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Leukemia

Brexucabtagene Autoleucel for Relapsed or Refractory B-Cell Precursor ALL

On October 1, 2021, the CD19-directed chimeric antigen receptor (CAR) T-cell therapy brexucabtagene autoleucel was approved for adults with relapsed or refractory B-cell precursor acute lymphoblastic leukemia (ALL).1 The product is available only through a restricted program under a Risk Evaluation ...

Leukemia

Asciminib for Philadelphia Chromosome–Positive Chronic Myeloid Leukemia

On October 29, 2021, the oral kinase inhibitor asciminib was granted accelerated approval for adults with Philadelphia chromosome–positive chronic myeloid leukemia (CML) in chronic phase previously treated with at least two tyrosine kinase inhibitors and regular approval for adults with...

Leukemia
Immunotherapy

Next-Generation Sequencing of Bone Marrow DNA to Predict Relapse Following CAR T-Cell Therapy in Patients With ALL

Next-generation sequencing of bone marrow samples from pediatric and young adult patients with acute lymphoblastic leukemia (ALL) treated with tisagenlecleucel was more accurate in predicting relapse than flow cytometry and monitoring of B-cell aplasia, according to the results from a study by...

Leukemia
Lymphoma
Immunotherapy

FDA Approves Rituximab Plus Chemotherapy for Several Pediatric Hematologic Malignancies

On December 2, the U.S. Food and Drug Administration (FDA) approved rituximab (Rituxan) in combination with chemotherapy for pediatric patients (≥ 6 months to < 18 years old) with previously untreated, advanced-stage, CD20-positive diffuse large B-cell lymphoma (DLBCL), Burkitt lymphoma,...

Leukemia

COG AAML1331 Trial: Arsenic Trioxide and All-Trans Retinoic Acid in Pediatric Patients With APL

As reported in JAMA Oncology by Kutny et al, the Children’s Oncology Group (COG) AAML1331 trial has shown that treatment with arsenic trioxide and all-trans retinoic acid (ATRA) with no maintenance therapy produced high event-free and overall survival rates in pediatric patients with acute...

Leukemia
Immunotherapy

Impact of Prior Blinatumomab Exposure on CD19-Targeted CAR T-Cell Therapy Outcomes in Pediatric Patients With B-Cell ALL

In a study reported in the Journal of Clinical Oncology, Myers et al found that lack of response to prior blinatumomab treatment was associated with poorer outcomes with CD19-targeted chimeric antigen receptor (CAR) T-cell therapy (CD19-CAR) in children and young adults with relapsed or refractory...

Leukemia

Novel Therapies Under Study in Acute Myeloid Leukemia

Newly identified genetic abnormalities in acute myeloid leukemia (AML), as well as therapies that can target some of those abnormalities, are now available as the landscape for treatment continues to evolve. During the 2021 National Comprehensive Cancer Network (NCCN) Annual Congress: Hematologic...

Leukemia

Novel Therapies Under Study in Acute Myeloid Leukemia

Newly identified genetic abnormalities in AML have led to novel therapies that can target some of them, as the landscape for treatment continues to evolve. During the 2021 National Comprehensive Cancer Network (NCCN) Annual Congress: Hematologic Malignancies, Alice S. Mims MD, presented updates in...

Leukemia

Study Examines Availability of All-Trans Retinoic Acid in U.S. Hospitals

New research published by Geer et al in JNCCN—Journal of the National Comprehensive Cancer Network has found that fewer than one-third of hospitals in the United States had immediate availability of all-trans retinoic acid (ATRA), a crucial blood cancer medication. ATRA is initiated early in the...

Leukemia

Novel Drug Combination May Help Children With Acute Promyelocytic Leukemia Avoid Conventional Chemotherapy

A clinical trial recently published by Kutny et al in JAMA Oncology found that the combination of all-trans retinoic acid and arsenic trioxide was highly effective in children with standard- and high-risk acute promyelocytic leukemia (APL). Nearly all patients in the trial survived for 2 years...

