© 2024 HSP News Service, L.L.C.
On May 15, the U.S. Food and Drug Administration (FDA) granted accelerated approval to the chimeric antigen receptor (CAR) T-cell therapy lisocabtagene maraleucel (Breyanzi) for adult patients with relapsed or refractory follicular lymphoma who have received two or more prior lines of systemic...
This is Part 3 of Treatment Strategies for Transplant-Ineligible Relapsed/Refractory DLBCL, a three-part video roundtable series. Scroll down to watch the other videos from this roundtable. In this video, Drs. Jason Westin, Dai Chihara, and Caron A. Jacobson discuss the third-line treatment of patients with transplant-ineligible diffuse large B-cell lymphoma (DLBCL). The patient is an 81-year-old man who was initially diagnosed with DLBCL, non-GCB subtype, with an International Prognostic Index Score of 3. He had a 7 x 6 cm retroperitoneal mass causing hydronephrosis and numerous smaller enlarged lymph nodes. He received 6 cycles of R-miniCHOP, and end-of-treatment PET/CT showed a complete response. Six months after completing treatment, a surveillance scan detected suspicion of relapse with multiple enlarged lymph nodes, and a repeat biopsy confirmed DLBCL. He declined a consultation with a CAR T-cell therapy center and was treated with 2 cycles of R-GemOx. Unfortunately, although PET/CT scans confirm that some areas have improved, there are now newly enlarged lymph nodes consistent with progressive disease. In the conversation that follows, the faculty discuss treatment options for patients with transplant-ineligible relapsed/refractory DLBCL, logistical barriers around the use of bispecific antibodies, managing toxicities such as cytokine-release syndrome, and the curative potential for bispecific antibodies.
This is Part 2 of Treatment Strategies for Transplant-Ineligible Relapsed/Refractory DLBCL, a three-part video roundtable series. Scroll down to watch the other videos from this roundtable. In this video, Drs. Jason Westin, Dai Chihara, and Caron A. Jacobson discuss the treatment of late relapsing diffuse large B-cell lymphoma (DLBCL). The patient is a 77-year-old woman who was previously diagnosed with DLBCL, GCB subtype, without MYC translocation, and with an International Prognostic Index Score of 2 at diagnosis with stage II disease. She was treated with R-CHOP for 6 cycles; however, she was hospitalized after cycle 4 with neutropenic fever, and cycles 5 and 6 were subsequently dose reduced. She achieved a complete response on the end-of-treatment PET/CT and regained her functional status back to baseline over the next 6 months. Two and half years after treatment, she presents with a new fullness in her right axilla, and a PET/CT shows FDG-avid adenopathy in bilateral axillae and the retroperitoneum. A repeat biopsy confirms DLBCL. In the conversation that follows, the faculty discuss the current standard-of-care treatment options for older patients with DLBCL whose disease progresses after 12 months, whether CAR T-cell therapy would be an option, the importance of repeat biopsy, and the role of tafasitamab plus lenalidomide in patients with DLBCL that is not refractory to initial therapy.
This is Part 1 of Treatment Strategies for Transplant-Ineligible Relapsed/Refractory DLBCL, a three-part video roundtable series. Scroll down to watch the other videos from this roundtable. In this video, Drs. Jason Westin, Dai Chihara, and Caron A. Jacobson discuss the treatment of early relapsed/refractory diffuse large B-cell lymphoma (DLBCL). The patient is a 76-year-old man who was diagnosed with DLBCL, non-GCB subtype, with no translocation of MYC and an International Prognostic Index score of 4 at diagnosis. He was treated with 6 cycles of R-CHOP and achieved a complete response on interim PET, but has progressive disease on end-of-treatment PET. He tolerated treatment relatively well and has a performance status of 1. A biopsy confirms refractory DLBCL. He has adequate organ function based on labs, a repeat echocardiogram, and pulmonary function testing, and his health-care team tells him that he is “too old for stem cell transplant.” In the conversation that follows, the faculty discuss the current standard-of-care treatment options for patients with DLBCL that progresses within 12 months of front-line therapy, whether there is a maximum age limit for CAR T-cell therapy, and special considerations that should be taken for patients after treatment with CAR T-cell therapy.
