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Lymphoma
Immunotherapy

KTE-X19 for Relapsed or Refractory Mantle Cell Lymphoma: ZUMA-2 Trial

In a phase II trial reported in The New England Journal of Medicine, Michael Wang, MD, and colleagues found that the anti-CD19 chimeric antigen receptor (CAR) T-cell therapy KTE-X19 produced a high response rate in patients with relapsed or refractory mantle cell lymphoma who had received previous...

Breast Cancer
Bladder Cancer
Lymphoma
Immunotherapy

FDA Pipeline: Approval of New Dosing for Biosimilar, Plus Two Fast Track Designations

The U.S. Food and Drug Administration (FDA) recently approved a new dose for a biosimilar referencing trastuzumab and granted Fast Track designations to agents for patients with urothelial cancer and follicular lymphoma. Approval of Multidose Vial of Trastuzumab Biosimilar The FDA approved a...

Leukemia
Lymphoma

Selected ASH Abstracts on Chronic Lymphocytic Leukemia and Small Lymphocytic Lymphoma

ABSTRACT 355: MURANO study: Four-year analysis confirms sustained benefit (compared to bendamustine and rituximab; n = 195) of time-limited venetoclax/rituximab (n = 194) in relapsed or refractory chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL; ClinicalTrials.gov NCT02005471)1...

Leukemia
Lymphoma

Selected ASH Abstracts on Chronic Lymphocytic Leukemia and Small Lymphocytic Lymphoma

To complement The ASCO Post’s continued 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 therapies for newly diagnosed chronic lymphocytic leukemia (CLL) and...

Solid Tumors
Lymphoma
Immunotherapy

Nivolumab for Children and Young Adults With Relapsed or Refractory Solid Tumors or Lymphoma

In the phase I/II ADVL1412 study reported in The Lancet Oncology, Davis et al identified the phase II dosage of nivolumab monotherapy in children and young adults with relapsed or refractory solid tumors or lymphoma. Objective responses were observed in patients with lymphoma, but not in those with ...

multiple myeloma
lymphoma
immunotherapy

A Discussion About CAR T-Cell Therapy for Multiple Myeloma and Lymphoma

Dr. Armitage discusses the role of CAR T-cell therapy in the management of multiple myeloma and lymphoma in a conversation with his colleagues Dr. Holstein and Dr. Lunning.

lymphoma

A Case of Diffuse Large B-Cell Lymphoma

Dr. Armitage presents a case and asks Dr. Lunning to describe how he would treat this patient. The patient is a 52-year-old man who found a neck mass himself. He went to his doctor and was prescribed antibiotics. When the antibiotics failed to impact the mass, a biopsy was performed and a diagnosis of diffuse large B-cell lymphoma was made. A positron emission tomography (PET) scan was positive in the neck, mediastinum, axilla, and retroperitoneum. The maximum standardized uptake (SUV) value was 29. A bone marrow biopsy was negative and the patient’s LDH level was slightly above normal. The patient was treated with six cycles of CHOP-R and responded to therapy. Nine months later this individual identified a new node in his neck. He returned to his doctor and a biopsy was performed. A diagnosis of large B-cell lymphoma was made. A PET scan showed disease in the neck and mediastinum, and the maximum SUV is now 18. How would Dr. Lunning approach such a person?

lymphoma

A Case of Relapsed/Refractory Hodgkin Lymphoma

Dr. Armitage presents a case and asks Dr. Lunning to describe how he would treat this patient. The patient is a 25-year-old man with a diagnosis of stage III nodular sclerosing Hodgkin lymphoma. His disease went into complete remission when the patient was treated with ABVD and he was well. One year after his last cycle of therapy, the patient returns to see you, and you detect a node in his neck. A PET scan is performed, showing there is no node larger than 2 cm, but these nodes were present both above and below the diaphragm. The standardized uptake value (SUV) maximum was 8. The lymph node biopsy reveals recurrent lymphoma. What will Dr. Lunning tell this patient?