Leukemia

Measurable Residual Disease Dynamics and Extended Follow-up in CLL14 Trial of Venetoclax/Obinutuzumab in Previously Untreated Chronic Lymphocytic Leukemia

In an analysis of the pivotal CLL14 trial reported in the Journal of Clinical Oncology, Al-Sawaf et al found that venetoclax plus obinutuzumab was associated with higher rates of undetectable measurable residual disease (MRD) and prolonged MRD doubling time vs chlorambucil plus obinutuzumab at 3...

leukemia
lymphoma

Jennifer A. Woyach, MD, on CLL/SLL: Using Minimal Residual Disease Assessment in Clinical Practice

Jennifer A. Woyach, MD, of The Ohio State University Comprehensive Cancer Center, talks about whether modifications of treatment based on minimal residual disease is beneficial to patients with chronic lymphocytic leukemia and small lymphocytic lymphoma.

leukemia

Alice S. Mims, MD, on AML: Updates on Managing Newly Diagnosed Disease

Alice S. Mims, MD, of The Ohio State University Comprehensive Cancer Center, discusses the many positive changes over the past 5 years in treating patients with newly diagnosed acute myeloid leukemia in the upfront setting. She also details future directions, including further combining therapies with targeted agents, the potential use of all-oral regimens, and using measurable residual disease as a possible endpoint in treatment responses.

Leukemia

Study Finds Type I Interferon May Enhance the Antileukemia Effect of Allogeneic Transplantation

In a study published by Magenau et al in the journal Blood Advances, researchers found that patients with high-risk acute myeloid leukemia (AML) who received a form of type I interferon after allogeneic hematopoietic stem cell transplant experienced reduced rates of disease relapse. Additionally,...

Leukemia
Genomics/Genetics

FDA Approves Asciminib for Philadelphia Chromosome–Positive CML

On October 29, the U.S. Food and Drug Administration (FDA) granted accelerated approval to the kinase inhibitor asciminib (Scemblix) for patients with Philadelphia chromosome–positive chronic myeloid leukemia (Ph+ CML) in chronic phase who have been previously treated with two or more tyrosine...

Leukemia
Genomics/Genetics

Addition of Enasidenib to Azacitidine in Newly Diagnosed IDH2-Mutant Acute Myeloid Leukemia

As reported in The Lancet Oncology by Courtney D. DiNardo, MD, and colleagues, an interim analysis of the phase II portion of a phase Ib/II trial (AG221-AML-005) showed that the addition of the oral mutant IDH2 protein inhibitor enasidenib to azacitidine significantly improved overall response rate ...

Leukemia

Noninferior Progression-Free Survival and Reduced Cardiovascular Toxicity With Acalabrutinib vs Ibrutinib in Previously Treated CLL

As reported in the Journal of Clinical Oncology by John C. Byrd, MD, of The Ohio State University Comprehensive Cancer Center, and colleagues, the phase III ELEVATE-RR trial has shown noninferior progression-free survival with the more-selective Bruton’s tyrosine kinase (BTK) inhibitor...

Leukemia

BTK Inhibition in CLL: An Embarrassment of Riches

Chronic lymphocytic leukemia (CLL) is a B-cell lymphoproliferative disorder defined by a specific phenotype and the presence of more than 5,000 clonal B cells in the peripheral blood.1 In the absence of this number of circulating cells, its soft-tissue/bone-marrow counterpart is semantically...

Leukemia

Ibrutinib vs Placebo Following Achievement of Undetectable MRD With First-Line Ibrutinib/Venetoclax in CLL

As reported in the Journal of Clinical Oncology by William G. Wierda, MD, PhD, and colleagues, findings in the measurable residual disease (MRD) cohort of the phase II CAPTIVATE study indicated a high disease-free survival rate with placebo and no significant benefit of continued ibrutinib in...

Hematologic Malignancies
Leukemia
Immunotherapy
Global Cancer Care

A Look at Tomorrow’s CAR T-Cell Therapy Today

Some of the most impressive data on chimeric antigen receptor (CAR) T-cell therapy have come from studies conducted in China. Attendees at the 2021 Pan Pacific Lymphoma Conference heard from one of the leading Chinese investigators, Peihua (Peggy) Lu, MD, of Lu Daopei Hospital, who described the...

