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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...
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...
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...
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,...
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...
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...
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...
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 ...
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 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...
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...
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 ...
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...
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...
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). ...
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...
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). ...
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...
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...
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...