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Lymphoma

FDA Grants Accelerated Approval to Pirtobrutinib for Relapsed or Refractory Mantle Cell Lymphoma

On January 27, the U.S. Food and Drug Administration (FDA) granted accelerated approval to pirtobrutinib (Jaypirca) for patients with relapsed or refractory mantle cell lymphoma after at least two lines of systemic therapy, including a Bruton’s tyrosine kinase (BTK) inhibitor. BRUIN Efficacy was...

Hematologic Malignancies
Survivorship
Gastrointestinal Cancer
Lymphoma
Leukemia
Myelodysplastic Syndromes

Risk of Subsequent Gastrointestinal Tract Malignancies After Blood or Marrow Transplantation

In a study reported in JAMA Oncology, McDonald et al found that receipt of blood or marrow transplantation (BMT) was associated with an increased risk of subsequent malignant neoplasms of the gastrointestinal (GI) tract. As stated by the investigators, “Survivors of BMT are at increased risk of...

Lymphoma

Receiving Chemotherapy in the Afternoon May Improve Treatment Outcomes in Some Patients With DLBCL

Utilizing chronochemotherapy—a method aimed at delivering chemotherapy at a time when the body is least vulnerable to its harmful effects and when the cancer cells are at their most vulnerable—may improve the outcomes of some patients with diffuse large B-cell lymphoma (DLBCL), according to a novel ...

Lymphoma

How Experts Treat Mantle Cell Lymphoma in First Complete Response

Options are growing in the treatment of mantle cell lymphoma after complete response. At the 2022 Pan Pacific Lymphoma Conference,1 the use of these newer strategies in older patients was discussed by Brad S. Kahl, MD, Professor of Medicine and Director of the Lymphoma Service at Washington...

Lymphoma

A Serendipitous Opportunity Steers a Theater Major Into Oncology

Lymphoma expert Jeremy S. Abramson, MD, was born in Westchester County, New York, but soon after, his family relocated to Bergen County, New Jersey, where he spent his formative years. “I attended Tenafly High School and had dual passions: one was the natural sciences and the other on the...

Lymphoma

Many Survivors of Childhood Hodgkin Lymphoma Show Signs of Neurocognitive Impairment

Long-term follow-up of survivors of childhood Hodgkin lymphoma from the St. Jude Lifetime Cohort showed signs of “epigenetic accelerated aging,” and many of these survivors had signs of neurocognitive impairment by their late 30s, researchers reported at the 2022 American Society of Hematology...

Lymphoma

MAGNOLIA Trial: Zanubrutinib Yields High Response Rates With Low Rate of Cardiac Events in Marginal Zone Lymphoma

Zanubrutinib—a next-generation Bruton’s tyrosine kinase (BTK) inhibitor—achieved high response rates and durable disease control with a low incidence of cardiac effects in patients with relapsed or refractory marginal zone lymphoma, according to updated findings from the final analysis of the phase ...

Leukemia
Lymphoma

FDA Approves Zanubrutinib for CLL or SLL

On January 19, the U.S. Food and Drug Administration (FDA) approved the kinase inhibitor zanubrutinib (Brukinsa) for the treatment of patients with chronic lymphocytic leukemia (CLL) or small lymphocytic lymphoma (SLL). SEQUOIA Trial: Treatment-Naive Patients Efficacy in treatment-naive patients...

Leukemia
Lymphoma

Is Zanubrutinib Poised to Become a New Standard of Care in Relapsed or Refractory CLL and SLL?

The next-generation Bruton’s tyrosine kinase (BTK) inhibitor zanubrutinib demonstrated superior progression-free survival compared with ibrutinib, with an improved cardiac safety profile, in the first head-to-head comparison between these two BTK inhibitors in relapsed or refractory chronic...

