymphoma Research Foundation, providing the latest updates on our grantees and their progress, as well as on the work of the Foundation. The Lymphoma Research Foundation is the nation’s largest nonprofit organization devoted to funding innovative lymphoma research and serving the lymphoma community through a comprehensive series of education programs, outreach initiatives, and patient services. Inside this Issue Mantle Cell Lymphoma Workshop 1 Letter from the CEO 2 ASCO President Interview News from the Field 5 12 Scientific Advisory Board 14 Foundation Update 15 LRF Convenes 11th Annual Mantle Cell Lymphoma Scientific Workshop Elizabeth Thompson, Lymphoma Research Foundation (LRF) CEO, and John Leonard, MD, Scientific Advisory Board Chair, welcome attendees to the LRF Mantle Cell Lymphoma Scientific Workshop. O n April 23 and 25, 2014, more than 50 lymphoma researchers gathered in Atlanta, Georgia for the Lymphoma Research Foundation (LRF) 11th Annual Mantle Cell Lymphoma (MCL) Scientific Workshop. This annual gathering, which included LRF MCL Consortium members, grantees, and scientists from the United States, Canada, and Europe, provides a unique opportunity for the world’s leading researchers to share scientific and clinical findings, discuss current challenges and successes, and strategize on the most important next steps in MCL research. In their welcoming remarks, LRF Chief Executive Officer Elizabeth Thompson and Scientific Advisory Board Chair John Leonard, MD (Weill Cornell Medical Center), noted LRF’s commitment to MCL research. As the world’s largest private funder of MCL research, LRF has played a central role in the advances made in this area. In his opening remarks, MCL Consortium Chair Leo I. Gordon, MD, FACP (Northwestern University Medical Center) noted that LRF grants have led to important developments in the field, including the sequencing of the MCL genome, identification of new molecular targets for therapy, research into molecular and cellular differences between MCL among individual patients, and the development of a genetically based prognostic model to help tailor treatments. In addition to directly funding MCL research, LRF plays an invaluable role in promoting collaborations between scientists and clinical researchers and between geographically dispersed research groups. Connections facilitated through LRF have led to the awarding of at least three large National Institutes of Health SPORE Project Grants and several other large federal grants, and numerous smaller grants from private sources. The pooling of expertise Continued on page 2 Letter from the CEO Dear Friends, Over the last few months, I have had the opportunity to attend several noteworthy scientific meetings. These programs offered the opportunity to learn firsthand about the latest issues and advances in cancer research and provided the honor of meeting with some of the talented clinicians and researchers who serve on our Scientific Advisory Board (SAB), work on Lymphoma Research Foundation (LRF) funded projects, or contribute to Foundation patient programs and clinical initiatives. The first of these, the LRF Mantle Cell Lymphoma (MCL) Workshop, convened in late April, brought together members of LRF’s MCL Consortium, current and former LRF grantees, and other interested researchers to discuss recent advances in the treatment of this particular subtype of lymphoma. The progress made in the study and treatment of MCL is remarkable and we invite you to read the proceedings of this year’s Workshop, which begin on page one. I have also recently returned from the American Society of Clinical Oncology (ASCO) Annual Meeting in Chicago. This year’s meeting was particularly exciting for LRF, as SAB member Julie Vose, MD, MBA of the University of Nebraska Medical Center, began her term as ASCO President. We are thrilled to have someone of Dr. Vose’s skills and talents representing patients, oncologists, and researchers not just in lymphoma, but across all cancers. A short interview with Dr. Vose may be found on page five. We are also pleased to bring you an expanded News from the Field section, highlighting a few of the notable abstracts in lymphoma research presented at ASCO by Foundation SAB members, on page 12. We highlight two LRF events that raise crucial awareness and support for our mission while giving participants the opportunity to enjoy the warm summer months. The Lymphoma Research Ride, under the dedicated leadership of former SAB Chair Bruce Cheson, has raised over three million dollars to date, and is preparing for its eighth year in Maryland this September, while our annual Golf Invitational raised over a quarter of a million dollars May 2014. More about these events may be found on pages 13 and 15. The research and events highlighted in this issue would not be possible without your continued support and dedication to our mission. On behalf of the LRF Board of Directors and staff, thank you for all you do to help us move forward in our efforts to eradicate lymphoma. Yours in purpose and progress, Elizabeth Thompson Chief Executive Officer MCL Workshop Proceedings continued from page 1 and resources that occurs through these collaborations is essential for making the greatest advances in MCL treatment. As renowned MCL researcher and MCL Consortium Executive Committee member Martin Dreyling, MD, PhD, explained, “It is tremendous what has been accomplished [through LRF and the MCL Scientific Workshop]. This meeting is instrumental for all the collaborations.” This report highlights the themes of LRF’s 2 Research Report 11th Annual MCL Scientific Workshop investigational therapies, and updates and provides a broad overview of each on recent clinical trials in MCL. The workshop also included a Keynote Address presentation. on the use of genomics research in MCL, and a debate on the role of allogeneic Scientific Highlights transplantation versus novel therapies for patients with relapsed or refractory MCL. The 2014 workshop included presenta- Key scientific highlights from the meettions on topics spanning many aspects of ing include: MCL research, including recent advances in the understanding of MCL biology, • A recent data analysis identifying four biologic and environmental factors results of laboratory studies evaluatthat are significantly associated with ing new potential targets for MCL therthe risk of developing MCL. apy, findings from preclinical trials of MCL Workshop- Highlights • Laboratory studies identifying genes that may contribute to the development of MCL, including ATM, NOTCH1, and UBR5. • Description of genetic material, including microRNAs and long noncoding RNAs, which may also play a role in MCL biology. • Molecular characteristics which may predict responses to certain therapies. • Nearby cells and soluble factors that may promote the survival of MCL cells and resistance to therapy. • Newer versions of active agents that may overcome drug resistance seen with some MCL therapies. • Strategies being evaluated to improve responses to therapy such as the use of maintenance therapy, the addition of radioimmunotherapy to autologous stem cell transplant, and the use of more intense induction regimens. • Combinations of targeted agents which have shown activity in preclinical studies and will be evaluated in upcoming clinical trials . • A cell cycle inhibitor currently under evaluation which appears to make cancer cells