Tweet Chat Recap: Evaluating Treatment Approaches for Relapsed/Refractory DLBCL – Targeted Oncology
By daniellenierenberg
Targeted Oncology was joined by Kami J. Maddocks, MD, associate professor of clinical internal medicine, Division of Hematology, The Ohio State University Comprehensive Cancer CenterJames, for the discussion of a 76-year-old man with relapsed/refractory diffuse large B-cell lymphoma (DLBCL) in a recent tweet chat. In this case scenario, the patient presented with stage IV high-risk disease and received R-CHOP (Rituximab [Rituxan], cyclophosphamide, doxorubicin, vincristine, prednisone), and radiotherapy.
Although the treatment appeared well-tolerated, the patient presented with similar symptoms as at diagnosis after completing 6 cycles with complete response to the therapy. According to the work-up, the patient is ineligible for transplant.
The patient was ineligible for stem cell transplantation (SCT), which Maddocks speculates may be due to the patients age, although other considerations could include comorbidities or intolerance to R-CHOP. Eligibility is the first thing she considers for her patients as it is currently the standard of care and the only curative approach for patients to receive salvage chemotherapy followed by consolidation with autologous SCT.
Maddocks told Targeted Oncology, In some patient cases, [the reason for ineligibility] is age even though there's no specific age cutoff, but we know that it's harder on the marrow as patients get older to collect stem cells and get that aggressive salvage chemotherapy. Patient comorbidities [can also impact eligibility], so heart conditions, lung conditions, renal insufficiency can be a problem. Performance status and then lastly, just if the patient had trouble getting to their initial chemotherapy with R-CHOP or had a lot of complications, then it's probably going to be harder for them to tolerate even more aggressive or intensive therapy.
In a twitter poll ahead of the chat, Targeted Oncology asked what the next best line of therapy for this patient might be, with 4 potential different treatment options. The option that drew the most attention, however, was the recently approved regimen of tafasitamab (Monjuvi) and lenalidomide (Revlimid).
Maddocks tweeted, All these options are potential therapeutic choices for this patient, but the combination of tafasitamab/lenalidomide is the only option approved in this setting. The treatment has a promising ORR [overall response rate], and CR [complete response], and the remissions for patients who respond are durable!
During the tweet chat, Maddocks reviewed each of the different treatment options in the poll, and why she selected this combination regimen as the next best line of therapy for this particular patient. Following the chat, she spoke with Targeted Oncology to share further insights on each of these therapeutic approaches and the importance of the FDAs approval of tafasitamab plus lenalidomide in this setting.
The combination of tafasitamab plus lenalidomide held the majority vote, which Maddocks agreed would be the next best line of therapy for this patient.
For patients who are not candidates or considered eligible for a salvage chemotherapy followed by autologous SCT, the tafasitamab/lenalidomide combination was recently approved in the setting of first relapse, and it's the only approved therapy in this setting, Maddocks said. Historically, we would give some sort of palliative chemotherapy approach if patients were candidates and interested in pursuing therapy, or consideration of clinical trial, but this is the only therapy approved in this setting.
The approval of tafasitamab in combination with lenalidomide includes an indication for patients who are not eligible for autologous SCT, as describes the patient in our case. This regimen was approved on the basis of the phase 2 L-MIND (NCT02399085) clinical trial, which explored this use of this regimen in 81 patients with relapsed/refractory DLBCL. Two-year follow-up demonstrated an ORR of 58.5%, which included CRs in 41.3% of patients and partial responses (PRs) in 17.5% of patients. In addition, 15.0% achieved stable disease, and the median duration of response was 34.6 months (95% CI, 26.1-34.6).1
I think this patient case is the perfect example of where this can fit into the treatment landscape, Maddocks explained. For patients who first relapse from the standard R-CHOP therapy, the toxicities were generally manageable, and with the response rate, this is a great option for patients at first relapse who are not going to be candidates for a transplant. I think maybe patients who go on to get palliative chemotherapy or maybe patients who get treatment with plans to go to transplant but just don't tolerate it and dont look like they're going to [undergo] aggressive therapy, this may be an option for those patients too, understanding that there is some role for CAR T in a set of those patients.
