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Breast Cancer
Leukemia

FDA Grants Priority Review to Obinutuzumab in CLL and Pertuzumab in Neoadjuvant Therapy for HER2-positive Early-stage Breast Cancer

Two drugs were recently given Priority Review designation by FDA. Obinutuzumab (GA101) was granted Priority Review for the treatment of chronic lymphocytic leukemia, based on final stage 1 data from the pivotal CLL11 trial. The FDA confirmed the action date is December 20, 2013. FDA also granted...

Hematologic Malignancies
Leukemia
Lymphoma

New Research on Combination Chemotherapy, Prognostic Biomarkers, and PET-guided Radiation Therapy in B-cell Malignancies 

The 12th International Conference on Malignant Lymphoma was held June 19-22, 2013, in Lugano, Switzerland. Over 3,000 hematologists, clinical oncologists, pathologists, and leading researchers attended the meeting, which featured new research on B-cell malignancies, follicular lymphoma, as well as...

Leukemia
Lymphoma

New Drug Application Submitted for Ibrutinib in the Treatment of Two B-cell Malignancies

Pharmacyclics, Inc, recently announced that it has submitted a New Drug Application (NDA) to the U.S. Food and Drug Administration (FDA) for the investigational oral Bruton’s tyrosine kinase inhibitor ibrutinib, for two relapsed/refractory B-cell malignancy indications: mantle cell lymphoma (MCL)...

Leukemia

ATRA and Arsenic Trioxide May Be Even Better Than ATRA and Chemotherapy in Treating Low-to-Intermediate Risk Acute Promyelocytic Leukemia 

All-trans retinoic acid (ATRA) plus arsenic trioxide bested the already high remission rates achieved by ATRA with chemotherapy, the standard of care for acute promyelocytic leukemia, in a phase III multicenter trial among patients with low-to-intermediate risk acute promyelocytic leukemia....

Leukemia

High Rate of Durable Remissions with Ibrutinib in Patients with Relapsed Chronic Lymphocytic Leukemia 

Durable remissions are uncommon with current treatments for relapsed chronic lymphocytic leukemia (CLL). Bruton’s tyrosine kinase is an essential component of B cell–receptor signaling that mediates interactions with the tumor microenvironment and promotes survival and proliferation of CLL cells....

Leukemia

Cord Blood Transplantation Benefits Some Children With Juvenile Myelomonocytic Leukemia 

A retrospective analysis of 110 patients with juvenile myelomonocytic leukemia found that single-unit, unrelated donor umbilical cord blood transplantation resulted in a 5-year disease-free survival rate of 44%. “Our data document that a significant proportion of children with this disease,...

Leukemia

FDA on CLL Drug Approval and Expanded Access

The ASCO Post article, “Ibrutinib CLL Trial: Where is the Equipoise?” published in May 2013, inaccurately conveyed that the Food and Drug Administration (FDA) requires an improvement in overall survival for chronic lymphocytic leukemia (CLL) drug approval and opposes allowing crossover in the...

Leukemia

Pharmacyclics' Reply

We acknowledge the letters submitted to The ASCO Post from a patient advocate and a chronic lymphocytic leukemia (CLL) patient enrolled on the RESONATE study (PCYC-1112-CA). At Pharmacyclics, we are committed to adhering to high scientific and ethical standards as we strive to develop novel...

Leukemia

Clinical Trials, Crossover, and Clinical Equipoise: An Advocate's Perspective

In a previous issue of The ASCO Post, Dr. Susan O’Brien wrote, “It is my understanding that the FDA strongly opposed allowing crossover [in the RESONATE trial]. I presume that is because the FDA also wants to see if there is a survival advantage.”1 The lack of crossover seems a valid concern to me...

Leukemia

Clinical Trials, Crossover, and Clinical Equipoise: A Patient's Perspective

I am writing with regard to two articles on the ethical imperative of clinical equipoise written by Susan O’Brien, MD, and Stephen J. Schuster, MD, and published recently in The ASCO Post.1,2 I was a victim of Pharmacyclics’ policies during one of their randomized ibrutinib trials (PCI-32765)...

