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Lymphoma

Zanubrutinib for Relapsed or Refractory Marginal Zone Lymphoma

On September 14, 2021, the Bruton’s tyrosine kinase inhibitor zanubrutinib was granted accelerated approval for adults with relapsed or refractory marginal zone lymphoma (MZL) who have had at least one prior anti-CD20–based regimen.1 Supporting Efficacy Data  Approval was based on findings in the...

Lymphoma

Final Analysis of iNNOVATE: Addition of Ibrutinib to Rituximab for Waldenström’s Macroglobulinemia

As reported in the Journal of Clinical Oncology by Buske et al, the final analysis of the pivotal phase III iNNOVATE trial has shown a continued progression-free survival benefit with the addition of ibrutinib to rituximab in patients with Waldenström’s macroglobulinemia after 50 months of...

Lymphoma
Immunotherapy

Tackling a Growing Need: Options After CAR T-Cell Therapy for Lymphoma

For aggressive B-cell lymphomas, chimeric antigen receptor (CAR) T-cell therapy saves lives, but relapse remains common, and a second-line standard of care is lacking. During the 2021 Pan Pacific Lymphoma Conference, Grzegorz (Greg) S. Nowakowski, MD, Professor of Medicine and Oncology, Lymphoma...

Lymphoma

DA-EPOCH-R for Children and Adolescents With Newly Diagnosed Primary Mediastinal B-Cell Lymphoma

In a phase II trial reported in the Journal of Clinical Oncology, Burke et al found that dose-adjusted etoposide, doxorubicin, and cyclophosphamide with vincristine and prednisone plus rituximab (DA-EPOCH-R) did not improve event-free survival vs historical controls in children and adolescents with ...

Lymphoma
Immunotherapy

Axicabtagene Ciloleucel for Adult Patients With Primary Mediastinal B-Cell Lymphoma: Real-World Outcomes

In a retrospective cohort study reported in a research letter in Blood Advances, Jennifer L. Crombie, MD, and colleagues found that axicabtagene ciloleucel produced high overall and complete response rates in patients with primary mediastinal B-cell lymphoma. They also observed some evidence to...

lymphoma

Kieron M. Dunleavy, MD: Update on Primary Mediastinal B-Cell Lymphoma

Kieron M. Dunleavy, MD, of Georgetown University, offers insights into the latest data on treating patients with primary mediastinal B-cell lymphoma: the optimal regimen; whether radiotherapy or stem cell transplants are needed; new information on the biology of the disease; novel agents such as CAR T-cell therapy and immune checkpoint inhibitors, and incorporating them into upfront treatment.

Lymphoma
Geriatric Oncology

Older Adults With Primary CNS Lymphoma: Treatment Opportunities and Challenges

The ASCO Post is pleased to present the Hematology Expert Review, an ongoing feature that quizzes readers on issues in hematology. In this installment, Drs. Abutalib, Desai, and DeAngelis explore the treatment of older patients with primary central nervous system lymphoma (PCNSL), which pose...

Immunotherapy
Lymphoma

Lymphoid Malignancies: What’s Next for Antibody-Drug Conjugates?

Antibody-drug conjugates are improving outcomes of patients with lymphoma, often those who have exhausted treatment options after chimeric antigen receptor (CAR) T-cell therapy. Four available antibody-drug conjugates are in the clinic, with brentuximab vedotin moving into the front-line...

Lymphoma

Putting Radiotherapy to Best Use With CAR T-Cell Therapy in Lymphoma

The integration of radiation therapy into chimeric antigen receptor (CAR) T-cell therapy may improve outcomes for patients with relapsed or refractory lymphoma, according to Charles A. Enke, MD, Professor and the Bill Bures and Jerry Pabst Chair in Radiation Oncology at the Fred and Pamela Buffett...

Lymphoma

Bispecific Antibodies Find a Place in B-Cell Lymphoma Treatment

In relapsed or refractory B-cell lymphomas, bispecific T-cell engager antibodies are finding a place in the treatment algorithm, said Christopher Flowers, MD, MS, FASCO, Professor and Chair of the Department of Lymphoma/Myeloma at The University of Texas MD Anderson Cancer Center, Houston. At the...