This study, which was presented during the 25th Congress of the European Hematology Association (EHA), demonstrated that the majority of toxicities were hematologic, and most were reversible. The most common grade 3 hematologic treatment-emergent adverse events (TEAEs) were neutropenia in 49.4% of patients, thrombocytopenia in 17.3%, and febrile neutropenia in 13.2%.1
These were able to be managed by holding the dose growth factor, and there was a population of patients who had to be dose-reduced on the lenalidomide. The starting dose was 25 mg, so the majority were able to maintain 20 mg if they were dose-reduced, although a few had to be reduced more than once, Maddocks said. The most common grade 3/4 or serious AEs were infection, probably not surprisingly, and overall, that's probably similar to what you see with other options in this setting. There was a small number of infusion reactions, but these were all grade 1 in the trial and were easily managed.
Non-hematologic TEAEs of grade 3 included pneumonia in 8.6% of patients and hypokalemia in 6.2%. Serious AEs reported included pneumonia in 8.6%, febrile neutropenia in 6.2%, and pulmonary embolism in 3.7%, as well as bronchitis, lower respiratory tract infection, atrial fibrillation, and congestive cardiac failure in 2.5% each.1
Given the safety profile of this combination of tafasitamab plus lenalidomide, this regimen is particularly suitable for a large proportion of patients with DLBCL, Gilles Salles, MD, PhD, lead author of L-MIND, toldTargeted Oncology. We do know that the median age of occurrence of DLBCL is in the late 60s, and there are many, many patients that are over 70 and that are not usually transplant eligible. Clearly this is a great opportunity for patients to receive this non-cytotoxic regimen.
Although this regimen is an exciting opportunity for patients with DLBCL and relapsed/refractory disease, 1 challenge that needs to be addressed is the potential use of tafasitamab plus lenalidomide in sequence with CAR T-cell therapy. There is very little experience, if any, of patients receiving the combination regimen after receiving CAR T-cell therapy. The combination and CAR T cells both target the same antigen, CD19, which can be problematic. As its known that some patients will lose CD19 expression on CAR T-cell therapy, the regimen may no longer be an effective treatment option.
For those patients that had failed CAR T-cell therapy, substantial proportions, about 30% of them, may have lost CD19 expression and then may not be eligible anymore for this regimen. There is, however, a substantial proportion of patients that retains CD19 and in whom tafasitamab/lenalidomide can be used as a treatment option, Salles commented.
A large proportion of patients will maintain CD19 expression following CAR T-cell therapy, so tafasitamab plus lenalidomide may still be effective in a percentage of patients.
Its hard to say because we dont have a lot of data, but we do know there are other CD19-directed therapies outside of CAR T cell development, Maddocks told Targeted Oncology. I think in the next few years, were going to see patients treated both pre- and post-CAR T with other CD19-directed therapies, and well have more information on this.
The combination of polatuzumab vedotin (Polivy) plus bendamustine (Bendeka) and rituximab (BR) was approved by the FDA as treatment of patients with relapsed/refractory DLBCL after 2 prior lines of therapy in June 2019 based on the findings from the phase 1b/2 GO29365 (NCT02257567) clinical trial. Although this option is also not FDA-approved for the treatment of patients after first relapse, Maddocks noted that this was the only treatment evaluated in a randomized trial. The study had included patients who were ineligible for transplant.
Significant improvements were observed with polatuzumab vedotin plus BR compared with BR alone in an international, multicenter, open-label study, particularly in regard to the ORR, CRs, progression-free survival (PFS), and overall survival (OS). CRs were observed in 40.0% of the patients with the combination versus 17.5% with BR alone. Survival rates favored the combination as well, with a median PFS of 9.5 months with the combination versus 3.7 months with BR alone (HR, 0.36; 95% CI, 0.21-0.63; P <.001) and a median OS of 12.4 months versus 4.7 months (HR, 0.42; 95% CI, 0.24-0.75; P =.002), respectively.2
The addition of polatuzumab did increase toxicity from the standpoint of cytopenias, but that didn't really translate to increased serious infections. It did add neuropathy as a side effect, but most of that was reversible, so I think this was a regimen that, by the addition of polatuzumab, was something that you could offer patients that did give them somewhat of a better overall response and was more durable than just giving them a palliative chemotherapy alone, Maddocks added. This is also a regimen that's been used in patients who were not able to achieve a remission to bridge them to CAR T or in some patients after CAR T, and so I can understand why this was definitely one of the more favorable choices.
