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Sarah C. Rutherford, MD, of Weill Cornell Medicine, discusses findings of the SWOG S1826 study, which showed nivolumab plus AVD (doxorubicin, vinblastine, and dacarbazine) improved progression-free and event-free survival and seemed to be better tolerated than brentuximab vedotin plus AVD in patients aged 60 and older with advanced-stage Hodgkin lymphoma (Abstract 181).
The chimeric antigen receptor (CAR) T-cell therapy lisocabtagene maraleucel may be a cost-effective second-line treatment option in patients with relapsed or refractory diffuse large B-cell lymphoma (DLBCL), according to a recent study published by Choe et al in Blood Advances. Background In cases...
William G. Wierda, MD, PhD, of The University of Texas MD Anderson Cancer Center, discusses results from the phase I/II BRUIN study, which shows encouraging response and overall survival in patients with Richter transformation. Although this condition remains a challenging diagnosis, pirtobrutinib represents a potential treatment option that warrants further investigation, according to Dr. Wierda (Abstract 1737).
Mikkael A. Sekeres, MD, of the Sylvester Comprehensive Cancer Center at the University of Miami Miller School of Medicine, reviews key abstracts from ASH 2023 on treatment of myelofibrosis, chronic lymphocytic leukemia, large B-cell lymphoma, and acute myeloid leukemia (Abstracts 620, 631, 781, 425).
The phase II PrE0405 trial met its primary endpoint, achieving a complete response rate of 85% in 33 patients with mantle cell lymphoma over age 60 who received bendamustine and rituximab, a standard chemoimmunotherapy regimen, along with venetoclax, which is investigational in this setting. The...
Bijal D. Shah, MD, of Moffitt Cancer Center and Research Institute, discusses a matching-adjusted indirect comparison of brexucabtagene autoleucel and pirtobrutinib in patients with relapsed or refractory mantle cell lymphoma who have been previously treated with a BTK inhibitor (Abstract 5136).
Jonathon B. Cohen, MD, of Winship Cancer Institute, Emory University, discusses safety and efficacy findings from the phase I/II BRUIN study. The trial found that pirtobrutinib continues to demonstrate durable efficacy and a favorable safety profile in heavily pretreated patients with relapsed or refractory mantle cell lymphoma (Abstract 981).
Patients with relapsed or refractory mantle cell lymphoma who received ibrutinib in combination with venetoclax experienced significantly better rates of progression-free survival compared with patients who received ibrutinib and placebo, according to findings from the international phase III...
Early results from a new study have demonstrated that the novel chimeric antigen receptor (CAR) T-cell therapy AT101 resulted in favorable complete response rates at higher dose levels in patients with relapsed or refractory B-cell non-Hodgkin lymphoma, according to new findings simultaneously...
Data presented at the 2023 ASH Annual Meeting & Exposition suggest that chimeric antigen receptor (CAR) T-cell immunotherapy remains a viable option for patients who have lymphoma that goes into remission before the cell therapy begins (Abstract 615). While the findings do not answer the...
For patients with large B-cell lymphoma (LBCL) who have an early relapse or whose cancer doesn’t respond to first-line treatment, randomized trials have shown that chimeric antigen receptor (CAR) T-cell therapy is superior to the historical standard of care, which included additional chemotherapy...
In an analysis from the European Mantle Cell Lymphoma Elderly Trial reported in the Journal of Clinical Oncology, Hoster et al found that outcomes with rituximab maintenance were better in patients aged ≥ 60 years with mantle cell lymphoma who had measurable residual disease (MRD)-negative vs...
Investigators have found that chimeric antigen receptor (CAR) T-cell therapy may be an effective but unaffordable second-line treatment option for patients with relapsed diffuse large B-cell lymphoma (DLBCL), according to a recent study published by Kelkar et al in the Annals of Internal Medicine....
On December 1, the U.S. Food and Drug Administration (FDA) granted accelerated approval to pirtobrutinib (Jaypirca) for adult patients with chronic lymphocytic leukemia or small lymphocytic lymphoma (CLL/SLL) who have received at least two prior lines of therapy, including a Bruton’s tyrosine...
In a retrospective study reported in the Journal of Clinical Oncology, Iacoboni et al found that preapheresis bendamustine exposure was associated with poorer outcomes among patients with relapsed or refractory large B-cell lymphoma receiving CD19-targeted chimeric antigen receptor (CAR) T-cell...