Leukemia

Treatment of Relapse of Acute Leukemia Post-Transplant: Still Hope for Patients With Chemosensitive Disease 

Disease recurrence is a devastating event after allogeneic hematopoietic stem cell transplantation as treatment for acute myeloid leukemia (AML). Median time to relapse is approximately 4 months and the majority of relapses occur within 2 years after transplant. The prognosis is usually poor....

Leukemia

No Benefit/Detriment of Donor Change in Second Stem Cell Transplant for Leukemia Relapse 

Minimal data are available on outcomes of second allogeneic hematopoietic stem cell transplantation from unrelated donors after a first transplant in patients with hematologic relapse of acute leukemia. In a study reported in Journal of Clinical Oncology, Maximilian Christopeit, MD, of University...

Leukemia

Front-Line Treatment Strategies to Achieve Long-Term Control of CLL Combined With Optimal Quality of Life 

“The management of chronic lymphocytic leukemia (CLL) is undergoing profound changes. Several new drugs have been approved for CLL treatment (fludarabine, bendamustine [Treanda], and the monoclonal antibodies alemtuzumab [Campath], rituximab [Rituxan], and ofatumumab [Arzerra]), and many more drugs ...

Leukemia

FDA Grants Volasertib Breakthrough Therapy Designation in AML

Boehringer Ingelheim Pharmaceuticals, Inc, has announced that the U.S. Food and Drug Administration (FDA) has granted Breakthrough Therapy designation to volasertib, an investigational inhibitor of polo-like kinase (Plk), which being evaluated for the treatment of patients aged 65 or older with...

Leukemia

FDA Approves Obinutuzumab for Chronic Lymphocytic Leukemia 

The U.S. Food and Drug Administration (FDA) has approved obinutuzumab (Gazyva) for use in combination with chlorambucil (Leukeran) to treat patients with previously untreated chronic lymphocytic leukemia (CLL). Obinutuzumab is the first drug with Breakthrough Therapy designation to receive FDA...

Leukemia

Sale of Ponatinib Suspended Due to Risk of Life-Threatening Blood Clots

The U.S. Food and Drug Administration (FDA) has asked the manufacturer of the tyrosine kinase inhibitor ponatinib (Iclusig) to suspend marketing and sales of the drug because of the risk of life-threatening blood clots and severe narrowing of blood vessels. Ariad Pharmaceuticals has agreed to...

Leukemia

Obinutuzumab in Previously Untreated Chronic Lymphocytic Leukemia

In the Clinic provides overviews of novel oncology agents, addressing indications, mechanisms, administration recommendations, safety profiles, and other essential information needed for the appropriate clinical use of these drugs. Indication On November 1, 2013, obinutuzumab (Gazyva) was approved...

Leukemia

FDA Grants Ofatumumab Breakthrough Therapy Designation for Previously Untreated CLL

The U.S. Food and Drug Administration (FDA) has granted Breakthrough Therapy designation for ofatumumab (Arzerra) in combination with chlorambucil (Leukeran) for the treatment of patients with chronic lymphocytic leukemia (CLL) who have not received prior treatment and are inappropriate for...

Leukemia
Lymphoma

Mounting Success in Trials of Genetically Engineered T Cells to Treat Leukemias and Lymphomas

Reports have been trickling in from centers conducting research on the use of chimeric antigen receptor–modified T cells (CAR-T) in hematologic cancer, and the news is encouraging. When directed against CD19, such personalized therapeutic T cells are known as CTL019, and small pilot trials of this...

leukemia

Leukemia Pioneer John M. Goldman, DM, Dies at 75

“He gave his honours to the world again,his blessed part to heaven, and slept in peace.” —William Shakespeare, Henry VIII In 1971, John M. Goldman, DM, FRCP, FRCPath, FMedSci, began research in chronic myeloid leukemia (CML), a uniformly fatal disease at the time. Over the ensuing decades, Dr....