more sensitive to other drugs. • Cellular immunotherapy strategies currently in early clinical trials, in which a patient’s immune cells are isolated, genetically modified to have enhanced antitumor activity, and infused back into the patient. Foundation’s contribution to this critical work. Tao and his group have been studying the interactions between cancer cells and surrounding cells in the laboratory to try Pathogenesis, Prognostic to understand these interactions at the molecular level. The researchers found Markers, and MCL Biology that certain proteins and small pieces of genetic information, called microRModerator: Martin Dreyling, MD, PhD – NAs, are involved in these interactions. University of Munich-Grosshadern These findings help elucidate the biolScientists are making progress in under- ogy of lymphoma and mechanisms of standing the biology of MCL and why the drug resistance, and may suggest a new prognosis may differ between individual potential therapeutic target. patients. This information may lead to the identification of new therapies and help Kenta Yamamoto (Columbia University guide treatment decisions. Medical Center) discussed the potential role of the ataxia telangiectasia mutated (ATM) gene in the biology of lymphoma. ATM is normally involved in the cell’s DNA repair mechanism, helping to correct the genetic errors that regularly arise in cells. However, the ATM gene is often mutated in lymphoma cancer cells and is inactivated in about half of MCL cases. To better understand the potential role of ATM in MCL, Mr. Yamamoto, who works in the laboratory of Dr. Shan Zha, MD, PhD, and his colleagues generated mice that lack ATM function specifically in B-cells. Work is underway characterizing the lymphomas that develop in these mice, to see how they may correlate with human MCL. Mr. Yamamoto is a young scientist working toward a PhD. Hearing from Mr. Yamamoto serves as a reminder that the LRF not only provides support to established investigators, but is also helping train the next generation of lymphoma researchers. • Discussions of ongoing issues in patient treatment, including the Jianguo Tao, MD, PhD (Moffitt Cancer Center) role of and best agent(s) for maintenance therapy, the optimal use of In the opening presentation of the sestargeted therapies, and the optimal sion, Jianguo Tao, MD, PhD (Moffitt induction therapy for both older and Cancer Center) reported results of laboratory studies investigating how the younger patients. environment around a tumor, called the The research presented at the Workshop, tumor microenvironment, affects cancer both by laboratory scientists and clin- cell growth and survival. Both direct cellical researchers, reflects the continual to-cell contact and the effects of soluble progress being made toward the LRF mis- factors promote cancer cell survival and sion to eradicate lymphoma and serve the development of drug resistance. Dr. those touched by this disease, and the Mamta Gupta, PhD (Mayo Clinic) presented results of laboratory studies investigating the potential role of long noncoding RNA (LncRNA) in MCL biology. Compared with microRNA, the functional significance of long noncoding RNA is not well understood. Recent scientific studies have suggested a possible role for long noncoding RNAs in the development of diseases including cancer. Continued on page 4 lymphoma.org 3 MCL Workshop- Pathogenesis MCL Workshop Proceedings continued from page 3 Dr. Gupta and her colleagues conducted next generation RNA sequencing to identify long noncoding RNAs in MCL cells. The researchers found several long noncoding RNAs that are present in lymphoma cells and may regulate the process by which certain proteins involved in cancer growth are translated. They provided mechanistic evidence that a protein name c-Myc, which is involved with cancer progression, is regulated through GAS5 LncRNAs. These studies provide new insight into lymphoma biology and suggest LncRNA such as GAS5 a new potential target for lymphoma therapy. David Yang, MD (Universit y of Wisconsin) discussed results of studies determining the validity and potential clinical significance of using a technique called immunohistochemistry to assess levels of the cancer-promoting protein MYC in patients with MCL. Previous studies have shown that a high level of MYC genetic material (RNA) is associated with poor prognosis in MCL. Immunohistochemistry detects levels of MYC protein rather than genetic material. Because immunohistochemistry is relatively easy to perform, it could be a useful technique if MYC levels were found to have clinical significance. Dr. Yang and his colleagues therefore conducted studies in which they determined whether levels of MYC RNA correlate with MYC levels as assessed by immunohistochemistry in patients with MCL and other lymphomas. The levels did significantly correlate. The researchers then found that MYC expression as determined by immunohistochemistry is independently predictive of prognosis, and may therefore have clinical utility. However, Dr. Yang explained that a larger study is needed to further evaluate the use of MYC immunohistochemistry in MCL. Girish Venkataraman, MD (University of Chicago) shared a case study in which 4 Research Report Mamta Gupta, PhD (Mayo Clinic) asks a question during a discussion period. an MCL patient did not show the molecular characteristics that are typically seen in MCL. In most cases, MCL is associated with elevated levels of cyclin D1, typically due to a chromosomal translocation between chromosomes 11 and 14 called t(11;14)(q13;q32). However, cases of cyclin D1-negative MCL have been reported. In this case, the patient had been diagnosed years prior with a cyclin D1-negative low-grade B-cell lymphoma. The lymphoma responded to treatment but eventually relapsed. Dr. Venkataraman reported on the molecular characteristics of the lymphoma; at this point, the lymphoma had cyclin D1 overexpression due to a translocation between chromosomes 2 and 11 (t(2;11)), causing an IGK-CCND1 translocation. Investigating cases of MCL that vary from the typical characteristics can help provide a more complete picture of MCL biology and help accurately diagnose patients. Clinical Research in MCL Moderator: Brad Kahl, MD – University of Wisconsin Carbone Cancer Center Clinical researchers are evaluating new ways to treat MCL along the disease continuum, from initial treatment to relapsed disease. Other researchers are identifying risk factors for MCL, to help predict who might be affected and why. Changes are being made to the way large clinical trials are funded in the United States; these may help streamline the clinical trials process, bringing the most pressing issues to the forefront. Ryan Cassaday, MD (University of Washington, Fred Hutchinson Cancer Center) discussed the potential use of high-dose radioimmunotherapy prior to autologous stem cell transplantation (ASCT) for patients with persistent or refractory MCL. In this investigational approach, patients receive high-dose radioimmunotherapy prior to ASCT to remove as many tumor cells as possible before transplant. The radiotherapy is linked to a monoclonal antibody, allowing targeted delivery of radiation directly to tumor cells and other cells expressing the target protein (CD20 in this study). The approach has shown benefit in other types of lymphoma but has not been well studied in MCL. Dr. Cassaday reported on