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Leukemia

Recent Reports and Perspectives on Chronic Lymphocytic Leukemia

Recent articles on developments and controversies in the treatment of chronic lymphocytic leukemia include the following features from The ASCO Post, which are also available at www.ascopost.com: “Recent FDA Approvals Foster Growing Treatment Armamentarium for Chronic Lymphocytic Leukemia and Rare ...

Leukemia

Linking Biology and Therapy in Chronic Lymphocytic Leukemia

Recent discoveries in biology, therapy, and (most importantly) the interplay between these two have led to groundbreaking advances in chronic lymphocytic leukemia (CLL). These advances underline the impact of the “translational” approach to cancer management in general. Standard of Care...

Leukemia

Sonic Hedgehog Factor GLI1 Induces Resistance to Cytarabine and Ribavirin in AML via Glucuronidation

Responses to cytarabine-based therapy in acute myeloid leukemia (AML) are often of short duration. Ribavirin has been used to inhibit the eukaryotic translation initiation factor (eIF4E) and has produced responses, including remissions, in AML, but relapse invariably occurs. As reported in Nature,...

Leukemia

From the Genome to the Bedside: New Treatment Options for Children and Young Adults With Philadelphia Chromosome–Like ALL

The outcome for adolescents and young adults with acute lymphoblastic leukemia (ALL) is inferior to that in children, and the outcome for children with ALL who experience relapse is dismal. Therefore, new therapeutic options are urgently needed to improve survival rates for this high-risk ALL...

Leukemia

Kinase-Activating Alterations Identified in Most Cases of  Philadelphia Chromosome–Like Acute Lymphoblastic Leukemia May Be Targetable With Available Tyrosine Kinase Inhibitors

In a study reported in The New England Journal of Medicine, Kathryn G. Roberts, PhD, of St. Jude Children’s Research Hospital, and colleagues performed detailed genomic analysis of patients with Philadelphia chromosome–like acute lymphoblastic leukemia (ALL) and identified kinase-activating...

Leukemia

The Next-to-Last Frontier in Managing Acute Promyelocytic Leukemia

The treatment of acute promyelocytic leukemia (APL) represents one of the major triumphs in the field of hematologic malignancies. With either the vitamin A derivative all-trans retinoic acid (ATRA) combined with anthracycline-based chemotherapy or ATRA plus arsenic trioxide (Trisenox),...

Leukemia

FDA Grants Orphan Drug Designation to BGB324 for Acute Myeloid Leukemia

The U.S. Food and Drug Administration (FDA) has granted orphan drug designation to BGB324 for the treatment of acute myeloid leukemia (AML). BGB324 is a first-in-class, highly selective small-molecule inhibitor of the Axl receptor tyrosine kinase. It blocks the epithelial-mesenchymal transition...

Leukemia

CD19-Directed CAR T Cells Produce Sustained Remission in Relapsed/Refractory Acute Lymphoblastic Leukemia

In a study reported in The New England Journal of Medicine, Shannon L. Maude, MD, PhD, of Children’s Hospital of Philadelphia, and Noelle Frey, MD, of the Perelman School of Medicine, University of Pennsylvania, and colleagues reported achieving sustained remissions in children and adults with...

Leukemia
Issues in Oncology

Childhood Obesity and Leukemia: Is It Time to Intervene?

"Obesity is associated with cancer mortality,” said Steven D. Mittelman, MD, PhD, at the recent American Association for Cancer Research (AACR) International Conference on Frontiers in Cancer Prevention Research.1 Dr. Mittelman presented a wealth of data to explain the link between obesity and...

Leukemia

Obinutuzumab May Have Synergistic Action With New Tyrosine Kinase Inhibitors

Final results from the phase I/II GAUGUIN study showed that obinutuzumab (Gazyva) monotherapy was active in patients with heavily pretreated relapsed or refractory chronic lymphocytic leukemia, European researchers reported in Blood. In phase II, median progression-free survival was 10.7 months,...

Leukemia

FDA Approves Blinatumomab to Treat Rare Form of Acute Lymphoblastic Leukemia

The U.S. Food and Drug Administration (FDA) today granted accelerated approval to blinatumomab (Blincyto) for the treatment of patients with Philadelphia chromosome–negative, relapsed or refractory precursor B-cell acute lymphoblastic leukemia (B-cell ALL). Blinatumomab is a bispecific...

Leukemia

FDA Grants Breakthrough Therapy Designation to Investigational CAR T-Cell Therapy

The U.S. Food and Drug Administration (FDA) has granted Breakthrough Therapy designation to JCAR015, an investigational chimeric antigen receptor therapy developed by Juno Therapeutics. The designation applies for the treatment of relapsed or refractory B-cell acute lymphoblastic leukemia and was...