As reported in The Lancet by Martin Dreyling, MD, PhD, and colleagues, results in the European Mantle Cell Lymphoma Network phase III TRIANGLE trial indicate that the addition of ibrutinib to immunochemotherapy and autologous stem cell transplantation (ASCT) significantly improved failure-free...
In an analysis of the EUROCARE-6 data set reported in The Lancet Oncology, Milena Sant, MD, and colleagues found that patients with lymphoid neoplasms from European countries with greater health expenditure had improved 10-year age-standardized relative survival. Study Details The study involved...
On December 1, 2023, pirtobrutinib (Jaypirca), a selective, noncovalent Bruton’s tyrosine kinase (BTK) inhibitor that inhibits both wild-type and C481-mutant BTK with equal low nanomolar potency and is designed to address several of the limitations of covalent BTK inhibitors, was granted...
In a Chinese study reported in The New England Journal of Medicine, Hu et al found that sequential CD7 chimeric antigen receptor (CAR) T-cell therapy and allogeneic hematopoietic stem cell transplantation (HSCT) without graft-vs-host disease (GVHD) prophylaxis was effective in patients with...
In a study reported in JACC: CardioOncology, Upshaw et al found that preexisting heart failure was associated with an increased risk of lymphoma and cardiovascular mortality among patients aged ≥ 65 years who were newly diagnosed with Hodgkin lymphoma. The study used linked Surveillance,...
The U.S. Food and Drug Administration (FDA) issued a safety communication,1 which was updated2 on March 22, 2023, informing the public that there have been reports of squamous cell carcinomas (SCC) and various lymphomas of the breast in the capsule or scar of breast implants. These lymphomas are ...
On March 7, 2024, the Bruton’s tyrosine kinase inhibitor zanubrutinib (Brukinsa) was granted accelerated approval in combination with the monoclonal antibody obinutuzumab for patients with relapsed or refractory follicular lymphoma after two or more lines of systemic therapy.1 Supporting Efficacy...
Classical Hodgkin lymphoma (HL) is a highly curable disease, but up to 25% of patients will develop relapsed or refractory classical HL. Although most patients achieve complete response following front-line therapy, key unmet clinical needs include reducing the relapse rate, decreasing acute and...
This is Part 3 of Treatment Options for Relapsed/Refractory Follicular Lymphoma: What Comes Next, a three-part video roundtable series. Scroll down to watch the other videos from this roundtable. In this video, Drs. Andrew M. Evens, L. Elizabeth Budde, and Carla Casulo discuss the third-line treatment of relapsed/refractory follicular lymphoma in a patient with high-risk features. The patient is a 65-year-old Black man who was initially diagnosed in 2014 and treated with R-CHOP followed by 2 years of rituximab maintenance. After his disease progressed in 2020, he was treated with bendamustine/obinutuzumab, obtaining a complete response, and then received obinutuzumab maintenance until April 2022. In February 2023, he presented with increasing abdominal pressure, fatigue, and drenching night sweats. A PET scan revealed multifocal disease progression, including a bulky left lower quadrant soft tissue mass near the lumbar spine. A biopsy confirmed grade 3 follicular lymphoma with prominent necrosis and multiple patches of large cells; it was positive for CD20, CD10, BCL-2, and BCL-6, and the Ki-67 was 60% to 70%. In the conversation that follows, the faculty discuss treatment options for patients with high-risk features, choosing between CAR T-cell–based therapies and bispecific antibodies in the third-line setting, and important considerations when administering CD3/CD20-targeted bispecific antibodies in the community setting.
