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We have seen remarkable progress in the outcomes of patients with advanced-stage follicular lymphoma over the past 2 decades.1 Recent manuscripts and presentations describing long-term follow-up of randomized trials comparing various chemotherapy platforms (all combined with anti-CD20 antibodies)...
Reem Karmali, MD, of the Robert H. Lurie Comprehensive Cancer Center of Northwestern University, discusses CAR T-cell therapy for relapsed/refractory DLBCL and other subtypes of lymphomas, ways to manage toxicities, and how to integrate this treatment into care plans.
On September 24, 2018, the U.S. Food and Drug Administration (FDA) granted regular approval to duvelisib (Copiktra) for adult patients with relapsed or refractory chronic lymphocytic leukemia (CLL) or small lymphocytic lymphoma (SLL) after at least two prior therapies. In addition, duvelisib...
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. On June 13, 2018, pembrolizumab (Keytruda) was granted...
In a phase III RELEVANCE trial reported in The New England Journal of Medicine by Morschhauser et al, no difference in complete response rate or interim progression-free survival was found between rituximab [Rituxan]/lenalidomide [Revlimid] vs rituximab/chemotherapy in newly diagnosed advanced...
In a phase II study reported in the Journal of Clinical Oncology, Evens et al found that a regimen of brentuximab vedotin (Adcetris) given sequentially before and after standard doxorubicin, vinblastine, and dacarbazine (AVD) was associated with good outcomes in untreated older patients with...
As the population continues to age, the interplay between aging and cancer increasingly shows cancer to be a disease of older people. By the year 2030, there will be an increased incidence of non-Hodgkin lymphoma (NHL) in older individuals.1 The median age of patients diagnosed with diffuse large...
AS MORE is learned about the genomic landscape in non-Hodgkin lymphoma, clinicians are grappling with how to apply this information in the clinic. At the 2018 Pan Pacific Lymphoma Conference, Andrew D. Zelenetz, MD, PhD, helped them understand this emerging area.1 Dr. Zelenetz is Professor of...
As novel therapies come on board for treating relapsed or refractory Hodgkin lymphoma, the field is advancing toward more personalized therapy. The goal, even in the advanced-disease setting, is to increase the chances of complete response and negative positron-emission tomography (PET), while...
BOOKMARK Title: The Cookie Cure: A Mother-Daughter Memoir of Cookies and CancerAuthors: Susan Stachler With Laura StachlerPublisher: SourcebooksPublication date: February 2018Price: $19.95, paperback, 320 pages Cancer memoirs vary in their voice and message. Some are slapstick humorous attempts to ...
In a Children’s Oncology Group phase I/II trial reported in The Lancet Oncology, Cole et al found that the combination of brentuximab vedotin (Adcetris) and gemcitabine was active in pediatric and young adult patients with relapsed or refractory Hodgkin lymphoma. As noted by the...
In a study reported in the Journal of Clinical Oncology, Kurtz et al found that baseline circulating tumor DNA (ctDNA) and molecular response to treatment were independent predictors of treatment outcome in diffuse large B-cell lymphoma. Study Details The association of ctDNA with treatment...
The European Commission (EC) recently approved the chimeric antigen receptor (CAR) T-cell therapy tisagenlecleucel (Kymriah) in the European Union (EU) for the treatment of pediatric and young adult patients up to 25 years of age with B-cell acute lymphoblastic leukemia (ALL) that is...
The U.S. Food and Drug Administration (FDA) has approved ibrutinib (Imbruvica) plus rituximab (Rituxan) for the treatment of adult patients with Waldenström's macroglobulinemia (WM). With this approval, the ibrutinib prescribing information now includes combination use with rituximab,...
As reported by Kim and colleagues in The Lancet Oncology, the phase III MAVORIC trial showed that the anti-C-C chemokine receptor 4 (CCR4) monoclonal antibody mogamulizumab (Poteligeo) significantly improved progression-free survival vs vorinostat (Zolinza) among patients with previously treated...
The U.S. Food and Drug Administration (FDA) has granted Orphan Drug designation to CPI-613 for the treatment of peripheral T-cell lymphoma. CPI-613 is a novel lipoic acid analog with an anticancer activity that inhibits multiple enzyme targets within the tricarboxylic acid cycle. This drug is...
On August 8, the U.S. Food and Drug Administration approved mogamulizumab-kpkc (Poteligeo) injection for intravenous use in the treatment of adult patients with relapsed or refractory mycosis fungoides or Sézary syndrome after at least one prior systemic therapy. This approval provides a new...
