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Matthew S. Davids, MD, on Younger Patients With CLL: Ibrutinib Plus Fludarabine, Cyclophosphamide, and Rituximab as Initial Therapy
Matthew S. Davids, MD, of Dana-Farber Cancer Institute, discusses phase II results from a multicenter study that showed the efficacy of ibrutinib plus fludarabine, cyclophosphamide, and rituximab in younger, fit patients with chronic lymphocytic leukemia who desire the possibility of a functional...
Matthew S. Davids, MD, on CLL/SLL: New Data on Ibrutinib, Venetoclax, and Rituximab Therapies
Matthew S. Davids, MD, of Dana-Farber Cancer Institute, summarizes three key studies from a session he co-moderated on ibrutinib plus venetoclax for first-line treatment of patients with chronic lymphocytic leukemia (CLL) and small lymphocytic lymphoma (SLL), long-term responses to these agents for ...
CLARITY: Ibrutinib Plus Venetoclax in Relapsed or Refractory Chronic Lymphocytic Leukemia
In the phase II CLARITY trial reported in the Journal of Clinical Oncology, Hillmen et al found that the combination of ibrutinib and venetoclax resulted in high rates of minimal residual disease eradication in patients with relapsed or refractory chronic lymphocytic leukemia (CLL). In the...
Anesthesia Exposure and Neurocognitive and Neuroimaging Outcomes in Long-Term Survivors of Childhood ALL
In a study reported in JAMA Oncology, Banerjee et al found that higher cumulative anesthesia exposure and duration of exposure during treatment of childhood acute lymphoblastic leukemia (ALL) may be associated with adverse neurocognitive and abnormal neuroimaging outcomes in long-term survivors....
Substitution of Clofarabine for Anthracycline/Etoposide in Induction Therapy for Pediatric Acute Myeloid Leukemia
In the phase III AML08 trial reported in the Journal of Clinical Oncology, Rubnitz et al found that the use of clofarabine instead of an anthracycline and etoposide in the first course of induction therapy may be a feasible strategy in pediatric patients with acute myeloid leukemia. The trial,...
Association of Antibodies With Pegaspargase Allergic Reactions and Failure of Rechallenge in Pediatric ALL
In a study reported in the Journal of Clinical Oncology, Liu et al determined the frequency of allergic reactions and consequences of development of antibodies to pegaspargase (PEG-ASP) among pediatric patients with newly diagnosed acute lymphoblastic leukemia (ALL). As noted by the...
QuANTUM-R: Quizartinib vs Salvage Chemotherapy in Relapsed or Refractory FLT3-ITD–Positive AML
In the phase III QuANTUM-R trial reported in The Lancet Oncology, Cortes et al found that the FLT3 inhibitor quizartinib produced a modest but significant improvement in overall survival vs salvage chemotherapy in relapsed or refractory FLT3 internal tandem duplication (FLT3-ITD)-positive acute...
Effect of Hematopoietic Stem Cell Transplantation on Outcome in Pediatric Hypodiploid B-ALL
In a report from the Children’s Oncology Group (COG) in the Journal of Clinical Oncology, McNeer et al found that hematopoietic stem cell transplantation (HSCT) did not improve outcomes in pediatric patients with hypodiploid B-lymphoblastic leukemia (B-ALL). Study Details The study was a...
Treatment Outcomes for Children With Hypodiploid Acute Lymphoblastic Leukemia
In a retrospective study reported in the Journal of Clinical Oncology, Pui et al found that minimal residual disease (MRD)-negative status, high hypodiploidy with 44 chromosomes, and MRD-stratified treatment were associated with improved outcomes among children treated for newly diagnosed...
Effect of Early Cardiotoxicity on Outcomes in Pediatric AML
In an analysis from the Children’s Oncology Group AAML0531 trial reported in the Journal of Clinical Oncology, Getz et al found that early treatment-related cardiotoxicity may be associated with poorer event-free and overall survival in pediatric acute myeloid leukemia (AML). Study Details...