outcomes with the therapy in patients with MCL who had received the therapy at the Fred Hutchinson Cancer Center, comparing outcomes in patients who Continued on page 6 Interview with Dr. Julie Vose An Interview with Julie M. Vose, President of ASCO T he 2014 Annual Meeting of the American Society of Clinical Oncology (ASCO) included the induction of Julie Vose, MD, MBA, FASCO of the University of Nebraska Medical Center, as ASCO President for the 2014-2015 term. Dr. Vose is a long time member of the Lymphoma Research Foundation‘s (LRF) Scientific Advisory Board and has been active in several Foundation initiatives including the LRF Clinical Research Mentoring Program, Lymphoma Rounds, and the North American Educational Forum, which she co-chaired in 2008. Dr. Vose is Neumann M. and Mildred E. Harris Professorial Chair and Chief of the Oncology/Hematology Division in the Department of Internal Medicine at the University of Nebraska Medical Center, and the Associate Director of Clinical Research and Co-Chair of the Lymphoma Program at the Fred and Pamela Buffet Cancer Center. She took time out of her busy schedule to answer a few questions for the Research Report on her new role and goals for her term as President. What prompted you to run for President of ASCO? I have been involved with ASCO since I was a fellow with volunteering for many projects and committees including the education, program, career development, and most recently the ASCO Board of Directors. ASCO is a multi-faceted organization which does so much to assist oncology patients, families and professionals that I became very excited by the programs that ASCO offered. I wanted to be a bigger part of the solution for making a difference for our patients with cancer by serving as ASCO President. What do you hope to accomplish during your presidency? My goals during my term as ASCO President and on the ASCO Executive Committee is to increase the knowledge learned from current patients based upon clinical trial information and from the 97% of patients who are treated off clinical trials to inform the treatments for tomorrow’s cancer patient. We will be doing this with the development of Cancer LinQ, the ASCO rapid learning system. In addition, we need to use data driven guidelines to enhance the quality of our programs so that our resources are used wisely. Overall, we need to utilize our healthcare dollars in a more efficient way to benefit our patients with cancer. How do you see your goals for your presidency affecting lymphoma research and patients specifically? The information learned from patients not currently on clinical trials will be evaluated and will assist us in formulating either new treatments or combinations of older treatments to improve the therapy for patients with all cancers including Long time LRF Scientific Advisory Board Member and new ASCO President, Dr. Julie Vose. lymphoma. Also by being a visible presence and the face of ASCO, I will bring lymphoma research to the forefront of the oncology world for care and research. How has your experience on the LRF Scientific Advisory Board prepared you for working on a larger scale with ASCO? The LRF Scientific Advisory Board is an excellent process for prioritizing precious funding raised from the Foundation. It has been an excellent example of experts and scientists working together to enhance the future of lymphoma care and research. The same collaborations exist in ASCO on a much larger scale involving all types of malignancies. I believe that cooperative agreements between non-profit organizations to assist each other and not duplicate efforts would benefit the research support available. What are the most important things patients and physicians should know about ASCO as an organization? ASCO is the largest international organization for oncology professionals and has 35,000 members. It has many programs and activities that support education, patient advocacy, research, and public policy. The mission of ASCO is to provide the physicians who care for cancer patients the information and support to treat the patients with the best available therapies. Through the philanthropic support of the Conquer Cancer Foundation, ASCO hopes to assist in building a future that has a world free from the fear of cancer. n For highlights of the lymphoma research presented at ASCO, see News from the Field on page 12. lymphoma.org 5 MCL Workshop - Clinical Research MCL Workshop Proceedings continued from page 4 had undergone standard ASCT without radioimmunotherapy. This analysis was conducted retrospectively, after patients had been treated, and thus was not designed to directly compare the two approaches. However, radioimmunotherapy was associated with better survival outcomes after adjusting for important factors such as disease risk, age, and sensitivity to chemotherapy at the time of transplant. Dr. Cassaday noted that these results contradict results of the Nordic MCL3 study, which did not show a benefit with standard-dose radioimmunotherapy for patients in first partial remission. He also explained that the radioimmunotherapy approach used for these patients is no longer available, but it provides proof-of-principle for future studies with alternative approaches to radioimmunotherapy. Peter Hosein, MD (Sylvester Co m p r e h e n s i ve C a n ce r Ce n t e r, U n i ve r s i t y o f M i a m i ) d i s c u s s e d approaches being evaluated to increase the efficacy of MCL therapy, including using a more intense induction regimen and adding maintenance therapy after induction therapy. In two sequential phase 2 trials, the researchers are evaluating four cycles of an intensified CHOPlike regimen and high-dose methotrexate alternating with a high-dose cytarabine combination, in addition to and rituximab in younger patients with MCL (median age, 57 years). Hospitalization is required for the duration of treatment due to the intensity of the regimen. Of 35 patients who were evaluated for efficacy, 34 patients attained a complete response and one patient attained a partial response. Maintenance therapy with thalidomide or rituximab was administered after induction therapy in 32 patients. After a median follow-up of 5.3 years, the median progression-free survival was 7.8 years and the median overall survival had not been reached. At 5 years, 84% of patients were alive and 57% were progression-free. Dr. Hosein concluded that this intensive immunochemotherapy that does not involve ASCT compared favorably with other intensive regimens, including those using ASCT. Martin Dreyling, PhD, MD (University of Munich-Grosshadern) provided an overview of ongoing and future clinical trials in MCL being conducted by the European MCL Network. For the initial treatment of patients younger than age 65, the MCL Younger trial found that alternating courses of R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone) and R-DHAP (rituximab, dexamethasone, cytarabine, and cisplatin) was more effective than R-CHOP alone as induction therapy before ASCT. Other European studies have investigated the potential role of total body irradiation (TBI) as a conditioning regimen prior to ASCT Essentially, in patients with residual lymphomas right before ASCT, TBI results in a significantly improved long term outcome . For older patients, the MCL Elderly R2 trial is comparing R-CHOP versus R-CHOP/Ara-C followed by maintenance rituximab with or without lenalidomide, and in elderly patients a regimen of bendamustine plus rituximab with or without ibrutinib is currently being evaluated followed by maintenance therapy with rituximab with or without ibrutinib. For patients with relapsed disease, European researchers have investigated the role of allogeneic SCT using dose-reduced conditioning for younger patients and the use of radioimmunotherapy in older patients. Researchers are also evaluating R-HAD (rituximab, highdose cytarabine, dexamethasone) with or without bortezomib. Other molecular therapies being evaluated upon a second relapse, or for patients not eligible for R-HAD, include ibrutinib vs. temsirolimus and a three-drug combination of bendamustine, rituximab, and temsirolimus. Thomas Habermann, MD (Mayo Clinic) presents data from the InterLymph NHL Subtypes Project. 