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leukemia

ICML 2017: Phase III GENUINE Trial: Ublituximab Plus Ibrutinib in High-Risk CLL

Data was recently presented from the phase III GENUINE trial of ublituximab, a novel glycoengineered anti–CD20 monoclonal antibody, in combination with ibrutinib (Imbruvica), a Bruton tyrosine kinase (BTK) inhibitor, for the treatment of high-risk chronic lymphocytic leukemia (CLL), at the...

leukemia
lymphoma

ICML 2017: Triplet Combination of Umbralisib, Ublituximab, and Ibrutinib in CLL/SLL/NHL

Data from the chemotherapy-free triple combination of umbralisib, an oral, next generation PI3K delta inhibitor; ublituximab, a novel glycoengineered anti-CD20 monoclonal antibody; and ibrutinib (Imbruvica) in patients with chronic lymphocytic leukemia (CLL)/small lymphocytic lymphoma (SLL) and...

Leukemia

Clofarabine-Based Consolidation in Younger Patients With AML

In a French randomized phase II trial reported in the Journal of Clinical Oncology, Thomas et al found that clofarabine-based consolidation may provide improved relapse-free survival vs conventional high-dose cytarabine in postremission treatment in younger patients with acute myeloid leukemia...

Hematologic Malignancies
Leukemia

Idelalisib Toxicities Appear to Be Immune-Related

Phosphoinositide 3-kinase (PI3K) inhibitors represent a highly active class of drug for the treatment of chronic lymphocytic leukemia (CLL). Idelalisib (Zydelig), a PI3K-delta inhibitor and the first PI3K inhibitor to be approved by the U.S. Food and Drug Administration (FDA) for CLL, has...

Leukemia

Venetoclax Achieves Durable and Deep Remissions in CLL

Preliminary study results suggest that venetoclax (Venclexta) plus rituximab (Rituxan) is a highly active combination in relapsed/refractory chronic lymphocytic leukemia (CLL), achieving durable responses and minimal residual disease negativity in previously treated patients. “The results of our...

Leukemia

Expert Point of View: David L. Porter, MD & Jonathan S. Serody, MD

In a separate interview with The ASCO Post, David L. Porter, MD, Director of Blood and Marrow Transplantation and the Jodi Fisher Horowitz Professor in Leukemia Care Excellence at the University of Pennsylvania, Philadelphia, said: “It is encouraging that many patients with acute lymphoblastic...

Leukemia

CAR T Cells in Relapsed B-Cell Acute Lymphoblastic Leukemia

Updated results in 51 adults with relapsed B-cell acute lymphoblastic leukemia (ALL) treated with chimeric antigen receptor (CAR) T cells at Memorial Sloan Kettering Cancer Center in New York showed high complete response rates regardless of pre–CAR T disease burden.1 That said, pretreatment...

Leukemia

First-in-Human Clinical Trial in Children and Young Adults With Leukemia

After phase I results of Seattle Children’s Pediatric Leukemia Adoptive Therapy (PLAT-02) trial, published by Gardner et al in Blood,1 showed T-cell immunotherapy to be effective in sending 93% of patients with relapsed or refractory acute lymphoblastic leukemia (ALL) into complete initial...

leukemia

First-In-Human Clinical Trial Aims to Extend Remission for Children and Young Adults With Leukemia Treated With T-Cell Immunotherapy

After phase I results of Seattle Children's Pediatric Leukemia Adoptive Therapy (PLAT-02) trial, published by Gardner et al in Blood, showed T-cell immunotherapy to be effective in sending 93% of patients with relapsed or refractory acute lymphoblastic leukemia (ALL) into complete initial...

Leukemia

Blinatumomab ‘Takes a BiTE’ Out of Acute Lymphoblastic Leukemia

An investigational immunotherapy is improving outcomes in difficult-to-treat acute lymphoblastic leukemia (ALL) and showing promise in other cancers, as well. Blinatumomab (Blincyto), the first U.S. Food and Drug Administration (FDA)-approved bispecific T-cell engager (BiTE), has demonstrated...

hematologic malignancies
leukemia

FDA Approves Midostaurin in Combination With Chemotherapy for Newly Diagnosed FLT3-Positive Acute Myeloid Leukemia

On April 28, 2017, the U.S. Food and Drug Administration (FDA) approved midostaurin (Rydapt) for the treatment of adult patients with newly diagnosed acute myeloid leukemia (AML) who are FLT3 mutation–positive, as detected by an FDA-approved test, in combination with standard cytarabine and...

Leukemia

Expert Point of View: Susan O'Brien, MD

Susan O’Brien, MD, Associate Director for Clinical Science, Chao Family Comprehensive Cancer Center, University of California Irvine Health, put the venetoclax (Venclexta) monotherapy study in context. “The study by Jones et al is impressive. Patients who fail on a prior kinase...

