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In a recent study reported by Marlow et al in The Journal of Pediatrics, researchers assessed the risk of leukemia in children with Down syndrome. Their findings pointed to stronger-than-expected associations between Down syndrome and acute myeloid leukemia (AML). Down syndrome is one of the most...
Jennifer R. Brown, MD, PhD, of Dana-Farber Cancer Institute, discusses treatment choices for patients with relapsed or refractory CLL/SLL, when to stop therapy due to adverse events, BTK inhibitors and their second-generation counterparts, the need for ways to manage disease progression on novel drugs, and minimal residual disease as a predictor of response.
Research published by Orgel et al in the journal Blood Advances showed that restricting calories, reducing fat and sugar intake, and increasing physical activity may boost the effectiveness of chemotherapy for older children and adolescents with leukemia. This intervention, which improved...
In an analysis from the Children’s Oncology Group (COG) AALL0331 trial reported in the Journal of Clinical Oncology, Mattano et al found that the addition of pegaspargase intensification did not improve the high rate of continuous complete remission achieved with a standard COG low-intensity...
Alexander E. Perl, MD, of the Abramson Cancer Center at the University of Pennsylvania, discusses the major changes in 2021 to the NCCN Clinical Practice Guidelines in Oncology for managing acute myeloid leukemia, including venetoclax plus azacitidine, a new standard of care in patients ineligible for intensive induction; oral azacitidine maintenance in fit patients unable to complete intensive consolidation chemotherapy or proceed to transplant; and an increased focus on minimal residual disease status post-induction.
On March 30, the U.S. Food and Drug Administration (FDA) approved a revised label for the combination of daunorubicin and cytarabine (Vyxeos) to include a new indication to treat newly diagnosed therapy-related acute myeloid leukemia (AML) or AML with myelodysplasia-related changes (AML-MRC) in...
For this installment of the Living a Full Life series, guest editor Jame Abraham, MD, spoke with physician-scientist Brian J. Druker, MD, Director of the Knight Cancer Institute at Oregon Health & Science University, Portland. In 2009, Dr. Druker won the Lasker-DeBakey Clinical Medical Research ...
In the phase I/II BRUIN trial reported in The Lancet, Anthony R. Mato, MD, and colleagues found that the noncovalent Bruton’s tyrosine kinase (BTK) inhibitor pirtobrutinib produced durable responses in patients with relapsed or refractory B-cell malignancies, including those previously treated with ...
In a study reported in The New England Journal of Medicine, Duncavage et al found that whole-genome sequencing in patients with acute myeloid leukemia (AML) or myelodysplastic syndromes (MDS) provided rapid genomic profiling that improved diagnostic yield vs conventional cytogenetic analysis, as...
Starting chemotherapy several days before the first lumbar puncture for diagnosis and treatment of acute lymphoblastic leukemia (ALL) may reduce the risk of central nervous system (CNS) relapse in children, according to a study published by Tang et al in the journal Blood. The research focused on...
In an Italian study reported in Leukemia, Mauro et al found that only a small minority of patients with chronic lymphocytic leukemia (CLL) developed an adequate immune response to pneumococcal vaccination, with response being more likely in patients who were younger, had previously untreated and...
Monotherapy with blinatumomab as consolidation therapy before allogeneic stem cell transplant appears to be the optimal treatment for children with high-risk first-relapse B-cell precursor acute lymphoblastic leukemia (ALL), according to an international phase III trial that compared this approach...
In a Groupe Francophone des Myélodysplasies phase II study reported in the Journal of Clinical Oncology, Cluzeau et al found that the combination of eprenetapopt and azacitidine produced high response rates in previously untreated patients with high-risk TP53-mutated myelodysplastic syndromes (MDS) ...
A specific type of acute myeloid leukemia (AML) that contains a rearrangement in the MLL gene (also known as KMT2A) might be made more sensitive to chemotherapy using an antibiotic currently available to treat diarrhea, according to new research published by Zeisig et al in Science Translational...
Pooled results of two phase I studies, reported in The Lancet by Reuben Benjamin, MBBS, of the Department of Haematological Medicine, King’s College Hospital, London, and colleagues, indicate that the genome-edited donor-derived allogeneic anti-CD19 chimeric antigen receptor (CAR) T-cell product...
To complement The ASCO Post’s continued comprehensive coverage of the 2020 American Society of Hematology (ASH) Annual Meeting & Exposition, here are several abstracts selected from the meeting proceedings focusing on novel therapeutic approaches in chronic lymphocytic leukemia (CLL). For full...
Researchers have identified a cellular resilience mechanism through which acute myeloid leukemia (AML) cells survive cancer treatment and repopulate, leading to disease relapse. The research, published by Cihangir Duy, PhD, MS, and colleagues in Cancer Discovery, also suggests that certain drugs...