Lymphoma
Solid Tumors
Hepatobiliary Cancer

FDA Pipeline: Priority Review in DLBCL, Fast Track Designations in T-Cell Lymphoma and Adenoid Cystic Carcinoma

Over the past week, the U.S. Food and Drug Administration (FDA) granted Priority Review to a combination therapy in diffuse large B-cell lymphoma (DLBCL); gave Fast Track designations for treatments in T-cell lymphoma and adenoid cystic carcinoma; granted Orphan Drug designation to an agent for the ...

Lung Cancer
Lymphoma
Bladder Cancer
Head and Neck Cancer
Gastroesophageal Cancer
Gastrointestinal Cancer
Immunotherapy

FDA Pipeline: Priority Reviews in Lung Cancers, Lymphoma

This week, the U.S. Food and Drug Administration (FDA) granted Priority Review to treatments for non–small cell and small cell lung cancers, as well as for diffuse large-B cell lymphoma (DLBCL); Breakthrough Therapy designation to an antibody-drug conjugate for bladder cancer; and a double Fast...

Lymphoma
Immunotherapy

Quality of Life With Tisagenlecleucel Therapy for Relapsed or Refractory DLBCL

Adult patients with diffuse large B-cell lymphoma (DLBCL) whose disease was effectively treated with the chimeric antigen receptor (CAR) T-cell therapy tisagenlecleucel showed sustained and clinically meaningful improvement in a variety of self-reported quality-of-life measures, according to...

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
Lymphoma

Combination Brentuximab Vedotin, Nivolumab Explored in First-Line, Salvage Therapies for Patients With Hodgkin Lymphoma

Two separate studies are investigating brentuximab vedotin plus nivolumab combination therapy for adults with Hodgkin lymphoma: one as first-line therapy and another as salvage therapy for relapsed/refractory classic disease, according to data presented at the 2019 Annual Meeting & Exposition...

Immunotherapy
Lymphoma

Bispecific Antibody Shows Activity in Post–CAR T-Cell Therapy for Non-Hodgkin Lymphoma

Mosunetuzumab, an ­investigational ­bispecific antibody, demonstrated activity in preliminary studies of patients with non-Hodgkin lymphoma (NHL), including those who are refractory to or relapsed after third-line chimeric antigen receptor (CAR) T-cell therapy. With further study, mosunetuzumab,...

Immunotherapy
Lymphoma

Expert Point of View: Basem M. William, MD, MRCP (UK), FACP, and Caron Jacobson, MD

Basem M. William, MD, MRCP (UK), FACP, Director of the T-Cell Lymphoma Program and Member of the Blood and Marrow Transplant Program at The Ohio State University Comprehensive Cancer Center, Columbus, said many of the new-generation bispecific antibodies are “highly promising.” He said they “are...

Immunotherapy
Lymphoma

Will Bispecific Antibodies Compete With CAR T-Cell Therapy in Lymphoma?

Are second-generation bispecific antibodies the next big thing in lymphoma? Studies of these drugs were among the highlights of the 2019 American Society of Hematology (ASH) Annual Meeting & Exposition. Years ago, the bispecific T-cell engager blinatumomab validated the concept of bispecific...

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...

Lymphoma

Haploidentical Related Donor vs Unrelated Cord Blood Hematopoietic Cell Transplantation for Hodgkin and Non-Hodgkin Lymphomas

In a retrospective analysis reported in the Journal of Clinical Oncology, Fatobene et al found that nonmyeloablative haploidentical related donor cell transplantation was associated with better outcomes compared to unrelated cord blood hematopoietic transplantation in patients with Hodgkin and...