The BTK inhibitor nemtabrutinib may offer a new treatment option for patients with relapsed hematologic malignancies such as chronic lymphocytic leukemia and non-Hodgkin lymphoma, according to a recent study published by Woyach et al in Cancer Discovery. Background Hematologic malignancies are...
Researchers have found that a DNA repair–facilitating mechanism may be responsible for a tumor’s treatment resistance and could be treated with a combination of chemotherapies, according to a recent study published by Marullo et al in Cancer Research. The mechanism involves the shuttling of...
In a retrospective study reported in the Journal of Clinical Oncology, Lewis et al found that prophylactic high-dose methotrexate did not appear to offer a clinically meaningful reduction in risk of central nervous system (CNS) disease progression in patients with high-risk aggressive B-cell...
In the summer of 2012, I was living my dream. At 28 years old, I had gone from an impoverished childhood in South Central Los Angeles to the high life in the city of Los Angeles. Unable to afford to go to college, an after-school program helped launch me into a career in the hospitality industry. I ...
Waldenström’s macroglobulinemia is a rare and incurable low-grade B-cell lymphoproliferative disease defined by specific genotypic subtypes that have implications for treatment response and long-term outcomes. Treatment—and there is no established standard—is mainly focused on controlling symptoms...
My intuition about my health has served me well over the past 10 years, possibly even saving my life from two serious cancers. In 2013, I was diagnosed with follicular lymphoma. I believe that my awareness of changes in my body led to its early discovery. One evening, after exercising at the gym...
In an analysis reported in a letter to the editor in The New England Journal of Medicine, Palmer et al identified evidence that polatuzumab vedotin-piiq–containing regimens were preferentially effective among patients with diffuse large B-cell lymphoma (DLBCL) with activated B cell (ABC) vs...
In a phase I/II study (TRANSCEND CLL 004) reported in The Lancet, Tanya Siddiqi, MD, and colleagues found evidence of activity with the CD19-directed chimeric antigen receptor (CAR) T-cell therapy lisocabtagene maraleucel in patients with relapsed or refractory chronic lymphocytic leukemia...
In a phase II trial (ROSEWOOD) reported in the Journal of Clinical Oncology, Zinzani et al found that the addition of zanubrutinib to obinutuzumab significantly improved objective response rate among patients with relapsed or refractory follicular lymphoma. Study Details In the open-label trial,...
In a study (STOP-CA) reported in JAMA, Neilan et al found that atorvastatin reduced the risk of decreased left ventricular ejection fraction (LVEF) in patients receiving anthracycline-based chemotherapy for the treatment of lymphoma. Study Details In the U.S.-Canadian double-blind trial, 300...
Alexey Danilov, MD, PhD, Co-Director, Toni Stephenson Lymphoma Center and Professor, Division of Lymphoma, Department of Hematology & Hematopoietic Cell Transplantation, City of Hope, Duarte, California, commented on the phase III ALPINE trial comparing ibrutinib and zanubrutinib in patients...
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...
New research has confirmed the superiority of lisocabtagene maraleucel over the standard of care for the second-line treatment of primary refractory or early relapsed large B-cell lymphoma, according to data presented by lead study author Jeremy S. Abramson, MD, Associate Professor of Medicine at...
Julio Chavez, MD, a hematologist at Moffitt Cancer Center, Tampa, Florida, commented on the updated results from the MAGNOLIA trial. “MAGNOLIA was a phase II trial that included patients with marginal zone lymphoma after one or more prior lines of therapy. At the ASH meeting, we heard updated...
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 ...
The addition of nivolumab, an immune checkpoint inhibitor, to chemotherapy significantly improved progression-free survival in adults and children with advanced classical Hodgkin lymphoma with reduced toxicity compared with standard-of-care brentuximab vedotin plus chemotherapy, according to the...
In the primary overall survival analysis of ZUMA-7, second-line treatment with axicabtagene ciloleucel significantly improved overall survival compared with high-dose therapy plus autologous stem cell transplantation (auto-HCT) in patients with early relapsed or refractory large B-cell lymphoma....
Details of the final analysis of the phase III ASPEN trial, which compared zanubrutinib and ibrutinib in symptomatic patients with Waldenström’s macroglobulinemia, were published in the Journal of Clinical Oncology by Meletios A. Dimopoulos, MD, and colleagues. The study supported the September...
Matthew J. Frank, MD, PhD, of Stanford University School of Medicine, discusses new findings showing that CD22 chimeric antigen receptor (CAR) T-cell therapy is an effective and safe salvage therapy for patients with CAR19-refractory large B-cell lymphoma. A multicenter phase II clinical trial is planned for 2023 (Abstract S230).