6 Research Report Thomas M. Habermann, MD (Mayo Clinic) presented results of MCL data from the InterLymph NHL Subtypes Project, a large analysis incorporating international data sets evaluating potential risk factors in several NHL subtypes. Continued on page 8 MCL Workshop - Keynote Address KEYNOTE SPEAKER Randy Gascoyne, MD T he MCL Workshop’s keynote speaker was Randy Gascoyne, MD, Research Director, Centre for Lymphoid Cancer, British Colombia Cancer Agency. A member of LRF’s Scientific Advisory Board (SAB), Dr. Gascoyne has been both a principal investigator and a collaborator on LRF funded projects in both MCL and follicular lymphoma. Dr. Gascoyne discussed recent advances and future directions in the application of genomics to MCL. The techniques used to perform genomic sequencing have improved dramatically since the first publication of the human genome in 2001. The technology used today, called next-generation sequencing (NGS), has already led to many discoveries in MCL, including the identification of several mutations that could be important in the development of MCL. Dr. Gascoyne reviewed the initial NGS work to come from his laboratory, identifying recurrent mutations in NOTCH1 and UBR5 in MCL. Dr. Gascoyne suggested that next-generation sequencing would continue to have a profound impact on cancer treatment by better elucidating the molecular biology of cancer, leading to the discovery of novel targets for therapy. He also reviewed the first NGS landscape paper published by LRF funded researcher Dr. Elias Campo (PNAS, 2013). Researchers have been exploring the molecular biology of MCL for years. The characteristic genetic event associated with MCL, the t(11;14) translocation leading to cyclin D1 overexpression, is important but not sufficient for the development of MCL. An understanding of the additional genetic alterations that may be involved could lead to the identification of new therapeutic targets. It could be that individual patients may require different therapies based on the molecular characteristics identified at diagnosis. Moreover, the type and frequency of these mutations may change throughout the course of the disease, particularly in the face of therapy. Dr. Gascoyne said that this type of application of genomics “will revolutionize the way we do medicine and the way we treat cancer.” Dr. Gascoyne and his colleagues found that recurrent mutations in NOTCH1 appear to be associated with significantly worse outcomes in MCL. Mutations in a specific enzyme (E3 ubiquitin ligase UBR5¬) are also recurrently found in MCL. Dr. Gascoyne noted that the types of mutations present in MCL cells may change over time as the disease progresses and develops resistance to therapy. The researchers have been investigating mutations associated with resistance to specific MCL therapies. A better understanding of the molecular mechanisms of resistance may explain why some patients respond to certain therapies while others do not. The researchers identified specific mutations (specifically involving TRAF2 and BIRC3 genes in the alternative NF-κB pathway) that are mutated in a subset of patients and likely predict resistance to ibrutinib. These patients may benefit from therapies that use other mechanisms of action. Looking forward, Dr. Gascoyne asserted that targeted genomic studies must be included into phase 2 and 3 clinical trials testing new agents in MCL. He suggested that these studies are needed “to understand the impact of these mutations on response to novel agents and determine resistance mechanisms, so we can achieve the goal of precision medicine.” n lymphoma.org 7 MCL Workshop- Novel Therapies MCL Workshop continued from page 6 Dr. Habermann noted that the etiology of MCL is unknown and no specific causes have been identified to date. In this analysis, various factors (lifestyle, demographic, and health-related) were compared among 14,129 patients with non-Hodgkin lymphoma, including 557 patients with MCL, and 23,096 individuals without lymphoma. The researchers identified 4 factors that were significantly associated with MCL risk. Individuals who were male, had a family history of a hematologic malignancy, or had lived on a farm (but not farm workers who did not live on farms) were associated with an increased risk of MCL. A history of Cristoph Rader, PhD (Scripps Research Institute) and Izidore Lossos, MD (University of atopy (predisposition to an allergic reacMiami) enjoy a discussion. Both investigators are Foundation MCL grantees. tion) was significantly associated with a lower risk of MCL. Dr. Habermann concluded that these findings pave the way in 2014 to discuss clinical trial priorities mTOR inhibitors have shown some efficafor future studies investigating environ- in lymphoma. Dr. Smith indicated that cy in relapsed MCL, not all patients with these changes will require a focusing of MCL respond to these agents and thus mental and genetic risk factors for MCL. efforts to identify the most pressing and newer agents within the class have been Mitchell Smith, MD, PhD (Cleveland potentially practice-changing issues in developed. Whereas the current mTOR inhibitors, such as temsirolimus and Cancer Clinic) led a discussion on recent MCL treatment. everolimus, block their target (mTORC1) changes to the way large federally through indirect effects, newer mTOR funded clinical trials are organized and Novel and Cellular inhibitors directly interfere with mTORC1. funded in the United States. Previously, Therapies Studies from Dr. Bi and colleagues prolarge clinical trials were conducted via vide new information on how these “cooperative groups” such as the Eastern Cooperative Oncology Group (ECOG) and Moderators: Michael Williams, MD – newer agents, called ATP competitive the Southwest Oncology Group (SWOG). University of Virginia; Leo Gordon, MD, inhibitors of mTOR, interact with compoFACP – Northwestern University Medical nents in the cell to inhibit cell growth and Over the past 5-10 years, there has been School induce apoptosis. Understanding these a movement away from having numerous independent cooperative groups A variety of novel approaches to MCL interactions may provide information on towards a more centralized system for therapy are being evaluated. These how to most effectively use the newer planning, organizing, and funding clini- include the use of investigational target- mTOR inhibitors. cal trials. These changes are taking place in an attempt to improve the speed and efficiency of clinical trials, to optimize scientific innovations, and to improve patient recruitment. Under