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lymphoma

Manali K. Kamdar, MD, on Primary Refractory and Early Relapsing DLBCL: Therapeutic Options

Manali K. Kamdar, MD, of University of Colorado Hospital, discusses the treatment landscape for the 30% to 40% of patients with diffuse large B-cell lymphoma (DLBCL) whose disease will relapse. Patients who experience relapse within 1 year of chemoimmunotherapy have poor outcomes with autotransplantation, but chimeric antigen receptor T-cell therapy has shown efficacy and manageable toxicity.

lymphoma

Tycel J. Phillips, MD, and Alex F. Herrera, MD, on Classical Hodgkin Lymphoma: New Data on Nivolumab, AVD, and Brentuximab Vedotin

Tycel J. Phillips, MD, and Alex F. Herrera, MD, both of the City of Hope National Medical Center, discuss results from the SWOG S1826 study, which showed that nivolumab and AVD (doxorubicin, vinblastine, and dacarbazine) improved progression-free survival vs brentuximab vedotin plus AVD in patients with advanced-stage classical Hodgkin lymphoma. Longer follow-up is needed to assess overall survival and patient-reported outcomes. This trial may be a key step toward harmonizing the pediatric and adult treatment of advanced-stage disease (LBA4).

lymphoma

Tycel J. Phillips, MD, and Alex F. Herrera, MD, on DLBCL: New Data on ctDNA Status and Clinical Outcomes

Tycel J. Phillips, MD, and Alex F. Herrera, MD, both of the City of Hope National Medical Center, discuss findings from the POLARIX study, which provided the largest prospectively collected circulating tumor DNA (ctDNA) data set on patients with previously untreated diffuse large B-cell lymphoma. Achieving ctDNA-negative status was associated with improved outcomes when patients were treated with polatuzumab vedotin-piiq plus combination chemotherapy vs combination chemotherapy alone (Abstract 7523).

Lymphoma
Immunotherapy

Nivolumab May Reduce Risk of Disease Progression or Death in Previously Untreated Patients With Hodgkin Lymphoma Compared to Brentuximab Vedotin

The immune checkpoint inhibitor nivolumab plus chemotherapy significantly reduced the risk of disease progression and disease-related death compared with standard treatment with the CD30-targeted drug brentuximab vedotin plus chemotherapy in pediatric and adult patients with previously untreated...

lymphoma

Muhit Özcan, MD, on DLBCL: Now Recruiting Previously Untreated Patients for a Study of Zilovertamab Vedotin Plus Chemotherapy

Muhit Özcan, MD, of Turkey’s Ankara University School of Medicine, discusses waveLINE-007, a two-part study now recruiting in more than 20 locations, to determine the safety and recommended phase II dose of the antibody-drug conjugate zilovertamab vedotin in combination with R-CHP (rituximab, cyclophosphamide, doxorubicin, prednisone) in previously untreated patients with diffuse large B-cell lymphoma (DLBCL). Efficacy of this regimen will be investigated in the second half of the study (Abstract TPS7589).

lymphoma

Muhit Özcan, MD, on DLBCL: Early Results on Zilovertamab Vedotin

Muhit Özcan, MD, of Turkey’s Ankara University School of Medicine, discusses phase II findings from the waveLINE-004 study. It showed that the antibody-drug conjugate zilovertamab vedotin had clinically meaningful antitumor activity in patients with relapsed or refractory diffuse large B-cell lymphoma (DLBCL) who experienced disease progression after, or have been ineligible for, autologous stem cell transplantation and/or chimeric antigen receptor T-cell therapy (Abstract 7531).

Lymphoma

I Was Unprepared for a Diagnosis of Mantle Cell Lymphoma

The irony is not missed on me. In August 2022, 2 months before I was to start my tenure as President of the Union for International Cancer Control (UICC), I was diagnosed with mantle cell lymphoma. My entire career over the past 30 years has been in the pursuit of improving global cancer control...

Leukemia
Lymphoma

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, Drs. Syed Ali Abutalib and L. Jeffrey Medeiros explore the World Health Organization (WHO) classification of hematopoietic and lymphoid tissue...