Leukemia

Racing Against Acute Lymphoblastic Leukemia: CTL019 Is a Fast CAR With Sustained Endurance

The long-term outcome for patients with relapsed or refractory acute lymphoblastic leukemia (ALL) is poor, with 5-year overall survival from first relapse being only approximately 10%.1,2 Patients with disease relapse following allogeneic transplant have the worse prognosis and are typically...

Leukemia

Transplants for AML in First Remission: A Great Leap Forward, Sideways, or Backward?

“All great truths begin as blasphemies.” —George Bernard Shaw (Annajanksa, 1918)   Until about 15 years ago, persons with acute myelogenous leukemia (AML) were considered candidates to receive a blood cell or bone marrow allotransplant in first remission only if they had had an HLA-identical...

Leukemia

Patients With Chronic Lymphocytic Leukemia Who Progress After Front-line Treatment May Be Candidates for Novel Noncytotoxic Therapies

Although patients who relapse within 3 years of front-line fludarabine, cyclophosphamide, and rituximab (Rituxan; FCR) therapy have poor survival when treated with conventional salvage regimens, these patients may be candidates for novel noncytotoxic therapies, according to an analysis of extended...

Leukemia

Victory for Pediatric Regimens in Adolescents and Young Adults With ALL

Long in the works, early results of the U.S. Intergroup C10403 trial clearly showed that treating acute lymphoblastic leukemia (ALL) in adolescents and young adults using a pediatric-inspired regimen improves event-free survival and overall survival and should be the backbone for future studies in...

Leukemia

Blinatumomab Achieves Complete Molecular Responses in Majority of B-Cell Leukemia Patients

Results from the international phase II BLAST study show that one cycle of blinatumomab (Blincyto) immunotherapy achieved complete minimal residual disease response in 78% of patients with acute lymphoblastic leukemia.1 Complete minimal residual disease response was achieved in 80% of patients...

Leukemia

Venetoclax Gaining Ground in Two Types of Leukemia

Venetoclax, formerly known as ABT-199, is moving forward into phase III development in acute myelogenous leukemia (AML) and chronic lymphocytic leukemia (CLL), based on encouraging data from separate phase Ib and II trials presented at the 56th Annual Meeting and Exposition of the American Society...

Leukemia

Nilotinib With Low-Intensity Chemotherapy Useful in Elderly Patients With Philadelphia Chromosome–Positive ALL

The addition of the tyrosine kinase inhibitor nilotinib (Tasigna) to standard low-intensity chemotherapy improved outcomes in elderly patients with newly diagnosed Philadelphia chromosome–positive acute lymphoblastic leukemia (ALL) and may represent a new approach to this group of patients, who are ...

Leukemia

CPX-351 Receives Fast Track Designation for Secondary Acute Myeloid Leukemia in Elderly Patients

The U.S. Food and Drug Administration (FDA) has granted Fast Track designation to Celator Pharmaceuticals’ investigational agent CPX-351, a liposomal formulation of cytarabine:daunorubicin, for the treatment of elderly patients with secondary acute myeloid leukemia. The FDA established the Fast...

Hematologic Malignancies
Leukemia

New Choosing Wisely List, Leukemia Quick-Takes From ASH

Nearly 5,000 scientific abstracts were presented at the 2014 American Society of Hematology (ASH) Annual Meeting and Exhibition in San Francisco. Along with our targeted coverage of the meeting’s key newsmakers, The ASCO Post provides you with these brief reports of other interesting...

Leukemia

Inotuzumab Ozogamicin Plus Low-Intensity Chemotherapy: A Winner in Older Patients With Leukemia

Inotuzumab ozogamicin combined with a low-intensity chemotherapy called mini-hyper-CVD achieved highly encouraging results in older patients with acute lymphoblastic leukemia (ALL) in a phase II study reported at the 56th Annual Meeting of the American Society of Hematology.1 After the...

Leukemia

CAR T Cells Impressive in Acute Lymphocytic Leukemia

As more experience is gained with the use of genetically engineered chimeric antigen receptor (CAR) T cells in patients with leukemia, the data continue to be highly encouraging. Three different groups using slightly different modifications of CAR T cells reported positive experiences in treating...

Leukemia

ASCO Releases Annual Report on Progress Against Cancer

ASCO recently released its report, Clinical Cancer Advances 2015: An Annual Report on Progress Against Cancer, and for the first time announced its cancer Advance of the Year: gains made in the treatment of chronic lymphocytic leukemia (CLL). The report credited improvements in CLL care with four...

Leukemia

Blinatumomab in Philadelphia Chromosome–Negative Relapsed/Refractory B-Cell Precursor ALL

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 December 3, 2014, blinatumomab (Blincyto) was granted...