Lymphoma

Study Suggests Ibrutinib May Obviate Need for Autologous Stem Cell Transplantation in Some Younger Patients With Mantle Cell Lymphoma

Although longer follow-up is needed, the results of the three-arm randomized TRIANGLE study suggest that the tyrosine kinase inhibitor ibrutinib may replace autologous stem cell transplantation (ASCT) after chemoimmunotherapy in younger patients with previously untreated mantle cell lymphoma (MCL). ...

Lymphoma

Expert Point of View: Jeremy S. Abramson, MD

Jeremy S. Abramson, MD, Director of Lymphoma, Mass General Cancer Center, Boston, commented on the clinical implications of the TRIANGLE study. “The TRIANGLE trial is a large, three-arm randomized trial addressing two critically important questions in the management of younger patients with mantle...

Lymphoma

Study Suggests Ibrutinib May Obviate Need for ASCT in Some Younger Patients With Mantle Cell Lymphoma

Although longer follow-up is needed, the results of the three-arm randomized TRIANGLE study suggest that the tyrosine kinase inhibitor ibrutinib may replace autologous stem cell transplantation (ASCT) after chemoimmunotherapy in younger patients with previously untreated mantle cell lymphoma (MCL). ...

Lymphoma

Circulating Tumor DNA Profiling and Outcomes in CNS Lymphoma

In a German study reported in the Journal of Clinical Oncology, Mutter et al found that circulating tumor DNA (ctDNA) identified prior to and during treatment was associated with poorer outcomes in patients with central nervous system (CNS) lymphoma. Study Details The study included 92 patients...

Lymphoma

Subcutaneous Epcoritamab for Relapsed or Refractory Large B-Cell Lymphoma

As reported in the Journal of Clinical Oncology by Catherine Thieblemont, MD, PhD, and colleagues, findings in a dose-expansion cohort of the phase I/II EPCORE NHL-1 study indicated high activity of the subcutaneous CD3 x CD20 T-cell–engaging bispecific antibody epcoritamab in patients with...

Lymphoma

Crizotinib Combined With Chemotherapy in Pediatric ALK-Positive Anaplastic Large Cell Lymphoma

As reported in the Journal of Clinical Oncology by Lowe et al, findings in an arm of the Children’s Oncology Group phase II ANHL12P1 trial (arm CZ) showed high event-free and overall survival rates with the addition of crizotinib to chemotherapy in newly diagnosed pediatric patients with...

Lymphoma

FDA Approves Mosunetuzumab-axgb, a First-in-Class Bispecific Antibody, in Relapsed or Refractory Follicular Lymphoma

On December 22, the U.S. Food and Drug Administration (FDA) approved mosunetuzumab-axgb (Lunsumio) for the treatment of adults with relapsed or refractory follicular lymphoma after two or more lines of systemic therapy. Mosunetuzumab-axgb is a CD20/CD3 T-cell–engaging bispecific antibody and...

Lymphoma

Concomitant and Sequential Nivolumab, Doxorubicin, Vinblastine, and Dacarbazine in Early-Stage Unfavorable Hodgkin Lymphoma

As reported in the Journal of Clinical Oncology by Bröckelmann et al, final results of the German Hodgkin Study Group phase II NIVAHL trial indicate nearly 100% progression-free survival and 100% overall survival at 3 years among patients with early-stage unfavorable classical Hodgkin lymphoma...

Lymphoma

Long-Term Follow-up of High-Dose Cytarabine and Autologous Stem Cell Transplantation in Mantle Cell Lymphoma

Long-term results of the phase III Mantle Cell Lymphoma Younger Trial were reported in the Journal of Clinical Oncology by Hermine et al. They showed a maintained advantage in time to treatment failure and an overall survival advantage with R-CHOP/R-DHAP (alternating rituximab plus...