Leukemia

Bosutinib Shows 'Acceptable Safety' in Philadelphia Chromosome–Positive Leukemia

Bosutinib (Bosulif) demonstrated “acceptable safety with manageable toxicities” in a phase I/II study among patients with chronic-phase chronic myeloid leukemia (CML) or advanced Philadelphia chromosome–positive leukemia (accelerated-phase/blast-phase CML or acute lymphoblastic leukemia). Patients...

Leukemia
Lymphoma

Expanded Options for Age and Donor Sources for Transplant

Although many oncologists consider matched sibling donors as the best source of grafts for hematopoietic cell transplantation, two separate studies presented at the recent American Society of Hematology Annual Meeting support the use of alternative donor grafts for patients with lymphoma and acute...

Leukemia

Role for Reduced-Intensity Conditioning Regimen in AML After Allogeneic Transplantation

Reduced-intensity conditioning and myeloablative-conditioning regimens following allogeneic hematopoietic cell transplantation in children with acute myeloid leukemia (AML) resulted in comparable survival, according to a study published in Blood. The study evaluated 181 patients, 39 treated with...

leukemia
lymphoma

Leukemia/Lymphoma Pioneer Geoffrey P. Herzig, MD, Dies

Many of the advances that have bettered mankind are attributed to those who were driven by a primary passion. Geoffrey P. Herzig, MD, lived the better part of his life with a primary passion: conducting research to increase the cure rate of leukemia and lymphoma patients. His friend and colleague,...

Leukemia

In CLL With Coexisting Conditions, Chlorambucil Produces Better Outcomes With Obinutuzumab Than With Rituximab

A randomized phase III trial conducted in 26 countries found that combining chlorambucil (Leukeran) with an anti-CD20 antibody—either obinutuzumab (Gazya) or rituximab (Rituxan)—produced better outcomes among patients with previously untreated chronic lymphocytic leukemia (CLL) and coexisting...

Leukemia

FDA Approves CliniMACS CD34 Reagent System for the Prevention of Graft-vs-Host Disease in AML

The U.S. Food and Drug Administration (FDA) has approved the Miltenyi Biotec’s CliniMACS CD34 Reagent System as a Humanitarian Use Device for the prevention of graft-vs-host disease in patients with acute myeloid leukemia (AML) in first complete remission undergoing allogeneic stem cell...

Leukemia

Encouraging Early Results With Novel Agents in CLL

Two novel agents have shown promising activity in chronic lymphocytic leukemia (CLL), including poor-risk patients: the Bcl-2 inhibitor ABT-199 and the small-molecule PI3K inhibitor IPI-145. Both drugs achieved excellent response rates in heavily pretreated relapsed/refractory patients including...

Leukemia

First-Line Obinutuzumab/Chlorambucil Improves Outcomes Over Rituximab/Chlorambucil in Older CLL Patients With Comorbidities

Obinutuzumab (Gazyva) plus chloramubucil outperformed rituximab (Rituxan) plus chlorambucil (Leukeran) as first-line therapy in older patients with chronic lymphocytic leukemia (CLL) and comorbidities in the large CLL 11 trial. Final results showed that obinutuzumab/chloramubucil improved overall...

Leukemia

FDA Approves Ibrutinib for the Treatment of Chronic Lymphocytic Leukemia

The U.S. Food and Drug Administration (FDA) has expanded the approved use of ibrutinib (Imbruvica) for the treatment of patients with chronic lymphocytic leukemia (CLL) who have received at least one previous therapy. Ibrutinib, an oral Bruton’s tyrosine kinase inhibitor, was previously granted...

Survivorship
Leukemia
Lymphoma

Long-Term Decline in Neuropsychological Function Seen After Cranial Radiotherapy for Pediatric Lymphoid Malignancy

Central nervous system–directed chemotherapy and cranial radiotherapy for childhood acute lymphoblastic leukemia or lymphoma have neurotoxic effects. In a study reported in Journal of Clinical Oncology, Ilse Schuitema, MSc, of Leiden University, and colleagues evaluated white matter changes and...