Lymphoma
Immunotherapy

Long-Term Outcomes in JULIET Trial of Tisagenlecleucel for Relapsed or Refractory Aggressive B-Cell Lymphomas

As reported by Stephen J. Schuster, MD, and colleagues in The Lancet Oncology, long-term outcomes of the pivotal phase II JULIET trial showed overall and complete response rates of 53% and 39% in adult patients with relapsed or refractory aggressive B-cell lymphomas treated with the T-cell...

Lymphoma
Immunotherapy

Bispecific Antibody Epcoritamab in Relapsed or Refractory B-Cell Non-Hodgkin Lymphoma

In a phase I/II study reported in The Lancet, Hutchings et al found that the novel bispecific antibody epcoritamab produced high response rates in patients with relapsed or refractory B-cell non-Hodgkin lymphoma. Epcoritamab works by targeting CD3 and CD20 and inducing T-cell–mediated cytotoxic...

Lymphoma

FDA Grants Zanubrutinib Accelerated Approval in Relapsed or Refractory Marginal Zone Lymphoma

On September 15, zanubrutinib (Brukinsa), a small-molecule inhibitor of Bruton’s tyrosine kinase (BTK), received accelerated approval from the U.S. Food and Drug Administration (FDA) for the treatment of adult patients with relapsed or refractory marginal zone lymphoma who have received at least...

Lymphoma
Immunotherapy

Assumptions, Data … and More Questions!

I read with great interest the results from the phase II ZUMA-12 study of axicabtagene ciloleucel, presented during the 2020 American Society of Hematology (ASH) Annual Meeting & Exposition.1 But the results raised several questions for me. Axicabtagene ciloleucel, an autologous anti-CD19...

Lymphoma

FDA Approves Zanubrutinib for Waldenström’s Macroglobulinemia

On August 31, the U.S. Food and Drug Administration (FDA) approved zanubrutinib (Brukinsa), a Bruton’s tyrosine kinase inhibitor, for adult patients with Waldenström’s macroglobulinemia. ASPEN Trial Zanubrutinib was investigated in ASPEN (ClinicalTrials.gov identifier: NCT03053440), a randomized,...

Leukemia
Lymphoma
COVID-19

Study Explores Relationship Between Anti-CD20 Therapy and Reduced Responses to mRNA COVID-19 Vaccines

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...

Hematologic Malignancies
Lymphoma

Ixazomib/Rituximab/Dexamethasone for Relapsed or Refractory Waldenström’s Macroglobulinemia

In a phase I/II trial (HOVON124/ECWM-R2) reported in the Journal of Clinical Oncology, Kersten et al found that the combination of oral ixazomib with subcutaneous rituximab and dexamethasone showed efficacy in patients with relapsed or refractory Waldenström’s macroglobulinemia, with a manageable...

Lymphoma

Axicabtagene Ciloleucel Improves Multiple Clinical Endpoints in Relapsed Follicular Lymphoma

For the treatment of relapsed or refractory follicular lymphoma, updated data from the ZUMA-5 trial, as compared with the findings of the external control cohort of SCHOLAR-5, showed substantial improvement in all key clinical endpoints with axicabtagene ciloleucel, ZUMA-5 investigators reported in ...

Lymphoma

Excess Cardiovascular Disease Risk in Patients With Early-Stage Lymphoma: Personalizing Radiotherapy Delivery

As reported in the Journal of Clinical Oncology by Cutter et al, an analysis from the UK NCRI RAPID trial of positron-emission tomography (PET)-directed therapy in patients with early-stage Hodgkin lymphoma indicated that the use of involved-field radiotherapy in PET-negative patients who had...

lymphoma
immunotherapy

Steven M. Horwitz, MD, on Advanced-Stage Mycosis Fungoides and Sezary Syndrome: Update on Management Practices

Steven M. Horwitz, MD, of Memorial Sloan Kettering Cancer Center, discusses treatments for advanced mycosis fungoides and Sezary syndrome, including brentuximab vedotin and mogamulizumab, and how best to choose among treatments.