Lymphoma
Lung Cancer
Gastrointestinal Cancer
Breast Cancer
Head and Neck Cancer
Immunotherapy

FDA Pipeline: Priority Reviews in Lymphoma, Lung Cancer, GIST, and Breast Cancer

This week, the U.S. Food and Drug Administration (FDA) granted Priority Review to agents in lymphoma, lung cancer, gastrointestinal stromal tumors, and breast cancer, and granted Fast Track designation to a first-in-class radioenhancer hafnium oxide nanoparticle in head and neck cancer. Priority...

Lymphoma
Immunotherapy

Expert Point of View: Edmund K. Waller, MD, PhD

Edmund K. Waller, MD, PhD, Professor, Departments of Medicine, Pathology, and Hematology and Medical Oncology at Emory University School of Medicine and Medical Director, Center for Stem Cell Processing and Apheresis at Emory, said he was not surprised to learn that bridging therapy was associated...

Lymphoma
Immunotherapy

Study Finds ‘Bridge’ to CAR T-Cell Therapy May Be Detrimental to Survival

The use of bridging therapy before treatment with axicabtagene ciloleucel was associated with worse overall survival in univariate, multivariate, and propensity score–matched analyses performed on data from the U.S. Lymphoma CAR T Consortium, investigators reported at the 2019 American Society of...

Lymphoma
Immunotherapy
Geriatric Oncology
Cost of Care

Expert Point of View: Michael Jain, MD, PhD

Michael Jain, MD, PhD, Assistant Member in the Department of Blood and Marrow Transplant and Cellular Immunotherapy at Moffitt Cancer Center, Tampa, Florida, commented on Dr. Kilgore’s findings. Dr. Jain was coauthor of a study by the U.S. Lymphoma CAR T Consortium that presented real-world data...

Lymphoma
Immunotherapy
Geriatric Oncology
Cost of Care

Real-World Data for CAR T-Cell Therapy Show Benefit in Older Patients With Lymphoma, Lower Subsequent Health-Care Costs

Once considered highly experimental, chimeric antigen receptor (CAR) T-cell therapy is now an established third-line treatment option for B-cell lymphomas and leukemias. CAR T-cell therapy has saved the lives of people who would otherwise have run out of treatment options. But the question is...

Lymphoma
Immunotherapy
Symptom Management

Expert Point of View: Jeremy S. Abramson, MD

Jeremy S. Abramson, MD, Director of the Jon and JoAnn Hagler Center for Lymphoma at Massachusetts General Hospital and Associate Professor of Medicine at Harvard Medical School, Boston, commented on the study by Topp et al for The ASCO Post. “Earlier use of steroids with axicabtagene ciloleucel...

Lymphoma
Immunotherapy
Symptom Management

Early Steroid Use May Reduce Toxicity With CAR T-Cell Therapy

In patients with large B-cell lymphoma undergoing chimeric antigen receptor (CAR) T-cell therapy with axicabtagene ciloleucel, earlier-than-usual intervention with corticosteroids and tocilizumab may reduce the incidence of severe cytokine-release syndrome, according to the findings of a...

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...

Lymphoma
Immunotherapy

Expert Point of View: Basem M. William, MD, MRCP(UK), FACP

Basem M. William, MD, MRCP(UK), FACP, Director of the T-Cell Lymphoma Program and Member of the Blood and Marrow Transplant Program at The Ohio State University Comprehensive Cancer Center–Arthur G. James Cancer Hospital and Richard J. Solove Research Institute, Columbus, Ohio, commented on the...

Lymphoma
Immunotherapy

CAR T-Cell Therapy Comes to Mantle Cell Lymphoma

Advanced mantle cell lymphoma appears to be a good target for chimeric antigen receptor (CAR) T-cell therapy. Treatment with KTE-X19, an anti-CD19 CAR T-cell product, led to unprecedented outcomes in patients with relapsed or refractory disease in the phase II ZUMA-2 study presented at the 2019 ASH ...