In the study, grade 3/4 neutropenia was observed more frequently in the combination arm (42.6%) compared with the BR alone arm (33.3%), but the occurrence of grade 3/4 infections was comparable between the 2 groups (23.1% vs. 20.5%, respectively). In addition, the study authors noted that although many of the fatal AEs occurred after disease progression, 11 patients in the BR arm experienced fatal AEs compared with 9 in the combination arm, infection being the most common, which was the cause in 4 patients in each arm.2
Although the regimen appeared tolerable in this setting, Maddocks tweeted, it is more attractive than chemotherapy alone and understandable why it was chosen [as the second-best option in the Twitter poll].
Among the treatment options considered in our twitter poll ahead of the tweet chat, selinexor (Xpovio) only caught the attention of 16.7% of voters, similar to CAR T-cell therapy. However, both of these options are currently only approved in patients who have received at least 2 prior lines of therapy, which this case did not.
In regard to selinexor in particular, Maddocks tweeted, Looking at the single arm phase 2 data, it also has the lowest overall response rates of all the options listed with an ORR of 28%.
Selinexor received its approval from the FDA in June 2020, which is indicated for the treatment of adult patients with relapsed/refractory DLBCL, not otherwise specified, who have received at least 2 prior systemic therapies. This is the only oral single-agent therapy approved in this setting, and it is also the only nuclear export inhibitor approved by the FDA for use in hematologic malignancies.
The agent was approved on the basis of the phase 2b SADAL clinical trial, which demonstrated an ORR of 29% with 13% CRs and 16% PRs. The responses achieved in the study were durable, which led to a median duration of response of 9.2 months in the overall population (95% CI, 4.8-23.0) and 13.5 months in those who had achieved a CR (95% CI, 9.3-23.0).3
The most common treatment-related AEs were cytopenias and gastrointestinal/constitutional symptoms, which were generally reversible and manageable with dose modifications and/or standard supportive care approaches. The most common on-hematologic AEs, which were mostly grade 1/2, were nausea (52.8%), fatigue (37.8%), and anorexia (34.6%). The most common grade 3/4 AEs included thrombocytopenia (39.4%), neutropenia (20.5%), and anemia (13.4%). No treatment-related grade 5 AEs were observed.
CAR T-cell therapy, on the other hand, offers a unique option to this patient case even though it is still only approved in patients who have progressed or relapsed after 2 prior therapies or SCT. The TRANSCEND-PILOT-017006 (NCT03483103) study is evaluating the potential for CAR T-cell therapy lisocabtagene maraleucel (liso-cel) as treatment of patients with relapsed/refractory aggressive B-cell non-Hodgkin lymphoma who have received at least 1 prior therapy and are ineligible for SCT. While this does appear promising for introducing CAR T-cell therapy earlier on for patients with DLBCL, the treatment is not available off trial and is not a standard approach.
Maddocks told Targeted Oncology, It's very clear who's eligible for autologous transplant by age and comorbidities, but with CAR T, it's not so clear all the time who is going to be a candidate. There's not as great of data or information on who is going to be a candidate for that or not. Probably more patients are going to be a candidate for transplant, but there is still going to be patients that are comorbidities that they're not going to be a candidate for CAR T cells, and while they're approved in this setting and they can be very effective, there's also logistical issues, including that right now there's only certain centers, most often transplant centers, that are able to administer CAR T cells, so the patient has to have access to a center, they have to be able to get through the time that their leukapheresis cells are sent out and then sent back, and there's still barriers to cost and insurance in some patients, too.
This particular patient case does represent a challenge, Maddocks said. Historically, this is not a patient that's going to be a candidate for an autologous SCT, and that's going to be the only curative approach. CAR T is not approved in this setting, which is the other curative approach we know outside of patients who are unable to get to autologous STC, or at least appears to be likely curative for a percentage of patients.
Overall, CAR T-cell therapy is not a viable treatment option for the patient depicted in our tweet chat discussion, although it can still offer curative opportunities to a select group of patients with DLBCL who are ineligible for transplant.
In conclusion, tafasitamab plus lenalidomide helps fulfill the unmet need of patients who are in first relapse but are ineligible for transplant, which is the only curative option for patients with relapsed/refractory DLBCL. Although CAR T cells appear hopeful in this space, more research needs to be done to further determine their role in the treatment paradigm.
When you look at relapsed DLBCL, in general, and have these options, it's exciting for our patients to be able to have these. All of these have come up in the last 1 to 2 years, CAR T being a little bit longer than the other 3 regimens, but they all have offered patients tolerable therapy in the setting of previously not having these options.
Reference
1. Salles G, Duell J, Gonzlez-Barca E, et al. Long-term outcomes from the phase II L-MIND study of Tafasitamab (MOR208) plus lenalidomide in patients with relapsed or refractory diffuse large B-cell lymphoma. Presented at: Presented at: EHA25 Virtual; June 11-21, 2020. Abstract EP1201.