the new system, called the National Clinical Trials Network (NCTN), clinical trial planning and prioritization will be overseen by disease-specific committees and subcommittees. Dr. Smith is serving as the chair of the MCL subcommittee; the broader lymphoma committee plans to meet later 8 Research Report ed agents designed to inhibit processes important to cancer cell growth and survival as well as immune-based therapies designed to harness the power of the immune system to fight MCL. Chengfeng Bi, MD, PhD (University of Nebraska Medical Center) presented results of studies comparing the mechanisms of action of different drugs within the class of mammalian target of rapamycin (mTOR) inhibitors, which include temsirolimus and everolimus. Although Selina Chen-Kiang, PhD (Cornell-Weill Medical Center) provided an update on studies investigating the potential use of the cell cycle (the process by which cells divide) as a target for MCL therapy. An investigational cell cycle inhibitor called PD0332991 (palbociclib) is currently being evaluated in clinical trials of various cancers. PD0332991 interferes with the cell cycle by inhibiting specific proteins, cyclin-dependent kinases 4 and 6. Dr. Chen-Kiang and her colleagues MCL Workshop- Novel Therapies proposed that prolonged inhibition of CDK4/6 in MCL cells may sensitize them to the effects of a partner drug. To evaluate this hypothesis, the researchers conducted a phase I study in which patients with relapsed MCL received PD0332991 in sequential combination with bortezomib. To identify genes that may be associated with responses to, or resistance to, PD0332991, the scientists have been conducting functional genomic analyses of MCL cells isolated serially from patients These studies identified ways that a cell cycle inhibitor may “reprogram” cancer cells, making them sensitive to other cancer drugs. These findings may help elucidate genome-based biomarkers for using these types of drugs for MCL therapy, which has broad implication for targeting the cell cycle in human cancers. also enhance the efficacy of other cancer therapies. C h r i s t o p h R a d e r, P h D ( S c r i p p s Research Institute) reviewed his research group’s progress on developing targeted agents against ROR1 as MCL therapy. ROR1 is a protein that is selectively expressed on the cell surface in certain types of cancer cells, including MCL. Because its expression appears to be fairly restricted, ROR1 may a good therapeutic target, as most healthy cells would be protected. In 2013, Dr. Rader’s produced monoclonal antibodies against ROR1, generated antibody-drug conjugates, and are currently investigating ways to increase the antibody-to-drug ratio to enhance the potency of the antibody-drug conjugate. Mariusz Wasik, MD (Abramson Cancer Center, University of Pennsylvania) discussed an investigational immunotherapeutic technique that involves harnessing the patient’s own immune system to maximize responses to MCL therapy with other agents such as small-molecule BTK inhibitor ibrutinib, the agent with substantial efficacy in MCL. The protocol involves isolating a patient’s T-cells from the blood and genetically modifying them to express chimeric antigen receptors (CARs) that recognize CD19, a protein that is expressed on the surface of many B-cell malignancies. These modified T-cells are then expanded in numbers in the laboratory then infused back into the patient; the modified T-cells may have an enhanced ability to recognize and destroy cancer cells. This immunotherapy approach has shown efficacy in other types of B-cell lymphoma. Dr. Wasik and his colleagues have begun evaluating the approach in MCL, either alone or in combination with Ibrutinib, in laboratory and animal studies. Richard Jones, PhD (The University of Texas, MD Anderson Cancer Center) discussed the use of intravenous immunoglobulin (IVIG) as a novel therapeutic approach in lymphoma. IVIG is a heterogeneous mixture of antibodies made from pooled plasma from more than 10,000 blood donors. IVIG is FDA-approved for a variety of conditions associated with immune deficiency and is used off-label in various autoimmune conditions. IVIG has a good safety profile and has been used for more than 20 Leslie Popplewell, MD (City of years. Dr. Jones suggested that IVIG Mariusz Wasik, MD (University of Pennsylvania) presents an Hope) also discussed the use of may have a role in the treatment of update on his LRF-funded research. CAR-engineered CD19-specific blood cancers, as it has been shown to inhibit the growth of lymphoma cells group received a grant from LRF to devel- T-cells in MCL therapy. Dr. Popplewell and other cancer cells in the laborato- op antibody-drug conjugates targeting and her colleagues have been evaluating ry, and case reports have indicated the MCL. An antibody conjugate is similar to the technique in patients with relapsed efficacy of IVIG in various tumor types. an unconjugated monoclonal antibody B-cell lymphoma to evaluate whether the Dr. Jones explained that IVIG may work such as rituximab but is physically linked immunotherapy can maximize responsthrough numerous mechanisms. One with another component designed to es to ASCT. A phase 1 trial showed the proposed mechanism involves suppres- increase the antibody’s potency and feasibility of isolating, treating, and sion of heat shock protein 70 (HSP-70), minimize toxicity to other cells. The sec- expanding CAR-engineered cells and a protein that is involved in resistance ond component may be a chemotherapy the safety of introducing the cells back to proteasome inhibitors such as bort- drug, radiotherapy, or a protein designed into patients. However, in some patients, ezomib. By blocking those resistance to enhance recruitment of other immune the modified cells did not persist in the Continued on page 10 mechanisms, administration of IVIG may cells. Dr. Rader and his colleagues have lymphoma.org 9 MCL Workshop- Debate MCL Workshop continued from page 9 blood. The researchers then modified the chimeric antigen receptor, using a second generation model with a costimulatory domain in an attempt to enhance the persistence of infused cells in the blood and to further enhance their function. A phase I study evaluating the second generation anti-CD19 CAR+ T-cells is currently underway in a group of patients with B-cell lymphomas with infusion shortly after autologous stem cell transplant during the period of pancytopenia after high dose chemotherapy. Finally, Dr. Popplewell described some further CAR T-cell modifications that are currently being evaluated in preclinical studies to improve the ability to treated cells to recognize and bind to their target cells. Mitchell Smith, MD, speaking on behalf of Xiaoxian Zhao, PhD (Cleveland Clinic), presented preclinical data on a new potential combination therapy approach for MCL therapy. To conduct their laboratory studies, Dr. Zhao and colleagues developed a novel MCL cell line (based originally on cells isolated from a patient with MCL) that has the typical molecular and cellular characteristics of MCL. This MCL cell line allows the researchers to evaluate the antitumor activity of potential therapies. Dr. Zhao and colleagues are evaluating the feasibility of combining ibrutinib with an investigational agent, ABT-199. Whereas ibrutinib inhibits the B-cell receptor signaling pathway, ABT-199 inhibits Bcl-2, a molecule involved in regulating cell