lymphoma
immunotherapy

James O. Armitage, MD, on Advanced Hodgkin Lymphoma: Choosing Among BEACOPP, A-AVD, and Checkpoint Inhibitors

James O. Armitage, MD, of the University of Nebraska Medical Center, discusses various treatment regimens for patients with Hodgkin lymphoma, including BEACOPP, brentuximab vedotin, ABVD, A-AVD, nivolumab, and pembrolizumab—and the factors to consider when choosing among them.

lymphoma

Sonali M. Smith, MD: Can CNS Prophylaxis Prevent Secondary High-Grade B-Cell Lymphomas?

Sonali M. Smith, MD, of the University of Chicago, discusses the many uncertainties in preventing secondary high-grade B-cell lymphomas, which have a poor prognosis; how to discern the patients at highest risk; and whether prophylaxis with monoclonal antibodies such as rituximab can mitigate the likelihood of secondary lymphoma.

lymphoma
immunotherapy

Bruce D. Cheson, MD, and Stephen M. Ansell, MD, PhD, on Non-Hodgkin and Follicular Lymphomas: Integrating Non–CAR T-Based Treatments

Stephen M. Ansell, MD, PhD, of the Mayo Clinic, and Bruce D. Cheson, MD, of the Lymphoma Research Foundation, engage in a lively debate about CAR T-cell therapy, how it fits in with immunotherapy and nonchemotherapy approaches, and how to decide which treatment is right for which patient, especially given the many challenges of obtaining CAR T cells.

lymphoma
immunotherapy

Alison J. Moskowitz, MD, on ABVD in Hodgkin Lymphoma: Adding Brentuximab Vedotin and Checkpoint Inhibitors to Standard Treatment

Alison J. Moskowitz, MD, of Memorial Sloan Kettering Cancer Center, discusses the combination ABVD (doxorubicin, bleomycin, vinblastine, and dacarbazine), individualized approaches for treating patients with Hodgkin lymphoma, and novel methods for risk stratification.

lymphoma

Jonathan W. Friedberg, MD, on Managing Indolent NHL With Oral Therapies

Jonathan W. Friedberg, MD, of the University of Rochester Medical Center, discusses treatment options for follicular lymphoma, focusing on the combination of lenalidomide and rituximab and why he uses that regimen for first relapse but not front-line therapy.

lymphoma

Andrew D. Zelenetz, MD, PhD, on MRD Testing in the Management of Non-Hodgkin Lymphoma

Andrew D. Zelenetz, MD, PhD, of Memorial Sloan Kettering Cancer Center, discusses the role of minimal residual disease evaluation in the treatment of non-Hodgkin lymphoma, techniques used to predict relapse such as immunosequencing and CAPP-Sequencing, and whether such assays could replace the use of imaging with its attendant radiation exposure.

supportive care
lymphoma

David S. Kroll, MD, on Recognizing and Treating Depression and Anxiety in Patients With Lymphoma

David S. Kroll, MD, of Brigham and Women’s Hospital, discusses the symptoms of distress in patients with lymphoma and other oncologic malignancies, risk factors for poor outcomes, and how best to approach the management of depression and anxiety in this population.

Leukemia
Lymphoma

Asparaginase Erwinia Chrysanthemi (Recombinant)-rywn for Acute Lymphoblastic Leukemia and Lymphoblastic Lymphoma

On June 30, 2021, asparaginase erwinia chrysanthemi (recombinant)-rywn was approved as a component of a multiagent chemotherapeutic regimen for treatment of acute lymphoblastic leukemia (ALL) and lymphoblastic lymphoma in adult and pediatric patients 1 month or older who have developed...

Lymphoma
Immunotherapy

Expert Point of View: Leslie Popplewell, MD

“Naratuximab emtansine plus rituximab appears to be an effective and well tolerated combination in a heavily pretreated population. The results of the study are very promising,” said Leslie Popplewell, MD, Associate Clinical Professor, Department of Hematology and Hematopoietic Cell...