Leukemia

High Hopes for AG-221 in Advanced Leukemia

Although the data are preliminary, single-agent AG-221 therapy targeted to the IDH2 (isocitrate dehydrogenase 2) mutation holds great promise as a nonchemotherapy approach to the treatment of advanced hematologic malignancies, including relapsed/refractory acute myelogenous leukemia (AML) and...

Leukemia

First Randomized Trial to Show Benefit of Tyrosine Kinase Inhibitor in Newly Diagnosed Acute Myeloid Leukemia

Sorafenib (Nexavar) added to chemotherapy improved event-free survival and relapse-free survival in younger patients with acute myeloid leukemia, according to results of the randomized, controlled phase II SORAML trial.1 However, no significant improvement in overall survival has been seen to ...

Leukemia

Venetoclax Receives Breakthrough Therapy Designation in Relapsed/Refractory CLL With 17p Deletion

The U.S. Food and Drug Administration has granted Breakthrough Therapy Designation to AbbVie’s investigational agent venetoclax (ABT-199) for the treatment of relapsed or refractory chronic lymphocytic leukemia (CLL) in patients with 17p deletion. Venetoclax is an investigational oral B-cell...

Leukemia

Prognostic Models and Front-Line Treatment Options for Chronic-Phase Chronic Myelogenous Leukemia

The ASCO Post is pleased to present “Hematology Expert Review,” an occasional feature that includes a case report detailing a particular hematologic condition followed by questions. Answers to each question, along with expert commentary, can be found in the sidebar. In this installment, we present...

Skin Cancer
Breast Cancer
Multiple Myeloma
Leukemia
Colorectal Cancer
Prostate Cancer
Pancreatic Cancer

NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®): 2015 Updates

For 2 decades, the NCCN Guidelines® have been recognized as the standard of cancer care in the United States, combining evidence, experience, and choice, so that multidisciplinary cancer treatment teams—including patients—are empowered to make informed decisions about cancer care,” said Robert W....

Leukemia

First-Line Imatinib With Early Switch to Nilotinib May Be Preferable to First-Line Use of More Potent Agents in CML

Using imatinib to treat chronic-phase chronic myeloid leukemia (CP-CML) first line, with selective switching to nilotinib (Tasigna) “leads to excellent molecular response and survival” and “may be preferable to universal first-line use of more potent agents, considering efficacy, toxicity, and...

Leukemia

Patients With Relapsed/Refractory CLL That Progresses Early on Ibrutinib Have Poor Outcomes

Most patients with relapsed/refractory chronic lymphocytic leukemia (CLL) who discontinued ibrutinib (Imbruvica) early “were difficult to treat and had poor outcomes,” according to a study of patients enrolled in four different clinical trials of ibrutinib, with or without rituximab (Rituxan), at...

Leukemia

Ibrutinib Plus Bendamustine/Rituximab Called a New Standard in Patients With Previously Treated CLL

The addition of ibrutinib (Imbruvica) to standard therapy with bendamustine (Treanda)/rituximab (Rituxan) significantly reduced the risk of disease progression or death and overall response rates compared with bendamustine/rituximab alone in previously treated chronic lymphocytic leukemia...

Leukemia

Durable Responses at 3-Year Follow-up for CLL Patients Receiving Single-Agent Ibrutinib

At a median follow-up of 3 years, ibrutinib (Imbruvica) demonstrated continued activity with durable responses that improved in quality with extended treatment of patients with chronic lymphocytic leukemia (CLL). In addition, grade 3 toxicity and adverse events leading to treatment discontinuation...

Leukemia
Myelodysplastic Syndromes

Advancing Classification and Risk Stratification for Leukemia and Myelodysplastic Syndromes

Refinements in the classification and risk stratification for leukemia and myelodysplastic syndromes were reported by three different investigators at the 2015 ASCO Annual Meeting. The first study showed that leukemia stem cell phenotypes are associated with outcomes in acute myeloid leukemia...

Leukemia

A Lasting Legacy

When Emil J Freireich, MD, retires from the University of Texas MD Anderson Cancer Center on September 1, he will have spent 50 years at the institution and a total of 60 years in the pursuit of curing childhood leukemia as well as other cancers and in the educational development of young...

Leukemia

Novel Combination Increases Progression-Free Survival in CLL Patients Who Are Not Candidates for Fludarabine

In the phase III COMPLEMENT 1 trial reported in The Lancet, ­Peter Hillmen, MB, ChB, of St. James’s University Hospital, Leeds, and colleagues found that the addition of the anti-CD20 antibody ofatumumab (Arzerra) to chlorambucil (Leukeran) increased progression-free survival among patients with...