Comparison of Methotrexate Intensification Regimens in Children and Young Adults With T-Cell ALL
As reported by Winter et al in the Journal of Clinical Oncology, findings in the Children’s Oncology Group (COG) AALL0434 trial indicate improved outcomes with a COG methotrexate intensification regimen vs a high-dose methotrexate intensification regimen in children and young adults with...
Treatment Intensification for Childhood B-Cell Lymphoblastic Leukemia With IKZF1 Deletion
In an analysis of Asian trials reported in the Journal of Clinical Oncology, Yeoh et al found evidence that treatment intensification improved outcomes in childhood B-cell acute lymphoblastic leukemia (B-ALL) with IKZF1 deletion (del). The analysis compared outcomes in the Malaysia-Singapore ALL...
Long-Term Outcomes With Dasatinib Plus Intensive Chemotherapy in Pediatric/Young Adult Ph-Positive ALL
In an analysis of the Children’s Oncology Group (COG) AALL0622 trial reported in the Journal of Clinical Oncology, Slayton et al found that adding dasatinib (Sprycel) to intensive chemotherapy produced good long-term outcomes in pediatric/young adult patients with newly diagnosed Philadelphia ...
Clearance of Somatic Mutations at Remission and Outcomes in AML
In a study reported in the Journal of Clinical Oncology, Morita et al found that clearance of somatic mutations at complete remission—particularly those in nonpreleukemic genes—was associated with improved outcomes in previously untreated patients with acute myeloid leukemia (AML)....
Dasatinib for Pediatric Chronic Myeloid Leukemia in Chronic Phase
As reported in the Journal of Clinical Oncology by Gore et al, a phase II trial has shown high response rates with dasatinib treatment in pediatric patients with Philadelphia chromosome–positive (Ph+) chronic myeloid leukemia in chronic phase (CML-CP). Findings in the trial supported the...
Effect of TP53 Germline Variations on Outcomes in Pediatric B-Cell ALL
In a study reported in the Journal of Clinical Oncology, Qian et al found that loss-of-function germline TP53 variants increase the risk of childhood B-cell acute lymphoblastic leukemia (ALL), as well as the risk of poorer response to therapy and second malignancies. Study Details In the study,...
MicroRNA Expression–Based Risk Model for Pediatric Acute Myeloid Leukemia
As reported in the Journal of Clinical Oncology, Lim et al have identified a microRNA expression–based risk model associated with event-free survival in pediatric acute myeloid leukemia (AML). The study involved comprehensive miRNA sequencing of 1,362 pediatric AML samples, consisting of...
Arsenic Trioxide and Reduced Anthracycline Dose in Pediatric Acute Promyelocytic Leukemia
In the phase III historically controlled Children’s Oncology Group (COG) AAML0631 trial, arsenic trioxide consolidation permitted the use of lower-dose anthracycline without appearing to compromise outcomes in pediatric patients with acute promyelocytic leukemia (APL). The results were...
Effect of Methotrexate and Corticosteroid Strategies on Neurocognitive Function in Patients With B-Lineage ALL
In a Children’s Oncology Group (COG) study (AALL06N1) reported in the Journal of Clinical Oncology, Hardy et al found that age < 10 years at diagnosis was associated with poorer neurocognitive function in patients with high-risk B-lineage acute lymphoblastic leukemia regardless of...
CD33 Splicing Polymorphism and Response to Gemtuzumab Ozogamicin in AML
In an analysis of the phase III Children’s Oncology Group AAML0531 trial, published by Lambda et al in the Journal of Clinical Oncology, the CD33-targeted immunoconjugate gemtuzumab ozogamicin was shown to have benefit among patients with de novo acute myeloid leukemia (AML) who carry the CC...
Blinatumomab After Failure of TKI Treatment in B-Precursor Acute Lymphoblastic Leukemia
In a phase II trial reported in the Journal of Clinical Oncology, Martinelli et al found that blinatumomab (Blincyto) produced complete responses in patients with relapsed/refractory Philadelphia chromosome–positive (Ph+) B-precursor acute lymphoblastic leukemia (ALL) progressing after...
