Benefit Suggested for Early Treatment of Advanced-Stage, Very Low–Tumor Burden Follicular Lymphoma
In the phase III JCOG1411/FLORA trial of patients with untreated advanced-stage, very low–tumor burden follicular lymphoma, rituximab induction delayed disease progression to high–tumor burden follicular lymphoma and delayed the initiation of cytotoxic chemotherapy, according to Japanese...
inMIND Trial: Tafasitamab Plus Lenalidomide and Rituximab in Relapsed or Refractory Follicular Lymphoma
The addition of tafasitamab, a CD19 monoclonal antibody, to the commonly used lenalidomide and rituximab backbone significantly improved progression-free survival in patients with relapsed or refractory follicular lymphoma, according to data presented during the 2024 American Society of Hematology...
Recent FDA Approvals in Lymphoma and in Rarer Tumors
The U.S. Food and Drug Administration (FDA) has approved brentuximab vedotin (Adcetris) in combination with lenalidomide and a rituximab product for adults with relapsed or refractory large B-cell lymphoma (LBCL)—including diffuse large B-cell lymphoma (DLBCL) not otherwise specified, DLBCL arising ...
Stem Cell Transplant May Not Be Necessary in First Remission for Patients With Mantle Cell Lymphoma and Undetectable MRD
Autologous stem cell transplantation (ASCT) does not improve survival outcomes for patients with mantle cell lymphoma who achieve a deep first complete remission with undetectable measurable residual disease (MRD) after induction therapy, according to data presented during the 2024 American Society ...
Is There a Link Between Tattoos and Increased Cancer Risk?
Skin cancers and lymphoma may be more prevalent among individuals with tattoos compared with those without tattoos, according to a recent study published by Clemmensen et al in BMC Public Health. Prior research has shown that tattoo ink does not just remain at the site of injection—instead, when...
Case 3: Relapsed/Refractory Nodal Marginal Zone Lymphoma
This is Part 3 of Evolving Treatment Landscape of Indolent Lymphoma, a three-part video roundtable series. Scroll down to watch the other videos from this roundtable. In this video, Drs. Laurie Sehn, Gilles Salles, and Sonali Smith discuss the treatment of relapsed/refractory nodal marginal zone lymphoma. The patient is a 68-year-old man who was diagnosed with marginal zone lymphoma in 2019 after a PET/CT scan found a large pelvic mass involving the bladder and causing left-sided hydronephrosis; SUVmax was 7, and LDH was normal. He received bendamustine plus rituximab for six cycles, achieving a complete response on PET. In 2023, surveillance CT showed a recurrent pelvic mass and several mesenteric lymph nodes; PET/CT showed no additional disease, and the SUVmax was 6. In the conversation that follows, the faculty discuss whether transformation is a concern in marginal zone lymphoma, the role of BTK inhibitors, and whether CAR T-cell therapy could be an option for this patient.
Case 2: Third-Line Treatment of Relapsed/Refractory Follicular Lymphoma
This is Part 2 of Evolving Treatment Landscape of Indolent Lymphoma, a three-part video roundtable series. Scroll down to watch the other videos from this roundtable. In this video, Drs. Laurie Sehn, Gilles Salles, and Sonali Smith discuss the third-line treatment of relapsed/refractory follicular lymphoma. The patient is a 74-year-old woman who originally presented in 2014 with asymptomatic low-bulk stage IVA follicular lymphoma, grade 1 to 2, for which she received four cycles of rituximab. In 2019, she developed symptomatic disease, with multiple nodes > 7 cm, and received bendamustine plus rituximab for six cycles, achieving a complete response. In December 2024, she presents with fatigue, progressive lymphadenopathy above and below the diaphragm, no B-symptoms, normal LDH, and SUVmax of 10. In the conversation that follows, the faculty discuss next steps for this patient, whether there are any actionable biomarkers for follicular lymphoma, and patient-specific factors to consider when selecting treatment in the third-line setting.