Lymphoma

New NCCN Pediatric Cancer Guidelines for B-Cell Lymphomas

The National Comprehensive Cancer Network® (NCCN®) has published new guidelines for treating children, adolescents, and young adults with pediatric aggressive mature B-cell lymphomas, including Burkitt lymphoma and diffuse large B-cell lymphoma. NCCN published the first pediatric NCCN Clinical...

Immunotherapy
Lymphoma

Brentuximab Vedotin Plus Nivolumab in Hodgkin Lymphoma

The combination of brentuximab vedotin and nivolumab is making headway as first-line therapy for older adults with Hodgkin lymphoma and as salvage therapy for adults with relapsed or refractory classic Hodgkin lymphoma, according to separate studies presented at the 2019 Annual Meeting &...

Lymphoma
Immunotherapy

Noninferiority of Four vs Six Cycles of CHOP for Patients With Favorable Prognosis B-Cell Lymphoma: FLYER Trial

As reported in The Lancet by Viola Poeschel, MD, and colleagues, the phase III FLYER trial has shown noninferiority of progression-free survival with four vs six cycles of cyclophosphamide/doxorubicin/vincristine/prednisone (CHOP) in combination with six doses of rituximab in patients with...

Solid Tumors
Lymphoma
Immunotherapy

Is Pembrolizumab Active in Pediatric Patients With PD-L1–Positive Advanced Solid Tumors or Lymphoma?

Interim analysis of the phase I/II KEYNOTE-051 trial, reported in The Lancet Oncology by Geoerger et al, indicated minimal activity of pembrolizumab in pediatric patients with programmed cell death ligand 1 (PD-L1)-positive advanced, relapsed, or refractory solid tumors; however, activity was...

Lymphoma
Immunotherapy

Rituximab-abbs: Biosimilar to Rituximab for Non-Hodgkin Lymphoma

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, rituximab-abbs was approved as the first...

Lymphoma
Immunotherapy

KEYNOTE-013 and KEYNOTE-170: Improving the Precision of Checkpoint Blockade in Patients With Diffuse Large B-Cell Lymphoma

Primary mediastinal B-cell lymphoma is an uncommon but distinct clinicopathologic variant of diffuse large B-cell lymphoma (DLBCL) that typically presents with an aggressive mediastinal mass and invasion of local structures. Most patients are young, typically in their 20s and 30s, and there is a...

Lymphoma
Immunotherapy

Pembrolizumab in Relapsed or Refractory Primary Mediastinal Large B-Cell Lymphoma: KEYNOTE-013 and KEYNOTE-170

Findings in the phase Ib KEYNOTE-013 and phase II KEYNOTE-170 trials, reported in the Journal of Clinical Oncology by Philippe Armand, MD, PhD, of Dana­Farber Cancer Institute, and colleagues, indicate that pembrolizumab is active in relapsed or refractory primary mediastinal large B-cell...

Lymphoma

The WHO Classification of Tumors of Hematopoietic and Lymphoid Tissues

The ASCO Post is pleased to present Hematology Expert Review, an ongoing feature that quizzes readers on issues in hematology. In this installment, Syed Ali Abutalib, MD, and L. Jeffrey Medeiros, MD, explore the updated World Health Organization (WHO) classification of hematopoietic and lymphoid ...

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
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).

lymphoma
immunotherapy

Catherine M. Diefenbach, MD, on Follicular Lymphoma: Polatuzumab Vedotin Plus Obinutuzumab/Lenalidomide

Catherine M. Diefenbach, MD, of the Perlmutter Cancer Center at NYU Langone, discusses a primary analysis of a phase Ib/II trial showing that the novel triplet combination of polatuzumab vedotin plus obinutuzumab/lenalidomide is safe and effective, with high complete response rates seen in a heavily pretreated and refractory population (Abstract 126).

Lymphoma

Zanubrutinib in Previously Treated Mantle Cell Lymphoma

On November 14, 2019, the oral Bruton’s tyrosine kinase (BTK) inhibitor zanubrutinib was granted accelerated approval in the treatment of adult patients with mantle cell lymphoma (MCL) who have received at least one prior therapy.1,2 Supporting Efficacy Data The approval was based on findings from...

