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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).

leukemia
lymphoma

Paolo Ghia, MD, PhD, on CLL/SLL and Ibrutinib Plus Venetoclax: A Primary Analysis of the CAPTIVATE Trial

Paolo Ghia, MD, PhD, of the Università Vita-Salute San Raffaele, discusses phase II results from the CAPTIVATE study, which examined ibrutinib plus venetoclax as a fixed-duration first-line treatment in patients with chronic lymphocytic leukemia/small lymphocytic lymphoma (Abstract 7501).

Lymphoma
Immunotherapy

Phase II Study of Naratuximab Emtansine Plus Rituximab in DLBCL

Adding the antibody-drug conjugate naratuximab emtansine to rituximab resulted in favorable overall survival and complete response rates for patients with relapsed or refractory diffuse large B-cell lymphoma (DLBCL), with a manageable safety profile. These findings from a phase II study were...

Issues in Oncology
Lymphoma
Leukemia
Kidney Cancer
CNS Cancers

Study Explores Incidence Rates for Various Pediatric Cancers Across Age and Racial Groups

New research has uncovered substantial differences in the rates of childhood cancers when considering a single year of age rather than grouping several years together. The study, published by Marcotte et al in the journal Cancer, also found that minority children seem to have different risks than...

Leukemia
Lymphoma

Ibrutinib/Venetoclax vs Chlorambucil/Obinutuzumab in Previously Untreated Older Patients With CLL/SLL

In a primary analysis of the phase III GLOW study, a once-daily, all-oral, fixed-duration dose of ibrutinib and venetoclax for chronic lymphocytic leukemia (CLL)/small lymphocytic lymphoma (SLL) resulted in superior progression-free survival than treatment with chlorambucil and obinutuzumab. Arnon...

Leukemia
Lymphoma

Zanubrutinib vs Ibrutinib in Relapsed/Refractory CLL/SLL: ALPINE Trial

Zanubrutinib—a second-generation Bruton's tyrosine kinase (BTK) inhibitor—significantly improved response rates and delayed disease progression as compared to the standard of care, ibrutinib, in patients with relapsed or refractory chronic lymphocytic leukemia or small lymphocytic lymphoma...

Lymphoma
Immunotherapy

Axicabtagene Ciloleucel Demonstrates Improvement Across Multiple Endpoints in Relapsed or Refractory Follicular Lymphoma

In the treatment of relapsed/refractory follicular lymphoma, a comparison of data from the ZUMA-5 trial with those of the external control cohort of the SCHOLAR-5 trial showed substantial improvement in all clinical endpoints with axicabtagene ciloleucel. John G. Gribben, DSc, FRCP, FRCPath,...

lymphoma

Ann S. LaCasce, MD, on Hodgkin Lymphoma: PET-Adapted Therapy for Bulky Disease

Ann S. LaCasce, MD, of Dana-Farber Cancer Institute, discusses results from the CALGB 50801 Alliance study, which showed that a PET scan–adapted approach may reduce the need for radiation treatment and may improve progression-free outcomes in patients with stage I/II bulky classic Hodgkin lymphoma (Abstract 7507).

Lymphoma

Addition of Copanlisib to Rituximab Improves Progression-Free Survival in Relapsed Indolent Non-Hodgkin Lymphoma

As reported in The Lancet Oncology by Matthew J. Matasar, MD, of Memorial Sloan Kettering Cancer Center, and colleagues, the phase III CHRONOS-3 trial has shown that the addition of the pan-class I PI3K inhibitor copanlisib to rituximab significantly improved progression-free survival vs rituximab ...

Lymphoma

Adding Targeted Agent to Treatment Shows Significant Benefits in Pediatric Patients With High-Risk Hodgkin Lymphoma

Integrating the antibody-drug conjugate brentuximab vedotin into the front-line treatment of pediatric patients with high-risk Hodgkin lymphoma “facilitated significant reduction in radiation exposure and yielded excellent outcomes,” Monika Metzger, MD, MSc, Director for the Central and South...

Lymphoma
Immunotherapy

Lisocabtagene Maraleucel for Relapsed or Refractory Large B-Cell Lymphoma

On February 5, 2021, lisocabtagene maraleucel was approved for the 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 (DLBCL) not otherwise specified (including DLBCL arising from...

Lymphoma

Pembrolizumab as Long-Term Treatment Option in Relapsed or Refractory Classical Hodgkin Lymphoma

For patients with relapsed or refractory classic Hodgkin lymphoma (HL), salvage chemotherapy followed by autologous hematopoietic stem cell transplant (HSCT) is the standard of care and can induce long-term remissions in at least 60% of patients.1,2 Patients with progression of disease after...

Lymphoma

Pembrolizumab Improves Progression-Free Survival vs Brentuximab Vedotin in Relapsed or Refractory Classic Hodgkin Lymphoma

As reported in The Lancet Oncology by John Kuruvilla, MD, of Princess Margaret Cancer Centre, Toronto, and colleagues, an interim analysis of the phase III KEYNOTE-204 trial has shown significantly improved progression-free survival with pembrolizumab vs brentuximab vedotin in patients with...

Lymphoma
Lung Cancer

FDA Pipeline: Applications Accepted for Marginal Zone Lymphoma and Lung Cancer

Recently, the U.S. Food and Drug Administration (FDA) granted Priority Review to zanubrutinib in pretreated patients with marginal zone lymphoma, and accepted a biologics license application for sintilimab injection in combination with pemetrexed and platinum chemotherapy for the first-line...

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