This is Part 2 of Treatment Options for Relapsed/Refractory Follicular Lymphoma: What Comes Next, a three-part video roundtable series. Scroll down to watch the other videos from this roundtable. In this video, Drs. Andrew M. Evens, L. Elizabeth Budde, and Carla Casulo discuss the management of patients with follicular lymphoma who experience progression of disease within 24 months (POD-24). The patient is a 71-year-old fit, White man who presented with fatigue and diffuse lymphadenopathy. After undergoing an excisional node biopsy, he was found to have follicular lymphoma grade 1/2 out of 3. A staging PET scan showed multiple hypermetabolic lesions. He received bendamustine/rituximab induction therapy for 6 cycles and obtained a metabolic complete response; he did not receive rituximab maintenance. Eight months later, he presented with swelling of the right eyelid with new, painful soft tissue lesions. A PET scan showed multiple hypermetabolic subcutaneous nodules in the upper back, left inguinal and right inguinal nodes, and right lateral thigh. In the conversation that follows, the faculty discuss the meaning and clinical implication of POD-24, optimal treatment options for patients who experience early recurrence, and whether autologous stem cell transplant is still an option in 2024.
This is Part 1 of Treatment Options for Relapsed/Refractory Follicular Lymphoma: What Comes Next, a three-part video roundtable series. Scroll down to watch the other videos from this roundtable. In this video, Drs. Andrew M. Evens, L. Elizabeth Budde, and Carla Casulo discuss the second-line treatment of relapsed follicular lymphoma in a patient with comorbidities. The patient is a 74-year-old Asian man who was diagnosed 5 years ago with follicular lymphoma grade 1/2 out of 3 and a Ki-67 score of 5% to 10%. His ECOG performance status was 1, but he had multiple comorbidities that led to a CIRS-G score of 12. After achieving a metabolic complete response on single-agent rituximab therapy, he received 2 years of rituximab maintenance therapy. Remission was maintained for 4 years, but 18 months after his last rituximab, he presented with right leg swelling that was negative for deep vein thrombosis. A coronal PET/CT scan showed a new large retroperitoneal mass abutting the right psoas and iliopsoas muscles, encasing his iliac vessels and ureter. In the conversation that follows, the faculty discuss the importance of repeat biopsy and molecular testing in patients with relapsed follicular lymphoma, how past medical history and comorbidities influence treatment choice, and the clinical implications of the AUGMENT trial.
As reported in the Journal of Clinical Oncology by L. Elizabeth Budde, MD, PhD, and colleagues, extended follow-up of the dose-escalation phase of a phase I/II trial showed that the CD20 x CD3 T-cell–engaging bispecific antibody mosunetuzumab-axgb—given as an off-the-shelf fixed-duration outpatient ...
“The practice of medicine is an art, not a trade….” —Sir William Osler Mantle cell lymphoma (MCL) accounts for approximately 5% to 7% of all lymphomas; the median age of patients with MCL is between 60 and 70 years. This lymphoma is generally considered incurable. Median survival in retrospective...
On March 14, the U.S. Food and Drug Administration (FDA) granted accelerated approval to lisocabtagene maraleucel (Breyanzi), a CD19-directed chimeric antigen receptor (CAR) T-cell therapy, for the treatment of adults with relapsed or refractory chronic lymphocytic leukemia (CLL) or small...
For patients with relapsed large B-cell lymphoma (LBCL) in complete remission, outcomes were better after autologous stem cell transplantation (ASCT) than with chimeric antigen receptor (CAR) T-cell therapy in a retrospective analysis of a large database presented at the 2023 American Society of...
On March 7, the U.S. Food and Drug Administration (FDA) granted accelerated approval to the small-molecule BTK inhibitor zanubrutinib (Brukinsa) in combination with the anti-CD20 monoclonal antibody obinutuzumab for patients with relapsed or refractory follicular lymphoma after two or more lines of ...
As reported in the Journal of Clinical Oncology by Camus et al, the final analysis of the phase III Ro-CHOP trial showed no significant progression-free or overall survival benefit with the addition of romidepsin (Ro) to CHOP (cyclophosphamide, doxorubicin, vincristine, prednisone) in previously...
In a Dutch study reported in the Journal of Clinical Oncology, Neppelenbroek et al found that doxorubicin treatment was associated with an increased risk of breast cancer among adolescent and adult Hodgkin lymphoma survivors. Study Details The study involved a cohort of 1,964 female 5-year Hodgkin...
In a retrospective case series reported in JAMA Network Open, Hashmi et al found that more than one-third of pediatric patients receiving treatment for newly diagnosed acute lymphoblastic leukemia/lymphoblastic lymphoma (ALL/LL) developed COVID-19 infection during a recent 2-year period. Study...