Case 1: Second-Line Treatment of Early Relapsing Follicular Lymphoma
This is Part 1 of Evolving Treatment Landscape of Indolent Lymphoma, a three-part video roundtable series. Scroll down to watch the other videos from this roundtable. In this video, Drs. Laurie Sehn, Gilles Salles, and Sonali Smith discuss the second-line treatment of early relapsing follicular lymphoma. The patient is a 41-year-old man originally diagnosed with grade 1 to 2 follicular lymphoma in 2023. He received bendamustine plus rituximab for six cycles, achieving a complete response on PET, and then started rituximab maintenance. After four cycles, he developed shortness of breath on exertion and night sweats. PET/CT confirmed recurrence of lymphadenopathy above and below the diaphragm, as well as a pleural-based mass (SUVmax of 16), pleural effusion, and peritoneal deposits; his LDH was normal. In the conversation that follows, the faculty discuss the clinical implications of progression-of-disease within 24 months in follicular lymphoma, the importance of ruling out transformation, and the role of novel therapies at disease relapse.
Novel CD19-1XX CAR With Calibrated Signaling in LBCL
In a single-institution phase I study reported in the Journal of Clinical Oncology, Jae H. Park, MD, and colleagues found that first-in-human use of a CD19-1XX chimeric antigen receptor (CAR) T-cell therapy with calibrated signaling showed high activity in patients with relapsed or refractory large ...
Chronic Lymphocytic Leukemia/Small Lymphocytic Lymphoma
“Care more particularly for the individual patient than for the special features of the disease.”—Sir William Osler Chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL) is the most common leukemia in the Western hemisphere. The majority of patients who require treatment are older than ...
Mantle Cell Lymphoma: Addition of Venetoclax to Ibrutinib
As reported in The Lancet Oncology by Michael Wang, MD, and colleagues, the phase III SYMPATICO trial has shown that venetoclax/ibrutinib significantly improved progression-free survival vs placebo/ibrutinib in patients with relapsed or refractory mantle cell lymphoma (MCL). Study Details In the...
Primary Analysis of ZUMA-2: Bruton Tyrosine Kinase Inhibitor–Naive Relapsed or Refractory Mantle Cell Lymphoma
ZUMA-2 is a single-arm, multicenter, open-label phase II study that investigated leukapheresed adults with mantle cell lymphoma whose disease was refractory to or had relapsed after up to five prior lines of therapy, including anthracycline or bendamustine-containing chemotherapy; anti-CD20...
FDA Approves Brentuximab Vedotin With Lenalidomide and Rituximab for Relapsed or Refractory LBCL
The U.S. Food and Drug Administration (FDA) has approved brentuximab vedotin (Adcetris) in combination with lenalidomide and a rituximab product for adult patients with relapsed or refractory large B-cell lymphoma (LBCL)—including diffuse large B-cell lymphoma (DLBCL) not otherwise specified, DLBCL ...
Triplet for Untreated TP53-Mutated Mantle Cell Lymphoma
First-line treatment with the Bruton’s tyrosine kinase inhibitor zanubrutinib plus the anti-CD20 monoclonal antibody obinutuzumab and the BCL2 inhibitor venetoclax appeared to be safe and active in previously untreated patients with TP53-mutated mantle cell lymphoma, based on the results of the...
Can R-CHOP–Like Therapy Effectively Treat Late-Relapse DLBCL?
Late relapse of diffuse large B-cell lymphoma (DLBCL) may represent a new lymphoma arising from a common precursor cell that is essentially chemotherapy-naive. Treatment with curative intent using a second-line regimen like R-CHOP (rituximab cyclophosphamide, doxorubicin, prednisone, and...
Early-Stage Classic Hodgkin Lymphoma
“It isn’t the mountains ahead to climb that wear you out; it’s the pebble in your shoe.” —Muhammad Ali Long-term survival in early-stage classic Hodgkin lymphoma (cHL) was first made possible by the introduction of the mantle and inverted Y fields of radiotherapy in the 1960s. The addition of...
FDA Approves Acalabrutinib With Bendamustine and Rituximab for Previously Untreated Mantle Cell Lymphoma
On January 16, the U.S. Food and Drug Administration (FDA) granted traditional approval to the Bruton’s tyrosine kinase inhibitor acalabrutinib (Calquence) with bendamustine and rituximab for adults with previously untreated mantle cell lymphoma who are ineligible for autologous hematopoietic stem...
Transplant-Free Treatment Approach in Relapsed Classical Hodgkin Lymphoma in Children and Adolescents and Young Adults
As reported in JAMA Oncology by Daw et al, findings in a cohort of the phase II CheckMate 744 trial indicated good outcomes with a response-adapted, transplantation-free treatment approach in children and adolescents and young adults (AYAs) with low-risk relapsed classical Hodgkin lymphoma (HL)....
