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Jennifer L. Crombie, MD, of Dana-Farber Cancer Institute, discusses the historically poor outcomes for patients with relapsed or refractory diffuse large B-cell lymphoma (DLBCL). Her study examined real-world data on the use of novel therapies in this population and found that outcomes with second- and third-line regimens of polatuzumab vedotin-piiq plus bendamustine and rituximab and tafasitamab plus lenalidomide remain suboptimal, with worse outcomes particularly after chimeric antigen receptor T-cell therapy (Abstract 7552).
Nirav N. Shah, MD, of the Medical College of Wisconsin, discusses the efficacy and safety of pirtobrutinib, a highly selective, noncovalent BTK inhibitor, studied for more than 3 years in the BRUIN trial. The results showed that the use of pirtobrutinib continues to have durable efficacy and a favorable safety profile in heavily pretreated patients with relapsed or refractory mantle cell lymphoma and prior BTK inhibitor therapy. Responses were observed in patients with high-risk disease features, including blastoid/pleomorphic variants, elevated Ki67 index, and TP53 mutations (Abstract 7514).
Nirav N. Shah, MD, of the Medical College of Wisconsin, discusses the efficacy and safety of pirtobrutinib, a highly selective, noncovalent BTK inhibitor, studied for more than 3 years in the BRUIN trial. The results showed that the use of pirtobrutinib continues to have durable efficacy and a favorable safety profile in heavily pretreated patients with relapsed or refractory mantle cell lymphoma and prior BTK inhibitor therapy. Responses were observed in patients with high-risk disease features, including blastoid/pleomorphic variants, elevated Ki67 index, and TP53 mutations (Abstract 7514).
Nirav N. Shah, MD, of the Medical College of Wisconsin, discusses phase II results showing that split-dose R-CHOP offers older patients with diffuse large B-cell lymphoma (DLBCL) an equivalent dose intensity as R-CHOP-21 through a fractionated dosing schedule, improving tolerability. At the end of treatment for these older patients, a complete response rate of 71% was comparable to outcomes with R-CHOP in younger patients with the disease (Abstract 7554).
Catherine C. Coombs, MD, of the University of California, Irvine, discusses prolonged pirtobrutinib therapy, which continues to demonstrate a safety profile amenable to long-term administration at the recommended dose without evidence of new or worsening toxicity signals. The safety and tolerability observed in patients on therapy for 12 months or more were similar to previously published safety analyses of all patients enrolled, regardless of follow-up (Abstract 7513).
Tycel J. Phillips, MD, and Swetha Kambhampati, MD, both of City of Hope National Medical Center, discuss new findings showing that the real-world effectiveness and safety of brexucabtagene autoleucel were similar to data from the pivotal ZUMA-2 trial in patients with relapsed or refractory mantle cell lymphoma, regardless of prior BTK inhibition, bendamustine, or autologous stem cell transplantation (Abstract 7507).
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.
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).
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).
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...
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).
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).
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...
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...
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...
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 ...
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...
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...
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...
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.
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.
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.
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...
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...
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...
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...
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...
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).
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...
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...
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...
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...
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...
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...
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...
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...
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...
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...
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...
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). ...
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...
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 ...
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...
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...
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...
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...
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...