Andrew Matthews, MD, on AML: CPX-351 vs Venetoclax/Azacitidine for Initial Therapy
2021 ASH Annual Meeting & Exposition
Andrew Matthews, MD, of the Abramson Cancer Center, University of Pennsylvania, discusses findings from a retrospective study at an academic institution, which showed there was no statistically significant difference in overall survival between induction with CPX-351 and venetoclax/azacitidine for adults with acute myeloid leukemia. Prospective studies to confirm similar effectiveness with careful attention to side effects, quality of life, and impact on transplant outcomes may help clinicians decide between these therapies (Abstract 795).
Alba Rodriguez-Meira, DPhil, of the University of Oxford, discusses a comprehensive analysis of the genetic, cellular, and molecular landscape of TP53-mediated transformation, providing insights into the evolution of chronic hematologic malignancies toward an aggressive acute leukemia. Because TP53 is the most commonly mutated gene in human cancer, these findings may well be of broad relevance (Abstract 3).
Daniel A. Ermann, MD, of the Huntsman Cancer Institute, University of Utah, discusses results from the largest retrospective study on outcomes utilizing radiotherapy in early-stage diffuse large B-cell lymphoma. Adding radiation to front-line multiagent chemotherapy was associated with a survival benefit for all patients with early-stage disease. An overall survival benefit was seen with the addition of radiation to front-line multiagent chemotherapy for patients with nodal involvement and those with specific extranodal involvement in the testes, thyroid, skin and soft tissue, and head and neck (Abstract 49).
Carsten Utoft Niemann, MD, PhD, of Copenhagen University Hospital, discusses a primary analysis of the phase II Vision HO141 trial, which showed the feasibility of stopping and restarting ibrutinib and venetoclax in patients with relapsed or refractory chronic lymphocytic leukemia who have undetectable measurable residual disease. A favorable benefit-risk profile was demonstrated, with no new safety signals (Abstract 69).
Roni Shouval, MD, PhD, of Memorial Sloan Kettering Cancer Center, discusses his findings, which show, for the first time, that TP53 alterations are a valuable prognostic and potentially predictive marker in patients with large B-cell lymphoma who receive CD19–CAR T-cell therapy. Gene-expression profiling suggests that TP53 alterations result in an immunosuppressive tumor microenvironment and impaired apoptosis signaling, which could lead to decreased CAR T-cell therapy efficacy (Abstract 710).
Masayuki Umeda, MD, of St. Jude Children's Research Hospital, discusses his research which showed that UBTF-TD (upstream binding transcription factor-tandem duplications) define a unique subtype of acute myeloid leukemia that previously lacked a clear oncogenic driver. UBTF-TD is associated with FLT3-ITD and WT1 mutations, adolescent age, and poor outcomes. These alterations are critical for future risk-stratification for this patient cohort.