Lymphoma

FDA Grants Accelerated Approval to Epcoritamab-bysp for Relapsed or Refractory B-Cell Lymphoma

On May 19, the U.S. Food and Drug Administration (FDA) granted accelerated approval to the bispecific CD20-directed CD3 T-cell engager epcoritamab-bysp (Epkinly) for patients with relapsed or refractory diffuse large B-cell lymphoma (DLBCL)–not otherwise specified, including DLBCL arising from...

Lymphoma

Adding Azacitidine to Standard Chemotherapy May Be Effective for Patients With PTCL-TFH

Researchers have found that azacitidine may be capable of increasing the effectiveness of chemotherapy and aiding nearly 90% of patients who had peripheral T-cell lymphoma with the T follicular helper cell phenotype (PTCL-TFH) achieve remission, according to a novel study published by Ruan et al in ...

Lymphoma

Does Stem Cell Transplantation Extend Survival in Patients With Advanced Cutaneous T-Cell Lymphomas?

In a French study (CUTALLO) reported in The Lancet, de Masson et al found that patients with advanced-stage cutaneous T-cell lymphomas who were able to undergo allogeneic hematopoietic stem cell transplantation (HSCT) had prolonged progression-free survival vs matched patients receiving...

Lymphoma

Subcutaneous vs Intravenous Rituximab in First-Line Treatment of Low–Tumor Burden Follicular Lymphoma

In a French phase III trial (FLIRT) reported in the Journal of Clinical Oncology, Cartron et al found that the use of subcutaneous (SC) vs intravenous (IV) rituximab was associated with improved progression-free survival in the first-line treatment of low–tumor burden follicular lymphoma. Study...

Lymphoma

Are Patients With Inflammatory Bowel Disease at Increased Risk for Developing Lymphoma?

Patients with inflammatory bowel disease (IBD) may be at an increased risk for developing lymphoma, a risk that has increased in patients with Crohn’s disease in recent years, according to a new study published by Olén et al in Clinical Gastroenterology and Hepatology. The new findings revealed...

lymphoma

Third-Line Treatment of Follicular Lymphoma

This is Part 3 of Advances in Follicular Lymphoma, a three-part video roundtable series. Scroll down to watch the other videos from this Roundtable.   In this video, Drs. Stephen M. Ansell, Loretta J. Nastoupil, and Gilles Salles discuss the third-line treatment of follicular lymphoma. The patient is a 58-year-old man with multiply relapsed follicular grade 1/2 non-Hodgkin lymphoma. He was initially diagnosed 3 years ago and received R-CHOP chemotherapy for six cycles followed by maintenance rituximab. Six months after completion of maintenance therapy, he had evidence of disease progression and received rituximab plus lenalidomide. Four months later, he again has evidence of disease progression, and a repeat biopsy confirms residual follicular grade 1/2 non-Hodgkin lymphoma without evidence of large-cell transformation.   The faculty discuss the role of genetic testing in deciding next steps for patients such as this, how to choose between chimeric antigen receptor T-cell therapy and treatment with bispecific antibodies, and considerations in treatment sequencing.

lymphoma

Recurrent Follicular Lymphoma

This is Part 2 of Advances in Follicular Lymphoma, a three-part video roundtable series. Scroll down to watch the other videos from this Roundtable.   In this video, Drs. Stephen M. Ansell, Loretta J. Nastoupil, and Gilles Salles discuss the management of recurrent follicular lymphoma. The patient is a 62-year-old man who was initially diagnosed with stage IVA follicular grade 1/2 non-Hodgkin lymphoma 18 months ago. He received bendamustine plus rituximab for six cycles and achieved a complete response, and did not receive maintenance therapy. Over the past 6 weeks, he has noticed an enlarging lymph node in his axilla, and a rebiopsy shows recurrent follicular grade 1/2 non-Hodgkin lymphoma. There is no involvement of large-cell transformation, and a restaging evaluation shows multiple sites of lymphadenopathy in the chest and abdomen; repeat bone marrow aspirate and biopsy shows 20% involvement by follicular lymphoma.    The faculty discuss the prognostic impact of early relapse, potential ways to identify patients in this high-risk group up front, the importance of re-biopsy to exclude transformation to large cell lymphoma, and the available second-line treatment options.