On June 15, 2023, the bispecific CD20-directed CD3 T-cell engager glofitamab-gxbm was granted accelerated approval for relapsed or refractory diffuse large B-cell lymphoma (DLBCL)–not otherwise specified or large B-cell lymphoma (LBCL) arising from follicular lymphoma after at least two lines of...
ASCO expert Corey Speers, MD, PhD, Professor of Radiation Oncology at the University Hospitals Seidman Cancer Center, Cleveland, provided thoughts on the IELSG37 trial at a press briefing. “The investigators should be congratulated for running the largest ever trial in primary mediastinal B-cell...
In the largest prospective study of patients with primary mediastinal B-cell lymphoma, radiation therapy was omitted in complete responders to immunochemotherapy without compromising outcomes. These findings were presented at the 2023 ASCO Annual Meeting.1 “Mediastinal radiotherapy may be safely...
This is Part 3 of Clinical Advances in Diffuse Large B-Cell Lymphoma, a three-part video roundtable series. Scroll down to watch the other videos from this Roundtable. In this video, Drs. Jeremy Abramson, Laurie Sehn, and Kieron Dunleavy discuss the third-line treatment of relapsed/refractory diffuse large B-cell lymphoma (DLBCL). Their patient was most recently treated with axicabtagene ciloleucel as second-line treatment for DLBCL, non–germinal center subtype, which had originally relapsed 11 months after treatment with pola-R-CHP. She develops grade 2 cytokine-release syndrome on day 2 of treatment with axicabtagene ciloleucel, but her symptoms resolve rapidly upon receiving tocilizumab. She develops confusion on day 4, consistent with grade 2 ICANS, for which she receives dexamethasone with improvement over 7 days. She has a very good partial response at 30 days, but at day 60 her disease progresses again. As they consider the next steps for this patient, the faculty discuss the importance of tailoring treatment to the patient’s needs and goals when therapy is unlikely to be curative. They review current novel therapies that have entered the treatment landscape, including combinations such as polatuzumab plus bendamustine/rituximab, as well as the recently approved bispecific antibodies glofitamab and epcoritamab.
This is Part 2 of Clinical Advances in Diffuse Large B-Cell Lymphoma, a three-part video roundtable series. Scroll down to watch the other videos from this Roundtable. In this video, Drs. Jeremy Abramson, Laurie Sehn, and Kieron Dunleavy discuss the second-line treatment of relapsed/refractory diffuse large B-cell lymphoma (DLBCL). Their patient is now 73 years of age and originally received pola-R-CHP for her DLBCL. Eleven months after completing treatment, she experiences biopsy-proven relapse involving nodes above and below the diaphragm and multifocal bone involvement. The faculty review their next steps in the second-line setting. They discuss considerations when selecting among CAR T-cell products, the logistics of CAR T-cell therapy and approaches to bridging therapy, as well as options for second-line therapy for patients who are not eligible for CAR T-cell therapy.
This is Part 1 of Clinical Advances in Diffuse Large B-Cell Lymphoma, a three-part video roundtable series. Scroll down to watch the other videos from this Roundtable. In this video, Drs. Jeremy Abramson, Laurie Sehn, and Kieron Dunleavy discuss the treatment of newly diagnosed high-risk diffuse large B-cell lymphoma (DLBCL). The patient is a 72-year-old woman who presents with adenopathy, fevers, and drenching night sweats. An axillary lymph node biopsy reveals DLBCL, non–germinal center B-cell subtype, without translocations of MYC or BCL2, but with IHC expression. Positron-emission tomography/computed tomography shows stage IV disease with liver and kidney involvement. Her LDH is elevated, ECOG performance status is 1, and International Prognostic Index is 4. In the conversation that follows, the faculty discuss their recommended chemotherapy regimen for patients such as this, whether there are patient- or disease-specific factors to consider when selecting between R-CHOP and Pola-R-CHP, and the role of CNS prophylaxis.
As reported in The New England Journal of Medicine by Jason R. Westin, MD, and colleagues, the overall survival analysis from the phase III ZUMA-7 trial showed significant benefit with axicabtagene ciloleucel vs standard care in patients with early relapsed or refractory large B-cell lymphoma. The...
