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Young people with B-cell acute lymphoblastic leukemia (ALL) who received doses of tisagenlecleucel, a chimeric antigen receptor (CAR) T-cell therapy, at the higher end of the approved dosing range had significantly better survival rates at 1 year compared with those who received lower doses within...
Although considered a rare occurrence in adolescents and young adults (AYAs), aged 15 to 39 years, the incidence of cancer in this age group has been increasing by approximately 30% since the 1970s. This year, it is estimated that nearly 90,000 new cases of cancer will be diagnosed in this...
Patients seeking to purchase chemotherapy drugs online face a confusing array of websites, over half of which potentially operate unsafely or illegally, according to a study published by Sun et al in JNCCN–Journal of the National Comprehensive Cancer Network. A survey of online pharmacies claiming...
In a first-in-patients phase Ib study reported in The Lancet Oncology, John M. Pagel, MD, PhD, and colleagues identified the safety profiles of the PI3Kδ inhibitor zandelisib given in intermittent vs continuous dosing schedules with or without rituximab in patients with relapsed of refractory...
Nicholas J. Short, MD, of The University of Texas MD Anderson Cancer Center, discusses updated results from a phase II study that suggests the chemotherapy-free regimen of simultaneous ponatinib and blinatumomab is safe and effective in patients with Philadelphia chromosome–positive acute lymphoblastic leukemia. For patients with newly diagnosed disease, stem cell transplantation does not appear to be needed in first remission (Abstract S114).
In a phase Ib study reported in the Journal of Clinical Oncology, Naval Daver, MD, and colleagues found that the doublet of venetoclax plus gilteritinib produced a high modified composite complete response rate in patients with FLT3-mutated relapsed or refractory acute myeloid leukemia. Dose...
Time-limited venetoclax-based regimens provide deeper and more durable remissions than chemoimmunotherapy combinations in patients with previously untreated chronic lymphocytic leukemia (CLL), regardless of patients’ fitness, according to late-breaking data presented during the European Hematology...
The ASCO Post is pleased to present Hematology Expert Review, an ongoing feature that quizzes readers on issues in hematology. In this installment, Drs. Syed Ali Abutalib and L. Jeffrey Medeiros explore the World Health Organization (WHO) classification of hematopoietic and lymphoid tissue...
In a phase II trial reported in the Journal of Clinical Oncology, Mishra et al found that maintenance treatment with the first-in-class small-molecule p53 reactivator eprenetapopt plus azacitidine following allogeneic hematopoietic stem cell transplantation (HSCT) was associated with “encouraging”...
As reported in The Lancet Oncology by Constantine S. Tam, MBBS, PhD, and colleagues, an interim analysis in the phase III SEQUOIA trial has shown significantly improved progression-free survival with first-line zanubrutinib vs bendamustine/rituximab in patients with chronic lymphocytic leukemia...
In an analysis of long-term follow-up of the UKALL2003 trial reported in the Journal of Clinical Oncology, Anthony V. Moorman, PhD, and colleagues found that whereas initial risk of relapse in children and young adults with acute lymphoblastic leukemia differed according to risk factors, risk...
A new treatment option has doubled overall survival for a difficult-to-treat subset of patients with acute myeloid leukemia (AML), according to data presented during the Presidential Symposium at the European Hematology Association (EHA) 2022 Congress in Vienna.1 Findings from the phase III...
New research published by Larkin et al in the journal Blood Advances has found that Black adolescent and young adult (AYA) patients with acute myeloid leukemia (AML) were five times more likely than comparable White patients to die within 30 days of beginning treatment—and were twice as likely to...
The U.S. Food and Drug Administration (FDA) is warning that results from the phase III DUO clinical trial show a possible increased risk of death with duvelisib compared to ofatumumab among patients with chronic lymphocytic leukemia (CLL) or small lymphocytic lymphoma (SLL). The trial also found...
As reported in the Journal of Clinical Oncology by Saro H. Armenian, DO, MPH, and colleagues, findings from the BMT Survivor Study (BMTSS) indicated that survivors of acute myeloid leukemia (AML) treated with blood or marrow transplantation (BMT) are at a markedly increased risk of...
In a single-institution phase II study reported in the Journal of Clinical Oncology, Tapan M. Kadia, MD, and colleagues found that venetoclax and a lower-intensity backbone of cladribine and low-dose cytarabine alternating with azacitidine and venetoclax resulted in a high response rate in older...
In a phase II trial (HOVON141/VISION) reported in The Lancet Oncology, Arnon P. Kater, MD, PhD, and colleagues found a high rate of 12-month progression-free survival among patients with relapsed or refractory chronic lymphocytic leukemia (CLL) who stopped venetoclax/ibrutinib after achieving...
Eunice S. Wang, MD, of Roswell Park Comprehensive Cancer Center, discusses long-term phase II findings of a trial evaluating crenolanib plus chemotherapy in newly diagnosed adults with FLT3-mutant acute myeloid leukemia. The study showed a composite complete remission rate of 86%. With a median follow-up of 45 months, median overall survival has not been reached. A phase III trial is ongoing (Abstract 7007).