2. Sehn LH, Herrera AF, Flowers CR, et al. Polatuzumab Vedotin in Relapsed or Refractory Diffuse Large B-Cell Lymphoma.J Clin Oncol. 2019;38(2):155-165. doi: 10.1200/JCO.19.00172
3. Kalakonda N, Cavallo F, Follows G, et al. A phase 2b study of selinexor in patients with relapsed/refractory (r/r) diffuse large B-cell lymphoma (DLBCL).Hematol Oncol. 2019;37(S2). doi: 10.1002/hon.31_2629
Continue reading here:
Tweet Chat Recap: Evaluating Treatment Approaches for Relapsed/Refractory DLBCL - Targeted Oncology
- 001 Cardiac Stem Cell Therapy [Last Updated On: June 24th, 2011] [Originally Added On: June 24th, 2011]
- 002 Wow! UW Research labs [Last Updated On: June 25th, 2011] [Originally Added On: June 25th, 2011]
- 003 cellalign [Last Updated On: June 28th, 2011] [Originally Added On: June 28th, 2011]
- 004 Cardiac Stem Cells in End-Stage Human Failing Hearts: Are they functional? [Last Updated On: August 25th, 2011] [Originally Added On: August 25th, 2011]
- 005 Designer Life: repair brain, heart with stem cells - Future Health keynote speaker [Last Updated On: September 4th, 2011] [Originally Added On: September 4th, 2011]
- 006 Cardiac Stem Cell Therapy at Rostock University [Last Updated On: September 4th, 2011] [Originally Added On: September 4th, 2011]
- 007 Stem Cells: Mending a broken heart? [Last Updated On: September 4th, 2011] [Originally Added On: September 4th, 2011]
- 008 Cardiovascular Derivatives of Embryonic Stem Cells in Cardiac Repair and Drug Discovery [Last Updated On: September 4th, 2011] [Originally Added On: September 4th, 2011]
- 009 Stem Cell Therapy in Cardiac Disease [Last Updated On: September 4th, 2011] [Originally Added On: September 4th, 2011]
- 010 Cardiac Recovery Points to Adult Stem Cells [Last Updated On: September 4th, 2011] [Originally Added On: September 4th, 2011]
- 011 Oral Surgeon utilizes StemSave to preserve stem cells in wisdom teeth to combat cardiac disease [Last Updated On: September 4th, 2011] [Originally Added On: September 4th, 2011]
- 012 Stem Cells and Cardiac Regeneration [Last Updated On: September 4th, 2011] [Originally Added On: September 4th, 2011]
- 013 Dr Victor Dzau on Stem Cells for Cardiac Repair. [Last Updated On: September 4th, 2011] [Originally Added On: September 4th, 2011]
- 014 Cardiomyogenic differentiation of Mesenchymal Stem cells (KUM2/9-15c) [Last Updated On: September 4th, 2011] [Originally Added On: September 4th, 2011]
- 015 Heart Failure Patient After Adult Stem Cell Therapy [Last Updated On: September 5th, 2011] [Originally Added On: September 5th, 2011]
- 016 Stem Cell operation in Cardiac Surgery-Al-Jazeerah [Last Updated On: September 7th, 2011] [Originally Added On: September 7th, 2011]
- 017 Heart Disease Patient Describes His Stem Cell Treatment [Last Updated On: September 9th, 2011] [Originally Added On: September 9th, 2011]
- 018 Cardiovascular Therapies: Spotlight on Stem Cell Research - Douglas Boyd [Last Updated On: September 16th, 2011] [Originally Added On: September 16th, 2011]
- 019 Adult Stem Cell [Last Updated On: September 20th, 2011] [Originally Added On: September 20th, 2011]
- 020 Heart repair using own stem cells after heart attack: Future Health keynote speaker [Last Updated On: September 20th, 2011] [Originally Added On: September 20th, 2011]
- 021 Stem Cell #8 Vas Cath Removal 04/28/11 [Last Updated On: September 20th, 2011] [Originally Added On: September 20th, 2011]
- 022 Adult Stem Cells Used To Rebuild Heart Tissue Video. More at http://www.stemcellfusion.com [Last Updated On: September 20th, 2011] [Originally Added On: September 20th, 2011]
- 023 Davos Question: Stem Cell Answer [Last Updated On: September 22nd, 2011] [Originally Added On: September 22nd, 2011]
- 024 Did you have a Heart Attack and Need to Recover your Cardiac Muscle? [Last Updated On: September 22nd, 2011] [Originally Added On: September 22nd, 2011]
