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...
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...
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...
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 ...
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...
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...
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...
Two hallmark toxicities of chimeric antigen receptor (CAR) T-cell therapy may be rare after 2 weeks following infusion in patients with diffuse large B-cell lymphoma (DLBCL), supporting a shorter, more flexible toxicity monitoring period., according to a recent study published by Ahmed et al in...
In a single-institution phase II trial reported in JAMA Oncology, Pinnix et al found that response-adapted radiation therapy featuring ultra–low-dose radiation therapy was a successful strategy in patients with indolent B-cell lymphoma of the ocular adnexa. As stated by the investigators:...
In a single-center phase I trial reported in The Lancet, Frank et al found that CD22-directed chimeric antigen receptor (CAR) T-cell therapy (CAR22) showed activity in patients with large B-cell lymphoma (LBCL) whose disease progressed on CD19-directed CAR T-cell therapy (CAR19). CD22 is a nearly...
As reported in The Lancet by Peter Borchmann, MD, and colleagues, the phase III HD21 trial showed that first-line positron-emission tomography (PET)-guided BrECADD (brentuximab vedotin, etoposide, cyclophosphamide, doxorubicin, dacarbazine, and dexamethasone) exhibited greater efficacy and...
Patients with mantle cell lymphoma may be susceptible to certain diseases and may benefit from evaluation for the risk of infection, according to a recent study published by Abalo in HemaSphere. Background “Patients [with mantle cell lymphoma] live with an increased risk of infections for many...
On June 26, the U.S. Food and Drug Administration (FDA) granted accelerated approval to epcoritamab-bysp (Epkinly), a bispecific CD20-directed CD3 T-cell engager, for adult patients with relapsed or refractory follicular lymphoma who have received two or more lines of systemic therapy. EPCORE ...
The results from a phase Ib/II study of a five-drug regimen of venetoclax, ibrutinib, prednisone, obinutuzumab, and lenalidomide (ViPOR) in patients with relapsed or refractory diffuse large B-cell lymphoma (DLBCL) show the treatment produced durable remissions in patients with specific molecular...
Patients with chronic lymphocytic leukemia (CLL) and non-Hodgkin lymphoma (NHL) who undergo frequent immunoglobulin G testing may be less likely to experience severe infections than those who don’t undergo frequent testing, according to a recent study published by Soumerai et al in Blood Advances....
A novel “armored” chimeric antigen receptor (CAR) T cell appears to be feasible for retreatment of patients with non-Hodgkin lymphoma (NHL) who fail to respond to standard CAR T-cell therapy, according to preliminary results of a phase I trial presented at the 2024 ASCO Annual Meeting.1 The unique...
As reported in the Journal of Clinical Oncology, Zanwar et al developed a prognostic model for overall survival in patients with Waldenström’s macroglobulinemia based on age, albumin level, and lactate dehydrogenase (LDH) level. Study Details In the study, data from 889 consecutive treatment-naive...
A novel “armored” type of chimeric antigen receptor (CAR) T-cell therapy called huCART19-IL18 may prove to be effective in patients with non-Hodgkin lymphoma who do not respond to standard CAR T-cell therapy, according to recent findings from a phase I clinical trial presented by Svoboda et al at...
Yasmin H. Karimi, MD, of the University of Michigan Comprehensive Cancer Center, discusses 2.5-year follow-up data on epcoritamab monotherapy for patients with relapsed or refractory large B-cell lymphoma. The subcutaneous regimen continues to demonstrate durable responses (Abstract 7039).
Yasmin H. Karimi, MD, of the University of Michigan Comprehensive Cancer Center, discusses data reaffirming the efficacy and feasibility of using epcoritamab plus R-DHAX/C (rituximab, dexamethasone, cytarabine, and oxaliplatin or carboplatin) in autologous stem cell transplant–eligible patients with diffuse large B-cell lymphoma. Response rates were reported to be high, and most patients proceeded to transplant (Abstract 7032).