In a study reported in The New England Journal of Medicine, Liu et al found that hypomethylating therapy was associated with upregulation of the oncogene SALL4 in a high proportion of patients with myelodysplastic syndrome. They also identified the gene region that is demethylated and responsible...
In a phase II study, researchers evaluated the efficacy of ibrutinib, fludarabine, cyclophosphamide, and obinutuzumab—a chemoimmunotherapy and targeted therapy combination—in 45 previously untreated patients with IGHV-mutated chronic lymphocytic leukemia (CLL). Nitin Jain, MD, of the Department of...
High-risk patients with TP53-mutated acute myeloid leukemia (AML) have limited treatment options and very poor prognoses. Magrolimab is a monoclonal antibody designed to block CD47, an immune macrophage checkpoint molecule that signals “don’t eat me,” thereby allowing leukemia cell destruction....
FLT3-ITD–mutated acute myeloid leukemia (AML) is an aggressive disease usually resistant to available treatment options, resulting in high front-line response rates but short response durations and low survival rates. Quizartinib—a potent selective FLT3 inhibitor—can work synergistically with...
Mutations in SF3B1 and U2AF1 can drive overexpression of activated IRAK4—which regulates inflammation and promotes cancer cell growth and survival—and are associated with a poor prognosis for patients with high-risk myelodysplastic syndrome (MDS) and acute myeloid leukemia (AML). Emavusertib is a...
The tyrosine kinase inhibitor ponatinib and monoclonal antibody blinatumomab—which targets CD19 on leukemia cells—are highly effective as monotherapies for patients with Philadelphia chromosome–positive (Ph+) acute lymphoblastic leukemia (ALL). The combination of the two therapies may provide an...
Eunice Wang, MD, Chief of Leukemia at Roswell Park Comprehensive Cancer Center, and colleagues presented the long-term results of a phase II clinical trial combining crenolanib, a second-generation FLT3 inhibitor, with standard intensive chemotherapy for the treatment of adults with newly diagnosed ...
Courtney D. DiNardo, MD, MSCE, of The University of Texas MD Anderson Cancer Center, and Stéphane de Botton, MD, PhD, of Institut Gustave Roussy, discuss phase III findings from the IDHENTIFY trial, which showed that mutational burden and co-mutational profiles differed between patients with relapsed or refractory acute myeloid leukemia that exhibited IDH2-R140 and IDH2-R172 mutations. Enasidenib improved survival outcomes for patients with IDH2-R172 mutations: median overall survival and 1-year survival rates were approximately double those in the conventional care arm (Abstract 7005).
Courtney D. DiNardo, MD, MSCE, of The University of Texas MD Anderson Cancer Center, and Jorge E. Cortes, MD, of Georgia Cancer Center at Augusta University, discuss phase III results from the ASCEMBL trial, which showed that after more than 2 years of follow-up, asciminib continued to yield superior efficacy and better safety and tolerability vs bosutinib in patients with chronic myeloid leukemia (CML) in chronic phase. These results continue to support the use of this kinase inhibitor as a new CML therapy, says Dr. Cortes, with the potential to transform the standard of care (Abstract 7004).
On May 25, the U.S. Food and Drug Administration (FDA) approved ivosidenib (Tibsovo) in combination with azacitidine for patients with newly diagnosed acute myeloid leukemia (AML) with a susceptible IDH1 mutation as detected by an FDA-approved test in adults aged 75 or older, or who have...
On May 20, the U.S. Food and Drug Administration approved azacitidine (Vidaza) for pediatric patients with newly diagnosed juvenile myelomonocytic leukemia (JMML). AZA-JMML-001 Efficacy was evaluated in AZA-JMML-001 (ClinicalTrials.gov identifier NCT02447666), an international, multicenter,...
In a study reported in the Journal of Clinical Oncology, Bruinink et al constructed a transcriptomic classifier for primary plasma cell leukemia (PCL) that identified high-risk PCL-like disease in patients with newly diagnosed multiple myeloma. As stated by the investigators, “Primary PCL is an...
Although considered a rare occurrence in adolescents and young adults (AYAs), aged 15 to 39 years, the incidence of cancer in this age group has been increasing by approximately 30% since the 1970s. This year, it is estimated that nearly 90,000 new cases of cancer will be diagnosed in this...
In a study reported in the British Journal of Haematology, Staron et al found that the prevalence of plasma cell and lymphoproliferative disorders among blood relatives of probands with light chain (AL) amyloidosis was low overall and varied according to proband AL amyloidosis subtype. Despite...
In a single-institution study reported in a research letter in JAMA Oncology, Kenzik et al found substantial rates of rehospitalization and emergency department visits after chimeric antigen receptor (CAR) T-cell therapy among commercially insured patients with cancer. Study Details The study...
Ongoing evaluation of novel, targeted, and immunotherapies has led to exciting advances across the array of hematologic malignancies over the past year. The availability of new treatment options, along with emerging data on novel combinations and sequencing approaches, is rapidly changing...
