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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...

leukemia
lymphoma

Adding Ibrutinib to Bendamustine/Rituximab May Increase Progression-Free Survival in Chronic Lymphocytic Leukemia or Small Lymphocytic Lymphoma

In the phase III HELIOS trial reported in The Lancet Oncology, Chanan-Khan et al found that the addition of the Bruton’s tyrosine kinase (BTK) inhibitor ibrutinib (Imbruvica) to bendamustine (Treanda)/rituximab (Rituxan) increased progression-free survival in patients with chronic lymphocytic ...

leukemia
lymphoma

Sagar Lonial, MD, and Alessandra Tedeschi, MD, on CLL/SLL: Results From the RESONATE-2 Trial

Sagar Lonial, MD, of the Emory University School of Medicine, and Alessandra Tedeschi, MD, of the Azienda Ospedaliera Niguarda Cà Granda, discuss this international study of ibrutinib vs chlorambucil in patients 65 years and older with treatment-naive chronic lymphocytic leukemia or small lymphocytic lymphoma (Abstract 495).

leukemia
myelodysplastic syndromes

Mikkael A. Sekeres, MD, on MDS and CMML Study Results: SWOG S1117

Mikkael A. Sekeres, MD, of the Cleveland Clinic, discusses an additional analysis of a phase II study of azacitidine combined with lenalidomide or with vorinostat vs azacitidine monotherapy in higher-risk myelodysplastic syndromes and chronic myelomonocytic leukemia (Abstract 908).

leukemia

James Foran, MD, on Clofarabine for AML: Clinical Trial Results of ECOG-ACRIN and ALFA/Clara

James Foran, MD, of the Mayo Clinic Cancer Center, discusses two key studies on clofarabine: as a single agent for induction and postremission therapy in newly diagnosed AML, and as the basis for consolidation in nonfavorable AML (Abstracts 217 and 218).

leukemia

Hagop M. Kantarjian, MD, on AML: Safety and Efficacy of Guadecitabine

Hagop M. Kantarjian, MD, of MD Anderson Cancer Center, discusses a study that compared efficacy and safety results of using 5-day and 10-day regimens of a novel hypomethylating agent in 103 treatment-naïve AML patients who were not candidates for intensive chemotherapy (Abstract 458).

leukemia

Margaret O'Donnell, MD, on Novel Approaches to Treatment for Older AML Patients

Margaret O'Donnell, MD, of the City of Hope National Medical Center, summarizes a session on this vital topic (Session 613).

leukemia

Andrew D. Zelenetz, MD, PhD, and Stephan Stilgenbauer, MD, PhD on CLL and Venetoclax: Clinical Trial Results

Andrew D. Zelenetz, MD, PhD, of Memorial Sloan Kettering Cancer Center, and Stephan Stilgenbauer, MD, PhD, of the University of Ulm, discuss this late-breaking abstract on venetoclax monotherapy and deep remissions in ultra-high risk relapsed/refractory chronic lymphocytic leukemia with 17p deletion (Abstract LBA6).

leukemia

Andrew D. Zelenetz, MD, PhD, on CLL: Idelalisib Plus Bendamustine and Rituximab

Andrew D. Zelenetz, MD, PhD, of Memorial Sloan Kettering Cancer Center, discusses a late-breaking abstract on the superiority of this three-drug combination compared to bendamustine and rituximab alone in patients with relapsed/refractory chronic lymphocytic leukemia (Abstract LBA5).

leukemia

Julie Vose, MD, MBA, on ALL Overall Survival: Academic vs Nonacademic Hospitals

Julie Vose, MD, MBA, of the University of Nebraska Medical Center, discusses a retrospective analysis of data on the overall survival of patients with acute lymphoblastic leukemia when initial therapy is given in academic hospitals vs nonacademic hospitals (Abstract 268).

leukemia

Sébastien Maury, MD, on ALL: Results of the Graall-R 2005 Study (French Language Version)

Sébastien Maury, MD, of the Hôpital Henri Mondor, discusses in French this study in which adding rituximab improved the outcome of adult patients with CD20-positive, Ph-negative B-cell precursor acute lymphoblastic leukemia (Abstract 1).

leukemia

Sébastien Maury, MD, on ALL: Results of the Graall-R 2005 Study

Sébastien Maury, MD, of the Hôpital Henri Mondor, discusses this study in which adding rituximab improved the outcome of adult patients with CD20-positive, Ph-negative B-cell precursor acute lymphoblastic leukemia (Abstract 1). To see the French language version of this newsreel, please click here.

leukemia

Richard M. Stone, MD, on AML: Results of the RATIFY Trial

Richard M. Stone, MD, of the Dana-Farber Cancer Institute, discusses this international prospective study on the survival impact of midostaurin, a multikinase inhibitor, in newly diagnosed acute myeloid leukemia with FLT3 mutations (Abstract 6).

hematologic malignancies
leukemia
lymphoma

Adding Ibrutinib to Bendamustine/Rituximab Increases Progression-Free Survival in Chronic Lymphocytic Leukemia or Small Lymphocytic Lymphoma

In the phase III HELIOS trial, reported in The Lancet Oncology, Chanan-Khan et al found that adding the Bruton’s tyrosine kinase inhibitor ibrutinib (Imbruvica) to bendamustine (Treanda)/rituximab (Rituxan) increased progression-free survival in patients with chronic lymphocytic leukemia or...

hematologic malignancies
leukemia
issues in oncology
issues in oncology

Germline ETV6 Variations as Basis of Novel Genetic Syndrome Associated With Childhood Acute Lymphoblastic Leukemia

In a systematic genetic study reported in The Lancet Oncology, Moriyama et al found that germline ETV6 variations identified in a small proportion of children with acute lymphoblastic leukemia (ALL) were associated with a novel syndrome predisposing carriers to disease. Recent data indicated that...

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