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Leukemia

Oral Regimen of Ibrutinib/Venetoclax Achieves High Rates of Undetectable Minimal Residual Disease in CLL

Updated results of the phase II CAPTIVATE trial continue to show high response rates as well as high rates of undetectable minimal residual disease (MRD) with ibrutinib plus venetoclax as front-line treatment of chronic lymphocytic leukemia (CLL) in patients under the age of 70 years. The...

Leukemia

Treating Patients With Chronic Lymphocytic Leukemia in 2020

With the availability of a number of effective targeted agents for the treatment of chronic lymphocytic leukemia (CLL), the question arises whether chemotherapy still has a role in treating this malignancy. At the 2019 American Society of Hematology (ASH) Annual Meeting & Exposition, CLL...

Leukemia
Immunotherapy

Expert Point of View: Javier Pinilla-Ibarz, MD, PhD

Javier Pinilla-Ibarz, MD, PhD, of Moffitt Cancer Center, Tampa, Florida, commented on this study: “ELEVATE TN compared front-line treatment with acalabrutinib alone or in combination with obinutuzumab vs obinutuzumab/chlorambucil and showed that a second-generation Bruton’s tyrosine kinase (BTK)...

Leukemia
Immunotherapy

Acalabrutinib Plus Obinutuzumab Superior to Obinutuzumab Plus Chlorambucil as Front-Line Treatment of CLL

Ibrutinib was the first Bruton’s tyrosine kinase (BTK) inhibitor to dramatically transform the treatment of patients with chronic lymphocytic leukemia (CLL) and other hematologic malignancies. The second-generation BTK inhibitor acalabrutinib is a more selective BTK inhibitor designed to have an...

Leukemia

FLAG-GO Achieves Deeper Remission Than FLAG-IDA in Favorable-Risk AML

Gemtuzumab ozogamicin, once approved in 2000 for the treatment of acute myeloid leukemia (AML), was taken off the market in 2010 due to toxicity concerns. Idarubicin has been used in place of gemtuzumab ozogamicin in some chemotherapy regimens. Gemtuzumab ozogamicin was reintroduced to the market...

Leukemia
Lymphoma
Multiple Myeloma
Immunotherapy

Highlights From ASH 2019 Included New Data in Leukemia, Lymphoma, and Multiple Myeloma

The ASH 2019 Annual Meeting & Exposition featured countless important sessions and lectures. It would be impossible to attend all the symposia, oral presentations, poster presentations, and special events. Below, we have selected some presentation highlights to supplement our coverage of the...

Immunotherapy
Leukemia

Expert Point of View: Javier Pinilla-Ibarz, MD, PhD

Javier Pinilla-Ibarz, MD, PhD, Moffitt Cancer Center, Tampa, Florida, commented on this study: “ELEVATE TN compared front-line treatment with acalabrutinib alone or in combination with obinutuzumab vs obinutuzumab/chlorambucil and showed that a second-generation Bruton’s tyrosine kinase (BTK)...

Immunotherapy
Leukemia

Pivotal Trial Evaluates Second-Generation BTK Inhibitor Alone and in Combination With Obinutuzumab for First-Line Treatment of CLL

The second-generation Bruton’s tyrosine kinase (BTK) inhibitor acalabrutinib, alone, or in combination with obinutuzumab significantly improved progression-free survival compared with a standard combination of obinutuzumab/chlorambucil in treatment-naive patients with chronic lympocytic leukemia...

Leukemia

Bruton’s Tyrosine Kinase Inhibitor Yields High Overall Response Rates in del(17p) CLL and SLL

In findings of the SEQUOIA trial and updated results of the AU-003 trial,1,2 zanubrutinib, a Bruton’s tyrosine inhibitor (BTK), was shown to produce high overall response rates for patients with chronic lymphocytic leukemia (CLL) and small lymphocytic lymphoma (SLL), even in the presence of...

Immunotherapy
Leukemia

Expert Point of View: Howard J. Weinstein, MD, and Robert A. Brodsky, MD

Commenting on the Children’s Oncology Group AALL1331 study, Howard J. Weinstein, MD, Chief of Pediatric Hematology­Oncology at Massachusetts General Hospital for Children and Harvard Medical School in Boston, said: “These are very promising results for children, adolescents, and young adults who...