Addition of Brentuximab Vedotin to Lenalidomide/Rituximab in Relapsed or Refractory DLBCL
In an interim analysis of a phase III trial (ECHELON-3) reported in the Journal of Clinical Oncology, Bartlett et al found that the addition of brentuximab vedotin (BV) to lenalidomide and rituximab improved overall survival in patients with relapsed or refractory diffuse large B-cell lymphoma...
Use of Denileukin Diftitox-cxdl in Relapsed or Refractory CTCL
In a registrational trial reported in the Journal of Clinical Oncology, Foss et al found that denileukin diftitox (DD)-cxdl—a fusion protein comprising diphtheria toxin fragments A and B and human interleukin-2—was active in patients with relapsed or refractory cutaneous T-cell lymphoma (CTCL)....
Nivolumab Plus AVD as Front-Line Therapy in Older Adults With Classical Hodgkin Lymphoma
In a phase I/II trial reported in the Journal of Clinical Oncology, Torka et al found that the addition of nivolumab to standard doxorubicin, vinblastine, and dacarbazine (N-AVD) was “highly effective” as front-line treatment for patients aged ≥ 60 with classical Hodgkin lymphoma. Study Details In...
Primary Analysis of ZUMA-2: Treatment of BTK Inhibitor–Naive Relapsed/Refractory Mantle Cell Lymphoma
A primary analysis of ZUMA-2, reported at the 2024 American Society of Hematology (ASH) Annual Meeting & Exposition, demonstrated durable responses to brexucabtagene autoleucel in patients with Bruton’s tyrosine kinase (BTK) inhibitor–naive mantle cell lymphoma. The findings from cohort 3 of...
SEQUOIA 5-Year Follow-up: Zanubrutinib vs Bendamustine/Rituximab in Treatment-Naive CLL/SLL
As reported in the Journal of Clinical Oncology by Shadman et al, 5-year follow-up of the phase III SEQUOIA trial demonstrated that zanubrutinib continued to show a progression-free survival benefit over bendamustine plus rituximab in previously untreated patients with chronic lymphocytic...
CTX130 CAR T-Cell Therapy for Relapsed or Refractory T-Cell Lymphoma
In a phase I dose-escalation study (COBALT-LYM) reported in The Lancet Oncology, Iyer et al found that CTX130 (volamcabtagene durzigedleucel)—a CD70-directed, allogeneic chimeric antigen receptor (CAR) immunotherapy manufactured from healthy donor T cells—had a manageable safety profile and showed...
Researchers May Have Uncovered Protein That Helps Cancer Cells Dodge CAR T-Cell Therapy
Researchers may have discovered a factor contributing to cancer cell evasion of chimeric antigen receptor (CAR) T-cell therapy, according to a recent study published by Chen et al in Cell. The findings could lead to more personalized therapies that improve survival among patients with cancer....
Autologous Stem Cell Transplantation May Not Improve Survival in Patients With MCL and Undetectable Minimal Residual Disease
Researchers have revealed that high-dose chemotherapy followed by autologous stem cell transplantation may not benefit patients with mantle cell lymphoma (MCL) who are in remission following initial treatment, according to new findings presented by Fenske et al at the 2024 American Society of...
Pirtobrutinib May Improve Survival Outcomes in Pretreated Patients With CLL or SLL
Researchers have found that the noncovalent Bruton's tyrosine kinase inhibitor (BTK) pirtobrutinib may offer superior progression-free survival in adults with chronic lymphocytic leukemia (CLL) or small lymphocytic lymphoma (SLL), according to recent findings presented by Sharman et al at the 2024...
Timothy S. Fenske, MD, on Lack of Benefit of Autologous Hematopoietic Cell Transplantation in Mantle Cell Lymphoma Patients in First Complete Remission With Undetectable Minimal Residual Disease
Timothy S. Fenske, MD, of the Medical College of Wisconsin presented an initial report from the ECOG-ACRIN EA4151 phase III randomized trial exploring outcomes of autologous hematopoietic cell transplantation (ASCT) in mantle cell lymphoma. The researchers randomized patients in first complete remission with undetectable minimal residual disease and found that ASCT was not associated with improved outcomes (Abstract LBA-6).
