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Krish Patel, MD, Director of the Lymphoma Program at the Swedish Cancer Institute in Seattle and Interim Director of the Hematological Malignancies and Cellular Therapy Program, commented on the implications of Dr. Soumerai’s presentation. “We know that, in general, reaching [undetectable...
Achieving undetectable measurable residual disease (MRD) is an important milestone in the treatment of patients with chronic lymphocytic leukemia (CLL) as well as those with other hematologic malignancies undergoing treatment. Now a small phase II study, presented at the 2021 American Society of...
Alba Rodriguez-Meira, DPhil, of the University of Oxford, discusses a comprehensive analysis of the genetic, cellular, and molecular landscape of TP53-mediated transformation, providing insights into the evolution of chronic hematologic malignancies toward an aggressive acute leukemia. Because TP53 is the most commonly mutated gene in human cancer, these findings may well be of broad relevance (Abstract 3).
In an analysis from the Children’s Oncology Group AAML1031 trial reported in the Journal of Clinical Oncology, Lamble et al found that increased CD123 expression was associated with high-risk genetic alterations and poorer treatment outcomes in pediatric patients with newly diagnosed acute myeloid...
Eunice S. Wang, MD, of Roswell Park Comprehensive Cancer Center, discusses phase III results showing that gilteritinib and azacitidine led to significantly higher composite complete response rates in patients with newly diagnosed FLT3-mutant acute myeloid leukemia who are ineligible for intensive induction chemotherapy. Overall survival was similar to that of azacitidine alone (Abstract 700).
Carsten Utoft Niemann, MD, PhD, of Copenhagen University Hospital, discusses a primary analysis of the phase II Vision HO141 trial, which showed the feasibility of stopping and restarting ibrutinib and venetoclax in patients with relapsed or refractory chronic lymphocytic leukemia who have undetectable measurable residual disease. A favorable benefit-risk profile was demonstrated, with no new safety signals (Abstract 69).
Masayuki Umeda, MD, of St. Jude Children's Research Hospital, discusses his research which showed that UBTF-TD (upstream binding transcription factor-tandem duplications) define a unique subtype of acute myeloid leukemia that previously lacked a clear oncogenic driver. UBTF-TD is associated with FLT3-ITD and WT1 mutations, adolescent age, and poor outcomes. These alterations are critical for future risk-stratification for this patient cohort.
A study presented by Matthew S. Davids, MD, of Dana-Farber Cancer Institute, and colleagues at the 2021 American Society of Hematology (ASH) Annual Meeting & Exposition (Abstract 640) suggests that a 2.5-year regimen involving ibrutinib and chemoimmunotherapy may provide deep and lasting...
Talha Badar, MD, of the Mayo Clinic, discusses the near-universal poor outcomes for patients with TP53-mutated acute myeloid leukemia and the findings that show allogeneic stem cell transplantation appears to improve the long-term survival in a subset of these patients. Effective therapies may successfully bridge patients to transplant and prolong survival for those who are transplant-ineligible (Abstract 797).
In separate analyses of 257 patients with acute leukemia or myelodysplastic syndrome (MDS) who developed COVID-19 and are part of the American Society of Hematology (ASH) RC COVID-19 Registry for Hematology, both neutropenia and having active MDS or leukemia (vs being in remission) were found to...
Oncologists and health-care professionals who treat patients with high-risk acute myeloid leukemia (AML) are missing important opportunities to have end-of-life discussions at earlier stages in the disease course, when patients are best able to discuss their options and preferences. These findings...
In the phase III AGILE trial, the combination of ivosidenib and azacitidine was found to be superior in treating newly diagnosed patients with IDH1-mutated acute myeloid leukemia (AML) compared to azacitidine alone in terms of event-free survival, the study’s primary endpoint. The combination also...
In one of the largest studies to date of the antibody response to vaccination against COVID-19 in people who had been treated for acute myeloid leukemia (AML) and myelodysplastic syndrome (MDS), patients responded well to two doses of the Moderna mRNA vaccine and saw a pronounced increase in levels ...
Paolo Ghia, MD, PhD, of the Università Vita-Salute San Raffaele and IRCCS Ospedale San Raffaele, discusses disease-free survival results from the measurable residual disease cohort of the phase II CAPTIVATE trial. This multicenter trial focuses on first-line ibrutinib plus venetoclax in patients with chronic lymphocytic leukemia (Abstract 68).
A study of U.S. adolescent and young adult patients with acute lymphoblastic leukemia (ALL) found that Hispanic patients were significantly underrepresented in a large clinical trial compared with the general patient population. The study, presented by Muffly et al at the 2021 American Society of...