Immunotherapy
Leukemia

Blinatumomab Post-reinduction Consolidation Improves Event-Free, Overall Survival vs Chemotherapy in Young Patients With B-Cell ALL

Among children, adolescents, and young adults with B-cell acute lymphoblastic leukemia (ALL), the bispecific T-cell engager blinatumomab improved event-free survival and overall survival, compared with standard chemotherapy, as post-reinduction consolidation therapy at first relapse prior to...

Hematologic Malignancies
Leukemia
Multiple Myeloma
Lymphoma
Immunotherapy

Conference Highlights From the 2019 American Society of Hematology Annual Meeting & Exposition

More than 25,000 specialists in hematology from over 115 countries attended the 61st American Society of Hematology (ASH) Annual Meeting & Exposition held last December in Orlando. The conference featured a stunning array of 4,900 abstracts with impressive new data in the treatment of multiple...

Leukemia

Dengue Virus Infection May Increase Risk of Developing Leukemia

Compared to individuals without a history of dengue virus infection, those previously infected with the virus had over twice the risk of developing leukemia, with the highest risk occurring between 3 and 6 years after infection. The results of a study conducted in Taiwan were published by Chien et...

Leukemia

Dasatinib vs Imatinib in Pediatric Philadelphia Chromosome–Positive ALL

In a Chinese phase III trial reported in JAMA Oncology, Shen et al found that dasatinib was associated was superior event-free survival vs imatinib when combined with intensive chemotherapy in pediatric patients with Philadelphia chromosome–positive acute lymphoblastic leukemia (ALL) not receiving...

Leukemia
Lymphoma

Expert Point of View: Joshua Brody, MD

Joshua Brody, MD, Director of the Lymphoma Immunotherapy Program at the Icahn School of Medicine at Mount Sinai, New York, commented on where zanubrutinib might fit in once the drug is approved. “The two abstracts presented at ASH 2019 …demonstrated remarkably high response rates, durations of...

Leukemia
Lymphoma

Two Clinical Trials Show Zanubrutinib Achieves High Response Rates in del(17p) CLL and SLL

The Bruton’s tyrosine kinase inhibitor (BTK) zanubrutinib continues to achieve high overall response rates for patients with chronic lymphocytic leukemia (CLL) and small lymphocytic lymphoma (SLL), even in the presence of high-risk cytogenetics, according to findings from two different trials...

Leukemia

Yale Cancer Center Study Suggests New Approaches Needed to Manage Ibrutinib-Related Toxicities in Patients With CLL

New findings by Yale Cancer Center and Smilow Cancer Hospital researchers show that, as the use of ibrutinib increases in patients with chronic lymphocytic leukemia (CLL), so do the rates of patients who stop taking the drug. The study was presented at the 2019 American Society of Hematology (ASH)...

Leukemia
Geriatric Oncology

Oral CC-486 Maintenance Therapy Extends Survival in Older Patients With AML

Use of CC-486—an investigational oral form of azacitidine—as maintenance therapy significantly improved overall survival and relapse-free survival in older patients with newly diagnosed acute myeloid leukemia (AML) who were in remission following induction chemotherapy with or without consolidation ...

Leukemia

ADMIRAL Trial: More Than Standard Chemotherapy Needed for FLT3-Mutant Advanced AML

The important ADMIRAL trial, reported by Perl et al in The New England Journal of Medicine1 and reviewed in this issue of The ASCO Post, shows the efficacy of a specific FLT3 inhibitor in patients with advanced acute myeloid leukemia (AML) and enhances the era of personalized medicine in leukemia. ...

Issues in Oncology
Prostate Cancer
Thyroid Cancer
Leukemia

Cancer Incidence in World Trade Center Responders to the September 11 Attacks

A study published by Shapiro et al in JNCI Cancer Spectrum showed that responders to the World Trade Center site after the attacks on September 11, 2001, have statistically significant elevations in cancer incidence for all cancer sites combined, and for prostate and thyroid cancer and leukemia....