Leukemia
Immunotherapy

FDA Approves Brexucabtagene Autoleucel for Relapsed or Refractory B-Cell Precursor ALL

On October 1, the U.S. Food and Drug Administration (FDA) approved brexucabtagene autoleucel (Tecartus), a CD19-directed chimeric antigen receptor (CAR) T-cell therapy, for adult patients with relapsed or refractory B-cell precursor acute lymphoblastic leukemia (ALL). ZUMA-3 Efficacy was evaluated ...

leukemia

Luis E. Aguirre, MD, on Chronic Myelomonocytic Leukemia: Keys to Assessment and Treatment

Luis E. Aguirre, MD, of the H. Lee Moffitt Cancer Center and Research Institute, discusses the subset of patients with chronic myelomonocytic leukemia who have a more indolent disease course. Features at diagnosis may include higher hemoglobin and platelet counts or JAK2, SF3B1, and IDH2 mutations; features associated with earlier initiation of treatment may include an elevated white blood cell count or a higher number of marrow blasts. Identifying the changes that occur between diagnosis and treatment are among future research goals (Abstract MDS-229).

Leukemia

Study Finds Genetic Predisposition to Higher Lymphocyte Production May Lead to Higher ALL Risk

Research published by Kachuri et al in the American Journal of Human Genetics reveals that children born with a genetic predisposition to produce more lymphocytes—particularly in relation to other types of white blood cells—may be at a higher risk of developing acute lymphoblastic leukemia (ALL)....

Leukemia

First-Line Acalabrutinib, Venetoclax, and Obinutuzumab for Chronic Lymphocytic Leukemia

In a phase II study reported in The Lancet Oncology, Matthew S. Davids, MD, and colleagues found that first-line triple combination therapy with acalabrutinib, venetoclax, and obinutuzumab produced measurable residual disease (MRD)-negative complete remission in a substantial proportion of patients ...

Leukemia

Fixed-Dose, First-Line Ibrutinib/Venetoclax Combination Achieves Durable Remissions in CLL

The combination of fixed-duration, first-line treatment with ibrutinib plus venetoclax achieved complete responses in more than half of patients with chronic lymphocytic leukemia (CLL)/small lymphocytic leukemia (SLL), based on the primary analysis of the fixed-dose cohort of the phase II CAPTIVATE ...

Leukemia

ELEVATE-RR Trial: Acalabrutinib as Effective as Ibrutinib, With Fewer Cardiac Effects, in Resistant CLL

Acalabrutinib was equally efficacious with less toxicity when compared directly with ibrutinib in patients with previously treated relapsed or refractory chronic lymphocytic leukemia (CLL), according to the results of an open-label, randomized, noninferiority phase III trial presented at the 2021...

leukemia

Curtis Lachowiez, MD, on AML: Venetoclax Combined With FLAG-IDA

Curtis Lachowiez, MD, of The University of Texas MD Anderson Cancer Center, discusses data that show combining venetoclax with FLAG-IDA chemotherapy to treat patients with newly diagnosed acute myeloid leukemia led to minimal residual disease negativity in more than 90% of those achieving a composite complete response (Abstract AML-024).

Leukemia
Immunotherapy

AUTO1: CAR T-Cell Product for Adult Patients With Relapsed or Refractory B-Cell ALL

In a phase I trial (ALLCAR19) reported in the Journal of Clinical Oncology, Roddie et al found that the fast off-rate autologous CD19 chimeric antigen receptor (CAR) T-cell therapy CAT19-41BB-Z—also known as AUTO1—was well tolerated and produced high remission rates in adults with relapsed or...

Leukemia

ELEVATE-RR Trial: Acalabrutinib as Effective as Ibrutinib, With Fewer Cardiac Effects, in Resistant CLL

Acalabrutinib was equally efficacious with less toxicity when compared directly with ibrutinib in patients with previously treated relapsed or refractory chronic lymphocytic leukemia (CLL), according to the results of an open-label, randomized, noninferiority phase III trial presented at the 2021...

Leukemia
Issues in Oncology

Ibrutinib and Cardiovascular Risk in Patients With Chronic Lymphocytic Leukemia

In a Canadian population-based cohort study reported in the Journal of Clinical Oncology, Abdel-Qadir et al found that ibrutinib treatment for chronic lymphocytic leukemia (CLL) is associated with increased risks of atrial fibrillation, bleeding, and heart failure, but not ischemic stroke or acute...