William G. Wierda, MD, PhD, of The University of Texas MD Anderson Cancer Center, discusses up to 5.5 years of follow-up data from the phase II CAPTIVATE study, showing that in patients with chronic lymphocytic leukemia (CLL)/small lymphocytic lymphoma (SLL), fixed duration ibrutinib plus venetoclax continues to provide clinically meaningful progression-free disease in those with high-risk genomic features as well as in the overall population (Abstract 7009).
Joshua D. Brody, MD, of the Icahn School of Medicine at Mount Sinai, discusses results from the EPCORE NHL-2 study, which was designed to evaluate the safety and efficacy of epcoritamab-bysp plus rituximab and lenalidomide in the first-line setting for patients with follicular lymphoma and to assess epcoritamab as maintenance therapy in this population (Abstract 7014).
Peter Riedell, MD, of The University of Chicago, discusses phase III findings on the regimen of brentuximab vedotin in combination with lenalidomide and rituximab for patients with relapsed or refractory diffuse large B-cell lymphoma (DLBCL). This therapy demonstrated a survival advantage in the third-line setting, but as this is an interim analysis, questions remain regarding long-term safety and duration of response, according to Dr. Riedell (Abstract LBA7005).
Peter Riedell, MD, of The University of Chicago, discusses phase III results on the use of tucidinostat plus R-CHOP in patients with previously untreated diffuse large B-cell lymphoma (DLBCL) with double expression of MYC and BCL2. The regimen appeared to improve event-free survival and complete response rates vs R-CHOP in the front-line setting. As this is an interim analysis, longer-term follow-up will be needed to better understand its impact, says Dr. Riedell.
David J. Andorsky, MD, of the Sarah Cannon Research Institute and Rocky Mountain Cancer Centers, discusses EPCORE NHL-6, an ongoing study of patients with relapsed or refractory diffuse large B-cell lymphoma (DLBCL) and follicular lymphoma (FL). As outpatients, the study participants were given subcutaneous epcoritamab-bysp to see whether they could be safely monitored and cytokine-release syndrome appropriately managed in the outpatient setting (Abstract 7029).
A chimeric antigen receptor (CAR) T-cell therapy approved for patients with large B-cell lymphoma has produced positive results in a pilot study involving patients with relapsed, treatment-resistant central nervous system (CNS) lymphoma. These findings from a small cohort were presented by Nayak et ...
Although advancements in the treatment of classical Hodgkin lymphoma have increased the 5-year relative survival rate of patients with the disease to nearly 90%, dose-intensified treatment strategies may increase the risk for acute and long-term toxicities. The German Hodgkin Study Group (GHSG)...
Muhit Özcan, MD, of Turkey’s Ankara University School of Medicine, discusses the ongoing phase III BELLWAVE-010 study of nemtabrutinib plus venetoclax vs venetoclax plus rituximab in previously treated patients with relapsed or refractory chronic lymphocytic leukemia (CLL)/small lymphocytic lymphoma (SLL) (Abstract TPS7089).
On May 30, the U.S. Food and Drug Administration (FDA) approved the chimeric antigen receptor (CAR) T-cell therapy lisocabtagene maraleucel (Breyanzi) for adult patients with relapsed or refractory mantle cell lymphoma who have received at least two prior lines of systemic therapy, including a...
Tattoos may be a risk factor in the development of lymphoma, according to a recent study published by Nielsen et al in eClinicalMedicine. Background A majority of individuals receive their first tattoos at a young age, exposing them to tattoo ink for a larger portion of their lives. The long-term...
About 3 years ago, I woke up from a sound sleep and was having a hard time breathing. It felt like someone was sitting on my neck, constricting my airways. I could feel prominent swelling in my lymph nodes along my neck and clavicle, and I was scared. A trip to the emergency room proved fruitless, ...
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...