- 025 Cardiac Tissue Can Regenerate [Last Updated On: September 22nd, 2011] [Originally Added On: September 22nd, 2011]
- 026 William F. Testimonial of Treatment Stem Cell [Last Updated On: September 23rd, 2011] [Originally Added On: September 23rd, 2011]
- 027 Stem Cell Heart Surgery must see [Last Updated On: September 24th, 2011] [Originally Added On: September 24th, 2011]
- 028 Valentine's Day Stem Cell Wish: Mending Broken Hearts [Last Updated On: September 24th, 2011] [Originally Added On: September 24th, 2011]
- 029 Advanced Cell Technology OneMedForum 2011 [Last Updated On: September 24th, 2011] [Originally Added On: September 24th, 2011]
- 030 Human 2.0: The Helix of Our Future [Last Updated On: September 24th, 2011] [Originally Added On: September 24th, 2011]
- 031 heart cell generation from human ES and iPS cells (embryonic and induced pluripotent stem cells).flv [Last Updated On: September 24th, 2011] [Originally Added On: September 24th, 2011]
- 032 Stem Cell Therapy and Stem Cell Treatment with Dell [Last Updated On: September 24th, 2011] [Originally Added On: September 24th, 2011]
- 033 UCD Med Student Receives Fulbright Award [Last Updated On: September 24th, 2011] [Originally Added On: September 24th, 2011]
- 034 Cardiomyocytes derived from mouse Embryonic stem cells [Last Updated On: September 25th, 2011] [Originally Added On: September 25th, 2011]
- 035 Immune Control of Stem Cell Mobilization [Last Updated On: September 25th, 2011] [Originally Added On: September 25th, 2011]
- 036 Better Drugs Through Stem Cells [Last Updated On: September 25th, 2011] [Originally Added On: September 25th, 2011]
- 037 stem cell derived cardiomyocytes [Last Updated On: September 25th, 2011] [Originally Added On: September 25th, 2011]
- 038 Stem Cells: Heart cells grown from mouse stem cells [Last Updated On: September 25th, 2011] [Originally Added On: September 25th, 2011]
- 039 Patel Stem Cell Heart Failure [Last Updated On: September 25th, 2011] [Originally Added On: September 25th, 2011]
- 040 Turning Adult Stem Cells into Medicine - Zannos Grekos, MD [Last Updated On: September 25th, 2011] [Originally Added On: September 25th, 2011]
- 041 Kevin's 2 Heart Transplants and Stem Cell Transplant [Last Updated On: September 25th, 2011] [Originally Added On: September 25th, 2011]
- 042 Breakthrough in Stem cell technology [Last Updated On: September 25th, 2011] [Originally Added On: September 25th, 2011]
- 043 Affordable Stem Cell Therapy in Guatemala (2hrs from Miami) [Last Updated On: September 26th, 2011] [Originally Added On: September 26th, 2011]
- 044 Cadiomyogenesis of human mesenchymal stem cells [Last Updated On: September 26th, 2011] [Originally Added On: September 26th, 2011]
- 045 Mark Mercola: Differentiating embryonic stem cells into adult tissues [Last Updated On: September 26th, 2011] [Originally Added On: September 26th, 2011]
- 046 Cardiomyocytic differentiation of endometrial stem cells. [Last Updated On: September 26th, 2011] [Originally Added On: September 26th, 2011]
- 047 Adult Stem Cell vs Embryonic Stem Cell Research Ethics Video [Last Updated On: September 26th, 2011] [Originally Added On: September 26th, 2011]
- 048 Pt. 1--Dr. Ali Denktas--Stem Cells as Markers after Myocardial Infarctions [Last Updated On: September 27th, 2011] [Originally Added On: September 27th, 2011]
- 049 Repairing Damaged Hearts with Stem Cells [Last Updated On: September 29th, 2011] [Originally Added On: September 29th, 2011]
- 050 Mouse GEN cells overexpressing Csx/Nkx2.5 and GATA4 behave like transient amplifying cells [Last Updated On: September 29th, 2011] [Originally Added On: September 29th, 2011]
- 051 20100804_axiogenesis.wmv [Last Updated On: September 29th, 2011] [Originally Added On: September 29th, 2011]
- 052 Beating Cardiomyocytes from E14 Cells [Last Updated On: September 29th, 2011] [Originally Added On: September 29th, 2011]