Leukemia

Conditioning Intensity for Allogeneic Transplantation in Patients With AML

In a study reported in the Journal of Clinical Oncology, Hourigan et al found that reduced-intensity conditioning for allogeneic hematopoietic cell transplantation was associated with poorer outcomes vs myeloablative conditioning in patients with acute myeloid leukemia (AML) who had genomic...

Leukemia
Immunotherapy

Expert Point of View: Howard J. Weinstein, MD

Commenting on the blinatumomab study, Howard J. Weinstein, MD, Chief of Pediatric Hematology-Oncology at Massachusetts General Hospital for Children and Harvard Medical School in Boston, said: “These are very promising results for children, adolescents, and young adults who have had a first...

Leukemia

Selected Abstracts on Novel Therapies for Chronic Myeloid Leukemia

To complement The ASCO Post’s comprehensive coverage of the 2019 American Society of Hematology (ASH) Annual Meeting & Exposition, here are several abstracts selected from the meeting proceedings focusing on novel therapeutic regimens for chronic myeloid leukemia (CML). For full details of...

Immunotherapy
Leukemia

Blinatumomab Outperforms Chemotherapy as Post-Reinduction Consolidation Therapy in Younger Patients With B-Cell ALL

Blinatumomab was superior to standard chemotherapy in children, adolescents, and young adults at the first relapse of B-cell acute lymphoblastic leukemia (ALL) as post-reinduction consolidation therapy prior to hematopoietic stem cell transplant (HSCT), according to the results of a late-breaking...

Leukemia

ADMIRAL Trial: Gilteritinib Improves Overall Survival in Relapsed or Refractory FLT3-Mutated AML

As reported in The New England Journal of Medicine by Alexander E. Perl, MD, of Abramson Cancer Center, University of Pennsylvania, and colleagues, the phase III ADMIRAL trial showed improved overall survival with the oral FMS-like tyrosine kinase 3 (FLT3) inhibitor gilteritinib vs salvage...

Leukemia

Activity of Ruxolitinib in Chronic Neutrophilic Leukemia and Atypical Chronic Myeloid Leukemia

In a phase II study reported in the Journal of Clinical Oncology, Dao et al found that the JAK1/2 inhibitor ruxolitinib was active in patients with chronic neutrophilic leukemia (CNL), with less activity observed in those with atypical chronic myeloid leukemia (CML) and greater activity observed...

Leukemia

Asciminib for Patients With CML After Failure of ABL Kinase Inhibitor Treatment

In a phase I trial reported in The New England Journal of Medicine, Hughes et al found that asciminib, an oral BCR-ABL1 inhibitor with a mechanism of action different from available ABL1 tyrosine kinase inhibitors, was active in patients with chronic myeloid leukemia (CML) after failure of ABL...

Leukemia
Immunotherapy

Fractionated Tisagenlecleucel Infusion for Adults With B-Cell Acute Lymphoblastic Leukemia May Improve Safety Without Reducing Efficacy

As reported by Noelle V. Frey, MD, and colleagues in the Journal of Clinical Oncology, single-center experience with the anti-CD19 chimeric antigen receptor (CAR) T-cell therapy tisagenlecleucel has shown that high-dose fractionated infusion with the ability to modify dosing in case of early signs...

Leukemia

Gilteritinib for Relapsed or Refractory AML With FLT3 Mutation

Late in 2018, the FLT3 inhibitor gilteritinib was approved for the treatment of adult patients who have relapsed or refractory acute myeloid leukemia (AML) with a FLT3 mutation, as detected by a U.S. Food and Drug Administration (FDA)-approved test.1,2 The FDA also approved an expanded indication...

Leukemia

Selected Abstracts From the 2019 ASH Annual Meeting & Exposition

To complement The ASCO Post’s comprehensive coverage of the 2019 American Society of Hematology (ASH) Annual Meeting & Exposition, here are several abstracts selected from the meeting proceedings focusing on novel therapeutic regimens for acute myeloid leukemia (AML). For full details of these...

Lymphoma
Leukemia

Acalabrutinib for Adult Patients With Chronic Lymphocytic Leukemia or Small Lymphocytic Lymphoma

On November 21, 2019, the Bruton’s tyrosine kinase (BTK) inhibitor acalabrutinib was approved for the treatment of adults with chronic lymphocytic leukemia (CLL) or small lymphocytic lymphoma (SLL).1,2 The review resulting in approval was conducted under Project Orbis, an initiative of the U.S....