Mercaptopurine Ingestion Habits and Risk of Relapse in Children With Acute Lymphoblastic Leukemia
In a report from the Children’s Oncology Group Study AALL03N1 published in the Journal of Clinical Oncology, Landier et al found no association between oral mercaptopurine ingestion habits in children with acute lymphoblastic leukemia and risk of relapse after adjustment for medication...
Blinatumomab vs Chemotherapy in Advanced Acute Lymphoblastic Leukemia
In the phase III TOWER trial reported in The New England Journal of Medicine, Kantarjian et al found that blinatumomab (Blincyto) treatment improved overall survival vs chemotherapy in heavily pretreated patients with B-cell precursor acute lymphoblastic leukemia (ALL). Blinatumomab received...
High Financial Burden for CML Patients Enrolled in Medicare Part D Receiving Targeted Oral Therapy
In a study reported in the Journal of Oncology Practice, Shen et al found that more than three-quarters of patients receiving targeted oral therapy for chronic myeloid leukemia (CML) reached the catastrophic phase of the Medicare Part D benefit within the calendar year of starting such treatment....
ASH 2016: Ibrutinib and TGR-1202 Combination Yields Encouraging Results in Patients With Relapsed Forms of Leukemia or Lymphoma
A combination of two targeted agents has demonstrated safety as well as encouraging signs of effectiveness in a phase I clinical trial in patients with relapsed or hard-to-treat chronic lymphocytic leukemia (CLL) or mantle cell lymphoma (MCL). Davids et al reported the findings at the 58th American ...
High Frequency and Poor Outcome of Philadelphia Chromosome–Like ALL Reported in Adults
In a study reported in the Journal of Clinical Oncology, Roberts et al found a high frequency of Philadelphia chromosome (Ph)–like acute lymphoblastic leukemia (ALL) in adults with B-cell ALL and poorer outcome with conventional therapy in these patients. Frequency of Disease The frequency...
Phase II Trial Shows Benefit of Ibrutinib in Relapsed/Refractory CLL With 17p Deletion
O’Brien et al found further evidence of the benefit of ibrutinib (Imbruvica) in relapsed/refractory chronic lymphocytic leukemia (CLL) with the 17p deletion, according to an extended analysis of the phase II RESONATE-17 trial reported in The Lancet Oncology. Ibrutinib currently is approved...
Shorter Remission Telomere Length Associated With Prolonged Neutropenia After Pediatric AML Treatment
In a study reported in the Journal of Clinical Oncology, Gerbing et al found that prolonged posttreatment neutropenia was associated with shorter chromosomal telomere length in pediatric patients receiving chemotherapy for acute myeloid leukemia (AML). Study Details The study included 53 patients ...
Study Finds Inotuzumab Ozogamicin Improves Outcomes vs Standard Therapy in Relapsed/Refractory ALL
In a phase III trial reported in The New England Journal of Medicine, Kantarjian et al found that treatment with the antibody-drug conjugate inotuzumab ozogamicin resulted in a greater complete remission rate and improved overall survival vs standard therapy in patients with relapsed/refractory...
Risk Factors for Acute Pancreatitis in Children/Young Adults With Acute Lymphoblastic Leukemia
In a study reported in the Journal of Clinical Oncology, Liu et al found that Native American ancestry, older age, higher cumulative dose of asparaginase, and a rare variant of the CPA2 gene increased risk for pancreatitis in children/young adults with acute lymphoblastic leukemia (ALL). Study...
Benefit of Dexamethasone and High-Dose Methotrexate in Children/Young Adults With High-Risk B-Acute Lymphoblastic Leukemia
As reported by Larsen et al in the Journal of Clinical Oncology, final data from the Children’s Oncology Group (COG) AALL0232 trial indicate that the event-free survival benefit of high-dose methotrexate was maintained in children/young adults with high-risk B-acute lymphoblastic leukemia....