Lymphoma

Novel Antibody-Drug Conjugate Under Study in Refractory DLBCL

The combination of the CD37-targeting antibody-drug conjugate naratuximab emtansine and rituximab yielded deep and long-lasting responses in patients with relapsed or refractory diffuse large B-cell lymphoma (DLBCL), in a phase II trial presented during the 2021 European Hematology Association...

Leukemia
Lymphoma

Expert Point of View: Jacqueline C. Barrientos, MD, MS

The ASCO Post invited Jacqueline C. Barrientos, MD, MS, Associate Professor of Medicine, CLL Research and Treatment Program, Zucker School of Medicine at Hofstra/Northwell, Lake Success, New York, to comment on the ALPINE findings presented at the European Hematology Association (EHA) Virtual...

Lymphoma
Leukemia

Zanubrutinib Superior to Ibrutinib for CLL/SLL in Phase III ALPINE Trial

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...

Lymphoma

CAR T-Cell Gene Therapy in Non-Hodgkin Lymphomas

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 gene therapies for resistant non-Hodgkin lymphomas (NHL), including...

Lymphoma

Impact of Nurse Navigation Program on Outcomes in Minority Patients With Aggressive Lymphoma

In a single-institution study reported in the journal Cancer, Hu et al found that use of a dedicated nurse navigation program contributed to redressing the recognized inequities in care and outcomes between minority patients and White patients with aggressive large B-cell lymphoma (LBCL).  As...

Lymphoma
Global Cancer Care

Study Explores Cost-Effectiveness of CHOP Therapy for Patients With DLBCL in Sub-Saharan Africa

In a clinical trial conducted in Malawi, researchers found that combination chemotherapy with CHOP (cyclophosphamide, doxorubicin, vincristine, and prednisone) provided curative benefit compared to current standard-of-care therapy in people diagnosed with diffuse large B-cell lymphoma (DLBCL)—and...

Lymphoma
Immunotherapy

Axicabtagene Ciloleucel for Relapsed or Refractory Follicular Lymphoma

On March 5, 2021, the CD19-directed genetically modified autologous T-cell immunotherapy axicabtagene ciloleucel was granted accelerated approval for treatment of adults with relapsed or refractory follicular lymphoma after two or more lines of systemic therapy.1,2 Axicabtagene ciloleucel is...

Lymphoma

Role of PI3K Inhibition in Indolent Lymphomas

As reported by Fowler et al in the Journal of Clinical Oncology1—and summarized in this issue of The ASCO Post—the international phase IIb UNITY-NHL trial of 208 patients with marginal zone lymphoma (MZL; n = 69), follicular lymphoma (FL; n = 117), and small lymphocytic lymphoma (SLL; n = 22)...

Lymphoma

Dual PI3Kδ/CK1ε Inhibitor Umbralisib in Relapsed or Refractory Indolent Non-Hodgkin Lymphoma

As reported in the Journal of Clinical Oncology by Nathan H. Fowler, MD, of The University of Texas MD Anderson Cancer Center, and colleagues, a phase IIb trial (UNITY-NHL) has shown that the dual PI3Kδ/casein kinase (CK)1ε inhibitor umbralisib produced durable responses in patients with relapsed...

lymphoma
immunotherapy

Martin H. Dreyling, MD, PhD, on Follicular Lymphoma: Safety and Efficacy of Tisagenlecleucel

Martin H. Dreyling, MD, PhD, of University Hospital Munich Grosshadern Klinikum, discusses phase II results from the ELARA trial, which suggests tisagenlecleucel may be a promising immunotherapy for adults with relapsed or refractory follicular lymphoma (Abstract S210).

Leukemia
Lymphoma

Expert Point of View: Jacqueline C. Barrientos, MD, MS

Invited discussant Jacqueline C. Barrientos, MD, MS, of Northwell Health Cancer Institute, Zucker School of Medicine at Hofstra/Northwell in Great Neck, New York, noted that, although both ibrutinib and venetoclax have shown superior results to chemotherapy, each drug is associated with toxicity....