Leukemia

Updated Data on Treatment With Ibrutinib and Venetoclax in Patients With CLL/SLL

Long-term follow-up of treatment with ibrutinib (Imbruvica) in patients with previously untreated and treated chronic lymphocytic leukemia (CLL)/small lymphocytic leukemia (SLL) has shown high response rates that are durable. At 5 years, 89% of patients with treatment-naive and relapsed or...

Leukemia

CAR T-Cell Therapy Shows Benefit in Patients With Treatment-Resistant Chronic Lymphocytic Leukemia

Researchers from Fred Hutchinson Cancer Research Center in Seattle reported early results from a small study of their chimeric antigen receptor (CAR) T-cell product (JCAR014) in chronic lymphocytic leukemia (CLL) at the 2016 American Society of Hematology (ASH) Annual Meeting & Exposition....

Leukemia

Different Subtypes of Acute Myeloid Leukemia Create Both Clinical and Research Challenges

Acute myeloid leukemia (AML) is the most common leukemia in adults. Each year, about 20,000 Americans will be diagnosed with AML, and roughly 10,000 people in this country will die of the disease. AML progresses quickly, and unless treatment begins soon and is effective , the prognosis is grim....

leukemia

Blinatumomab After Failure of TKI Treatment in B-Precursor Acute Lymphoblastic Leukemia

In a phase II trial reported in the Journal of Clinical Oncology, Martinelli et al found that blinatumomab (Blincyto) produced complete responses in patients with relapsed/refractory Philadelphia chromosome–positive (Ph+) B-precursor acute lymphoblastic leukemia (ALL) progressing after...

leukemia

Mercaptopurine Ingestion Habits and Risk of Relapse in Children With Acute Lymphoblastic Leukemia

In a report from the Children’s Oncology Group Study AALL03N1 published in the Journal of Clinical Oncology, Landier et al found no association between oral mercaptopurine ingestion habits in children with acute lymphoblastic leukemia and risk of relapse after adjustment for medication...

Leukemia
Cost of Care

Financial Burden of Targeted Oral Therapy for Patients With Chronic Myeloid Leukemia

In a study reported in the Journal of Oncology Practice, Chan Shen, PhD, of The University of Texas MD Anderson Cancer Center, and colleagues found that more than three-quarters of patients receiving targeted oral therapy for chronic myeloid leukemia (CML) reached the catastrophic phase of the...

leukemia

Association of DNA Thioguanine Nucleotide Concentration and Outcome During Maintenance Therapy for Childhood ALL

In a substudy of a European phase III trial (Nordic Society of Pediatric Hematology and Oncology ALL2008) reported in The Lancet Oncology, Nygaard Nielsen et al found that higher leukocyte DNA-incorporated thioguanine nucleotide (DNA-TGN) levels were associated with an improved relapse-free...

leukemia

Benefit of Imatinib in Chronic Myeloid Leukemia Persists Long Term in IRIS Trial

Long-term follow-up of patients with chronic myeloid leukemia (CML) randomized to imatinib in the IRIS trial was reported by Hochhaus et al in The New England Journal of Medicine. In the open-label crossover-design trial, 1,106 patients with CML were randomized to receive imatinib at 400 mg/d (n = ...

leukemia

Blinatumomab vs Chemotherapy in Advanced Acute Lymphoblastic Leukemia

In the phase III TOWER trial reported in The New England Journal of Medicine, Kantarjian et al found that blinatumomab (Blincyto) treatment improved overall survival vs chemotherapy in heavily pretreated patients with B-cell precursor acute lymphoblastic leukemia (ALL). Blinatumomab received...

leukemia

Clofarabine-Based Consolidation in Younger Patients With Acute Myeloid Leukemia in First Remission

In a French phase II trial reported in the Journal of Clinical Oncology, Thomas et al found that clofarabine-based consolidation may provide improved relapse-free survival vs conventional high-dose cytarabine in postremission treatment in younger patients with acute myeloid leukemia (AML) and no...

Leukemia

Study Finds Children, Parents Overreport Adherence to Leukemia Treatment

New research suggests that young patients with acute lymphocytic leukemia (ALL)—the most common type of pediatric cancer—and their parents are likely to report to their physician that they took more of their anticancer medication than they actually did. The study, published by Landier et al in...