lymphoma

Newly Diagnosed Follicular Lymphoma

This is Part 1 of Advances in Follicular Lymphoma, a three-part video roundtable series. Scroll down to watch the other videos from this Roundtable.   In this video, Drs. Stephen M. Ansell, Loretta J. Nastoupil, and Gilles Salles discuss the management of newly diagnosed follicular lymphoma. The patient is a 64-year-old woman with increased lymphadenopathy in the neck, axillae, mediastinum, and retroperitoneum; the lymph nodes in the retroperitoneum have amalgamated to form an 8-cm mass. A biopsy of a cervical lymph node shows follicular grade 1/2 non-Hodgkin lymphoma, with 30% involvement by follicular lymphoma. The patient has an ECOG performance status of 1.   The faculty discuss the current indications for treatment of newly diagnosed follicular lymphoma, reviewing GELF criteria, the importance of prognostic and predictive factors such as FLIPI and FLIPI2, and the available first-line treatment options.

Lymphoma
Immunotherapy

Sugemalimab in Relapsed or Refractory Extranodal Natural Killer/T-Cell Lymphoma

In a Chinese phase II study (GEMSTONE-201) reported in the Journal of Clinical Oncology, Huang et al found that the PD-L1 inhibitor sugemalimab produced durable responses in patients with relapsed or refractory extranodal natural killer/T-cell lymphoma. Study Details In the multicenter trial, 78...

Lymphoma
Immunotherapy

FDA Approves Polatuzumab Vedotin-piiq Plus R-CHP for Previously Untreated DLBCL–Not Otherwise Specified and High-Grade B-Cell Lymphoma

On April 19, the U.S. Food and Drug Administration (FDA) approved the antibody-drug conjugate polatuzumab vedotin-piiq (Polivy) with a rituximab product, cyclophosphamide, doxorubicin, and prednisone (R-CHP) for previously untreated adult patients who have diffuse large B-cell lymphoma (DLBCL)–not...

Lymphoma

Update on Withdrawal of Ibrutinib Accelerated Approvals for MCL and MZL in the United States

AbbVie announced that it intends to voluntarily withdraw, in the United States, accelerated ibrutinib (Imbruvica) approvals for patients with mantle cell lymphoma (MCL) who have received at least one prior therapy as well as patients with marginal zone lymphoma (MZL) who require systemic therapy...

Lymphoma

Addition of Bortezomib to R-CHOP in Patients With DLBCL According to Molecular Subgroups: 5-Year Follow-up of the REMoDL-B Study

In a 5-year analysis of the UK/Swiss phase III REMoDL-B trial reported in the Journal of Clinical Oncology, Davies et al found that the addition of bortezomib to R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisolone; RB-CHOP) as initial treatment was associated with...

Lymphoma

Pirtobrutinib for Relapsed or Refractory Mantle Cell Lymphoma

On January 27, 2023, pirtobrutinib was granted accelerated approval for treatment of relapsed or refractory mantle cell lymphoma after at least two lines of systemic therapy, including a Bruton’s tyrosine kinase (BTK) inhibitor.1 Pirtobrutinib is a noncovalent inhibitor of BTK. Supporting Efficacy...

lymphoma

Alex F. Herrera, MD, on Previously Untreated DLBCL: Circulation Tumor DNA and Risk Profiling

Alex F. Herrera, MD, of the City of Hope National Medical Center, discusses results from the POLARIX study, which showed that circulating tumor DNA (ctDNA) analysis has prognostic value for patients with previously untreated diffuse large B-cell lymphoma. Patients who did not achieve 2.5 or greater log-fold change and/or did not have ctDNA clearance following one cycle of polatuzumab vedotin along with rituximab, cyclophosphamide, doxorubicin, and prednisone had inferior outcomes than those who did. Early changes in ctDNA levels may be of use in risk-adapted trial designs to identify patients in need of alternative treatment. (Abstract 542).