survival. Targeting two different pathways important to MCL biology may yield greater antitumor activity. In laboratory studies, the combination of ibrutinib and ABT-199 did appear to have greater activity against MCL cell lines. The researchers conducted molecular studies elucidating the effects of these therapies at the molecular level. Dr. Smith concluded that 10 Research Report the data support further investigation of toxicity and mortality. Therefore, allothis therapeutic strategy for MCL. geneic SCT is typically reserved for certain cases in carefully selected patients. However, there is a reason that allogeDebate: Novel Therapies neic SCT is still considered despite its Versus Allogeneic Stem risks—it has the potential to induce a Cell Transplant complete response even in patients with treatment-refractory disease. The introduction of novel therapies is changing the treatment landscape for The decision of whether to use novel MCL. However, the treatment of relapsed agents or allogeneic SCT was debated and refractory MCL remains a complex by two workshop participants. The parand challenging issue in which many ticipants debated the best approach for factors must be considered. Among the a hypothetical 63 year-old patient with treatment options that are considered intermediate-risk relapsed MCL who has for some patients with relapsed or refrac- a suitable donor for allogeneic SCT. Brad tory MCL are novel therapies and allo- Kahl, MD (University of Wisconsin) was geneic stem cell transplantation (SCT). assigned to argue in favor of novel therAllogeneic SCT differs from autologous apies and Koen van Besien, MD (Weill SCT in the original of the donor stem Cornell Medical Center) was assigned cells that are used to repopulate the to argue in favor of allogeneic stem cell immune system after a conditioning regi- transplantation. Both clinicians agreed men. Whereas autologous SCT uses the that the treatment of relapsed/refracpatient’s own cells, which are collected tory MCL is complex, and the decision and stored prior to the conditioning for transplant-eligible patients is more regimen, allogeneic SCT uses cells from realistically a question of how to best another individual. Because the cells are sequence the use of novel therapies and from another person, allogeneic SCT allogeneic SCT. carries a much higher risk of significant Brad Kahl, MD (University of Wisconsin) and Koen van Besien, MD (Weill Cornell Medical Center) debate treatment options during a hypothetical MCL case study. MCL Workshop- Summary Arguing in favor of novel therapies, Dr. Kahl noted that multiple novel therapies are now FDA-approved for relapsed or refractory MCL including bortezomib, lenalidomide, and ibrutinib. Other agents, including temsirolimus and idelalisib, have demonstrated efficacy in early trials, as have novel combinations such as lenalidomide and rituximab. Dr. Kahl pointed out that durable responses have been reported with some of these novel strategies. There are also agents earlier in development such as ABT-199, which may provide additional options in the future. Combinations of targeted agents may yield even greater efficacy. A planned clinical trial will evaluate ibrutinib administered along with other targeted agents in patients with relapsed or refractory MCL. Given the potential benefit of targeted agents, Dr. Kahl concluded that targeted therapy would be the preferred initial option for this patient, reserving allogeneic SCT for a later time. Arguing in favor of allogeneic SCT, Dr. van Besien noted that allogeneic SCT offers the potential for long-term complete remission. Although allogeneic SCT is associated with a high mortality risk, outcomes after allogeneic SCT have improved in recent years even though the age of patients undergoing the procedure has been increasing (and the risk of toxicity is higher in older patients). Dr. van Besien argued that patients typically receive allogeneic SCT when their disease is highly resistant to chemotherapy; if patients could undergo the procedure earlier in the course of the disease, when the MCL is still sensitive to chemotherapy, outcomes could be better. In regards of what type of SCT procedure to use, Dr. van Besien noted that less intensive conditioning regimens, called reducedintensity conditioning (RIC), have been developed in an attempt to reduce toxicity. However, data suggest that RIC regimens are not necessarily less toxic than conventional regimens. One approach that could be considered is the use of umbilical cord blood transplants, which 2014-2015 MCL Consortium Executive Committee members: Brad Kahl, MD (University of Wisconsin) Leo Gordon, MD, FACP (Northwestern University Medical School), Chair Martin Dreyling, MD, PhD (University of Munich-Grosshadern) Not pictured: Steven Bernstein, MD (University of Rochester) Pedro Jares, MD (University of Barcelona IDIBAPS) may cause less graft versus host disease (GVHD). Both speakers, as well as conference attendees, emphasized the importance of patient preference in developing a treatment plan for relapsed or refractory MCL. Particularly for cases in which there is no clear path, the patient’s treatment goals and preferences have a key role in the treatment decision-making process. Summary For more than a decade, the MCL Consortium has served as a valuable resource for MCL investigators by providing research funding and promoting collaborations that increase the impact of individual research efforts. There has been great progress in MCL in recent years, leading to the development of multiple new effective therapies. There is still work to be done, both in the laboratory and in the context of clinical trials. Scientists left the MCL workshop with new ideas and strengthened connections, ready to press forward toward the goal of eliminating lymphoma. LRF looks forward to continuing to play a central role in these crucial efforts. LRF would like to extend special thanks to Celgene Corporation, and Millennium: The Takeda Oncology Company, for supporting the Annual MCL Scientific Workshop through unrestricted educational grants. n To support LRF’s research initiatives, visit community.lymphoma.org/ supportresearch lymphoma.org 11 News from the Field News from the Field - ASCO Special Edition The annual meeting of the American Society of Clinical Oncology (ASCO) took place in Chicago from May 30 through June 3, 2014, convening over 25,000 oncology professionals from a wide range of specialties. The following are a selection of the significant studies in lymphoma research presented by Lymphoma Research Foundation (LRF) Scientific Advisory Board (SAB) members during the meeting. T he results of the RESONATE trial, presented at ASCO and published concurrently in the New England Journal of Medicine (NEJM), provided further evidence of ibrutinib’s (Imbruvica) effectiveness as an alternative to chemotherapy. 