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Joe Schroers-Martin, MD, of Stanford University, discusses his latest study findings, which show that follicular lymphoma driver mutations are detectable in blood and saliva years prior to a clinical diagnosis. These data build on previous work and suggest that researchers may be able to stratify people at elevated risk of clinical malignancy (Abstract 709).
In the phase III POLARIX trial reported in The New England Journal of Medicine, Tilly et al found that polatuzumab vedotin-piiq plus R-CHP (rituximab, cyclophosphamide, doxorubicin, and prednisone) significantly improved progression-free survival vs R-CHOP (rituximab, cyclophosphamide, doxorubicin, ...
As reported in The New England Journal of Medicine by Bishop et al, the phase III BELINDA trial showed no improvement in event-free survival with second-line tisagenlecleucel vs standard of care including salvage chemotherapy and autologous hematopoietic stem cell transplantation (HSCT) in patients ...
In a single-center retrospective study reported in the Journal of Clinical Oncology, Shouval et al found that the presence of TP53 alterations was associated with poorer outcomes in patients treated with CD19-targeted chimeric antigen receptor (CAR) T-cell therapy (CD19–CAR-T) for relapsed or...
Roni Shouval, MD, PhD, of Memorial Sloan Kettering Cancer Center, discusses his findings, which show, for the first time, that TP53 alterations are a valuable prognostic and potentially predictive marker in patients with large B-cell lymphoma who receive CD19–CAR T-cell therapy. Gene-expression profiling suggests that TP53 alterations result in an immunosuppressive tumor microenvironment and impaired apoptosis signaling, which could lead to decreased CAR T-cell therapy efficacy (Abstract 710).
Michael R. Bishop, MD, of the University of Chicago, discusses insights from findings of the phase III BELINDA study, which may inform the design of future CAR T-cell trials, as well as the use of second-line tisagenlecleucel therapy in patients with relapsed or refractory aggressive B-cell non-Hodgkin lymphoma (Abstract LBA-6).
As reported in The Lancet Oncology by Caron A. Jacobson, MD, and colleagues, the phase II ZUMA-5 trial showed that axicabtagene ciloleucel, an autologous anti-CD19 chimeric antigen receptor (CAR) T-cell therapy, produced high rates of durable responses in patients with relapsed or refractory...
The POLARIX study found patients with diffuse large B-cell lymphoma (DLBCL) had a significantly higher likelihood of survival without disease progression 2 years after receiving a new drug combination known as pola-R-CHP (polatuzumab vedotin-piiq with rituximab, cyclophosphamide, doxorubicin, and...
In an analysis of the phase III BELINDA trial presented by Bishop et al during the 2021 American Society of Hematology (ASH) Annual Meeting & Exposition (Abstract LBA-6), the chimeric antigen receptor (CAR) T-cell therapy tisagenlecleucel was not found to improve event-free survival over the...
In the primary analysis of the phase III ZUMA-7 trial, the chimeric antigen receptor (CAR) T-cell therapy axicabtagene ciloleucel led to a fourfold increase in event-free survival over the standard of care in the second-line treatment of relapsed or refractory large B-cell lymphoma, according to...
As reported in the Journal of Clinical Oncology by Bachy et al, the Lymphoma Study Association phase III Ro-CHOP trial showed no progression-free survival benefit with the addition of the histone deacetylase inhibitor romidepsin to CHOP (cyclophosphamide, doxorubicin, vincristine, and prednisone)...
Daniel A. Ermann, MD, of the Huntsman Cancer Institute, University of Utah, discusses results from the largest retrospective study on outcomes utilizing radiotherapy in early-stage diffuse large B-cell lymphoma. Adding radiation to front-line multiagent chemotherapy was associated with a survival benefit for all patients with early-stage disease. An overall survival benefit was seen with the addition of radiation to front-line multiagent chemotherapy for patients with nodal involvement and those with specific extranodal involvement in the testes, thyroid, skin and soft tissue, and head and neck (Abstract 49).