The ASCO Post obtained comments on the Smart Stop study from Dipenkumar Modi, MD, a medical oncologist and hematologist at the Barbara Ann Karmanos Cancer Institute and Assistant Professor of Oncology at Wayne State University School of Medicine, Detroit. Dr. Modi applauded the investigators for...
A four-drug targeted therapy regimen proved safe and effective as the first-line treatment of diffuse large B-cell lymphoma (DLBCL), achieving a 100% response rate after four cycles, researchers from The University of Texas MD Anderson Cancer Center, Houston, reported at the 2023 American Society...
Session co-moderator Carla Casulo, MD, offered her thoughts on the response-adapted use of ultra-low–dose radiotherapy in gastric MALT (mucosa-associated lymphoid tissue) lymphoma, as reported by the investigators from MD Anderson Cancer Center. Dr. Casulo is Associate Professor of Medicine and...
For patients with gastric MALT (mucosa-associated lymphoid tissue) lymphoma, an “ultra-low dose” of radiotherapy was as effective as the higher, standard dose in providing local control and freedom from distant relapse, researchers from The University of Texas MD Anderson Cancer Center reported at...
For patients with relapsed large B-cell lymphoma (LBCL) in complete remission, outcomes were better after autologous stem cell transplantation (ASCT) than with chimeric antigen receptor (CAR) T-cell therapy in a retrospective analysis of a large database presented at the 2023 American Society of...
In a phase II trial (JACKPOT8 Part B) reported in The Lancet Oncology, Song et al found that the selective JAK1 tyrosine kinase inhibitor golidocitinib showed activity in patients with relapsed or refractory peripheral T-cell lymphoma. Study Details In the trial, 104 patients from sites in...
Researchers may have uncovered a novel strategy to identify which patients may experience poorer outcomes from chimeric antigen receptor (CAR) T-cell therapy prior to treatment, according to a recent study published by Faramand et al in Blood Cancer Discovery. The findings indicate opportunities to ...
Andrew D. Zelenetz, MD, PhD, Medical Director of Quality Informatics at Memorial Sloan Kettering Cancer Center, New York, offered his thoughts on the combination of venetoclax and ibrutinib in the treatment of mantle cell lymphoma, as presented at the 2023 American Society of Hematology (ASH)...
The combination of ibrutinib and venetoclax has led to an improved progression-free survival rate in patients with relapsed or refractory mantle cell lymphoma (MCL), according to findings presented at the 2023 American Society of Hematology (ASH) Annual Meeting & Exposition.1 Interim analysis...
A novel chimeric antigen receptor (CAR) natural killer (NK)-cell therapy may be effective at treating patients with relapsed or refractory B-cell malignancies, according to a novel study published by Marin et al in Nature Medicine. Study Methods and Results In the new phase I/II trial, researchers...
As reported in the Journal of Clinical Oncology by Brad S. Kahl, MD, and colleagues, long-term follow-up of the phase III Eastern Cooperative Oncology Group RESORT study (E4402) showed that rituximab maintenance did not improve overall survival vs rituximab retreatment in rituximab induction...
Investigators have assessed whether specific tumor characteristics were associated with improved outcomes in patients with large B-cell lymphoma who received chimeric antigen receptor (CAR) T-cell therapy, according to a recent study published by Locke et al in Nature Medicine. The findings may...
In an analysis from the phase III GALLIUM study reported in the Journal of Clinical Oncology, Pott et al identified measurable residual disease (MRD) status and related outcomes among patients receiving obinutuzumab- and rituximab-based treatment for previously untreated follicular lymphoma. Study...
Mazyar Shadman, MD, MPH, of the University of Washington, discusses new data suggesting that in patients with relapsed large B-cell lymphoma who achieve a complete response, treatment with autologous transplantation may be associated with a lower relapse rate and improved progression-free survival compared with CAR T-cell therapy, including those with early treatment failure (Abstract 781).
In a long-term analysis from the LYMA trial reported in the Journal of Clinical Oncology, Sarkozy et al found that rituximab maintenance following autologous stem cell transplantation (ASCT) continued to be of benefit vs observation in the first-line treatment of younger patients with mantle cell...