391 patients with relapsed or refractory chronic lymphocytic leukemia (CLL) or small lymphocytic lymphoma (SLL) received either ibrutinib or the standard chemotherapy ofatumumab. The one-year overall survival for patients who received ibrutinib was 90 percent, a significant improvement over the 81 percent rate for patients treated with ofatumumab. Former SAB member John Byrd, MD of Ohio State University was first author on both the ASCO abstract and NEJM paper; SAB members Kristie Blum, MD of Ohio State University and Sandeep Dave, MD, MS of Duke University contributed to the NEJM publication. T he ROMULUS study evaluated new antibody drug conjugates polatuzumab vedotin and pinatuzumab vedotin with rituximab (Rituxan) against each other in relapsed or refractory diffuse large B-cell lymphoma (DLBCL) and follicular lymphoma (FL) patients, seeking to further gauge their effectiveness and toxicity. The two drugs demonstrated similar levels of effectiveness, with polatuzumab vedotin showing response in 56 percent of patients in DLBCL and 70 percent of patients in FL, while pinatuzumab vedotin demonstrated response in 57 percent of patients in DLBCL and 62 percent of 12 Research Report patients in FL. The study is still ongoing; further studies of polatuzumab vedotin and rituximab are planned. A number of researchers with LRF ties contributed to this study, including SAB members Ranjana Advani, MD, PhD of Stanford University, Bruce Cheson, MD, FACP, FAAAS, of Georgetown University, and Oliver Press, MD, PhD of Fred Hutchinson Cancer Research Center, and 2014 Career Development Award recipient Catherine Diefenbach, MD of New York University. I delalisib is an oral drug that inhibits the protein PI3K, which contributes to tumor growth across a variety of nonHodgkin lymphoma (NHL) subtypes. Multiple studies of idelalisib were presented at ASCO, which is currently under evaluation by the U.S. Food and Drug Administration (FDA) in indolent refractory NHL and CLL. One abstract of note looked specifically at idelalisib plus rituximab in CLL subpopulations with common genetic markers that generally indicate poor prognosis. Researchers found that the combination therapy remained effective across all these highrisk subpopulations, with 76.5 percent of patients in the highest-risk subgroup, achieving a response, a rate only slightly lower than the 80 percent of patients who possessed neither high-risk indicator. SAB members Bruce Cheson and Andrew Zelenetz, MD, PhD of Memorial Sloan-Kettering Cancer Center, as well as former SAB member Susan O’Brien, MD of MD Anderson Cancer Center, contributed to the abstract. Three studies of idelalisib also ran concurrently in the May 29 issue of Blood. The studies, available in full on Blood’s website, further reinforced idelalisib’s efficacy in relapsed or refractory patients with indolent NHL, MCL, and CLL respectively. Contributions to these studies were made by the above researchers as well as John Byrd and SAB Member Brad Kahl, MD of the University of Wisconsin. In an accompanying commentary, Bruce Cheson noted that the growing number of positive results for oral agents such as idelalisib “provide further encouragement that the possibility of a chemotherapy-free world is, indeed, a rapidly approaching reality in indolent non-Hodgkin lymphomas, mantle cell lymphoma, and chronic lymphocytic leukemia.” A new combination therapy of lenalidomide (Revlimid) and rituximab was also featured in multiple abstracts at ASCO. A study by the Alliance cooperative group of the therapy as a first treatment in FL featured contributions from SAB members Nancy Bartlett, MD of Washington University Medical School in St. Louis, Kristie Blum, and Bruce Cheson and SAB Chair John Leonard, MD of Weill Cornell Medical Center. Of the 57 patients evaluated, 93 percent responded to treatment, with 72 percent achieving a complete response in an average of 10 weeks. 89 percent of the patients reached two years without further progression of their disease. The findings suggest this therapy could be an effective alternative to standard chemotherapy regimens. H odgkin lymphoma (HL) therapies discussed at ASCO included the ongoing Echelon-1 study, which examined the combination therapy brentuximab vedotin (Adcetris) plus doxorubicin, vinblastine, and dacarbaxine (A+AVD) versus doxorubicin, bleomycin, vinblastine, and dacarbaxine (ABVD) as a first treatment for advanced classical HL. This ongoing trial is a response to an earlier trial comparing A+AVD to brentuximab vedotin plus ABVD (A+ABVD), which concluded that A+ABVD had an unacceptably high rate of pulmonary toxicity (side effects in the lungs) compared to ABVD alone, but noted a lack of those side effects in the A+AVD group. Researchers on Research Ride Lymphoma Research Ride Prepares for Eighth Annual Event O ver the past seven years, one of the Lymphoma Research Foundation’s (LRF) largest annual fundraisers has been the Lymphoma Research Ride, held in Montgomery County, Maryland. Founded in 2007 by Bruce Cheson, MD, Deputy Chief, Division of HematologyOncology and Head of Hematology at the Lombardi Comprehensive Care Center at Georgetown University, and his wife, Christine Cheson, the Research Ride is a non-competitive bike ride where survivors, family, friends, individuals, community teams and corporate teams ride in honor and in memory of those whose lives have been touched by Cyclists gather at the starting line for the 2013 Research Ride. lymphoma. To date, this event has raised more than $3 million The funds raised by the Research Ride are crucial to supporting dollars to fund and raise awareness for lymphoma research. LRF’s grant portfolio. The $455,000 raised in 2013 funded 85 Inspired by the success of the Maryland Research Ride, LRF’s percent of the 2014 Postdoctoral Fellowship grants. In 2014, Dr. Cheson and the planning committee hope to surpass that Chicago Chapter established their own Research Ride in 2013. number, with a fundraising goal of $550,000. Dr. Cheson, a long time member of LRF’s Scientific Advisory Board (SAB) and Chair from 2010 through 2012, began the ride as a The 2014 ride will be held Sunday, September 28. Riders of all way to give back to his patients. “The Ride is a truly extraordinary skill levels are encouraged to participate, and may choose from a experience for the patients, their families, and caregivers,” 25, 40, or 50 mile route. Children ages 10 and above are eligible Dr. Cheson says, “with music, food, and an amazing sense of to ride if accompanied by an adult rider. Training rides will be held in the months leading up to the event. Non-participants enthusiasm and empowerment.” can sponsor the ride by donating to a specific participant or An avid cyclist himself, Dr. Cheson fields his own Research Ride team, or making a general donation. Corporate sponsorships are team that is often at the top of the fundraising totals – for the also available at a variety of levels. Volunteers are also welcome 2013 Ride, they raised more than $52,000. For their dedication to assist and participate in organizing the event. No previous to raising awareness and funding for lymphoma research, the experience is necessary! For more information or to donate, visit Chesons were honored with the Distinguished Service Award at lymphoma.org/Ride2014 or contact Laurie Alfano-Cristaldi at [email protected]. n LRF’s 2013 Gala. News from the Field continued from page 12 this trial, which include SAB members Stephen Ansell, MD, PhD of Mayo Clinic, Nancy Bartlett , Jonathan Friedberg, MD of the University of Rochester , and Anas Younes, MD of Memorial Sloan-Kettering Cancer Center, hypothesize that simply substituting the bleomycin in ABVD for brentuximab vedotin will effectively treat the disease while reducing the pulmonary side effects. The trial is currently enrolling at multiple centers in the United States, Canada, Europe, and Asia. S elinexor, a targeted oral therapy that inhibits the