A study of nearly 25,000 patients with acute lymphoblastic leukemia (ALL) aged up to 30 years old revealed significant gaps in survival rates between White, Hispanic, and Black patients, as well as worse outcomes among those of lower socioeconomic status. Biologic or genetic factors accounted for...
On October 1, 2021, the CD19-directed chimeric antigen receptor (CAR) T-cell therapy brexucabtagene autoleucel was approved for adults with relapsed or refractory B-cell precursor acute lymphoblastic leukemia (ALL).1 The product is available only through a restricted program under a Risk Evaluation ...
On October 29, 2021, the oral kinase inhibitor asciminib was granted accelerated approval for adults with Philadelphia chromosome–positive chronic myeloid leukemia (CML) in chronic phase previously treated with at least two tyrosine kinase inhibitors and regular approval for adults with...
Next-generation sequencing of bone marrow samples from pediatric and young adult patients with acute lymphoblastic leukemia (ALL) treated with tisagenlecleucel was more accurate in predicting relapse than flow cytometry and monitoring of B-cell aplasia, according to the results from a study by...
On December 2, the U.S. Food and Drug Administration (FDA) approved rituximab (Rituxan) in combination with chemotherapy for pediatric patients (≥ 6 months to < 18 years old) with previously untreated, advanced-stage, CD20-positive diffuse large B-cell lymphoma (DLBCL), Burkitt lymphoma,...
As reported in JAMA Oncology by Kutny et al, the Children’s Oncology Group (COG) AAML1331 trial has shown that treatment with arsenic trioxide and all-trans retinoic acid (ATRA) with no maintenance therapy produced high event-free and overall survival rates in pediatric patients with acute...
In a study reported in the Journal of Clinical Oncology, Myers et al found that lack of response to prior blinatumomab treatment was associated with poorer outcomes with CD19-targeted chimeric antigen receptor (CAR) T-cell therapy (CD19-CAR) in children and young adults with relapsed or refractory...
Newly identified genetic abnormalities in acute myeloid leukemia (AML), as well as therapies that can target some of those abnormalities, are now available as the landscape for treatment continues to evolve. During the 2021 National Comprehensive Cancer Network (NCCN) Annual Congress: Hematologic...
Newly identified genetic abnormalities in AML have led to novel therapies that can target some of them, as the landscape for treatment continues to evolve. During the 2021 National Comprehensive Cancer Network (NCCN) Annual Congress: Hematologic Malignancies, Alice S. Mims MD, presented updates in...
New research published by Geer et al in JNCCN—Journal of the National Comprehensive Cancer Network has found that fewer than one-third of hospitals in the United States had immediate availability of all-trans retinoic acid (ATRA), a crucial blood cancer medication. ATRA is initiated early in the...
A clinical trial recently published by Kutny et al in JAMA Oncology found that the combination of all-trans retinoic acid and arsenic trioxide was highly effective in children with standard- and high-risk acute promyelocytic leukemia (APL). Nearly all patients in the trial survived for 2 years...
In an analysis of the pivotal CLL14 trial reported in the Journal of Clinical Oncology, Al-Sawaf et al found that venetoclax plus obinutuzumab was associated with higher rates of undetectable measurable residual disease (MRD) and prolonged MRD doubling time vs chlorambucil plus obinutuzumab at 3...
Jennifer A. Woyach, MD, of The Ohio State University Comprehensive Cancer Center, talks about whether modifications of treatment based on minimal residual disease is beneficial to patients with chronic lymphocytic leukemia and small lymphocytic lymphoma.
Alice S. Mims, MD, of The Ohio State University Comprehensive Cancer Center, discusses the many positive changes over the past 5 years in treating patients with newly diagnosed acute myeloid leukemia in the upfront setting. She also details future directions, including further combining therapies with targeted agents, the potential use of all-oral regimens, and using measurable residual disease as a possible endpoint in treatment responses.
In a study published by Magenau et al in the journal Blood Advances, researchers found that patients with high-risk acute myeloid leukemia (AML) who received a form of type I interferon after allogeneic hematopoietic stem cell transplant experienced reduced rates of disease relapse. Additionally,...
On October 29, the U.S. Food and Drug Administration (FDA) granted accelerated approval to the kinase inhibitor asciminib (Scemblix) for patients with Philadelphia chromosome–positive chronic myeloid leukemia (Ph+ CML) in chronic phase who have been previously treated with two or more tyrosine...
As reported in The Lancet Oncology by Courtney D. DiNardo, MD, and colleagues, an interim analysis of the phase II portion of a phase Ib/II trial (AG221-AML-005) showed that the addition of the oral mutant IDH2 protein inhibitor enasidenib to azacitidine significantly improved overall response rate ...