Leukemia

Phase II Studies Evaluate New Approaches in Richter Transformation

Despite advances in treating chronic lymphocytic leukemia (CLL), the 5% to 10% of patients who develop Richter transformation continue to have poor outcomes. For these patients, median progression-free survival is approximately 6 months, and median overall survival is about 8 months. Phase II...

leukemia
issues in oncology

Children, Parents Overreport Leukemia Treatment Adherence

New research suggests that young patients with acute lymphocytic leukemia (ALL) and their parents are likely to report to their physician that they took more of their anticancer medication than they actually did. The study, published by Landier et al in Blood, found that 84% of patients with ALL...

leukemia

Adding Idelalisib to Bendamustine/Rituximab in Relapsed or Refractory Chronic Lymphocytic Leukemia

As reported by Zelenetz et al in The Lancet Oncology, an interim analysis of a phase III trial has shown the superiority of adding the phosphoinositide-3-kinase δ inhibitor idelalisib (Zydelig) to bendamustine/rituximab (Rituxan) in patients with relapsed or refractory chronic lymphocytic...

Leukemia

Postinduction MRD Predicts Outcome From Transplantation in NPM1-Mutant AML

In an analysis of a French trial reported in the Journal of Clinical Oncology, Balsat et al found that postinduction minimal residual disease was predictive of outcome and benefit from allogeneic stem cell transplantation (ASCT) in patients with NPM1-mutant acute myeloid leukemia (AML). Nicolas...

Leukemia

Retinoic Acid and Arsenic Trioxide vs Retinoic Acid and Chemotherapy in APL

As reported in the Journal of Clinical Oncology by Platzbecker et al, the final results of the Italian-German phase III APL0406 trial indicate that the combination of all-trans retinoic acid (ATRA) and arsenic trioxide (ATO [Trisenox]) is associated with better outcomes than standard ATRA plus...

leukemia

High Financial Burden for CML Patients Enrolled in Medicare Part D Receiving Targeted Oral Therapy

In a study reported in the Journal of Oncology Practice, Shen et al found that more than three-quarters of patients receiving targeted oral therapy for chronic myeloid leukemia (CML) reached the catastrophic phase of the Medicare Part D benefit within the calendar year of starting such treatment....

leukemia

Diagnosis and Management of AML in Adults: 2017 European LeukemiaNet Recommendations From an International Expert Panel

An international panel of experts has released updated evidence-based and expert opinion–based recommendations for the diagnosis and treatment of acute myeloid leukemia (AML) in adults. The recommendations were issued by the European LeukemiaNet (ELN) and published by Döhner et al in...

leukemia

Three Genetic Alterations Identified in Non–Down Syndrome Pediatric Acute Megakaryoblastic Leukemia

Research led by St. Jude Children’s Research Hospital has identified three genetic alterations to help identify high-risk pediatric patients with acute megakaryoblastic leukemia (AMKL) who may benefit from allogeneic stem cell transplants. The study, published by de Rooij et al in Nature...

Geriatric Oncology
Leukemia

Androgen Maintenance in Elderly Patients With AML

The addition of norethandrolone as maintenance therapy improved survival in patients aged ≥ 60 years with acute myeloid leukemia (AML), according to a French phase III trial reported in the Journal of Clinical Oncology by Pigneux et al. Norbert Ifrah, MD, of CHU d’Angers, France, is the...

Leukemia

I’m Learning to Live With Chronic Cancer

I was feeling a bit more tired than usual as the Christmas holidays approached in December 2012, but I chocked it up to the frenetic pace of the season and keeping up with caring for my two young children, ages 4 and 12. I had none of the other typical warning signs of chronic myeloid leukemia...

Leukemia

Diamonds Are Forever, Tyrosine Kinase Inhibitors Are Not?

Sir Donald Munger: “You have been on holiday, I understand. Relaxing, I hope?” James Bond: “Oh, hardly relaxing, but most satisfying.” (Diamonds Are Forever) As tyrosine kinase inhibitors became the mainstay of therapy for patients with chronic myeloid leukemia (CML), our assumption has been that...

Leukemia

Safety of Stopping Imatinib in CML With Undetectable Minimal Residual Disease for at Least 2 Years

As reported in the Journal of Clinical Oncology by Gabriel Etienne, MD, PhD, of the Institut Bergonié, Bordeaux, and colleagues, long-term follow-up in the French Stop Imatinib (STIM1) study indicates that imatinib can be safely stopped in patients with chronic myeloid leukemia (CML) with...

Leukemia

Expert Point of View: Richard Furman, MD

“These results are interesting, important, and relevant for maintenance post chemotherapy, but if we are not using chemotherapy, they may not be relevant,” said Richard Furman, MD, of Weill Cornell Medical College, New York Presbyterian Hospital, New York. He said that newer drugs such as...