Increased Breast Cancer Risk Reported in Childhood Sarcoma and Leukemia Survivors With No History of Chest Radiotherapy
In an analysis of the Childhood Cancer Survivor Study reported in the Journal of Clinical Oncology, Henderson et al found that childhood survivors of sarcoma and leukemia with no history of chest radiotherapy were at an increased risk of breast cancer. Increased Risk The study included data from...
Adding Ibrutinib to Bendamustine/Rituximab May Increase Progression-Free Survival in Chronic Lymphocytic Leukemia or Small Lymphocytic Lymphoma
In the phase III HELIOS trial reported in The Lancet Oncology, Chanan-Khan et al found that the addition of the Bruton’s tyrosine kinase (BTK) inhibitor ibrutinib (Imbruvica) to bendamustine (Treanda)/rituximab (Rituxan) increased progression-free survival in patients with chronic lymphocytic ...
Adding Ibrutinib to Bendamustine/Rituximab Increases Progression-Free Survival in Chronic Lymphocytic Leukemia or Small Lymphocytic Lymphoma
In the phase III HELIOS trial, reported in The Lancet Oncology, Chanan-Khan et al found that adding the Bruton’s tyrosine kinase inhibitor ibrutinib (Imbruvica) to bendamustine (Treanda)/rituximab (Rituxan) increased progression-free survival in patients with chronic lymphocytic leukemia or...
Germline ETV6 Variations as Basis of Novel Genetic Syndrome Associated With Childhood Acute Lymphoblastic Leukemia
In a systematic genetic study reported in The Lancet Oncology, Moriyama et al found that germline ETV6 variations identified in a small proportion of children with acute lymphoblastic leukemia (ALL) were associated with a novel syndrome predisposing carriers to disease. Recent data indicated that...
BRAF Inhibition Successful in Relapsed/Refractory BRAF V600E–Mutant Hairy Cell Leukemia
In two phase II studies reported in The New England Journal of Medicine, Tiacci et al found that the BRAF inhibitor vemurafenib (Zelboraf) produced responses in nearly all patients with BRAF V600E–positive hairy cell leukemia who relapsed after treatment with a purine analog or who had...
Long-Term Follow-Up Suggests No Detrimental Survival Effect of Dexrazoxane in Pediatric Patients With Leukemia or Lymphoma
In an analysis of Children’s Oncology Group (COG) trials reported in the Journal of Clinical Oncology, Chow et al found that dexrazoxane use did not appear to be associated with poorer survival among pediatric patients with leukemia or lymphoma in long-term follow-up. Study Details The...
Addition of Ofatumumab to Chlorambucil Increases Progression-Free Survival in Previously Untreated CLL Patients Who Are Not Candidates for Fludarabine
In the phase III COMPLEMENT 1 trial reported in The Lancet, Hillmen et al found that the addition of the anti-CD20 antibody ofatumumab (Arzerra) to chlorambucil (Leukeran) increased progression-free survival among patients with chronic lymphocytic leukemia (CLL) who were not considered candidates...
Single-Center Experience Indicates Relatively Good Prognosis After Allogeneic Stem Cell Transplantation Failure in CLL
In a retrospective single-center study reported in Journal of Clinical Oncology, Rozovski and colleagues found that chronic lymphocytic leukemia (CLL) patients with disease progression after allogeneic stem cell transplantation had a relatively good prognosis, with apparent benefit of salvage...
Less Than 95% Adherence to Mercaptopurine Maintenance Associated With Nearly Threefold Increased Risk of Relapse in Pediatric ALL
In a Children’s Oncology Group study (COG-AALL03N1) reported in JAMA Oncology, Bhatia et al found that < 95% adherence to mercaptopurine treatment was associated with a nearly threefold increase in the risk of relapse in children with acute lymphoblastic leukemia (ALL). Among adherent...