Leukemia
Symptom Management

Risk of Asparaginase-Associated Pancreatitis in Patients With Acute Lymphoblastic Leukemia

In a study reported in the Journal of Clinical Oncology, Rank et al found a similar risk of asparaginase-associated pancreatitis in older children, adolescents, and adults and greater associated morbidity in adolescents with acute lymphoblastic leukemia treated according to the Nordic Society of...

leukemia
immunotherapy

Jeff P. Sharman, MD, on CLL: Trial Results on Acalabrutinib, Obinutuzumab, and Chlorambucil

Jeff P. Sharman, MD, of the Willamette Valley Cancer Institute and US Oncology Research, discusses phase III findings from the ELEVATE TN study, which showed that acalabrutinib plus obinutuzumab and acalabrutinib monotherapy improved progression-free survival in patients with treatment-naive chronic lymphocytic leukemia (Abstract 31).

leukemia
immunotherapy

Patrick A. Brown, MD, on B-Cell ALL in Children, Adolescents, and Young Adults: Blinatumomab vs Chemotherapy

Patrick A. Brown, MD, of Johns Hopkins University, discusses phase III findings from a Children’s Oncology Group Study showing that blinatumomab was superior to chemotherapy in terms of efficacy and tolerability for young patients as a post-reinduction therapy in the setting of high- and intermediate-risk first relapse of B-cell acute lymphoblastic leukemia (Abstract LBA-1).

leukemia
myelodysplastic syndromes
genomics/genetics

Ilaria Iacobucci, PhD, on AML and MDS: Moving Beyond Gene Panel–Based Classifications

Ilaria Iacobucci, PhD, of St. Jude Children’s Research Hospital, discusses her work to more accurately define mutation subtypes in acute myeloid leukemia and myelodysplastic syndromes, as well as the implications for diagnosis, prognosis, and treatment (Abstract LBA-4 ).

leukemia

Jerald P. Radich, MD, on CML: Predicting Deep Molecular Response to Treatment

Jerald P. Radich, MD, of the Fred Hutchinson Cancer Research Center, discusses a gene-expression model that distinguishes patients with chronic myeloid leukemia who achieved a deep molecular response from those with a poor response to treatment. This work could yield new therapeutic targets that could potentially turn a poor responder into a good responder who might even achieve treatment-free remission (Abstract 665).

leukemia

Andrew H. Wei, MBBS, PhD, on AML: Results From the QUAZAR Trial on Oral Azacitidine

Andrew H. Wei, MBBS, PhD, of The Alfred Hospital, Melbourne, discusses phase III findings on oral azacitidine (CC-486), the first treatment used in the maintenance setting shown to improve both overall and disease-free survival in patients with acute myeloid leukemia that is in remission following induction chemotherapy (Abstract LBA-3).

leukemia
lymphoma

Jennifer Crombie, MD, on Relapsed or Refractory CLL/SLL: Results From a Phase I Trial of Duvelisib and Venetoclax

Jennifer Crombie, MD, of Dana-Farber Cancer Institute, discusses early study results which showed that duvelisib plus venetoclax showed activity in patients with relapsed or refractory chronic lymphocytic leukemia/small lymphocytic lymphoma, with no dose-limiting toxicities observed (Abstract 1763).

Leukemia
Immunotherapy

ASH 2019: Blinatumomab vs Standard Chemotherapy for Pediatric Patients With Relapsed B-ALL

Blinatumomab improved survival in children with relapsed B-acute lymphoblastic leukemia (B-ALL) compared with standard chemotherapy, accordings to findings from a study presented by Brown et al at the 2019 American Society of Hematology (ASH) Annual Meeting & Exposition (Abstract LBA-1)....

Leukemia
Myelodysplastic Syndromes

ASH 2019: New Genomic Mutational and Expressional Data in AML, MDS

Researchers have completed the first comprehensive analysis combining full genomic sequencing and gene-expression profiles of more than 1,300 patients with acute myeloid leukemia (AML) or myelodysplastic syndrome (MDS). The research was presented by Iacobucci et al during the 2019 American Society...