Sanjal H. Desai, MBBS, of the University of Minnesota, discusses results from a multicenter cohort, which shows that, for transplant-eligible patients with relapsed or refractory classical Hodgkin lymphoma, PD-1–based salvage therapy at any point before transplantation is associated with improved progression-free survival, compared with brentuximab vedotin or chemotherapy-based salvage regimens (Abstract 182).
Adam S. Kittai, MD, of The Ohio State University, discusses his data supporting the use of CAR T-cell therapy for patients with Richter’s transformation. Given the high response rate to CD19 CAR T-cell treatment, along with early relapse in most patients, allogeneic stem cell transplantation at response should also be considered, he says (Abstract 108).
Michael Wang, MD, of The University of Texas MD Anderson Cancer Center, discusses phase III results from the Sympatico study, which shows the combination of ibrutinib and venetoclax improved progression-free survival vs ibrutinib plus placebo in patients with relapsed or refractory mantle cell lymphoma. According to Dr. Wang, these findings demonstrate a favorable benefit-risk profile for ibrutinib plus venetoclax in this patient population (Abstract LBA2).
Jennifer A. Woyach, MD, of The Ohio State University Comprehensive Cancer Center, discusses phase I/II findings of the BRUIN study on the use of pirtobrutinib after covalent Bruton’s tyrosine kinase (BTK) inhibitors in patients with chronic lymphocytic leukemia or small lymphocytic lymphoma (CLL/SLL). The results suggest that continuing BTK pathway inhibition following a covalent BTK inhibitor may be an important sequencing approach to consider in the treatment of CLL/SLL (Abstract 325).
Sarah C. Rutherford, MD, of Weill Cornell Medicine, discusses findings of the SWOG S1826 study, which showed nivolumab plus AVD (doxorubicin, vinblastine, and dacarbazine) improved progression-free and event-free survival and seemed to be better tolerated than brentuximab vedotin plus AVD in patients aged 60 and older with advanced-stage Hodgkin lymphoma (Abstract 181).
The chimeric antigen receptor (CAR) T-cell therapy lisocabtagene maraleucel may be a cost-effective second-line treatment option in patients with relapsed or refractory diffuse large B-cell lymphoma (DLBCL), according to a recent study published by Choe et al in Blood Advances. Background In cases...
William G. Wierda, MD, PhD, of The University of Texas MD Anderson Cancer Center, discusses results from the phase I/II BRUIN study, which shows encouraging response and overall survival in patients with Richter transformation. Although this condition remains a challenging diagnosis, pirtobrutinib represents a potential treatment option that warrants further investigation, according to Dr. Wierda (Abstract 1737).
Mikkael A. Sekeres, MD, of the Sylvester Comprehensive Cancer Center at the University of Miami Miller School of Medicine, reviews key abstracts from ASH 2023 on treatment of myelofibrosis, chronic lymphocytic leukemia, large B-cell lymphoma, and acute myeloid leukemia (Abstracts 620, 631, 781, 425).
The phase II PrE0405 trial met its primary endpoint, achieving a complete response rate of 85% in 33 patients with mantle cell lymphoma over age 60 who received bendamustine and rituximab, a standard chemoimmunotherapy regimen, along with venetoclax, which is investigational in this setting. The...
Bijal D. Shah, MD, of Moffitt Cancer Center and Research Institute, discusses a matching-adjusted indirect comparison of brexucabtagene autoleucel and pirtobrutinib in patients with relapsed or refractory mantle cell lymphoma who have been previously treated with a BTK inhibitor (Abstract 5136).
Jonathon B. Cohen, MD, of Winship Cancer Institute, Emory University, discusses safety and efficacy findings from the phase I/II BRUIN study. The trial found that pirtobrutinib continues to demonstrate durable efficacy and a favorable safety profile in heavily pretreated patients with relapsed or refractory mantle cell lymphoma (Abstract 981).
Patients with relapsed or refractory mantle cell lymphoma who received ibrutinib in combination with venetoclax experienced significantly better rates of progression-free survival compared with patients who received ibrutinib and placebo, according to findings from the international phase III...