Lymphoma

Brentuximab Vedotin Combined With Chemotherapy in Pediatric Classical Hodgkin Lymphoma

On November 10, 2022, brentuximab vedotin was approved for use in combination with doxorubicin, vincristine, etoposide, prednisone, and cyclophosphamide for pediatric patients aged ≥ 2 years with previously untreated high-risk classical Hodgkin lymphoma.1 Supporting Efficacy Data Approval was...

leukemia
lymphoma

Jennifer R. Brown, MD, PhD, on CLL/SLL: New Findings on Zanubrutinib vs Ibrutinib for Relapsed or Refractory Disease

Jennifer R. Brown, MD, PhD, of Dana-Farber Cancer Institute, discusses phase III findings of the ALPINE study, which showed that zanubrutinib is more efficacious and better tolerated than ibrutinib as a treatment for patients with relapsed or refractory chronic lymphocytic leukemia (CLL) and small lymphocytic lymphoma (SLL). In this first head-to-head comparison of the two BTK inhibitors, the superior progression-free survival of zanubrutinib was observed across all major subgroups, including high-risk patients (Abstract LBA-6).

Leukemia
Lymphoma
Genomics/Genetics

Scientists Map Genetic Evolution of CLL to Richter Syndrome

Richter syndrome is an aggressive lymphoma that develops in up to 1% of patients with chronic lymphocytic leukemia (CLL) and it serves as an example of histologic transformation. While recent advances have transformed the treatment landscape of CLL, Richter syndrome remains associated with poor...

Lymphoma
Immunotherapy

Pilot Study Investigates Axicabtagene Ciloleucel in Primary and Secondary CNS Lymphoma

The chimeric antigen receptor (CAR) T-cell therapy axicabtagene ciloleucel was deemed safe and showed encouraging signs of efficacy in a small pilot trial involving patients with lymphoma of the brain and/or spinal cord, according to findings presented by Caron A. Jacobson, MD, MMSc, and colleagues ...

Lymphoma
Survivorship

Study Finds Adult Survivors of Pediatric Hodgkin Lymphoma Experience Significant Epigenetic Age Acceleration Associated With Neurocognitive Deficits

Research shows that long-term survivors of pediatric Hodgkin lymphoma are at an elevated risk for a variety of health conditions, including cardiopulmonary morbidity, cognitive impairment, and premature death, and could also be at heightened risk for the premature onset of dementia. A new study of...

Issues in Oncology
Lymphoma

Clinical Trial Lab-Based Eligibility Criteria Disproportionately Excluded Non-White Patients With DLBCL From Study Participation

A previous analysis by Khurana et al on the impact of inclusion/exclusion criteria in clinical trial design for patients with diffuse large B-cell lymphoma (DLBCL) found that up to 24% of patients treated with standard immunochemotherapy were excluded based on five lab-based criteria alone. A new...

lymphoma

Kathryn R. Tringale, MD, on Primary CNS Lymphoma: Initial Treatment Response in More Than 500 Patients

Kathryn R. Tringale, MD, of Memorial Sloan Kettering Cancer Center, discusses an assessment of 559 patients with primary central nervous system (CNS) lymphoma and the factors associated with consolidation therapy selection, outcomes after consolidation therapy accounting for patient factors, and patterns of disease failure. The initial treatment response was prognostic and predictive of relapse patterns (Abstract 557).

lymphoma

Eva Hoster, PhD, on Mantle Cell Lymphoma: Predictive Value of Minimal Residual Disease on Efficacy of Rituximab Maintenance

Eva Hoster, PhD, of Munich University, discusses results from the European MCL Elderly Trial, which confirmed the strong efficacy of rituximab maintenance in minimal residual disease (MRD)-negative patients with mantle cell lymphoma (MCL) after induction. Omitting maintenance based on MRD-negativity is thus discouraged. Considering the short time to progression, more effective treatment strategies should be explored in MRD-positive patients to improve long-term prognosis (Abstract 544).