Although many agents have been able to successfully inhibit the proliferative capacity of cancer cells or disable mutations that spur cancer growth, one area that has proven elusive is the apoptotic pathway—the cell’s means of resisting death. That is until recently. Dysregulation of B-cell...
Although programmed cell death protein 1 (PD-1) blockade is highly effective in Hodgkin lymphoma, not all patients respond, and not all responses are durable. Stephen M. Ansell, MD, PhD, Chair of the Mayo Clinic Lymphoma Group and Professor of Medicine at the Mayo Clinic, Rochester, described...
Today, the U.S. Food and Drug Administration approved mogamulizumab-kpkc (Poteligeo) injection for intravenous use for the treatment of adult patients with relapsed or refractory mycosis fungoides or Sézary syndrome after at least one prior systemic therapy. This approval provides a new...
FOR THE TREATMENT of lymphoma, antibody-drug conjugates (ADCs) are becoming an important class of drugs, as described at the 2018 Pan Pacific Lymphoma Conference by Brad Kahl, MD, Professor of Medicine at Washington University School of Medicine, St. Louis.1 “We have one ADC—brentuximab vedotin...
THE EMERGENCE of chimeric antigen receptor (CAR) T-cell therapy has sparked a wave of optimism in hematologic malignancies, but as experience in using CAR T-cell therapy has grown, new challenges have surfaced. A pioneer in the field, David G. Maloney, MD, PhD, enlightened attendees on these issues ...
In a Swedish study reported in the Journal of Clinical Oncology, Weibull et al found that childbearing potential in young women treated for Hodgkin lymphoma in more recent years is similar to that in the general population. Study Details The study included 449 women aged 18 to 40 years identified ...
Peggy Burhenn, MS, RN-BC, AOCNS, of the City of Hope National Medical Center, discusses the challenges of working with older lymphoma patients and the importance of effective geriatric assessments.
Julie M. Vose, MD, MBA, of the University of Nebraska Medical Center, and David G. Maloney, MD, PhD, of Fred Hutchinson Cancer Research Center and winner of this year’s Oliver Press Memorial Award, discuss three CAR T-cell products for lymphoma treatment, comparing their efficacy, toxicity, ease of use, and the clinical resources needed.
Jonathan W. Friedberg, MD, of the University of Rochester Medical Center, discusses treatments that enhance progression-free and overall survival and clear minimal residual disease—obinutuzumab plus chemotherapy, lenalidomide, and rituximab—and the types of lymphoma patients who may benefit.
Bruce D. Cheson, MD, of Georgetown University Hospital, and Richard I. Fisher, MD, of Fox Chase Cancer Center, discuss ways to incorporate PET and CT scanning into standard of care for and research studies on lymphoma.
Philip J. Bierman, MD, of the University of Nebraska Medical Center, discusses how to identify and treat the 1% to 2% of patients with diffuse large B-cell lymphoma who have central nervous system involvement as well as systemic sites at the time of diagnosis.
Laurie H. Sehn, MD, MPH, of the British Columbia Cancer Centre for Lymphoid Cancer, discusses the challenges of treating high-grade B-cell lymphoma in older patients and those with comorbidities. Several strategies have been devised, but more research is needed as well as more options for novel therapies.
Steven M. Horwitz, MD, of Memorial Sloan Kettering Cancer Center, discusses aggressive subtypes of peripheral T-cell lymphoma and the coming data that may help clarify what could be the most effective treatments.
John G. Gribben, MD, DSc, of the Barts Cancer Institute, discusses how understanding the role of the tumor microenvironment can help identify treatment targets, including combination therapies, and improve outcome for patients with indolent lymphomas.
Kieron M. Dunleavy, MD, of George Washington University, discusses the need for drug combinations to improve lymphoma therapy, despite unexpected toxicities, as our understanding of the molecular biology grows.
Stephen M. Ansell, MD, PhD, of the Mayo Clinic, discusses the efficacy of PD-1 blockade in Hodgkin lymphoma, new findings related to PD-1 therapy, current combination approaches, and future treatments.
Andrew D. Zelenetz, MD, PhD, of Memorial Sloan Kettering Cancer Center, discusses the various ways genomics can be used in diagnosing and treating non-Hodgkin lymphoma and the need for a proper support tool to help interpret the data.
