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The lymphomas are an incredibly complex assemblage of neoplastic diseases. They are not one disease, and, at least based on the World Health Organization (WHO) Classification of Tumors published in 2017, they represent a collection of approximately 80 different malignancies, a number that will...
Vitamin D is a steroid-like hormone involved primarily in human calcium homeostasis. Obtained through sun exposure as well as food and dietary supplements,1 vitamin D in humans is metabolized in the liver and kidneys to its active form, 1,25-dihydroxyvitamin D (1,25[OH]2D).2 Other cell types,...
On April 21, the U.S. Food and Drug Administration (FDA) expanded the indication of ibrutinib (Imbruvica) to include its combination with rituximab for the initial treatment of adult patients with chronic lymphocytic leukemia (CLL) or small lymphocytic lymphoma (SLL). This review was conducted...
In a phase II trial reported in The New England Journal of Medicine, Michael Wang, MD, and colleagues found that the anti-CD19 chimeric antigen receptor (CAR) T-cell therapy KTE-X19 produced a high response rate in patients with relapsed or refractory mantle cell lymphoma who had received previous...
The U.S. Food and Drug Administration (FDA) recently approved a new dose for a biosimilar referencing trastuzumab and granted Fast Track designations to agents for patients with urothelial cancer and follicular lymphoma. Approval of Multidose Vial of Trastuzumab Biosimilar The FDA approved a...
ABSTRACT 355: MURANO study: Four-year analysis confirms sustained benefit (compared to bendamustine and rituximab; n = 195) of time-limited venetoclax/rituximab (n = 194) in relapsed or refractory chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL; ClinicalTrials.gov NCT02005471)1...
To complement The ASCO Post’s continued comprehensive coverage of the 2019 American Society of Hematology (ASH) Annual Meeting & Exposition, here are several abstracts selected from the meeting proceedings focusing on novel therapies for newly diagnosed chronic lymphocytic leukemia (CLL) and...
In the phase I/II ADVL1412 study reported in The Lancet Oncology, Davis et al identified the phase II dosage of nivolumab monotherapy in children and young adults with relapsed or refractory solid tumors or lymphoma. Objective responses were observed in patients with lymphoma, but not in those with ...
Dr. Armitage discusses the role of CAR T-cell therapy in the management of multiple myeloma and lymphoma in a conversation with his colleagues Dr. Holstein and Dr. Lunning.
Dr. Armitage presents a case and asks Dr. Lunning to describe how he would treat this patient. The patient is a 52-year-old man who found a neck mass himself. He went to his doctor and was prescribed antibiotics. When the antibiotics failed to impact the mass, a biopsy was performed and a diagnosis of diffuse large B-cell lymphoma was made. A positron emission tomography (PET) scan was positive in the neck, mediastinum, axilla, and retroperitoneum. The maximum standardized uptake (SUV) value was 29. A bone marrow biopsy was negative and the patient’s LDH level was slightly above normal. The patient was treated with six cycles of CHOP-R and responded to therapy. Nine months later this individual identified a new node in his neck. He returned to his doctor and a biopsy was performed. A diagnosis of large B-cell lymphoma was made. A PET scan showed disease in the neck and mediastinum, and the maximum SUV is now 18. How would Dr. Lunning approach such a person?
Dr. Armitage presents a case and asks Dr. Lunning to describe how he would treat this patient. The patient is a 25-year-old man with a diagnosis of stage III nodular sclerosing Hodgkin lymphoma. His disease went into complete remission when the patient was treated with ABVD and he was well. One year after his last cycle of therapy, the patient returns to see you, and you detect a node in his neck. A PET scan is performed, showing there is no node larger than 2 cm, but these nodes were present both above and below the diaphragm. The standardized uptake value (SUV) maximum was 8. The lymph node biopsy reveals recurrent lymphoma. What will Dr. Lunning tell this patient?
Over the past week, the U.S. Food and Drug Administration (FDA) granted Priority Review to a combination therapy in diffuse large B-cell lymphoma (DLBCL); gave Fast Track designations for treatments in T-cell lymphoma and adenoid cystic carcinoma; granted Orphan Drug designation to an agent for the ...
This week, the U.S. Food and Drug Administration (FDA) granted Priority Review to treatments for non–small cell and small cell lung cancers, as well as for diffuse large-B cell lymphoma (DLBCL); Breakthrough Therapy designation to an antibody-drug conjugate for bladder cancer; and a double Fast...
Adult patients with diffuse large B-cell lymphoma (DLBCL) whose disease was effectively treated with the chimeric antigen receptor (CAR) T-cell therapy tisagenlecleucel showed sustained and clinically meaningful improvement in a variety of self-reported quality-of-life measures, according to...
The ASH 2019 Annual Meeting & Exposition featured countless important sessions and lectures. It would be impossible to attend all the symposia, oral presentations, poster presentations, and special events. Below, we have selected some presentation highlights to supplement our coverage of the...