Administering time-limitedcombination regimens of venetoclax plus obinutuzumab or venetoclax plus obinutuzumab and ibrutinib was superior to chemoimmunotherapy in achieving undetectable measurable residual disease (MRD) in the peripheral blood at month 15 in fit patients with chronic lymphocytic...
Joshua Brody, MD, Director of the CLL/Lymphoma Immunotherapy Program, Icahn School of Medicine at Mount Sinai, New York, who was not involved in these trials, commented: “CLL is an extremely prevalent disease affecting nearly 200,000 patients in the United States. Most patient do not require...
Two different trials presented at the 2021 American Society of Hematology (ASH) Annual Meeting & Exposition found that fixed-duration treatment with ibrutinib and venetoclax achieved deep and sustained undetectable measurable residual disease (MRD) status when used as first-line therapy for...
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...
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...
In the phase III AGILE trial reported in The New England Journal of Medicine, Montesinos et al found that the addition of ivosidenib to azacitidine in induction therapy significantly prolonged event-free survival in patients with newly diagnosed IDH1-mutated acute myeloid leukemia. An overall...
For older patients with acute myeloid leukemia (AML), front-line treatment with liposomal daunorubicin/cytarabine (CPX-351) appears to be equivalent to treatment with a hypomethylating agent plus venetoclax, according to data presented at the 2021 American Society of Hematology (ASH) Annual Meeting ...
Acute lymphoblastic leukemia (ALL) cells from patients whose cancers did not respond to CD19-targeted chimeric antigen receptor (CAR) T-cell therapy had gene regulation signatures that could potentially facilitate treatment resistance, according to results presented at the American Association for...
According to a large multiethnic study presented by Sok et al at the American Association for Cancer Research (AACR) Annual Meeting 2022, Latinx children with acute lymphoblastic leukemia (ALL) and measurable residual disease (MRD)-negative status were more likely to relapse compared with...
Yaqi Zhao, MSc, of St. Jude Children’s Research Hospital, discusses findings from the phase III INO-VATE trial, which showed that inotuzumab ozogamicin reduced the signs and symptoms of acute lymphoblastic leukemia associated with a variety of gene and chromosome changes. Future studies may confirm which patients are more likely to benefit from this agent (Abstract CT027).
In an analysis from the Children’s Oncology Group protocol AAML1013 reported in the Journal of Clinical Oncology, Pollard et al found that the addition of sorafenib to standard chemotherapy may benefit pediatric patients with high allelic ratio FLT3-ITD–positive acute myeloid leukemia (AML). Study...
In this video, Drs. Richard Stone, Courtney DiNardo, and Eunice Wang discuss therapy options for minimal residual disease (MRD)-positive acute myeloid leukemia (AML). The case is a 44-year-old man with no past medical history who presents with fevers and fatigue. He is diagnosed with AML and achieves morphologic remission after treatment with 7+3 (cytarabine/daunorubicin) plus gemtuzumab; however MRD flow cytometry reveals 0.1% blasts, which persists after consolidation with high-dose cytarabine. The faculty discuss how they would approach the next steps for this patient and the importance of reducing the disease burden prior to the initiation of allogeneic stem cell transplant.
In this video, Drs. Richard Stone, Courtney DiNardo, and Eunice Wang treatment options for primary refractory FLT3-ITD–positive acute myeloid leukemia (AML). The case is a 60-year-old man with a history of hypertension and hyperlipidemia who presents with fatigue. He is diagnosed with FLT3-ITD–positive AML and is enrolled in a clinical trial where he receives 7+3 (cytarabine/daunorubicin) and midostaurin; after achieving complete remission, his disease eventually recurs. The faculty discuss potential treatment options for this patient, such as FLAG-IDA-VEN and gilteritinib both alone and in combination.
In this video, Drs. Richard Stone, Courtney DiNardo, and Eunice Wang discuss the management of newly diagnosed older patients with acute myeloid leukemia (AML). The case is a 75-year-old woman with no past medical history who presents with fever and bone pain. She is diagnosed with AML, and next-generation sequencing reveals a mutation in IDH1, among others. The faculty discuss the potential choices for induction therapy in older patients such as this, debating the merits of intensive chemotherapy vs lower-intensity options such as azacitidine/venetoclax and azacitidine/ivosidenib.
This is Part 1 of Updates in Acute Myeloid Leukemia, a four-part video roundtable series. Scroll down to watch the other videos from this Roundtable. In this video, Drs. Richard Stone, Courtney DiNardo, and Eunice Wang discuss the management of newly diagnosed younger patients with acute myeloid leukemia (AML). The case is a 23-year-old woman with no past medical history who presents with very heavy menstrual periods and fatigue, and is diagnosed with AML with key mutations found in DNMT3A, NPM1, and IDH2. The faculty discuss the evolution of induction therapy options for younger patients with AML, as oncologists move from standard 7+3 (cytarabine/daunorubicin) chemotherapy to more personalized approaches.
“The value of experience is not in seeing much, but in seeing wisely.” —Sir William Osler To complement The ASCO Post’s continued comprehensive coverage of the 2021 American Society of Hematology (ASH) Annual Meeting & Exposition, here are several abstracts selected from the meeting...