Leukemia

Ibrutinib for Previously Treated Chronic Lymphocytic Leukemia

On February 12, 2014, ibrutinib (Imbruvica) was granted accelerated approval for the treatment of patients with chronic lymphocytic leukemia (CLL) who have received at least one prior therapy.1,2 Ibrutinib previously received accelerated approval for the treatment of patients with mantle cell...

Leukemia
Cost of Care

Higher Copayment Associated With Greater Discontinuation of and Nonadherence to Tyrosine Kinase Inhibitor Treatment in CML

The availability of the tyrosine kinase inhibitor imatinib (Gleevec) has dramatically increased survival in chronic myeloid leukemia (CML). Nonadherence to therapy with imatinib and other tyrosine kinase inhibitors is associated with disease progression and treatment resistance. In a study reported ...

Leukemia

FDA Grants Orphan Drug Status to Pracinostat for the Treatment of Acute Myeloid Leukemia

The U.S. Food and Drug Administration (FDA) has granted orphan drug designation to the investigational drug pracinostat for the treatment of acute myeloid leukemia (AML). The FDA’s Orphan Drug Designation program provides orphan status to drugs defined as those intended for the safe and effective...

Leukemia

Omacetaxine Mepesuccinate Receives Full FDA Approval for CML

The U.S. Food and Drug Administration (FDA) has granted full approval to omacetaxine mepesuccinate (Synribo) for injection. The full approval was based on the final analysis of two phase II trials that evaluated the efficacy and tolerability data of omacetaxine. The agent received an accelerated...

Leukemia

Gemtuzumab Ozogamicin Reduces Relapse, Improves Event-Free Survival in Pediatric AML

The monoclonal antibody gemtuzumab ozogamicin (Mylotarg) improved event-free survival and reduced the risk of relapse in children with acute myeloid leukemia (AML) in a study from the Children’s Oncology Group, presented at the 55th American Society of Hematology (ASH) Annual Meeting and Exposition ...

Leukemia

Idelalisib Plus Rituximab in Heavily Pretreated Relapsed CLL: ‘Dawn of a New Age’?

Idelalisib plus rituximab (Rituxan) improved progression-free survival, overall response rates, and overall survival compared with rituximab alone in heavily pretreated patients with relapsed chronic lymphocytic leukemia (CLL). Moreover, the combination provided effective, durable disease control...

Leukemia

Novel Therapies May Help Wipe Out Residual Acute Lymphoblastic Leukemia

Minimal residual disease after induction and consolidation for the treatment of acute leukemia might be eradicated by novel therapies, thus obviating the need for stem cell transplantation. That is the prediction of Matthew J. Wieduwilt, MD, PhD, Assistant Clinical Professor of Medicine at the...

Leukemia

Minimal Residual Disease Before and After Transplant: What Does It Mean?

In patients with acute leukemia, outcomes after hematopoietic stem cell transplantation are negatively impacted by the presence of minimal residual disease. However, transplant can prolong survival in patients with minimal residual disease after consolidation, according to two studies presented at...

Leukemia

Adding Idelalisib to Rituximab Improved Survival in Patients With Relapsed CLL

Receiving rituximab (Rituxan) with idelalisib, rather than rituximab with placebo, “significantly improved progression-free survival, response rate, and overall survival” among patients with relapsed chronic lymphocytic leukemia (CLL) who were less able to undergo chemotherapy because of clinically ...

Leukemia

Long-Term Benefit With Dasatinib After Imatinib Failure in Chronic-Phase Chronic Myeloid Leukemia

Patients with chronic myeloid leukemia (CML) in the chronic phase who are resistant or intolerant to imatinib (Gleevec) can experience long-term benefit with dasatinib (Sprycel), according to long-term results of a randomized phase III study. The CA180-034 study also found that early molecular and...