Leukemia

Lenalidomide Maintenance Extends Progression-Free Survival in CLL

Lenalidomide (Revlimid), a cornerstone of therapy for multiple myeloma in the modern era, is making headway as maintenance therapy in chronic lymphocytic leukemia (CLL). Separate phase III studies presented at the 2016 American Society of Hematology (ASH) Annual Meeting & Exposition showed...

leukemia

Venetoclax Plus Rituximab Studied in Relapsed or Refractory Chronic Lymphocytic Leukemia

In a phase Ib study reported in The Lancet Oncology, Seymour et al found that the combination of the BCL2 inhibitor venetoclax (Venclexta) and the anti-CD20 monoclonal antibody rituximab (Rituxan) was highly active in patients with relapsed or refractory chronic lymphocytic leukemia...

Leukemia

Treating the Whole Person

Twenty-five years ago, I was a physically fit woman of 45 in training to run a marathon, which had been a lifelong goal. I was feeling fine and had no hint of the illness that would nearly take my life and has forever changed it. While ramping up to go the 26.2-mile distance, I decided to have a...

Leukemia

Expert Point of View: Armand Keating, MD

“This study shows that a great deal of innovation can come from existing knowledge. The 7+3 regimen has been around since I was an intern,” admitted Armand Keating, MD, of the University of Toronto and Princess Margaret Hospital, Toronto, Ontario, Canada. “Using the liposomal formulation of...

Leukemia

CPX-351 Improves Survival Post Transplant in Older High-Risk Patients With Acute Myeloid Leukemia

Induction therapy with the experimental chemotherapy called CPX-351—a liposomal formulation of cytarabine and daunorubicin—outperformed standard “7+3” cytarabine plus daunorubicin by extending survival in older high-risk patients with acute myeloid leukemia (AML) who subsequently underwent...

Leukemia

Expert Point of View: Mikkael A. Sekeres, MD, MS

Mikkael A. Sekeres, MD, MS, Director of the Leukemia Program at the Cleveland Clinic Taussig Cancer Center in Ohio, commented on vadastuximab talirine in newly diagnosed acute myeloid leukemia (AML). He noted that the drug is similar to gemtuzumab ozogamicin, another antibody-drug conjugate that...

Leukemia

Vadastuximab Talirine Shows Early Promise in Newly Diagnosed Acute Myeloid Leukemia

The investigational CD33-directed antibody-drug conjugate vadastuximab talirine yielded high overall and complete response rates when combined with standard “7+3” chemotherapy for patients newly diagnosed with acute myeloid leukemia.1 Results from this phase Ib study were presented at the 2016...

Leukemia

Expert Point of View: Amir T. Fathi, MD

“In the past few years, there has been increased reporting of other, less traditional, response criteria in acute myeloid leukemia (AML), including morphologic leukemia-free state, partial response, and complete remission [or complete response] with incomplete recovery. There is some concern that...

Leukemia

Achieving Complete Response Is Key to Improving Survival in Older Patients With AML

The importance of achieving complete response after intensive therapy in older adults with acute myeloid leukemia (AML) was confirmed in a follow-up analysis of the E2906 North American Intergroup trial.1 Patients in complete response had superior survival in this landmark analysis. This finding...

Leukemia

Expert Point of View: Mikkael Sekeres, MD

In his practice, Mikkael Sekeres, MD, of the Cleveland Clinic Foundation, has not initiated dose reductions of tyrosine kinase inhibitors, but “anecdotally, my patients tell me that they have reduced the dose. Many of them cannot afford to continue treatment indefinitely, and some have side...

Leukemia

Reducing Doses and Stopping Tyrosine Kinase Inhibitors Gain Favor in Chronic Myeloid Leukemia

Tyrosine kinase inhibitors, such as imatinib, nilotinib (Tasigna), and dasatinib (Sprycel), have revolutionized the treatment of chronic myeloid leukemia (CML). A substantial percentage of patients achieve deep and meaningful remissions on these agents. More recently, partly driven by patients’ and ...

Leukemia

Expert Point of View: Stephen P. Hunger, MD

Stephen P. Hunger, MD, Chief of the Division of Pediatric Oncology and Director of the Center for Childhood Cancer Research at The Children’s Hospital of Philadelphia, and the Jeffrey E. Perelman Distinguished Chair in the Department of Pediatrics at the University of Pennsylvania, Philadelphia,...

Leukemia

Reduced-Intensity Chemotherapy Leads to More Relapses in Childhood ALL

Children with acute lymphoblastic leukemia (ALL) considered at standard risk for relapse should continue to receive standard-intensity regimens, according to findings from the international randomized AIEOP-BFM ALL 2000 trial.1 A reduced-intensity treatment for children with ALL considered to have ...

leukemia

ASH 2016: Children With Down Syndrome and ALL Fare as Well as Other Children Treated on ALL Consortium Protocols

Despite an elevated risk of toxicity from chemotherapy, children with Down syndrome and acute lymphoblastic leukemia (ALL) did not experience higher rates of relapse or treatment-related mortality compared with other children treated on Dana-Farber Cancer Institute ALL Consortium Protocols,...

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