As reported in the Journal of Clinical Oncology by John C. Byrd, MD, of The Ohio State University Comprehensive Cancer Center, and colleagues, the phase III ELEVATE-RR trial has shown noninferior progression-free survival with the more-selective Bruton’s tyrosine kinase (BTK) inhibitor...
Chronic lymphocytic leukemia (CLL) is a B-cell lymphoproliferative disorder defined by a specific phenotype and the presence of more than 5,000 clonal B cells in the peripheral blood.1 In the absence of this number of circulating cells, its soft-tissue/bone-marrow counterpart is semantically...
As reported in the Journal of Clinical Oncology by William G. Wierda, MD, PhD, and colleagues, findings in the measurable residual disease (MRD) cohort of the phase II CAPTIVATE study indicated a high disease-free survival rate with placebo and no significant benefit of continued ibrutinib in...
Some of the most impressive data on chimeric antigen receptor (CAR) T-cell therapy have come from studies conducted in China. Attendees at the 2021 Pan Pacific Lymphoma Conference heard from one of the leading Chinese investigators, Peihua (Peggy) Lu, MD, of Lu Daopei Hospital, who described the...
On October 1, the U.S. Food and Drug Administration (FDA) approved brexucabtagene autoleucel (Tecartus), a CD19-directed chimeric antigen receptor (CAR) T-cell therapy, for adult patients with relapsed or refractory B-cell precursor acute lymphoblastic leukemia (ALL). ZUMA-3 Efficacy was evaluated ...
Luis E. Aguirre, MD, of the H. Lee Moffitt Cancer Center and Research Institute, discusses the subset of patients with chronic myelomonocytic leukemia who have a more indolent disease course. Features at diagnosis may include higher hemoglobin and platelet counts or JAK2, SF3B1, and IDH2 mutations; features associated with earlier initiation of treatment may include an elevated white blood cell count or a higher number of marrow blasts. Identifying the changes that occur between diagnosis and treatment are among future research goals (Abstract MDS-229).
Research published by Kachuri et al in the American Journal of Human Genetics reveals that children born with a genetic predisposition to produce more lymphocytes—particularly in relation to other types of white blood cells—may be at a higher risk of developing acute lymphoblastic leukemia (ALL)....
In a phase II study reported in The Lancet Oncology, Matthew S. Davids, MD, and colleagues found that first-line triple combination therapy with acalabrutinib, venetoclax, and obinutuzumab produced measurable residual disease (MRD)-negative complete remission in a substantial proportion of patients ...
The combination of fixed-duration, first-line treatment with ibrutinib plus venetoclax achieved complete responses in more than half of patients with chronic lymphocytic leukemia (CLL)/small lymphocytic leukemia (SLL), based on the primary analysis of the fixed-dose cohort of the phase II CAPTIVATE ...
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...
Curtis Lachowiez, MD, of The University of Texas MD Anderson Cancer Center, discusses data that show combining venetoclax with FLAG-IDA chemotherapy to treat patients with newly diagnosed acute myeloid leukemia led to minimal residual disease negativity in more than 90% of those achieving a composite complete response (Abstract AML-024).
In a phase I trial (ALLCAR19) reported in the Journal of Clinical Oncology, Roddie et al found that the fast off-rate autologous CD19 chimeric antigen receptor (CAR) T-cell therapy CAT19-41BB-Z—also known as AUTO1—was well tolerated and produced high remission rates in adults with relapsed or...
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 a Canadian population-based cohort study reported in the Journal of Clinical Oncology, Abdel-Qadir et al found that ibrutinib treatment for chronic lymphocytic leukemia (CLL) is associated with increased risks of atrial fibrillation, bleeding, and heart failure, but not ischemic stroke or acute...
Requirements instituted to address racial and ethnic disparities in clinical trial enrollment did not lead to increased inclusion of Black and Hispanic participants in clinical acute leukemia research, according to a new study published by Andrew Hantel, MD, and colleagues in the journal Blood...
In a study reported in JAMA Oncology, Mangum et al found that focal deletions in chromosome 22q11.22 were associated with poor outcomes in pediatric patients with B-cell acute lymphoblastic leukemia (ALL) with IKZF1 alterations. As stated by the investigators, “Alterations in the IKZF1 gene drive...
Patients with lymphoma or other lymphoid cancers should continue to take steps to protect themselves from COVID-19 even if they have been vaccinated against the disease, a new study by Jennifer Crombie, MD, and colleagues published in Blood Advances suggests. The study found that patients who had...
Outcomes in adults with acute lymphoblastic leukemia (ALL) are almost rivaling those in pediatric ALL, thanks to the benefits achieved by incorporating blinatumomab and inotuzumab into chemotherapy regimens. New ways of administering the chemotherapy component are also increasing tolerability and...