L. Elizabeth Budde, MD, PhD, of City of Hope, discusses phase I/II findings that showed mosunetuzumab monotherapy induces deep and durable remissions in patients with relapsed or refractory follicular lymphoma who have received two or more prior lines of treatment, including those with double-refractory disease. Because follicular lymphoma is associated with frequent relapses and decreasing progression-free intervals with successive lines of conventional therapy, these data are encouraging (Abstract 127).
An interim analysis of the TRANSFORM trial comparing the chimeric antigen receptor (CAR) T-cell immunotherapy lisocabtagene maraleucel to standard of care found that the CAR T-cell therapy significantly improved event-free survival for patients with large B-cell lymphoma that persisted or returned...
The bispecific antibody mosunetuzumab achieved deep and durable remissions as monotherapy in patients with relapsed or refractory follicular lymphoma who had received two or more prior lines of therapy, according to pivotal results of a phase I/II trial presented at the 2021 American Society of...
In a single-institution study reported in the journal Cancer, and reviewed in the September 10, 2021, issue of The ASCO Post, Bei Hu, MD, and colleagues from Levine Cancer Institute/Atrium Health found that the use of a dedicated nurse navigation program aided in producing similar patterns of...
On December 2, the U.S. Food and Drug Administration (FDA) approved rituximab (Rituxan) in combination with chemotherapy for pediatric patients (≥ 6 months to < 18 years old) with previously untreated, advanced-stage, CD20-positive diffuse large B-cell lymphoma (DLBCL), Burkitt lymphoma,...
In a single-institution phase II trial reported in the Journal of Clinical Oncology, Jain et al found that chemotherapy-free treatment with the combination of ibrutinib and rituximab produced high overall and complete response rates in patients with previously untreated mantle cell lymphoma aged ≥...
In a phase II study reported in the Journal of Clinical Oncology, Castillo et al found that venetoclax produced a high major response rate in previously treated patients with Waldenström’s macroglobulinemia. As stated by the investigators, “BCL2 is overexpressed and confers prosurvival signaling in ...
In a single-institution study reported in Cancer, Bei Hu, MD, of the Department of Hematologic Oncology and Blood Disorders, Levine Cancer Institute/Atrium Health in Charlotte, and colleagues found that use of a dedicated nurse navigation program contributed to redressing the recognized inequities...
Although treating patients with relapsed or refractory diffuse large B-cell lymphoma (DLBCL) remains challenging, some newer therapies on the horizon offer promise, including bispecific antibodies, anti-CD47 antibodies, antibody-drug conjugates, and chimeric antigen receptor (CAR) T-cell therapy,...
In an Italian phase III trial (FOLL12) reported in the Journal of Clinical Oncology, Luminari et al found that a response-adapted postinduction strategy resulted in poorer progression-free survival vs standard rituximab maintenance in patients with previously untreated advanced follicular lymphoma...
Jennifer A. Woyach, MD, of The Ohio State University Comprehensive Cancer Center, talks about whether modifications of treatment based on minimal residual disease is beneficial to patients with chronic lymphocytic leukemia and small lymphocytic lymphoma.
New evidence suggests that adding the Bruton's tyrosine kinase (BTK) inhibitor ibrutinib to a standard chemotherapy regimen may improve survival among younger people with a specific form of diffuse large B-cell lymphoma (DLBCL). The findings, published by Wyndham Wilson, MD, PhD, in Cancer Cell,...
Non-Hodgkin lymphoma is one of the most common cancers diagnosed in the United States, accounting for nearly 4% of all cancers. This year, about 81,600 individuals will be diagnosed with non-Hodgkin lymphoma, and nearly 21,000 will die from the cancer. A study by Ocier et al published in Cancer...
Recently, the U.S. Food and Drug Administration (FDA) granted Priority Review to agents for several kinds of lymphoma, as well as nasopharyngeal cancer; a Breakthrough Therapy designation for a treatment for patients with NTRK-positive advanced solid tumors; and Fast Track designation for...