Lymphoma
Leukemia
Immunotherapy

Report Outlines Advance in Retreatment With CAR T-Cell Therapy in Patients With Relapsed or Refractory Non-Hodgkin Lymphoma or CLL

Researchers from the University of Pennsylvania’s Abramson Cancer Center presented preliminary results of an ongoing phase I clinical trial demonstrating successful retreatment with chimeric antigen receptor (CAR) T-cell therapy for patients whose cancers relapsed after previous CAR T-cell therapy. ...

lymphoma

Jia Ruan, MD, PhD, on Mantle Cell Lymphoma: Phase II Findings on Acalabrutinib/Lenalidomide/Rituximab

Jia Ruan, MD, PhD, of Meyer Cancer Center, Weill Cornell Medicine, and NewYork-Presbyterian Hospital, discusses trial results demonstrating that the triple chemotherapy-free combination of acalabrutinib, lenalidomide, and rituximab is well tolerated, highly effective, and produces high rates of minimal residual disease (MRD)-negative complete response as an initial treatment for patients with mantle cell lymphoma, including those with TP53 mutations. Real-time MRD analysis may enable treatment de-escalation during maintenance to minimize toxicity, which warrants further evaluation. An expansion cohort of acalabrutinib/lenalidomide/obinutuzumab is being launched (Abstract 73).

lymphoma
genomics/genetics

Stephen M. Ansell, MD, PhD, and Patrizia Mondello, MD, PhD: New Findings on How the IRF4 Gene Shapes Tumor Immunity in Follicular Lymphoma

Stephen M. Ansell, MD, PhD, and Patrizia Mondello, MD, PhD, both of the Mayo Clinic, discuss the 20% of patients with follicular lymphoma (FL) who relapse early and experience a poor prognosis. The researchers found that FLs with high levels of IRF4 expression are associated with a suppressive tumor microenvironment, and selective IRF4 silencing restores antilymphoma T-cell immunity. Further investigation is warranted to identify the mechanisms by which IRF4 controls tumor immunity to develop precision therapies for this population (Abstract 70).

lymphoma

Tomohiro Aoki, MD, PhD, on the Spatial Tumor Microenvironment and Outcome of Relapsed/Refractory Classical Hodgkin Lymphoma

Tomohiro Aoki, MD, PhD, of the University of British Columbia and the Centre for Lymphoid Cancer at BC Cancer, discusses a novel prognostic model applicable to patients with relapsed or refractory classical Hodgkin lymphoma who were treated with autologous stem cell transplantation. The model has shown the interaction between the biomarker CXCR5 on HRS cells (Hodgkin and Reed/Sternberg cells, hallmarks of Hodgkin lymphoma) with specific follicular T helper cells and macrophages, a prominent crosstalk axis in relapsed disease. This insight opens new avenues to developing predictive biomarkers (Abstract 71).  

lymphoma
immunotherapy

Tycel J. Phillips, MD, on Mantle Cell Lymphoma: New Findings on Glofitamab Monotherapy

Tycel J. Phillips, MD, of the City of Hope National Medical Center, discusses data that showed fixed-duration glofitamab monotherapy induced high and durable complete response rates in patients with mantle cell lymphoma (MCL) who received obinutuzumab pretreatment. This is one of the largest data sets and longest follow-ups reported with a CD20/CD3 bispecific monoclonal antibody for patients with relapsed or refractory MCL (Abstract 74).

lymphoma

Paolo F. Caimi, MD, on DLBCL: Outcomes After R-ICE Chemoimmunotherapy

Paolo F. Caimi, MD, of the Taussig Cancer Institute, Cleveland Clinic, discusses new findings showing that patients with diffuse large B-cell lymphoma (DLBCL) who achieve a complete response after salvage therapy with rituximab, ifosfamide, carboplatin, and etoposide (R-ICE) can achieve long-term disease control, regardless of the time to relapse from initial therapy, particularly if they proceed to autologous stem cell transplant (ASCT). These results suggest that second-line chemotherapy followed by ASCT and/or CAR T-cell therapy for chemosensitive and chemorefractory patients may maximize patient outcomes, regardless of time to relapse (Abstract 156).