Leukemia
Issues in Oncology

Study Suggests Demographic Enrollment Reporting Requirements for Acute Leukemia Clinical Trials Are Lacking

Requirements instituted to address racial and ethnic disparities in clinical trial enrollment did not lead to increased inclusion of Black and Hispanic participants in clinical acute leukemia research, according to a new study published by Andrew Hantel, MD, and colleagues in the journal Blood...

Leukemia
Genomics/Genetics

Effect of Concurrent Focal 22q11.22 Deletions and IKZF1 Alterations on Outcomes in Pediatric Patients With B-Cell ALL

In a study reported in JAMA Oncology, Mangum et al found that focal deletions in chromosome 22q11.22 were associated with poor outcomes in pediatric patients with B-cell acute lymphoblastic leukemia (ALL) with IKZF1 alterations. As stated by the investigators, “Alterations in the IKZF1 gene drive...

Leukemia
Lymphoma
COVID-19

Study Explores Relationship Between Anti-CD20 Therapy and Reduced Responses to mRNA COVID-19 Vaccines

Patients with lymphoma or other lymphoid cancers should continue to take steps to protect themselves from COVID-19 even if they have been vaccinated against the disease, a new study by Jennifer Crombie, MD, and colleagues published in Blood Advances suggests. The study found that patients who had...

Leukemia
Immunotherapy

Outcomes Notably Improving for Adult ALL

Outcomes in adults with acute lymphoblastic leukemia (ALL) are almost rivaling those in pediatric ALL, thanks to the benefits achieved by incorporating blinatumomab and inotuzumab into chemotherapy regimens. New ways of administering the chemotherapy component are also increasing tolerability and...

Leukemia
Genomics/Genetics

Study Identifies Possible New Genetic Biomarkers of Pediatric Leukemia

In a study published by Magnum et al in JAMA Oncology, researchers reported on how two separate DNA changes appear to predict aggressive childhood leukemias when they occur in combination. The team evaluated tumor characteristics of more than 1,300 pediatric patients with B-cell acute lymphoblastic ...

Leukemia
Immunotherapy

Donor-Derived CD7 CAR T Cells May Lead to Remissions in Patients With Relapsed or Refractory T-ALL

In a Chinese single-institution phase I study reported in the Journal of Clinical Oncology, Pan et al found that donor-derived CD7 chimeric antigen receptor (CAR) T-cell therapy produced a high complete remission rate in patients with relapsed or refractory T-cell acute lymphoblastic leukemia...

Leukemia
Immunotherapy

Experimental Small-Molecule Inhibitor May Improve Responses to Cellular Therapies in Advanced CLL

Too many “exhausted” T cells left in the wake of aggressive chemotherapy regimens for patients with advanced chronic lymphocytic leukemia (CLL) make it more challenging for chimeric antigen receptor (CAR) T-cell therapy to do its job. Now, a new study from researchers at the Perelman School of...

hematologic malignancies
leukemia
immunotherapy

Alexey V. Danilov, MD, PhD, on Lymphoid Malignancies: Novel Agents Targeting BTK Inhibitor–Resistant Disease

Alexey V. Danilov, MD, PhD, of City of Hope, discusses the uses and side effects of cellular and immune therapies, including venetoclax and obinutuzumab, which may prove to be effective in treating highly resistant lymphoid malignancies such as chronic lymphocytic leukemia.

Leukemia
Skin Cancer
Gynecologic Cancers
Kidney Cancer
Lung Cancer
Thyroid Cancer
Immunotherapy

FDA Pipeline: Reviews for Agents in Lung Cancer, Thyroid Cancer, Kidney Cancer, and More

Recently, the U.S. Food and Drug Administration (FDA) accepted applications for agents aiming to treat non–small cell lung cancer (NSCLC), differentiated thyroid cancer, renal cell carcinoma (RCC), hypersensitive acute lymphoblastic leukemia (ALL), mucosal melanoma, and endometrial carcinoma....

Leukemia
Lymphoma

Asparaginase Erwinia Chrysanthemi (Recombinant)-rywn for Acute Lymphoblastic Leukemia and Lymphoblastic Lymphoma

On June 30, 2021, asparaginase erwinia chrysanthemi (recombinant)-rywn was approved as a component of a multiagent chemotherapeutic regimen for treatment of acute lymphoblastic leukemia (ALL) and lymphoblastic lymphoma in adult and pediatric patients 1 month or older who have developed...