Lymphoma
Immunotherapy

Pembrolizumab Plus Ifosfamide, Carboplatin, and Etoposide in Relapsed or Refractory Classical Hodgkin Lymphoma

In a phase II trial reported in JAMA Oncology, Locke J. Bryan, MD, and colleagues found that the combination of pembrolizumab with ICE chemotherapy (a regimen including ifosfamide, carboplatin, and etoposide) produced a high rate of complete response in patients with relapsed or refractory...

Lymphoma
Issues in Oncology

Gut Microbiome May Influence How Patients With Non-Hodgkin Lymphoma Respond to CAR T-Cell Therapy

Researchers have revealed how microorganisms in the gut may influence the outcomes of patients with non-Hodgkin lymphoma undergoing chimeric antigen receptor (CAR) T-cell therapy, according to a study published by Stein-Thoeringer et al in Nature Medicine. Background Microorganisms live in or on...

Lymphoma

Omission of Radiotherapy in Children and Adolescents With Early-Stage Classical Hodgkin Lymphoma With Adequate Response to OEPA Chemotherapy

As reported in The Lancet Oncology by Mauz-Körholz et al, children and adolescents with early-stage classical Hodgkin lymphoma enrolled in the EuroNet-PHL-C1 study who had an adequate response to an OEPA chemotherapy regimen (vincristine, etoposide, prednisone, and doxorubicin) and did not receive...

Lymphoma
Immunotherapy

Axicabtagene Ciloleucel in Refractory Large B-Cell Lymphoma: 5-Year Results of the ZUMA-1 Trial

As reported in the journal Blood by Sattva S. Neelapu, MD, and colleagues, 5-year outcomes from the the phase II ZUMA-1 trial showed that axicabtagene ciloleucel was associated with maintained response in one-third of patients with refractory large B-cell lymphoma. The estimated 5-year overall...

Leukemia
Lymphoma

Zanubrutinib for Chronic Lymphocytic Leukemia or Small Lymphocytic Lymphoma

On January 19, 2023, the kinase inhibitor zanubrutinib was approved for treatment of chronic lymphocytic leukemia (CLL) or small lymphocytic lymphoma (SLL).1 Supporting Efficacy Data Approval was based on findings in the SEQUOIA trial (ClinicalTrials.gov identifier NCT03336333) in patients with...

Lymphoma

Have We Reached the Limits of Chemotherapy for Burkitt Lymphoma?

Burkitt lymphoma (BL) is a fascinating disease from which many groundbreaking medical and oncologic lessons have been learned. Since the Irish surgeon Denis P. Burkitt, MD, FRCS, FRS, first described rapidly enlarging jaw and facial tumors in Ugandan children in 1958,1 the study of BL has led to...

Lymphoma
Genomics/Genetics

Whole-Genome Sequencing May Illuminate the Genetic Evolution of Classical Hodgkin Lymphoma

Researchers have discovered that whole-genome sequencing—rather than the current standard of exome sequencing—may allow physicians to better identify genetic changes that drive cancer development and growth, and create the most effective, personalized treatment plans for patients with classical...

Lymphoma

Addition of Bortezomib to First-Line Dexamethasone, Rituximab, and Cyclophosphamide for Waldenström’s Macroglobulinemia

As reported in the Journal of Clinical Oncology by Buske et al, the European Consortium for Waldenström’s Macroglobulinemia (ECWM)-1 study has shown a numeric benefit in progression-free survival with the addition of bortezomib to dexamethasone, rituximab, and cyclophosphamide (DRC; B-DRC) in the...

Lymphoma
Immunotherapy

Brexucabtagene Autoleucel in Relapsed or Refractory Mantle Cell Lymphoma in Standard-of-Care Practice

In an analysis from the U.S. Lymphoma CAR T Consortium reported in the Journal of Clinical Oncology, Wang et al found that standard-of-care treatment with brexucabtagene autoleucel in relapsed or refractory mantle cell lymphoma since its approval in this setting has been associated with response...