Lymphoma

ASH 2019: Pilot Study of Next-Generation Sequencing for Undetectable Minimal Residual Disease in Patients With Follicular Lymphoma

Patients with follicular lymphoma who have been treated and are in remission for at least 2 years may no longer be incurable based on highly sensitive testing. This may mean they no longer need therapy or active follow-up, according to findings presented by Sarraf Yazdy et al at the 2019 American...

Lymphoma

ASH 2019: PET-Directed Therapy for Early-Stage DLBCL

Most people diagnosed with early-stage, or limited, diffuse large B-cell lymphoma (DLBCL) may be able to safely skip radiation treatment after a clear positron-emission tomography (PET) scan, according to new clinical trial results from SWOG presented by Persky et al at the 2019 American Society of ...

lymphoma

Loretta J. Nastoupil, MD, on Follicular Lymphoma: Trial Results With Obinutuzumab/Lenalidomide

Loretta J. Nastoupil, MD, of The University of Texas MD Anderson Cancer Center, discusses phase II study findings that showed obinutuzumab in combination with lenalidomide for patients with previously untreated, high tumor burden follicular lymphoma was associated with improved outcomes (Abstract 125).

Immunotherapy
Lymphoma
Geriatric Oncology

ASH 2019: CAR T-Cell Therapy Shows Activity, Reduces Health-Care Utilization in Older Patients With DLBCL

A new analysis of Medicare claims data presented by  Kilgore et al at the 2019 American Society of Hematology (ASH) Annual Meeting & Exposition (Abstract 793) has provided the first real-world evidence using claims data available after the approval of autologous anti-CD19 chimeric antigen...

Immunotherapy
Lymphoma

ASH 2019: Early Data Signal Potential for Bispecific Antibody in Non-Hodgkin Lymphoma

The investigational bispecific antibody mosunetuzumab is showing activity in preliminary studies of patients with non-Hodgkin lymphoma (NHL), including those who are refractory to or relapsed after third-line chimeric antigen receptor (CAR) T-cell therapy. If preliminary findings are validated by...

Solid Tumors
Lymphoma
Immunotherapy

Atezolizumab for Pediatric and Young Adult Patients With Previously Treated Solid Tumors or Lymphomas

In a phase I/II study reported in The Lancet Oncology, Geoerger et al found little activity of atezolizumab alone in pediatric and young adult patients with relapsed or refractory malignancies (including solid tumors, non-Hodgkin lymphoma, and Hodgkin lymphoma) with known or expected programmed...

Hepatobiliary Cancer
Lymphoma
Neuroendocrine Tumors
Gastrointestinal Cancer
Genomics/Genetics

FDA Pipeline: Recent Designations in Hepatocellular Carcinoma, Cholangiocarcioma, Lymphoma, and More

Over the past few weeks, the U.S. Food and Drug Administration (FDA) granted reviews or designations to treatments for gastrointestinal cancers and lymphoma, and also provided authorizations for products designed to screen for malignancies and tumor mutational burden. Priority Review for Nivolumab...

Lymphoma

Answers to Hematology Expert Review Questions

Question 1 Which of the following statements about nodular lymphocyte-predominant HL is correct? Correct answer: A. Nodular lymphocyte-predominant HL can transform into large B-cell lymphoma. Expert Perspective Nodular lymphocyte-predominant HL is a B-cell neoplasm characterized by a nodular or...

Lymphoma

The World Health Organization Classification of Tumors of Hematopoietic and Lymphoid Tissues

The ASCO Post is pleased to present Hematology Expert Review, an ongoing feature that quizzes readers on issues in hematology. In this installment, Drs. Abutalib and Medeiros explore the updated World Health Organization (WHO) classification of nodular lymphocyte-predominant Hodgkin lymphoma. For...

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