Lymphoma
Leukemia

Fixed-Dose, First-Line Ibrutinib/Venetoclax Combination Achieves Durable Remissions in CLL

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 ...

Lymphoma
Survivorship

Parenthood Status and Use of Assisted Reproductive Techniques in Younger Hodgkin Lymphoma Survivors

In a Danish population-based study reported in the Journal of Clinical Oncology, Øvlisen et al found that parenthood rates in younger Hodgkin lymphoma survivors who did not experience early relapse were similar to those in the general population, but that use of assisted reproductive techniques...

Lymphoma

Recovery of Gonadal Function With PET-Adapted Regimen for Advanced Hodgkin Lymphoma

In a prospective analysis from the phase III Lymphoma Study Association AHL2011 trial reported in the Journal of Clinical Oncology, Demeestere et al found that patients with advanced Hodgkin lymphoma receiving a positron-emission tomography (PET)-adapted regimen had a reduced risk of gonadal...

Lymphoma

Second-Line Pembrolizumab Plus Chemotherapy Regimen for Relapsed or Refractory Classic Hodgkin Lymphoma

In a phase II trial reported in the Journal of Clinical Oncology, Alison J. Moskowitz, MD, and colleagues found that second-line therapy with pembrolizumab plus gemcitabine, vinorelbine, and liposomal doxorubicin (GVD) in relapsed or refractory classic Hodgkin lymphoma produced responses in all...

Lymphoma

PI3K Inhibition With Copanlisib Plus ­Rituximab in Relapsed Indolent Non-Hodgkin Lymphoma

Better understanding of the mechanism behind the malignant transformation of B cells has led to an explosion of “targeted” therapy. With the growing knowledge of the role of the B-cell receptor and its downstream kinases, it appeared that we were entering a new era in the management of patients...

Lymphoma
Immunotherapy

Loncastuximab Tesirine-lpyl for Relapsed or Refractory Large B-Cell Lymphoma

On April 23, 2021, loncastuximab tesirine-lpyl, a CD19-directed antibody and alkylating agent conjugate, was granted accelerated approval for treatment of adult patients with relapsed or refractory large B-cell lymphoma after two or more lines of systemic therapy, including diffuse large B-cell...

lymphoma
immunotherapy

Martin Hutchings, MD, PhD, on Hodgkin Lymphoma: Brentuximab Vedotin With Chemotherapy

Martin Hutchings, MD, PhD, of Copenhagen University Hospital, discusses a 5-year update of the phase III ECHELON-1 study, which suggested brentuximab vedotin plus doxorubicin, vinblastine, and dacarbazine benefits patients with previously untreated stage III or IV classical Hodgkin lymphoma (Abstract S205).

lymphoma

Gaurav Goyal, MD, on DLBCL: Comparing R-CHOP and R-EPOCH for Overall Survival Benefits

Gaurav Goyal, MD, of the University of Alabama at Birmingham, reports on findings from a large multi-institutional database study, which showed there was no apparent difference in overall survival between R-CHOP and R-EPOCH among patients with advanced-stage MYC-rearranged, double-hit, or triple-hit diffuse large B-cell lymphoma. Further studies are needed for better risk stratification to optimize outcomes (Abstract S224).

Lymphoma
Immunotherapy

ctDNA and Early Relapse After Axicabtagene Ciloleucel Infusion in Large B-Cell Lymphoma

In a prospective study reported in the Journal of Clinical Oncology, Frank et al found that monitoring of circulating tumor DNA (ctDNA) improved detection of early relapse after axicabtagene ciloleucel infusion in patients with relapsed or refractory large B-cell lymphoma. Study Details A total of...

lymphoma

Brian K. Link, MD, on Mantle Cell Lymphoma: Expert Perspective on Treatments Now and Those to Come

Brian K. Link, MD, of the University of Iowa Carver College of Medicine, reviews three abstracts on state-of-the-art therapies for mantle cell lymphoma: bendamustine, rituximab, lenalidomide and bortezomib; treatment patterns and outcomes for previously untreated patients; and venetoclax, lenalidomide, and rituximab in newly diagnosed disease (Abstracts 7503, 7504, and 7505).

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