Leukemia

Synergy of IAP Antagonist and Demethylating Agents Against AML Stem/Progenitor Cells

In a study reported in the Journal of the National Cancer Institute, Carter and colleagues identified deregulated apoptotic components in acute myeloid leukemia (AML) stem/progenitor cells and investigated the effects of the novel inhibitor of apoptosis (IAP) protein antagonist and SMAC mimetic...

Leukemia

FDA Approves Ofatumumab for Previously Untreated Chronic Lymphocytic Leukemia

The U.S. Food and Drug Administration (FDA) has approved ofatumumab (Arzerra) injection in combination with chlorambucil (Leukeran) for the treatment of previously untreated patients with chronic lymphocytic leukemia (CLL), for whom fludarabine-based therapy is considered inappropriate. The...

leukemia
lymphoma

The Leukemia & Lymphoma Society Surpasses $1 Billion Investment in Blood Cancer Research

The Leukemia & Lymphoma Society (LLS) has announced that it has passed the $1 billion mark in research investment, a significant milestone in the cancer research landscape as the Society continues its 65-year pursuit of advancing breakthrough therapies, finding cures, and ensuring access to...

Leukemia

Ofatumumab Plus Chlorambucil for Previously Untreated CLL in Patients Not Treatable With Fludarabine-Based Regimens

In the Clinic provides overviews of novel oncology agents, addressing indications, mechanisms, administration recommendations, safety profiles, and other essential information needed for the appropriate clinical use of these drugs. On April 17, 2014, ofatumumab (Arzerra) received regular approval...

Leukemia

Volasertib Granted Orphan Drug Designation for Acute Myeloid Leukemia

The U.S. Food and Drug Administration (FDA) has granted Orphan Drug Designation to volasertib for acute myeloid leukemia. Volasertib is currently being evaluated in a phase III clinical trial for the treatment of patients aged 65 or older, with previously untreated AML, who are ineligible for...

Leukemia

Supplemental New Drug Application Submitted for Ibrutinib in CLL

Pharmacyclics, Inc, and Janssen Biotech, Inc, have announced the submission of a supplemental New Drug Application to the U.S. Food and Drug Administration (FDA), based on data from the randomized, multicenter, open-label phase III RESONATE study, a head-to-head comparison of single-agent ibrutinib ...

Leukemia

FDA Approves Mercaptopurine Oral Suspension for Acute Lymphoblastic Leukemia

On April 28, 2014, the U.S. Food and Drug Administration approved a 20 mg/mL oral suspension of mercaptopurine (Purixan) indicated for the treatment of patients with acute lymphoblastic leukemia (ALL) as part of a combination regimen. Successive clinical trials have demonstrated that mercaptopurine ...

Leukemia
Myelodysplastic Syndromes

Early Data for AG-221 Show Unprecedented Activity in Acute Myeloid Leukemia and Myelodysplastic Syndrome

Although the data are preliminary, experts were impressed with responses to a novel IDH2 inhibitor called AG-221 in patients with hematologic malignancies. In the first clinical trial of AG-221, there were three complete remissions, two complete remissions with incomplete platelet count recovery...

Breast Cancer
Colorectal Cancer
Lung Cancer
Prostate Cancer
Skin Cancer
Leukemia
Lymphoma
Multiple Myeloma
Survivorship

NCCN Clinical Practice Guidelines in Oncology: 2014 Updates

At the 19th Annual Conference of the National Comprehensive Cancer Network (NCCN), held recently in Hollywood, Florida, NCCN Panel members presented updates for several tumor types, briefly summarized here. For a more complete description of all updates, visit www.nccn.org. Breast Cancer Guidelines ...

Leukemia

Looking Ahead in Treating Chronic Lymphocytic Leukemia

It’s the dawn of a new era in the treatment of chronic lymphocytic leukemia (CLL), largely due to the development of agents targeting the BCR signaling pathway, according to John C. Byrd, MD, of The Ohio State University Comprehensive Cancer Center, Columbus. At the 19th Annual Conference of the...

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