Despite the marked efficacy of ibrutinib, acalabrutinib, and venetoclax in chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL), treatment failure can occur through the development of resistance. In addition, patients in whom Bruton’s tyrosine kinase (BTK) inhibitors and BCL2...
Selinexor: On December 18, 2020, the U.S. Food and Drug Administration (FDA) approved selinexor (Xpovio) in combination with bortezomib (Velcade) and dexamethasone for the treatment of adult patients with multiple myeloma who have received at least one prior therapy. Venetoclax: On October 16,...
Results from a phase II study presented by Nicholas J. Short, MD, and colleagues at the 2020 American Society of Hematology (ASH) Annual Meeting & Exposition showed that first-line treatment with a regimen of chemotherapy combined with the monoclonal antibody blinatumomab resulted in increased...
It has been well documented that, collectively, Black individuals have the highest death rates and shortest survival of any racial/ethnic group in the United States for most cancers. Black men also have the highest cancer incidence.1 Although the causes of these inequities are complex and include...
Since the introduction of imatinib almost 18 years ago, similar next-generation tyrosine kinase inhibitors have been approved for chronic myeloid leukemia (CML), including dasatinib, nilotinib, bosutinib, and ponatinib. These drugs attack a similar target, making it more likely that resistance to...
The world of hematologic malignancies continues to move forward at a robust pace despite the challenges of the COVID era. Although some areas of clinical trials and basic research suffered short-term stoppages or delays due to the pandemic, the studies presented at the 2020 American Society of...
A combination of genetic mutations may explain the higher incidence of and poorer outcomes from pediatric leukemia in Hispanic and Latino patients, according to a new study published by Raca et al in the journal Leukemia. Researchers said a novel therapeutic drug combination—as well as testing for...
Recently, the U.S. Food and Drug Administration (FDA) issued a Breakthrough Therapy designation to asciminib for chronic myeloid leukemia (CML); a Breakthrough Device designation to an assay designed to help select patients with cachexia for treatment with an investigational therapeutic; and an...
In the prospective LAST study reported in JAMA Oncology, Ehab Atallah, MD, and Kathryn Flynn, PhD, of the Medical College of Wisconsin, Milwaukee, and colleagues, found that stopping tyrosine kinase inhibitor therapy in patients with chronic myeloid leukemia (CML) was associated with the...
Patients with relapsed or refractory chronic lymphocytic leukemia (CLL) treated with the combination of fixed-duration venetoclax/rituximab had a longer overall survival and progression-free survival at 5 years compared with those treated with bendamustine/rituximab, according to a 5-year analysis...
In a single-institution study reported in the Journal of Clinical Oncology, Kadauke et al found that risk-adapted tocilizumab reduced the expected incidence of grade 4 cytokine-release syndrome in pediatric patients receiving CD19-directed chimeric antigen receptor (CAR) T-cell...
Commenting on this trial, Marlise Luskin, MD, of Dana-Farber Cancer Institute, Boston, explained that the treatment of AML in older adults remains a particular challenge for leukemia clinicians. “Although many older patients eligible for intensive induction chemotherapy achieve complete remission,...
Health-related quality of life was sustained in patients taking oral azacitidine (also known as CC-486) compared with placebo in patients with acute myeloid leukemia (AML), according to results of the phase III QUAZAR AML-001 trial reported at the 2020 American Society of Hematology (ASH) Annual...
As reported in the Journal of Clinical Oncology by Angiolillo et al, findings from the phase III Children’s Oncology Group (COG) AALL0932 trial indicated that “outstanding outcomes” can be achieved with maintenance therapy with a reduced frequency of vincristine/dexamethasone pulses in pediatric...
As reported in The New England Journal of Medicine by Andrew H. Wei, MBBS, PhD, and colleagues, the phase III QUAZAR AML-001 trial has shown prolonged overall survival with oral azacitidine maintenance therapy vs placebo in patients with acute myeloid leukemia (AML) in first remission. The oral...
In the phase II FIGARO trial reported in the Journal of Clinical Oncology, Craddock et al found that intensified reduced-intensity conditioning with fludarabine/amsacrine/cytarabine–busulfan (FLAMSA-Bu) did not improve outcomes following allogeneic stem cell transplantation vs standard...
Sara Zarnegar-Lumley, MD, of Vanderbilt University Medical Center, discusses an analysis of a large cohort confirming the age-associated prevalence of IDH mutations in patients, across the age spectrum, with acute myeloid leukemia and therapeutic implications. IDH-mutated genes were found to co-occur frequently with other mutations, some of which favorably impact outcomes in patients younger than 60 (Abstract 388).
As reported in the Journal of Clinical Oncology by Burnett et al, findings from the phase III MRC AML17 trial indicated that four courses of chemotherapy, compared to three courses, reduced the cumulative incidence of relapse and improved relapse-free survival, but not overall survival, in younger...