- 053 Heart cells grown from human embryonic stem cells [Last Updated On: September 29th, 2011] [Originally Added On: September 29th, 2011]
- 054 First US Patient In Stem Cell Transplant [Last Updated On: September 29th, 2011] [Originally Added On: September 29th, 2011]
- 055 Be still my beating stem cell heart [Last Updated On: October 1st, 2011] [Originally Added On: October 1st, 2011]
- 056 Beating Human Heart Cells from Embryonic Stem Cells [Last Updated On: October 1st, 2011] [Originally Added On: October 1st, 2011]
- 057 Spontaneously and rhythmically beating engineered human heart tissue from pluripotent stem cells [Last Updated On: October 3rd, 2011] [Originally Added On: October 3rd, 2011]
- 058 Cardiac Stem Cell Therapy - How it works [Last Updated On: October 3rd, 2011] [Originally Added On: October 3rd, 2011]
- 059 Doctors To Use 'Trained' Stem Cells To Heal Heart [Last Updated On: October 5th, 2011] [Originally Added On: October 5th, 2011]
- 060 Beating Heart Stem Cells [Last Updated On: October 5th, 2011] [Originally Added On: October 5th, 2011]
- 061 AM RADIO, DR. AMIT PATEL AND STEM CELLS SAVED MY LIFE - Video [Last Updated On: October 14th, 2011] [Originally Added On: October 14th, 2011]
- 062 New heart built with stem cells - Video [Last Updated On: October 15th, 2011] [Originally Added On: October 15th, 2011]
- 063 Adult Stem Cells For Heart Disease: Today's Reality - Video [Last Updated On: October 15th, 2011] [Originally Added On: October 15th, 2011]
- 064 H9 beating stem cells - Video [Last Updated On: October 27th, 2011] [Originally Added On: October 27th, 2011]
- 065 Double Blind Trial of Stem Cells for Heart Failure - Video [Last Updated On: October 27th, 2011] [Originally Added On: October 27th, 2011]
- 066 Repairing Damaged Hearts with Stem Cells - Video [Last Updated On: October 27th, 2011] [Originally Added On: October 27th, 2011]
- 067 Cardiac differentiation of hES cells at 20x - Video [Last Updated On: October 27th, 2011] [Originally Added On: October 27th, 2011]
- 068 SPRAY-ON STEM CELLS - Video [Last Updated On: October 28th, 2011] [Originally Added On: October 28th, 2011]
- 069 Stem Cells: A smart use for wisdom teeth - Video [Last Updated On: November 12th, 2011] [Originally Added On: November 12th, 2011]
- 070 VistaGen's Stem Cell Derived Cardiomyocytes - Video [Last Updated On: November 12th, 2011] [Originally Added On: November 12th, 2011]
- 071 Stem Cell Research [Last Updated On: November 12th, 2011] [Originally Added On: November 12th, 2011]
- 072 The Power of Stem Cells - Video [Last Updated On: November 12th, 2011] [Originally Added On: November 12th, 2011]
- 073 Beating iCellĀ® Cardiomyocytes - Video [Last Updated On: November 13th, 2011] [Originally Added On: November 13th, 2011]
- 074 SCIPIO: Cardiac stem cells and postinfarction heart failure - Video [Last Updated On: November 15th, 2011] [Originally Added On: November 15th, 2011]
- 075 Beating Cardiomyocytes in Cell Culture - Video [Last Updated On: November 15th, 2011] [Originally Added On: November 15th, 2011]
- 076 Stem Cells Heal Heart Attack Damage. - Video [Last Updated On: December 7th, 2011] [Originally Added On: December 7th, 2011]
- 077 C2CAM - 2011.11.15 - Dulce Base - Regenerative Medicine - Info - Video [Last Updated On: December 7th, 2011] [Originally Added On: December 7th, 2011]
- 078 Latest Update on Stem Cell Research at UW - Dr. Timothy Kamp - Video [Last Updated On: December 7th, 2011] [Originally Added On: December 7th, 2011]
- 079 Coast To Coast AM: Regenerative Medicine / Dulce Base 11-15-2011 Download Link - Video [Last Updated On: December 7th, 2011] [Originally Added On: December 7th, 2011]
- 080 C2CAM - 2011.11.15 - Dulce Base - Regenerative Medicine - Video [Last Updated On: December 7th, 2011] [Originally Added On: December 7th, 2011]