Loncastuximab Tesirine May Improve Outcomes in High-Risk Follicular Lymphoma, Marginal Zone Lymphoma
The antibody loncastuximab tesirine may offer a benefit in patients with high-risk follicular lymphoma and marginal zone lymphoma, according to the findings of two clinical trials presented by Alderuccio et al and Lossos et al at the 2024 American Society of Hematology (ASH) Annual Meeting &...
Preclinical Findings Show Ketogenic Diet Enhances CAR T-Cell Function, Improves Tumor Control
Findings from a series of studies conducted in mice, human tissues, and healthy volunteers suggest that a ketogenic diet may enhance the effectiveness of chimeric antigen receptor (CAR) T-cell therapy. The results point to β-hydroxybutyrate (BHB), a substance produced when a ketogenic diet is...
Maayan Levy, PhD, and Marco Ruella, MD, on How a Ketogenic Diet Enhances CAR T-Cell Antitumor Function Via Beta-Hydroxybutyrate (BHB)
Maayan Levy, PhD, and Marco Ruella, MD, of the University of Pennsylvania, Perelman School of Medicine, discuss findings on whether ketogenic diet-derived BHB can be provided as a dietary intervention to augment CAR-T function in multiple cancer models. The results of this study will be translated into a first-in-human clinical trial of BHB-supplementation during CAR-T 19 treatment for relapsed or refractory B cell lymphoma. The data were presented during the ASH Plenary Scientific Session (Abstract 4).
Glofitamab or Rituximab Plus Gemcitabine/Oxaliplatin in Relapsed/Refractory DLBCL
As reported in The Lancet by Abramson et al, the phase III STARGLO trial has shown significantly improved overall survival with glofitamab plus gemcitabine/oxaliplatin vs rituximab plus gemcitabine/oxaliplatin in patients with transplant-ineligible relapsed or refractory diffuse large B-cell...
Determining the Optimal First-Line Management of Advanced Classical Hodgkin Lymphoma
“While clinical trials emphasize improvement in cure rates for patients with advanced classical Hodgkin lymphoma, an important goal is reducing the potential long-term effects of treatment,” commented Iris Isufi, MD, of the Smilow Cancer Hospital and Yale Cancer Center, New Haven, Connecticut, and ...
Valemetostat in Relapsed or Refractory Non-Hodgkin Lymphoma
In a phase I study reported in The Lancet Oncology, Maruyama et al found that valemetostat—a novel dual inhibitor of EZH2 and EZH1—showed activity in patients with relapsed or refractory non-Hodgkin lymphoma. Study Details In the study, 90 patients from sites in Japan and the United States were...
A Diagnosis of Lymphoma Has Changed My Life
I’m 50, just a year older than my father was when he died of colorectal cancer. I was 14 when my dad died, so to me, cancer has always been synonymous with death. From a young age, my brothers and I had a goal: to make sure we packed in enough life before age 50. It never occurred to us that death ...
Valemetostat in Relapsed or Refractory Peripheral T-Cell Lymphoma
In a phase II trial (VALENTINE-PTCL01) reported in The Lancet Oncology, Zinzani et al found that valemetostat—a novel dual inhibitor of EZH1 and EZH2—was active in patients with relapsed or refractory peripheral T-cell lymphoma (PTCL). Study Details In the trial, 133 patients with relapsed or...
New Data From SWOG S1826 Trial May Confirm Benefit of Nivolumab Plus AVD in Patients With Hodgkin Lymphoma
Researchers have found that the combination of nivolumab plus doxorubicin, vinblastine, and dacarbazine (AVD) may reduce the risk of cancer progression and mortality in patients with Hodgkin lymphoma compared with standard treatment, according to a recent study published by Herrera et al in The New ...
Autologous vs Allogeneic Stem Cell Transplantation in Younger Patients With Peripheral T-Cell Lymphoma: 7-Year Follow-up
In an analysis reported in the Journal of Clinical Oncology, Tournilhac et al identified 7-year outcomes of the phase III AATT trial evaluating autologous vs allogeneic transplantation in younger patients with peripheral T-cell lymphoma. Study Details In the trial, 103 patients (aged 18–60) from...