On September 14, 2021, the Bruton’s tyrosine kinase inhibitor zanubrutinib was granted accelerated approval for adults with relapsed or refractory marginal zone lymphoma (MZL) who have had at least one prior anti-CD20–based regimen.1 Supporting Efficacy Data Approval was based on findings in the...
As reported in the Journal of Clinical Oncology by Buske et al, the final analysis of the pivotal phase III iNNOVATE trial has shown a continued progression-free survival benefit with the addition of ibrutinib to rituximab in patients with Waldenström’s macroglobulinemia after 50 months of...
For aggressive B-cell lymphomas, chimeric antigen receptor (CAR) T-cell therapy saves lives, but relapse remains common, and a second-line standard of care is lacking. During the 2021 Pan Pacific Lymphoma Conference, Grzegorz (Greg) S. Nowakowski, MD, Professor of Medicine and Oncology, Lymphoma...
In a phase II trial reported in the Journal of Clinical Oncology, Burke et al found that dose-adjusted etoposide, doxorubicin, and cyclophosphamide with vincristine and prednisone plus rituximab (DA-EPOCH-R) did not improve event-free survival vs historical controls in children and adolescents with ...
In a retrospective cohort study reported in a research letter in Blood Advances, Jennifer L. Crombie, MD, and colleagues found that axicabtagene ciloleucel produced high overall and complete response rates in patients with primary mediastinal B-cell lymphoma. They also observed some evidence to...
Kieron M. Dunleavy, MD, of Georgetown University, offers insights into the latest data on treating patients with primary mediastinal B-cell lymphoma: the optimal regimen; whether radiotherapy or stem cell transplants are needed; new information on the biology of the disease; novel agents such as CAR T-cell therapy and immune checkpoint inhibitors, and incorporating them into upfront treatment.
The ASCO Post is pleased to present the Hematology Expert Review, an ongoing feature that quizzes readers on issues in hematology. In this installment, Drs. Abutalib, Desai, and DeAngelis explore the treatment of older patients with primary central nervous system lymphoma (PCNSL), which pose...
Antibody-drug conjugates are improving outcomes of patients with lymphoma, often those who have exhausted treatment options after chimeric antigen receptor (CAR) T-cell therapy. Four available antibody-drug conjugates are in the clinic, with brentuximab vedotin moving into the front-line...
The integration of radiation therapy into chimeric antigen receptor (CAR) T-cell therapy may improve outcomes for patients with relapsed or refractory lymphoma, according to Charles A. Enke, MD, Professor and the Bill Bures and Jerry Pabst Chair in Radiation Oncology at the Fred and Pamela Buffett...
In relapsed or refractory B-cell lymphomas, bispecific T-cell engager antibodies are finding a place in the treatment algorithm, said Christopher Flowers, MD, MS, FASCO, Professor and Chair of the Department of Lymphoma/Myeloma at The University of Texas MD Anderson Cancer Center, Houston. At the...
As reported by Stephen J. Schuster, MD, and colleagues in The Lancet Oncology, long-term outcomes of the pivotal phase II JULIET trial showed overall and complete response rates of 53% and 39% in adult patients with relapsed or refractory aggressive B-cell lymphomas treated with the T-cell...
In a phase I/II study reported in The Lancet, Hutchings et al found that the novel bispecific antibody epcoritamab produced high response rates in patients with relapsed or refractory B-cell non-Hodgkin lymphoma. Epcoritamab works by targeting CD3 and CD20 and inducing T-cell–mediated cytotoxic...
On September 15, zanubrutinib (Brukinsa), a small-molecule inhibitor of Bruton’s tyrosine kinase (BTK), received accelerated approval from the U.S. Food and Drug Administration (FDA) for the treatment of adult patients with relapsed or refractory marginal zone lymphoma who have received at least...
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...
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,...
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...
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...
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 ...
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...
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.
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.
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.
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.
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.