Two separate studies are investigating brentuximab vedotin plus nivolumab combination therapy for adults with Hodgkin lymphoma: one as first-line therapy and another as salvage therapy for relapsed/refractory classic disease, according to data presented at the 2019 Annual Meeting & Exposition...
Mosunetuzumab, an investigational bispecific antibody, demonstrated activity in preliminary studies of patients with non-Hodgkin lymphoma (NHL), including those who are refractory to or relapsed after third-line chimeric antigen receptor (CAR) T-cell therapy. With further study, mosunetuzumab,...
Basem M. William, MD, MRCP (UK), FACP, Director of the T-Cell Lymphoma Program and Member of the Blood and Marrow Transplant Program at The Ohio State University Comprehensive Cancer Center, Columbus, said many of the new-generation bispecific antibodies are “highly promising.” He said they “are...
Are second-generation bispecific antibodies the next big thing in lymphoma? Studies of these drugs were among the highlights of the 2019 American Society of Hematology (ASH) Annual Meeting & Exposition. Years ago, the bispecific T-cell engager blinatumomab validated the concept of bispecific...
More than 25,000 specialists in hematology from over 115 countries attended the 61st American Society of Hematology (ASH) Annual Meeting & Exposition held last December in Orlando. The conference featured a stunning array of 4,900 abstracts with impressive new data in the treatment of multiple...
In a retrospective analysis reported in the Journal of Clinical Oncology, Fatobene et al found that nonmyeloablative haploidentical related donor cell transplantation was associated with better outcomes compared to unrelated cord blood hematopoietic transplantation in patients with Hodgkin and...
This week, the U.S. Food and Drug Administration (FDA) granted Priority Review to agents in lymphoma, lung cancer, gastrointestinal stromal tumors, and breast cancer, and granted Fast Track designation to a first-in-class radioenhancer hafnium oxide nanoparticle in head and neck cancer. Priority...
Edmund K. Waller, MD, PhD, Professor, Departments of Medicine, Pathology, and Hematology and Medical Oncology at Emory University School of Medicine and Medical Director, Center for Stem Cell Processing and Apheresis at Emory, said he was not surprised to learn that bridging therapy was associated...
The use of bridging therapy before treatment with axicabtagene ciloleucel was associated with worse overall survival in univariate, multivariate, and propensity score–matched analyses performed on data from the U.S. Lymphoma CAR T Consortium, investigators reported at the 2019 American Society of...
Michael Jain, MD, PhD, Assistant Member in the Department of Blood and Marrow Transplant and Cellular Immunotherapy at Moffitt Cancer Center, Tampa, Florida, commented on Dr. Kilgore’s findings. Dr. Jain was coauthor of a study by the U.S. Lymphoma CAR T Consortium that presented real-world data...
Once considered highly experimental, chimeric antigen receptor (CAR) T-cell therapy is now an established third-line treatment option for B-cell lymphomas and leukemias. CAR T-cell therapy has saved the lives of people who would otherwise have run out of treatment options. But the question is...
Jeremy S. Abramson, MD, Director of the Jon and JoAnn Hagler Center for Lymphoma at Massachusetts General Hospital and Associate Professor of Medicine at Harvard Medical School, Boston, commented on the study by Topp et al for The ASCO Post. “Earlier use of steroids with axicabtagene ciloleucel...
In patients with large B-cell lymphoma undergoing chimeric antigen receptor (CAR) T-cell therapy with axicabtagene ciloleucel, earlier-than-usual intervention with corticosteroids and tocilizumab may reduce the incidence of severe cytokine-release syndrome, according to the findings of a...
Joshua Brody, MD, Director of the Lymphoma Immunotherapy Program at the Icahn School of Medicine at Mount Sinai, New York, commented on where zanubrutinib might fit in once the drug is approved. “The two abstracts presented at ASH 2019 …demonstrated remarkably high response rates, durations of...
The Bruton’s tyrosine kinase inhibitor (BTK) zanubrutinib continues to achieve high overall response rates for patients with chronic lymphocytic leukemia (CLL) and small lymphocytic lymphoma (SLL), even in the presence of high-risk cytogenetics, according to findings from two different trials...
Basem M. William, MD, MRCP(UK), FACP, Director of the T-Cell Lymphoma Program and Member of the Blood and Marrow Transplant Program at The Ohio State University Comprehensive Cancer Center–Arthur G. James Cancer Hospital and Richard J. Solove Research Institute, Columbus, Ohio, commented on the...
Advanced mantle cell lymphoma appears to be a good target for chimeric antigen receptor (CAR) T-cell therapy. Treatment with KTE-X19, an anti-CD19 CAR T-cell product, led to unprecedented outcomes in patients with relapsed or refractory disease in the phase II ZUMA-2 study presented at the 2019 ASH ...