Leukemia

ASH 2019: Oral Azacitidine Improves Survival in Older Patients With AML in First Remission

Treatment with an investigational oral form of azacitidine, CC-486, improved overall survival in older patients with newly diagnosed acute myeloid leukemia (AML) who were in remission following standard induction chemotherapy with or without consolidation therapy, according to a phase III study...

Leukemia
Issues in Oncology

ASH 2019: Should African American Patients With AML and Evidence of Abnormal Kidney Function Be Enrolled Into Clinical Trials?

A study of more than 1,000 patients with acute myeloid leukemia (AML) revealed that African Americans were more likely to have evidence of abnormal kidney functioning than whites, but this was not associated with any difference in overall survival. The findings, presented by Statler et al at the...

Leukemia
Genomics/Genetics

ASH 2019: Genomic Features of AML in Patients Aged 60 or Older May Predict Stem Cell Transplant Outcome

For older patients with acute myeloid leukemia (AML), the prospects for success of a stem cell transplant can often be predicted based on the particular set of leukemic genetic characteristics, according to results presented by Murdock et al at the 2019 American Society of Hematology (ASH) Annual...

leukemia

Tait D. Shanafelt, MD, on CLL in Younger Patients: Comparing Ibrutinib and Rituximab With FCR

Tait D. Shanafelt, MD, of Stanford University, discusses extended follow-up data that show ibrutinib plus rituximab improved clinical outcomes vs the standard therapy of fludarabine/cyclophosphamide/ rituximab in younger patients with previously untreated chronic lymphocytic leukemia (Abstract 33).

leukemia

Mhairi Copland, PhD, MB BChir, on Blast Phase CML: A Possible Treatment Advance

Mhairi Copland, PhD, MB BChir, of the University of Glasgow, discusses results of a study on the combination of ponatinib and fludarabine, cytarabine, idarubicin, and G-CSF for patients with blast phase chronic myeloid leukemia, a rare complication with a poor outcome (Abstract 497).

leukemia

Nitin Jain, MD, on First-Line Ibrutinib Plus Venetoclax in CLL

Nitin Jain, MD, of The University of Texas MD Anderson Cancer Center, discusses findings from two studies showing that the combination of ibrutinib and venetoclax is an effective chemotherapy-free oral regimen for patients with high-risk, previously untreated chronic lymphocytic leukemia (Abstract 34).

myelodysplastic syndromes
leukemia

Mikkael A. Sekeres, MD, on Newly Diagnosed Hematologic Malignancies: Early Trial Findings on Glasdegib Plus Azacitidine

Mikkael A. Sekeres, MD, of the Cleveland Clinic, discusses results of a phase Ib study of glasdegib in combination with azacitidine, which showed activity in patients with untreated myelodysplastic syndromes, acute myeloid leukemia, and chronic myelomonocytic leukemia who are ineligible for intensive chemotherapy (Abstract 177).

Leukemia
Issues in Oncology

ASH 2019: Lower Area-Based Income and Educational Attainment Associated With Poorer Survival Among Pediatric Patients With AML

Children from lower-income neighborhoods were 2.4 times more likely to die during treatment for acute myeloid leukemia (AML) than children from middle- and high-income neighborhoods, according to findings from a study that analyzed nearly 1,500 clinical trial participants. While previous research...

Leukemia

Calaspargase Pegol-mknl for Pediatric and Young Adult Patients With Acute Lymphoblastic Leukemia

In late 2018, calaspargase pegol-mknl, an asparagine-specific enzyme, was approved for use as a component of a multiagent chemotherapeutic regimen for acute lymphoblastic leukemia (ALL) in pediatric and young adult patients aged 1 month to 21 years.1,2 The new product provides for a longer interval ...

Leukemia

Glasdegib in Older Patients With AML or Those With Comorbidities

In the Clinic provides overviews of novel oncology agents, addressing indications, mechanisms of action, administration recommendations, safety profiles, and other essential information needed for the appropriate clinical use of these drugs. Late in 2018, the Hedgehog pathway inhibitor glasdegib...

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