Leukemia
Lymphoma

Expert Point of View: Jacqueline C. Barrientos, MD, MS

The ASCO Post invited Jacqueline C. Barrientos, MD, MS, Associate Professor of Medicine, CLL Research and Treatment Program, Zucker School of Medicine at Hofstra/Northwell, Lake Success, New York, to comment on the ALPINE findings presented at the European Hematology Association (EHA) Virtual...

Lymphoma
Leukemia

Zanubrutinib Superior to Ibrutinib for CLL/SLL in Phase III ALPINE Trial

Zanubrutinib, a second-generation Bruton’s tyrosine kinase (BTK) inhibitor, significantly improved response rates and delayed disease progression as compared with the standard of care, ibrutinib, in patients with relapsed or refractory chronic lymphocytic leukemia or small lymphocytic lymphoma...

Leukemia

ELEVATE-RR Trial: Acalabrutinib vs Ibrutinib in Previously Treated Patients With CLL

As reported in the Journal of Clinical Oncology by John C. Byrd, MD, and colleagues, the phase III ELEVATE-RR trial has shown noninferior progression-free survival with the more selective Bruton’s tyrosine kinase (BTK) inhibitor acalabrutinib vs the less selective inhibitor ibrutinib in previously...

Leukemia

Expert Point of View: Guru Subramanian Guru Murthy

Invited discussant Guru Subramanian Guru Murthy, MD, MS, of the Medical College of Wisconsin, Milwaukee, commented on the study of aspacytarabine in the first-line therapy for patients with acute myeloid leukemia (AML) unfit for standard chemotherapy. “This study elegantly highlights there is still ...

Leukemia

Study Finds Cytarabine Prodrug Active and Safe in Older Compromised Patients With AML

Aspacytarabine, a cytarabine prodrug, was reported to be safe and effective as first-line therapy for patients with acute myeloid leukemia (AML) who were unfit for intensive induction chemotherapy, according to the results of a phase II study presented during the 2021 ASCO Annual Meeting.1 The...

Leukemia

Pulsed Vincristine/Dexamethasone Maintenance in Pediatric Acute Lymphoblastic Leukemia

In a Chinese phase III trial (CCCG-ALL-2015) reported in The Lancet Oncology, Yang et al found that 1 year of maintenance therapy with pulsed vincristine and dexamethasone was noninferior to 2 years in low-risk pediatric patients with acute lymphoblastic leukemia and was borderline inferior in...

Leukemia
Genomics/Genetics

Can Treatment With Thiopurines Induce Mutations That May Lead to Pediatric Leukemia Relapse?

Chemotherapy has helped make acute lymphoblastic leukemia (ALL) one of the most survivable childhood cancers. Now, a research team has shown how thiopurines may lead to mutations that set patients up for disease relapse. These findings were published by Yang et al in Nature Cancer. The research...

Leukemia

B-Cell Acute Lymphoblastic Leukemia: Update on Clinical Trials

“Learning never exhausts the mind.” —Leonardo da Vinci To complement The ASCO Post’s continued comprehensive coverage of the 2020 American Society of Hematology (ASH) Annual Meeting & Exposition, here are several abstracts selected from the meeting proceedings focusing on treatments under study ...

Leukemia

Phase III GLOW Trial: Improved Outcomes With First-Line Ibrutinib Plus Venetoclax in Elderly Patients With CLL

Fixed-duration ibrutinib and venetoclax as a first-line treatment yielded superior outcomes compared with chlorambucil plus obinutuzumab in patients with chronic lymphocytic leukemia (CLL), based on the primary analysis of the phase III GLOW trial presented during the European Hematology...

Leukemia
Immunotherapy

Combination Ficlatuzumab and Cytarabine Show Clinical Activity in Relapsed/Refractory AML

Despite advances in the treatment of acute myeloid leukemia (AML), only 29.5% of patients with the cancer are alive 5 years after diagnosis. Even with aggressive therapy, just 30% of patients achieve a complete remission with a median survival of 7.5 months, making it imperative to develop novel...

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