Lymphoma

Will Ibrutinib Replace Stem Cell Transplantation as First-Line Treatment for Mantle Cell Lymphoma?

In a recent trial of the European MCL Network, people with mantle cell lymphoma who received the Bruton’s tyrosine kinase inhibitor ibrutinib had rates of progression-free survival and overall survival that were on par with the current standard of care (high-dose immunochemotherapy followed by...

Breast Cancer
Lymphoma

Breast Implants After Mastectomy Associated With Very Low Risk of ALCL

The incidence of anaplastic large cell lymphoma (ALCL) has surged in recent years—possibly because of the growing use of textured breast implants. Considering this trend, some patients with breast cancer who undergo mastectomy may wonder if the benefits of getting reconstructive implants are worth...

Lymphoma

Novel Research Suggests New Way to Target Mantle Cell Lymphoma Using FOXO1 Inhibitors

Preclinical research has shown that mantle cell lymphoma is so critically dependent on the FOXO1 protein that by blocking its activity with an experimental drug, the cancer’s growth may be slowed, according to a new study published by Jang et al in the Journal of Clinical Investigation....

Lymphoma
Cost of Care
Immunotherapy

Cost-Effectiveness of Polatuzumab Vedotin-piiq Plus R-CHP and CAR T-Cell Therapy vs Standard of Care in DLBCL

In a study reported in the Journal of Clinical Oncology, Vijenthira et al found that front-line polatuzumab vedotin-piiq plus rituximab, cyclophosphamide, doxorubicin, and prednisone (R-CHP), second-line chimeric antigen receptor (CAR) T-cell therapy, or the combination would not be likely to be...

Leukemia
Lymphoma

FDA Approves New Dosing Regimen for Asparaginase Erwinia Chrysanthemi (Recombinant)-rywn

On November 18, the U.S. Food and Drug Administration (FDA) approved a new Monday/Wednesday/Friday dosing regimen for asparaginase erwinia chrysanthemi (recombinant)-rywn (Rylaze). Under the new regimen, patients should receive 25 mg/m2 intramuscularly on Monday and Wednesday mornings and 50 mg/m2...

Breast Cancer
Lymphoma
Survivorship

Cost-Effectiveness of COG Breast Cancer Screening Guidelines for Hodgkin Lymphoma Survivors Who Received Chest Irradiation

In a cost-effective analysis reported in the Journal of Clinical Oncology, Wong et al found that only the mammography component of the Children’s Oncology Group (COG) breast cancer screening guidelines for chest-irradiated Hodgkin lymphoma survivors was cost-effective; magnetic resonance imaging...

Lymphoma
Immunotherapy

FDA Approves Brentuximab Vedotin in Combination With Chemotherapy for Pediatric Patients With Classical Hodgkin Lymphoma

On November 10, the U.S. Food and Drug Administration (FDA) approved the CD30-directed antibody-drug conjugate brentuximab vedotin (Adcetris) in combination with doxorubicin, vincristine, etoposide, prednisone, and cyclophosphamide for pediatric patients aged 2 years and older with previously...

Lymphoma

Lisocabtagene Maraleucel Improves Event-Free Survival in Second-Line Treatment of Relapsed or Refractory LBCL

As reported in The Lancet by Manali Kamdar, MD, of the University of Colorado Cancer Center, Aurora, and colleagues, an interim analysis of the phase III TRANSFORM trial has shown significantly improved event-free survival with second-line lisocabtagene maraleucel vs standard-of-care salvage...

Lymphoma
Immunotherapy

ECHELON-1 Shows Benefit for First-Line Brentuximab Vedotin Plus AVD in Advanced Hodgkin Lymphoma

The results of ECHELON-1 were presented by David J. Straus, MD, of Memorial Sloan Kettering Cancer Center, New York, at the 2022 National Comprehensive Cancer Network (NCCN) Annual Congress: Hematologic Malignancies. Dr. Straus said: “It is a great honor and privilege to present updated results...