Leukemia

Azacitidine Increased Median Overall Survival Among Patients Aged 65 and Older With > 30% Blasts

A multicenter, randomized, open-label, phase III trial among the difficult-to-treat population of patients aged aged 65 and older with acute myeloid leukemia (AML) with > 30% bone marrow blasts “showed that azacitidine was associated with a clinically meaningful improvement” in median overall...

Breast Cancer
Leukemia

Shadowed by Cancer

Although genetic testing has not turned up any inherited mutations that might explain the number of cancers that have plagued my immediate family, over the past 15 years, I have lost my father, aunt, and sister to the disease. In 2001, my husband, Wayne, died of acute promyelocytic leukemia, and...

Leukemia

Inotuzumab Ozogamicin Receives FDA Breakthrough Therapy Designation for Acute Lymphoblastic Leukemia

Pfizer recently announced that the U.S. Food and Drug Administration (FDA) has granted Breakthrough Therapy designation to the company’s investigational antibody-drug conjugate inotuzumab ozogamicin for acute lymphoblastic leukemia (ALL). The FDA’s decision was based on the results of the phase III ...

Leukemia

Changing the Outlook for Chronic Lymphocytic Leukemia

Small-molecule inhibitors, especially ibrutinib (Imbruvica) and idelalisib (Zydelig), have greatly changed the outlook for patients with chronic lymphocytic leukemia. William G. Wierda, MD, PhD, Professor and Center Medical Director in the Department of Leukemia at The University of Texas MD...

Leukemia

Does Low-Dose Radiation Cause Leukemia?

Data from A-bomb survivors, persons with ankylosing spondylitis and neoplasms treated with radiation therapy, and many other sources show a strong association between exposure to ionizing radiation (particles or electromagnetic waves with sufficient energy to cause an ionization such as photons and ...

Leukemia

Chronic Myelogenous Leukemia: What Drug for Which Patient?

Treatment of chronic myelogenous leukemia (CML) with tyrosine kinase inhibitors is “the golden child success story of targeted treatment,” Jerald P. Radich, MD, of the Fred Hutchinson Cancer Research Center and Seattle Cancer Care Alliance, Seattle, Washington, told attendees at the National...

Hematologic Malignancies
Leukemia

BRAF Inhibition Successful in Relapsed/Refractory Hairy Cell Leukemia

In two phase II studies reported in The New England Journal of Medicine, ­Enrico Tiacci, MD, of the University of Perugia, Italy, and colleagues found that the BRAF inhibitor vemurafenib (Zelboraf) produced responses in nearly all patients with BRAF V600E–positive hairy cell leukemia that relapsed...

Hematologic Malignancies
Leukemia
Issues in Oncology

Acute Myeloid Leukemia in the Elderly: Trial Data Stir Hope for the Transplant Option

Older patients with acute myeloid leukemia (AML) have high relapse rates after induction chemotherapy, low survival rates, and fewer treatment options compared with younger patients. One of the options for both younger and older patients is hematopoietic cell transplantation, but relatively few...

Hematologic Malignancies
Leukemia
Myelodysplastic Syndromes

Selected Abstracts From 2015 ASH Annual Meeting

Here are several abstracts selected from the proceedings of this year’s American Society of Hematology (ASH) Annual Meeting and Exposition, highlighting therapeutics in acute leukemias and myelodysplastic syndromes. For full details of these study abstracts, visit...

Leukemia

Pediatric Regimen Achieves Higher-Than-Expected Survival in Young Adults With Acute Lymphoblastic Leukemia

Adolescents and younger adults with acute lymphoblastic leukemia (ALL) had superior outcomes on a “pediatric” regimen compared with adult treatment protocols. A multicenter phase II study included patients aged 18–50, extending the upper limit of “younger,” since most other trials of this approach...

Leukemia

Promising Upfront Combination in Older Patients With Acute Lymphoblastic Leukemia

Frontline treatment with the antibody-drug conjugate inotuzumab ozogamicin plus deintensified chemotherapy is a promising option for older patients with Philadelphia chromosome–negative acute lymphoblastic leukemia (ALL). Phase II results suggest that this combination has the ability to improve...

Leukemia

Midostaurin: A New Standard of Care in Acute Myeloid Leukemia?

Upfront treatment with midostaurin added to standard chemotherapy improved survival compared with placebo plus chemotherapy in high-risk patients with acute myeloid leukemia (AML) characterized by FLT3 mutations. No new drugs have been approved for AML since 1990, and midostaurin is the first...

Hematologic Malignancies
Leukemia
Issues in Oncology

Ibrutinib Bests Standard of Care for Elderly Patients With CLL

First-line treatment with the Bruton’s tyrosine kinase inhibitor ibrutinib (Imbruvica) significantly reduced the risk of dying or disease progression compared with chlorambucil (Leukeran) in older treatment-naive patients with chronic lymphocytic leukemia (CLL) in the RESONATE-2 trial. At the time...

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