Breast Cancer
Lymphoma

Association of Anthracycline Use With Risk of Congestive Heart Failure Among Patients Treated for Breast Cancer or Lymphoma

In a retrospective, population-based, case-control study reported in JAMA Network Open, Larsen et al found that patients receiving anthracyclines for breast cancer or lymphoma were at a significantly elevated risk of congestive heart failure vs noncancer controls. No significant difference in risk...

Lymphoma

Complete Response to Glofitamab at End of Treatment Heralds Prolonged Remission in Lymphoma

Patients with large B-cell lymphoma who achieve a complete response to glofitamab are very likely to remain in remission 12 months after the end of treatment, according to Martin Hutchings, MD, PhD, of Rigshospitalet in Copenhagen, who reported these findings at the 2022 American Society of...

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

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

CAR T-Cell Therapy vs Chemoimmunotherapy in Second-Line Treatment of Resistant Large B-Cell Lymphoma

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...

Lymphoma

Expert Point of View: Julio Chavez, MD

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...

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

Expert Point of View: Alexey Danilov, MD, PhD

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...

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...

Survivorship
Lymphoma

Dietary Intervention May Help Reduce Chronic Fatigue, Improve Quality of Life for Cancer Survivors

Researchers have discovered that dietary interventions may help reduce fatigue, improve diet quality, and lead to an overall better quality of life for cancer survivors, according to a new study published by Weinhold et al in Nutrition and Cancer.  Background For many cancer survivors, the side...

Lymphoma

Mosunetuzumab-axgb for Relapsed or Refractory Follicular Lymphoma

On December 22, 2022, mosunetuzumab-axgb, a bispecific CD20-directed CD3 T-cell engager, was granted accelerated approval for adults with relapsed or refractory follicular lymphoma after two or more lines of systemic therapy.1 Supporting Efficacy Data Approval was based on findings in the...

Lymphoma

Complete Response to Glofitamab at End of Treatment Heralds Prolonged Remission in Lymphoma

Patients with large B-cell lymphoma who achieve a complete response to glofitamab are very likely to remain in remission 12 months after the end of treatment, according to Martin Hutchings, MD, PhD, of Rigshospitalet in Copenhagen, who reported these findings at the 2022 American Society of...

Lymphoma

CAR T-Cell Therapy vs Chemoimmunotherapy in Second-Line Treatment of Resistant Large B-Cell Lymphoma

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...

Issues in Oncology
Lymphoma
Leukemia
Cardio-oncology

Findings on Cardiovascular Imaging in Patients Receiving Ibrutinib: Association With Cardiotoxicity

In a study reported in JAMA Oncology, Buck et al found that myocardial injury detected on cardiovascular magnetic resonance imaging (CMR) was common in patients treated with ibrutinib and was associated with an increased risk of major adverse cardiac events. Study Details The study included data...

Colorectal Cancer
Lymphoma
Survivorship

Association of Radiation and Procarbazine Dose With Risk of Colorectal Cancer in Survivors of Hodgkin Lymphoma

In a Dutch study reported in JAMA Oncology, Geurts et al found a dose-response relationship between radiotherapy and risk of colorectal cancer among survivors of Hodgkin lymphoma, with the risk being increased with increasing procarbazine dose. Study Details The nested case-control study included...

Survivorship
Leukemia
Lymphoma
Sarcoma

Dexrazoxane and Long-Term Heart Function in Survivors of Childhood Cancer Treated With Doxorubicin

In a study reported in the Journal of Clinical Oncology, Eric J. Chow, MD, MPH, and colleagues found that the use of dexrazoxane was associated with long-term protection of heart function in childhood cancer survivors who received doxorubicin for their cancer. According to the study investigators,...

Sarcoma
Solid Tumors
Lymphoma

MDM2 Inhibitor Milademetan in Advanced Liposarcoma, Solid Tumors, or Lymphomas

In a first-in-human, phase I, dose-escalation and dose-expansion study reported in the Journal of Clinical Oncology, Mrinal M. Gounder, MD, and colleagues identified the dose and schedule for further evaluation of the oral MDM2 inhibitor milademetan in a population of patients with advanced...

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...

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