Lymphoma
Immunotherapy

High-Dose Chemotherapy and Stem Cell Transplant vs CAR T-Cell Therapy for Resistant DLBCL

Which is the preferred second-line treatment option for patients with relapsed or refractory diffuse large B-cell lymphoma (DLBCL): high-dose chemotherapy and autologous stem cell transplantation (ASCT) or chimeric antigen receptor (CAR) T-cell therapy? This was the subject of a debate at the...

Lymphoma

‘TRANSFORMING’ Our Thinking About Second-Line Therapy for High-Risk Large B-Cell Lymphoma: Bring in the CARs

As reported in The Lancet by Kamdar et al,1 and summarized in this issue of The ASCO Post, the international phase III TRANSFORM trial was completed in 184 patients with primary refractory or early (≤ 12 months) relapsed large B-cell lymphoma (LBCL). Patients were randomly assigned to receive...

Lymphoma
Immunotherapy

Addition of Brentuximab Vedotin to Chemotherapy in Pediatric High-Risk Hodgkin Lymphoma

As reported in The New England Journal of Medicine by Castellino et al, the phase III Children’s Oncology Group (COG) AHOD1331 trial showed improved event-free survival with brentuximab vedotin plus chemotherapy vs standard chemotherapy in previously untreated pediatric patients with high-risk...

Lymphoma

PET-Adapted Therapy for Bulky Stage I/II Classical Hodgkin Lymphoma

As reported in the Journal of Clinical Oncology by Ann S. LaCasce, MD, MMSc, and colleagues, the phase II CALGB 50801/Alliance trial has shown that a positron-emission tomography (PET)-adapted treatment strategy allowed many patients with bulky stage I/II classical Hodgkin lymphoma to avoid...

Lymphoma

Response-Adapted Ultra–Low Dose Radiation Achieves Complete Response in Majority of Patients With Orbital Indolent B-Cell Lymphomas

Using a novel response-adapted ultra–low dose radiation therapy strategy, researchers at The University of Texas MD Anderson Cancer Center observed a 90% complete response rate in patients with orbital indolent B-cell lymphomas. Results were presented by Pinnix et al at the 2022 American Society...

Lymphoma

Managing Lymphomas in the Future: Some Bright Spots Are Emerging

Although standard therapies may provide long-lasting remissions for many patients with various subtypes of lymphoma, there is a critical need for new strategies for the sizable high-risk subset. At the 2022 Pan Pacific Lymphoma Conference, four experts in the field described future therapies for...

Lymphoma

What Is the Best Induction Regimen for Newly Diagnosed PCNSL?

Primary central nervous system lymphoma (PCNSL) accounts for less than 1% of all non-Hodgkin lymphomas and between 3% and 4% of all brain tumors, with an age-adjusted incidence rate of four cases per million persons per year. Approximately 1,500 new cases are diagnosed each year in the United...

Lymphoma
Immunotherapy

Changing the Algorithm for Relapsed or Refractory Large B-Cell Lymphomas

Despite a significant potential for cure, relapsed and refractory large B-cell lymphomas (LBCL) comprise the most common cause of lymphoma-related mortality. Sequential relapses reflect the limits of repeated exposure to chemotherapy, even when delivered at high doses. More than 30 years ago,...

Lymphoma

Determining Prognosis in Aggressive Lymphomas: Integrating Liquid Biopsy Into Imaging Assessment

The incorporation of blood-based measurements—ie, “liquid biopsies”—into imaging assessment may refine the accuracy of prognosis in aggressive lymphomas, as described by David Kurtz, MD, PhD, Assistant Professor in the Division of Oncology, Stanford University Medical Center, in a talk at the 2022...

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