No Difference in Event-Free Survival With Stem Cell Transplantation Using Matched Unrelated vs Sibling Donor Grafts in Children With ALL
In a European trial (Berlin-Frankfurt-Muenster study group trial ALL-SCT-BFM 2003) reported in the Journal of Clinical Oncology, Peters et al found no difference in event-free survival with stem cell transplantation using matched unrelated vs sibling donors in pediatric patients with high-risk...
Factors in Ibrutinib Discontinuation in Patients With Chronic Lymphocytic Leukemia
In a single-center study reported in JAMA Oncology, Maddocks et al found that Richter’s transformation accounted for early progression-related discontinuation of ibrutinib (Imbruvica) in patients with chronic lymphocytic leukemia (CLL) and that CLL progression but not Richter’s...
Bispecific CD19-Directed CD3 T-Cell Engager Blinatumomab Active in Adults With Relapsed/Refractory B-Cell Precursor ALL
In a phase II study reported in The Lancet Oncology, Topp et al found that the bispecific CD19-directed CD3 T-cell engager (BiTE) blinatumomab (Blincyto) was highly active in adults with relapsed or refractory B-cell precursor acute lymphoblastic leukemia (ALL). Blinatumomab binds to CD19 expressed ...
Anti-CD19 Bispecific T Cell Engager Blinatumomab Shows Activity in Relapsed/Refractory B-Precursor ALL
In a phase II study reported in the Journal of Clinical Oncology, Topp et al found that the bispecific T-cell engager (BiTE) antibody blinatumomab produced a high response rate in patients with relapsed or refractory B-precursor acute lymphoblastic leukemia (ALL). BiTEs induce a transient cytolytic ...
CD19-Directed CAR T Cells Produce Sustained Remission in Relapsed/Refractory ALL
In a study reported in The New England Journal of Medicine, Maude et al reported achieving sustained remissions in children and adults with relapsed/refractory acute lymphoblastic leukemia (ALL) using autologous CD19-targeted chimeric antigen receptor (CAR)-modified T cells. Study Details In the...
Adding Gemtuzumab Ozogamicin to Chemotherapy Improves Event-Free Survival but Not Overall Survival in Children and Adolescents With De Novo AML
In a Children’s Oncology Group phase III trial reported in the Journal of Clinical Oncology, Gamis et al found that the addition of gemtuzumab ozogamicin (Mylotarg), an immunoconjugate targeting CD33, resulted in significantly prolonged event-free survival but not overall survival when added...
Minimal Residual Disease–Based Risk-Directed Therapy Is Effective in Children With BCR-ABL1–Like B-Cell ALL
BCR-ABL1–like acute lymphoblastic leukemia (ALL), a recently identified B-cell ALL subtype associated with poor outcome, has a gene-expression profile similar to BCR-ABL1–positive disease without the presence of the BCR-ABL1 fusion protein. In a retrospective analysis reported in the...
Event-Free Survival Benefit, Greater Toxicity of Augmented Postremission Therapy for Children/Young Adults With High-Risk Acute Lymphoblastic Leukemia
In a UK phase III trial (UKALL 2003) reported in The Lancet Oncology, Vora et al found that augmented postremission therapy provided an event-free survival benefit at the cost of increased toxicity in children and young adults with clinical standard- or intermediate-risk but minimal residual...
Ibrutinib Resistance Mutations Identified in CLL Patients
Ibrutinib is an irreversible inhibitor of Bruton’s tyrosine kinase that was recently approved for treatment of chronic lymphocytic leukemia (CLL) patients who have received at least one prior therapy. A small proportion of CLL patients have been observed to relapse during ibrutinib treatment, ...
No Overall Survival Improvement With Elacytarabine vs Investigator Choice in Patients With Relapsed/Refractory AML
Current treatment options for relapsed/refractory acute myeloid leukemia (AML), which carries a very poor prognosis, are generally ineffective. In a phase III trial (CLAVELA) reported in the Journal of Clinical Oncology, Roboz et al found that elacytarabine, a novel elaidic acid ester of...