protein exportin 1 (XP01), was featured at ASCO in presentations of early clinical trials across a variety of cancers. SAB member Andre Goy, MD of Jon Theurer Cancer Center contributed to a study measuring dose levels and effectiveness of selinexor in 28 patients with relapsed or refractory NHL. Patients demonstrated a disease control rate (stable disease or better) of 74 percent across all dose levels, with an objective response rate of 28 percent. The trial is still ongoing, but current results suggest the therapy may be effective in patients whose disease is resistant to other treatments. Additional studies are planned in Richter’s Syndrome and DLBCL specifically. n lymphoma.org 13 Scientific Advisory Board Lymphoma Research Foundation’s SCIENTIFIC ADVISORY BOARD 2013 - 2014 The Lymphoma Research Foundation’s volunteer Scientific Advisory Board, comprised of 45 world-renowned lymphoma experts, guides the Foundation’s research activities, seeking out the most innovative and promising lymphoma research projects for support. There’s still time to participate in a late summer or fall Lymphomathon! Since 2003, the Lymphoma Research Foundation (LRF) has raised almost $11.7 million through its nationwide Lymphomathon program. Funds raised by participants support LRF’s mission of eradicating lymphoma and serving those touched by this disease. Puget Sound July 20 Chicago August 24 Los Angeles September 6 Philadelphia September 21 Arizona November 8 Register at lymphomathon.org Leave a Legacy Remember LRF in Your Will Your bequest can have a lasting impact on LRF’s mission to eradicate lymphoma and serve those touched by this disease. To learn more about including LRF in your estate planning, please contact us at [email protected] LRF National Headquarters 115 Broadway, Suite 1301 New York, NY 10006 212-349-2910 212-349-2886 (Fax) [email protected] LRF Helpline 800-500-9976 [email protected] Stay Connected 14 Research Report John P. Leonard, MD Chair New York-Presbyterian Hospital, Weill Cornell Medical Center Leo I. Gordon, MD, FACP Chair Elect Northwestern University Medical School Bruce D. Cheson, MD, FACP, FAAAS Immediate Past Chair Georgetown University Hospital, Lombardi Comprehensive Cancer Center Ranjana Advani, MD Stanford University Medical Center Stephen Ansell, MD, PhD Mayo Clinic Nancy Bartlett, MD Washington University Medical School Steven H. Bernstein, MD University of Rochester Medical Center, James P. Wilmot Cancer Center Kristie A. Blum, MD The Ohio State University Comprehensive Cancer Center John Chan, MD City of Hope Kojo S.J. Elenitoba-Johnson, MD University of Michigan Medical School Laura Pasqualucci, MD Columbia University Herbert Irving Comprehensive Cancer Center Richard I. Fisher, MD Past Chair Fox Chase Cancer Center Temple University School of Medicine Oliver Press, MD, PhD Past Chair Fred Hutchinson Cancer Research Center University of Washington Medical Center Christopher R. Flowers, MD, MS Winship Cancer Institute of Emory University Nathan H. Fowler, MD The University of Texas MD Anderson Cancer Center Jonathan Friedberg, MD University of Rochester James P. Wilmot Cancer Center Randy Gascoyne, MD BC Cancer Agency Andre Goy, MD John Theurer Cancer Center Kanti R. Rai, MD, BS Hofstra North Shore - LIJ School of Medicine Sonali M. Smith, MD The University of Chicago Eduardo Sotomayor, MD H. Lee Moffitt Cancer Center Louis M. Staudt, MD, PhD National Cancer Institute Center for Cancer Research Julie M. Vose, MD, MBA University of Nebraska Medical Center Michael E. Williams, MD Thomas M. Habermann, MD University of Virginia Mayo Clinic School of Medicine Elaine S. Jaffe, MD National Cancer Institute Wyndham Wilson, MD, PhD National Cancer Institute Brad S. Kahl, MD University of Wisconsin Carbone Cancer Center Thomas Witzig, MD Mayo Clinic Neil E. Kay, MD Mayo Clinic Ann S. LaCasce, MD Morton Coleman, MD Harvard Medical School New York-Presbyterian Hospital, Weill Cornell Medical Dana-Farber Cancer Institute Center Izidore Lossos, MD University of Miami Carlo M. Croce, MD Sylvester Comprehensive The Ohio State University Cancer Center Comprehensive Cancer Center Ari Melnick, MD New York-Presbyterian Myron S. Czuczman, MD Hospital Roswell Park Cancer Institute Weill Cornell Medical Center Riccardo Dalla-Favera, MD Craig Moskowitz, MD Columbia University Memorial Sloan-Kettering Herbert Irving Comprehensive Cancer Center Cancer Center Owen O’Connor, MD, PhD Sandeep Dave, MD, MS New York-Presbyterian Duke University Hospital, Columbia University Medical Center Kieron Dunleavy, MD National Cancer Institute Anas Younes, MD Memorial Sloan-Kettering Cancer Center Andrew D. Zelenetz, MD, PhD Memorial Sloan-Kettering Cancer Center Members Emeritus Joseph R. Bertino, MD Founding Chair UMDNJ-Robert Wood Johnson Medical School The Cancer Institute of New Jersey Charles Coltman, MD San Antonio Cancer Institute Saul Rosenberg, MD Stanford University School of Medicine Foundation Update Annual Golf Invitational Raises $276,000 for Lymphoma Research A LEGACY OF PROGRESS A FUTURE of PROMISE 2014 ANNUAL GALA WEDNESDAY, OCTOBER 8, 2014 MANDARIN ORIENTAL, NEW YORK Steve Prince, Chairman, LRF Board of Directors, and Jim Stern. SAVE THE DATE L RF held its Annual Golf Invitational on May 19, 2014 at Quaker Ridge Golf Club in Scarsdale, New York. The outing was attended by 80 golfers and raised $276,000 to support our mission. “The Lymphoma Research Foundation was honored to host its annual Golf Invitational at the world-renowned Quaker Ridge Golf Club,” said Steven J. Prince, LRF Chairman of the Board. “This event was a wonderful opportunity for golf enthusiasts of all levels to enjoy a fun-filled day on one of the best golf courses in the world, while raising awareness and funds for lifechanging lymphoma research.” Golfers enjoyed a round of golf on the pristine course and beautiful spring weather, followed by a cocktail hour, dinner and awards ceremony with prizes for contest winners. LRF would like to express our sincere appreciation to Steve Prince and Jim Stern, who served as the Presenting Sponsors/Underwriters of the event; as well as Michael Targoff, Tournament Sponsor. For more information about the LRF Golf Invitational, including photos from the event, visit lymphoma.org/golf. n North American Educational Forum on Lymphoma October 24 to 26, 2014 Manhattan Beach, California The North American Educational Forum on Lymphoma is the most comprehensive lymphoma-specific educational conference in North America. This annual 2 ½ day program provides critical information on treatment options, support issues, clinical trials and the latest advances in lymphoma research. lymphoma.org/EdForum lymphoma.org 15 NONPROFIT ORGANIZATION US POSTAGE PAID NEW YORK, NY PERMIT #370 Lymphoma Research Foundation 115 Broadway, Suite 1301 New York, NY 10006 2015 Grants Now Open Adolescent/Young Adult Lymphoma Cooperative Group Correlative Grant • Open to researchers pursuing correlative clinical/translational studies in AYA lymphomas that are adjunct to a major NCI cooperative group research project in lymphoma. Young Investigator Grants • Three-Year Clinical Investigator Career Development Award • Two-Year Postdoctoral Fellowship • Lymphoma Clinical Research Mentoring Program For RFPs, visit lymphoma.org/research/grants or contact [email protected] Application Deadline: September 3, 2014
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