As reported in the Journal of Clinical Oncology by Peters et al, the phase III FORUM trial showed superior overall survival with total-body irradiation plus etoposide vs combination chemoconditioning in pediatric patients with acute lymphoblastic leukemia (ALL) undergoing allogeneic hematopoietic...
Christian Marinaccio, PhD Candidate, of Northwestern University, describes research he is conducting in the laboratory of John D. Crispino, PhD, which shows the loss of the tumor suppressor gene LKB1/STK11 facilitates progression of myeloproliferative neoplasms to acute myeloid leukemia (Abstract 1).
Pooled results of two phase I studies, reported in The Lancet by Benjamin et al, indicate that the genome-edited, donor-derived allogeneic anti-CD19 chimeric antigen receptor (CAR) T-cell product UCART19 is active and has a manageable toxicity profile in pediatric and adult patients with relapsed...
In a study reported in JAMA Oncology, Areej El-Jawahri, MD, and colleagues found that integrated palliative and oncology care was associated with better quality of life vs usual care among patients receiving treatment for acute myeloid leukemia (AML). The investigators stated, “Patients with AML...
The randomized phase II CAPTIVATE trial showed that a fixed-duration treatment approach with 12 cycles of ibrutinib and venetoclax as first-line therapy for chronic lymphocytic leukemia (CLL) achieved a 30-month progression-free survival of more than 95% in patients with undetectable minimal...
A study by Ivy Abraham, MD, of the University of Illinois at Chicago, and colleagues, investigated the contribution of structural violence, specifically neighborhood socioeconomic status, on the racial/ethnic differences in the survival of patients with acute myeloid leukemia (AML). They found that ...
On December 17, the U.S. Food and Drug Administration (FDA) approved rituximab-arrx (Riabni), a biosimilar to rituximab (Rituxan), for the treatment of adult patients with non-Hodgkin lymphoma, chronic lymphocytic leukemia, granulomatosis with polyangiitis (Wegener's granulomatosis), and...
It has been well documented that, collectively, Black individuals have the highest death rates and shortest survival of any racial/ethnic group in the United States for most cancers. Black men also have the highest cancer incidence.1 Although the causes of these inequities are complex and include...
Nitin Jain, MD, of The University of Texas MD Anderson Cancer Center, reviews six important abstracts on CAR T-cell treatments for B-cell acute lymphoblastic leukemia (ALL): successful 24-hour manufacture of CAR T-cell therapy; ALLCAR19, a novel fast-off rate therapy; donor-derived CD19-targeted treatment; CAR 2.0 therapy to manage post-transplant relapse; UCART22, allogeneic engineered T cells expressing anti-CD22 chimeric antigen receptor; and inotuzumab ozogamicin in pediatric CD-22–positive disease (Session 614, Abstracts 159-164).
Farhad Ravandi, MD, of The University of Texas MD Anderson Cancer Center, offers his expert perspective on key treatment studies in acute myeloid leukemia on the use of gilteritinib, consolidation chemotherapy, venetoclax, cladribine, azacitidine, quizartinib, decitabine, and CPX-351 (Session 616 [Abstracts 24- 29]).
Jorge E. Cortes, MD, of the Georgia Cancer Center at Augusta University, reviews four important studies of treatment advances in chronic myeloid leukemia (CML): nilotinib vs dasatinib in newly diagnosed disease; final 5-year results from the BFORE trial on bosutinib vs imatinib for chronic phase (CP) CML; data from the OPTIC trial on ponatinib for CP-CML; and a novel class of mutated cancer-related genes associated with the Philadelphia translocation (Abstracts 45, 46, 48, 49).
Hassan Awada, MD, of the Taussig Cancer Institute, Cleveland Clinic Foundation, discusses the use of newer machine-learning techniques to help decipher a set of prognostic subgroups that could predict survival, thus potentially improving on traditional methods and moving acute myeloid leukemia into the era of personalized medicine (Abstract 34).
Relapse is the primary obstacle to cure in leukemia. The term minimal residual disease (MRD) was coined in the early 1990s to describe finding a disease-specific marker in the context of a morphologic-appearing remission. The technique first used for MRD detection was the Southern blot (!), but the ...
In a systematic review and meta-analysis reported in JAMA Oncology, Nicholas J. Short, MD, of The University of Texas MD Anderson Cancer Center, and colleagues, found that measurable residual disease (MRD) negativity is associated with superior disease-free and overall survival in patients with...
An assortment of agents has been approved in the United States for the first-line treatment of chronic lymphocytic leukemia (CLL), and all of them are effective, explained Richard Furman, MD, of Weill-Cornell Medical College, NewYork-Presbyterian Hospital, New York. In the modern era, most patients ...