Julie M. Vose, MD, MBA, of the University of Nebraska Medical Center, discusses promising pathways for inhibitors—BTK, PI3K, EZH2, bcl-2—and the clinical trials for single agents and combinations that suggest their potential for lymphoma treatment.
In an individual patient-level analysis reported in the Journal of Clinical Oncology, Shi et al found that progression-free survival could serve as a surrogate endpoint for overall survival in the first-line treatment of diffuse large B-cell lymphoma (DLBCL). The study involved data from 7,507...
Results of the phase III Trans-Tasman Radiation Oncology Group 99.03 trial reported in the Journal of Clinical Oncology by MacManus et al indicate that use of systemic therapy following involved-field radiotherapy (IFRT) increased progression-free survival in patients with stage I or II low-grade...
The U.S. Food and Drug Administration (FDA) has granted Orphan Drug designation to CPI-613 for the treatment of Burkitt lymphoma. Burkitt lymphoma is a highly aggressive hematologic B-cell malignancy classically characterized by the overexpression of c-Myc. Due to the rapid proliferation rate of...
BRUCE D. CHESON, MD, Director of the Division of Hematology/Oncology at the Lombardi Comprehensive Cancer Center, Washington, DC, agreed that rituximab (Rituxan) plus lenalidomide (Revlimid; R2) is a reasonable first-line option, considering the findings of the RELEVANCE trial. “Dr. Fowler showed ...
IN PATIENTS with previously untreated advanced follicular lymphoma, the chemotherapy-free combination of rituximab (Rituxan) plus lenalidomide (Revlimid), the so-called R-squared (R2) regimen, yielded outcomes as good as those in patients who received standard rituximab-chemotherapy, in the interim ...
Austrian researchers have discovered that a small number of patients taking targeted drugs known as Janus kinase (JAK) inhibitors to treat myelofibrosis may develop aggressive lymphomas. They also speculate that screening for a preexisting B-cell clone before starting therapy may help prevent this...
In an analysis of the GALLIUM trial reported in the Journal of Clinical Oncology, Hiddemann and colleagues found that obinutuzumab (Gazyva) appeared to provide consistent progression-free survival benefit vs rituximab (Rituxan) in previously untreated follicular lymphoma, irrespective of which...
THE U.S. FOOD and Drug Administration (FDA) granted accelerated approval to pembrolizumab (Keytruda) for the treatment of adult and pediatric patients with refractory primary mediastinal large B-cell lymphoma or who have relapsed after two or more prior lines of therapy on June 13, 2018. The newest ...
When I was diagnosed with diffuse large B-cell lymphoma (DLBCL) in 2013, I used to joke that if I had to get cancer, this wasn’t a bad one to have. At just 32, I was otherwise healthy, and my prognosis for a cure was good, according to my oncologist. So I felt confident that once I underwent...
In the phase II DAWN study reported in the Journal of Clinical Oncology, Gopal et al found that ibrutinib (Imbruvica) produced a response in a minority of patients with relapsed or refractory follicular lymphoma. Study Details In the study, 110 patients with ≥ 2 prior lines of treatment...
In patients with Waldenström’s macroglobulinemia, the risk of disease progression was reduced by 80% with the combination of ibrutinib (Imbruvica) and rituximab (Rituxan) over rituximab alone, in the international phase III iNNOVATE trial, reported at the 2018 ASCO Annual Meeting1 and...
Positive interim data were recently presented from an ongoing phase II study of tazemetostat—a potent, selective, orally available EZH2 inhibitor—as a monotherapy for patients with relapsed or refractory follicular lymphoma. The data, presented by Salles et al at the 23rd Annual...
Fourteen-month results from the JULIET clinical trial showed ongoing durable responses are achievable with tisagenlecleucel (Kymriah) when administered to adult patients with relapsed or refractory diffuse large B-cell lymphoma (DLBCL). This updated analysis was presented by Borchmann et al at ...
Today, the U.S. Food and Drug Administration (FDA) granted accelerated approval to pembrolizumab (Keytruda) for the treatment of adult and pediatric patients with refractory primary mediastinal large B-cell lymphoma or those who have relapsed after two or more prior lines of therapy. KEYNOTE-170...
The phase III iLLUMINATE (PCYC-1130) trial recently met its primary endpoint of improvement in progression-free survival. The study evaluated ibrutinib (Imbruvica) in combination with obinutuzumab (Gazyva) in patients with previously untreated chronic lymphocytic leukemia or small lymphocytic...