The National Comprehensive Cancer Network® (NCCN®) has published new guidelines for treating children, adolescents, and young adults with pediatric aggressive mature B-cell lymphomas, including Burkitt lymphoma and diffuse large B-cell lymphoma. NCCN published the first pediatric NCCN Clinical...
The combination of brentuximab vedotin and nivolumab is making headway as first-line therapy for older adults with Hodgkin lymphoma and as salvage therapy for adults with relapsed or refractory classic Hodgkin lymphoma, according to separate studies presented at the 2019 Annual Meeting &...
As reported in The Lancet by Viola Poeschel, MD, and colleagues, the phase III FLYER trial has shown noninferiority of progression-free survival with four vs six cycles of cyclophosphamide/doxorubicin/vincristine/prednisone (CHOP) in combination with six doses of rituximab in patients with...
Interim analysis of the phase I/II KEYNOTE-051 trial, reported in The Lancet Oncology by Geoerger et al, indicated minimal activity of pembrolizumab in pediatric patients with programmed cell death ligand 1 (PD-L1)-positive advanced, relapsed, or refractory solid tumors; however, activity was...
In the Clinic provides overviews of novel oncology agents, addressing indications, mechanisms of action, administration recommendations, safety profiles, and other essential information needed for the appropriate clinical use of these drugs. Late in 2018, rituximab-abbs was approved as the first...
Primary mediastinal B-cell lymphoma is an uncommon but distinct clinicopathologic variant of diffuse large B-cell lymphoma (DLBCL) that typically presents with an aggressive mediastinal mass and invasion of local structures. Most patients are young, typically in their 20s and 30s, and there is a...
Findings in the phase Ib KEYNOTE-013 and phase II KEYNOTE-170 trials, reported in the Journal of Clinical Oncology by Philippe Armand, MD, PhD, of DanaFarber Cancer Institute, and colleagues, indicate that pembrolizumab is active in relapsed or refractory primary mediastinal large B-cell...
The ASCO Post is pleased to present Hematology Expert Review, an ongoing feature that quizzes readers on issues in hematology. In this installment, Syed Ali Abutalib, MD, and L. Jeffrey Medeiros, MD, explore the updated World Health Organization (WHO) classification of hematopoietic and lymphoid ...
On November 21, 2019, the Bruton’s tyrosine kinase (BTK) inhibitor acalabrutinib was approved for the treatment of adults with chronic lymphocytic leukemia (CLL) or small lymphocytic lymphoma (SLL).1,2 The review resulting in approval was conducted under Project Orbis, an initiative of the U.S....
Jennifer Crombie, MD, of Dana-Farber Cancer Institute, discusses early study results which showed that duvelisib plus venetoclax showed activity in patients with relapsed or refractory chronic lymphocytic leukemia/small lymphocytic lymphoma, with no dose-limiting toxicities observed (Abstract 1763).
Catherine M. Diefenbach, MD, of the Perlmutter Cancer Center at NYU Langone, discusses a primary analysis of a phase Ib/II trial showing that the novel triplet combination of polatuzumab vedotin plus obinutuzumab/lenalidomide is safe and effective, with high complete response rates seen in a heavily pretreated and refractory population (Abstract 126).
On November 14, 2019, the oral Bruton’s tyrosine kinase (BTK) inhibitor zanubrutinib was granted accelerated approval in the treatment of adult patients with mantle cell lymphoma (MCL) who have received at least one prior therapy.1,2 Supporting Efficacy Data The approval was based on findings from...
Patients with follicular lymphoma who have been treated and are in remission for at least 2 years may no longer be incurable based on highly sensitive testing. This may mean they no longer need therapy or active follow-up, according to findings presented by Sarraf Yazdy et al at the 2019 American...
Most people diagnosed with early-stage, or limited, diffuse large B-cell lymphoma (DLBCL) may be able to safely skip radiation treatment after a clear positron-emission tomography (PET) scan, according to new clinical trial results from SWOG presented by Persky et al at the 2019 American Society of ...
Loretta J. Nastoupil, MD, of The University of Texas MD Anderson Cancer Center, discusses phase II study findings that showed obinutuzumab in combination with lenalidomide for patients with previously untreated, high tumor burden follicular lymphoma was associated with improved outcomes (Abstract 125).
A new analysis of Medicare claims data presented by Kilgore et al at the 2019 American Society of Hematology (ASH) Annual Meeting & Exposition (Abstract 793) has provided the first real-world evidence using claims data available after the approval of autologous anti-CD19 chimeric antigen...
The investigational bispecific antibody mosunetuzumab is showing activity in preliminary studies of patients with non-Hodgkin lymphoma (NHL), including those who are refractory to or relapsed after third-line chimeric antigen receptor (CAR) T-cell therapy. If preliminary findings are validated by...
In a phase I/II study reported in The Lancet Oncology, Geoerger et al found little activity of atezolizumab alone in pediatric and young adult patients with relapsed or refractory malignancies (including solid tumors, non-Hodgkin lymphoma, and Hodgkin lymphoma) with known or expected programmed...