Combination Targeted Therapy Produces Durable Remissions in Some Patients With Relapsed Diffuse Large B-Cell Lymphoma
The results from a phase Ib/II study of a five-drug targeted therapy regimen—venetoclax, ibrutinib, prednisone, obinutuzumab, and lenalidomide (ViPOR)—in the treatment of relapsed or refractory diffuse large B-cell lymphoma (DLBCL) showed the treatment produced durable remissions and potential...
Atezolizumab, Venetoclax, and Obinutuzumab in Richter Transformation Diffuse Large B-Cell Lymphoma
In a phase II trial (MOLTO) reported in the The Lancet Oncology, Tedeschi et al found that the combination of the PD-L1 blocker atezolizumab, the BCL2 inhibitor venetoclax, and the anti-CD20 antibody obinutuzumab was active in Richter transformation diffuse large B-cell lymphoma (DLBCL-RT). Study...
FDA Approves Ready-to-Use Version of Bortezomib for Subcutaneous Administration
The U.S. Food and Drug Administration (FDA) has approved a new presentation of bortezomib (Boruzu) for ready-to-use subcutaneous or intravenous administration. This new ready-to-use oncology product reduces the compounding preparation steps typically required with administration. Bortezomib, a...
New Studies Explore Relationships Between Heart Failure and Lymphoma, Arterial Thromboembolism and Cancer
In two studies recently reported in JACC: CardioOncology, Upshaw and colleagues1 examined the impact of preexisting heart failure on mortality in older patients in the United States with newly diagnosed Hodgkin lymphoma, and Gon and colleagues2 analyzed the incidence and impact of arterial...
CAR T-Cell Therapy in Refractory Follicular Lymphoma
On May 15, 2024, lisocabtagene maraleucel (Breyanzi) was granted accelerated approval for adults with relapsed or refractory follicular lymphoma with two or more prior lines of systemic therapy.1 The agent is a CD19-directed genetically modified autologous T-cell immunotherapy. Supporting Efficacy...
Acalabrutinib Plus Chemoimmunotherapy Improves Progression-Free Survival in Older Patients With Mantle Cell Lymphoma
Combining Bruton’s tyrosine kinase (BTK) inhibition with chemoimmunotherapy induction significantly extended progression-free survival for older patients with mantle cell lymphoma, and there was also a trend toward improvement on the overall survival benefit, according to data presented during the...
FDA Approves Immunotherapy for Relapsed or Refractory CTCL
On August 8, the U.S. Food and Drug Administration (FDA) approved denileukin diftitox-cxdl (Lymphir), a novel immunotherapy for the treatment of adult patients with relapsed or refractory cutaneous T-cell lymphoma (CTCL) who have received at least one prior systemic therapy. Denileukin diftitox is...
Extranodal Marginal Zone Lymphoma: Is Overtreatment Common?
Most patients with extranodal marginal zone lymphoma (MZL) are overtreated, according to Emanuele Zucca, MD, of the Oncology Institute of Southern Switzerland and Institute of Oncology Research in Bellinzona and the Università della Svizzera Italiana in Lugano. “Aggressive therapy is not needed in...
Glofitamab Combination Therapy Shows Survival Benefit in Relapsed or Refractory Diffuse Large B-Cell Lymphoma
A novel treatment regimen with the bispecific antibody glofitamab has demonstrated improvements in survival outcomes for patients with relapsed or refractory diffuse large B-cell lymphoma (DLBCL), according to data presented at the European Hematology Association (EHA) 2024 Congress.1 The phase III ...
Cancer Risk From Exposure to Pesticides May Be Comparable to Risk From Smoking, Study Finds
Agricultural pesticides may carry a similar risk as smoking for some types of cancers, according to a recent study published by Gerken et al in Frontiers in Cancer Control and Society. Background In modern agriculture practices, pesticides are essential to ensure high enough crop yields and food...
Addition of Ibrutinib to Immunochemotherapy and ASCT Improves Survival in Mantle Cell Lymphoma
As reported in The Lancet by Martin Dreyling, MD, PhD, of Ludwig Maximilian University Hospital Munich, 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...
Triplet Combination Improves Survival in Relapsed or Refractory Diffuse Large B-Cell Lymphoma in Third-Line Setting
The anti-CD30 antibody-drug conjugate brentuximab vedotin is a standard of care for certain types of lymphomas, including classical Hodgkin lymphoma in combination with multiagent chemotherapy. Brentuximab vedotin has also shown efficacy and safety in combination with lenalidomide and rituximab in...