In the phase I/II BRUIN trial reported in The New England Journal of Medicine, Anthony R. Mato, MD, and colleagues found that the noncovalent (reversible) Bruton’s tyrosine kinase (BTK) inhibitor pirtobrutinib exhibited strong activity in patients with relapsed or refractory chronic lymphocytic...
On May 19, 2023, epcoritamab-bysp was granted accelerated approval by the U.S. Food and Drug Administration for treatment of relapsed or refractory diffuse large B-cell lymphoma (DLBCL)–not otherwise specified, including DLBCL arising from indolent lymphoma, and high-grade B-cell lymphoma after two ...
In the primary overall survival analysis of ZUMA-7, second-line treatment with axicabtagene ciloleucel significantly improved overall survival compared with high-dose therapy plus autologous stem cell transplantation (auto-HCT) in patients with early relapsed or refractory large B-cell lymphoma....
The addition of nivolumab, an immune checkpoint inhibitor, to chemotherapy significantly improved progression-free survival in adults and children with advanced classical Hodgkin lymphoma with reduced toxicity compared with standard-of-care brentuximab vedotin plus chemotherapy, according to the...
Researchers have found that repeated COVID-19 vaccination may increase the vaccine’s effectiveness at preventing the infections in patients with lymphoma, particularly after four doses, according to a new study published by Wijaya et al in The Lancet. Background Patients with lymphoma often have...
This is Part 3 of Clinical Advances in Mantle Cell Lymphoma, a three-part video roundtable series. Scroll down to watch the other videos from this Roundtable. In this video, Drs. Brad Kahl, Jonathon Cohen, and Peter Martin discuss the second-line treatment of relapsed/refractory mantle cell lymphoma. The patient is a 76-year-old man with a history of mantle cell lymphoma who received bendamustine/rituximab followed by rituximab maintenance 5 years prior for advanced-stage disease. His recurrence was detected recently by physical exam with new axillary and cervical adenopathy; he has normal blood counts, and there is no bone marrow involvement. PET scan imaging shows several sites of nodal involvement plus splenic involvement, his performance status is 0, and he has no major comorbidities. The faculty discuss next steps for this patient, including the importance of repeat biopsies for patients with relapsed/refractory disease. They review major treatment options in the second line, particularly the role of BTK inhibitors and CAR T-cell therapy.
This is Part 2 of Clinical Advances in Mantle Cell Lymphoma, a three-part video roundtable series. Scroll down to watch the other videos from this Roundtable. In this video, Drs. Brad Kahl, Jonathon Cohen, and Peter Martin discuss the management of newly diagnosed mantle cell lymphoma in older patients. The patient is a 74-year-old man who presents to the clinic for the evaluation of worsening back pain. Computed tomography shows bulky retroperitoneal and mesenteric adenopathy, which leads to a biopsy that revealed mantle cell lymphoma (cyclin D1 positive) with a Ki-67 of 15%. He has extensive disease on PET imaging, with 20% marrow involvement and a high-intermediate MIPI-C score. The faculty discuss what their initial treatment considerations would be for this patient, and how a p53 mutation might change their strategy. They also discuss a recent real-world analysis showing the benefit of maintenance rituximab after both R-CHOP and bendamustine/rituximab, as well as the SHINE study of ibrutinib added to standard therapy in newly diagnosed older patients with mantle cell lymphoma.
This is Part 1 of Clinical Advances in Mantle Cell Lymphoma, a three-part video roundtable series. Scroll down to watch the other videos from this Roundtable. In this video, Drs. Brad Kahl, Jonathon Cohen, and Peter Martin discuss the management of newly diagnosed mantle cell lymphoma in younger patients. The patient is a 54-year-old man who presents with inguinal lymphadenopathy and increasing fatigue. He has widespread adenopathy in the 3-4 cm range, and the spleen tip is palpable. Lymph node biopsy shows classic mantle cell lymphoma with Ki-67 of 35%; PET imaging shows involvement of most nodal regions with some bladder compression; and bone marrow biopsy shows 40% mantle cell lymphoma involvement, but no 17p deletion of p53 mutation. The patient is classified as low-intermediate risk on MIPI-C. The faculty discuss the next steps for this patient in light of the changing treatment landscape for mantle cell lymphoma in younger individuals. They consider whether a watch-and-wait approach might be appropriate, the role of novel agents in induction regimens, and treatment de-intensification strategies.
In an analysis reported in JAMA Network Open, Phillips et al found that adult survivors of childhood cancer were at an increased risk of new-onset memory impairment vs their siblings. Modifiable factors associated with increased risk of impairment among survivors were identified. Study Details The...