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The next-generation Bruton’s tyrosine kinase (BTK) inhibitor zanubrutinib demonstrated superior progression-free survival compared with ibrutinib, with an improved cardiac safety profile, in the first head-to-head comparison between these two BTK inhibitors in relapsed or refractory chronic...
Although longer follow-up is needed, the results of the three-arm randomized TRIANGLE study suggest that the tyrosine kinase inhibitor ibrutinib may replace autologous stem cell transplantation (ASCT) after chemoimmunotherapy in younger patients with previously untreated mantle cell lymphoma (MCL). ...
Jeremy S. Abramson, MD, Director of Lymphoma, Mass General Cancer Center, Boston, commented on the clinical implications of the TRIANGLE study. “The TRIANGLE trial is a large, three-arm randomized trial addressing two critically important questions in the management of younger patients with mantle...
Although longer follow-up is needed, the results of the three-arm randomized TRIANGLE study suggest that the tyrosine kinase inhibitor ibrutinib may replace autologous stem cell transplantation (ASCT) after chemoimmunotherapy in younger patients with previously untreated mantle cell lymphoma (MCL). ...
In a German study reported in the Journal of Clinical Oncology, Mutter et al found that circulating tumor DNA (ctDNA) identified prior to and during treatment was associated with poorer outcomes in patients with central nervous system (CNS) lymphoma. Study Details The study included 92 patients...
As reported in the Journal of Clinical Oncology by Catherine Thieblemont, MD, PhD, and colleagues, findings in a dose-expansion cohort of the phase I/II EPCORE NHL-1 study indicated high activity of the subcutaneous CD3 x CD20 T-cell–engaging bispecific antibody epcoritamab in patients with...
As reported in the Journal of Clinical Oncology by Lowe et al, findings in an arm of the Children’s Oncology Group phase II ANHL12P1 trial (arm CZ) showed high event-free and overall survival rates with the addition of crizotinib to chemotherapy in newly diagnosed pediatric patients with...
On December 22, the U.S. Food and Drug Administration (FDA) approved mosunetuzumab-axgb (Lunsumio) for the treatment of adults with relapsed or refractory follicular lymphoma after two or more lines of systemic therapy. Mosunetuzumab-axgb is a CD20/CD3 T-cell–engaging bispecific antibody and...
As reported in the Journal of Clinical Oncology by Bröckelmann et al, final results of the German Hodgkin Study Group phase II NIVAHL trial indicate nearly 100% progression-free survival and 100% overall survival at 3 years among patients with early-stage unfavorable classical Hodgkin lymphoma...
Long-term results of the phase III Mantle Cell Lymphoma Younger Trial were reported in the Journal of Clinical Oncology by Hermine et al. They showed a maintained advantage in time to treatment failure and an overall survival advantage with R-CHOP/R-DHAP (alternating rituximab plus...
On November 10, 2022, brentuximab vedotin was approved for use in combination with doxorubicin, vincristine, etoposide, prednisone, and cyclophosphamide for pediatric patients aged ≥ 2 years with previously untreated high-risk classical Hodgkin lymphoma.1 Supporting Efficacy Data Approval was...
Jennifer R. Brown, MD, PhD, of Dana-Farber Cancer Institute, discusses phase III findings of the ALPINE study, which showed that zanubrutinib is more efficacious and better tolerated than ibrutinib as a treatment for patients with relapsed or refractory chronic lymphocytic leukemia (CLL) and small lymphocytic lymphoma (SLL). In this first head-to-head comparison of the two BTK inhibitors, the superior progression-free survival of zanubrutinib was observed across all major subgroups, including high-risk patients (Abstract LBA-6).
Richter syndrome is an aggressive lymphoma that develops in up to 1% of patients with chronic lymphocytic leukemia (CLL) and it serves as an example of histologic transformation. While recent advances have transformed the treatment landscape of CLL, Richter syndrome remains associated with poor...
The chimeric antigen receptor (CAR) T-cell therapy axicabtagene ciloleucel was deemed safe and showed encouraging signs of efficacy in a small pilot trial involving patients with lymphoma of the brain and/or spinal cord, according to findings presented by Caron A. Jacobson, MD, MMSc, and colleagues ...
Research shows that long-term survivors of pediatric Hodgkin lymphoma are at an elevated risk for a variety of health conditions, including cardiopulmonary morbidity, cognitive impairment, and premature death, and could also be at heightened risk for the premature onset of dementia. A new study of...
A previous analysis by Khurana et al on the impact of inclusion/exclusion criteria in clinical trial design for patients with diffuse large B-cell lymphoma (DLBCL) found that up to 24% of patients treated with standard immunochemotherapy were excluded based on five lab-based criteria alone. A new...
Kathryn R. Tringale, MD, of Memorial Sloan Kettering Cancer Center, discusses an assessment of 559 patients with primary central nervous system (CNS) lymphoma and the factors associated with consolidation therapy selection, outcomes after consolidation therapy accounting for patient factors, and patterns of disease failure. The initial treatment response was prognostic and predictive of relapse patterns (Abstract 557).
Eva Hoster, PhD, of Munich University, discusses results from the European MCL Elderly Trial, which confirmed the strong efficacy of rituximab maintenance in minimal residual disease (MRD)-negative patients with mantle cell lymphoma (MCL) after induction. Omitting maintenance based on MRD-negativity is thus discouraged. Considering the short time to progression, more effective treatment strategies should be explored in MRD-positive patients to improve long-term prognosis (Abstract 544).
Researchers from the University of Pennsylvania’s Abramson Cancer Center presented preliminary results of an ongoing phase I clinical trial demonstrating successful retreatment with chimeric antigen receptor (CAR) T-cell therapy for patients whose cancers relapsed after previous CAR T-cell therapy. ...
Jia Ruan, MD, PhD, of Meyer Cancer Center, Weill Cornell Medicine, and NewYork-Presbyterian Hospital, discusses trial results demonstrating that the triple chemotherapy-free combination of acalabrutinib, lenalidomide, and rituximab is well tolerated, highly effective, and produces high rates of minimal residual disease (MRD)-negative complete response as an initial treatment for patients with mantle cell lymphoma, including those with TP53 mutations. Real-time MRD analysis may enable treatment de-escalation during maintenance to minimize toxicity, which warrants further evaluation. An expansion cohort of acalabrutinib/lenalidomide/obinutuzumab is being launched (Abstract 73).
Stephen M. Ansell, MD, PhD, and Patrizia Mondello, MD, PhD, both of the Mayo Clinic, discuss the 20% of patients with follicular lymphoma (FL) who relapse early and experience a poor prognosis. The researchers found that FLs with high levels of IRF4 expression are associated with a suppressive tumor microenvironment, and selective IRF4 silencing restores antilymphoma T-cell immunity. Further investigation is warranted to identify the mechanisms by which IRF4 controls tumor immunity to develop precision therapies for this population (Abstract 70).
Tomohiro Aoki, MD, PhD, of the University of British Columbia and the Centre for Lymphoid Cancer at BC Cancer, discusses a novel prognostic model applicable to patients with relapsed or refractory classical Hodgkin lymphoma who were treated with autologous stem cell transplantation. The model has shown the interaction between the biomarker CXCR5 on HRS cells (Hodgkin and Reed/Sternberg cells, hallmarks of Hodgkin lymphoma) with specific follicular T helper cells and macrophages, a prominent crosstalk axis in relapsed disease. This insight opens new avenues to developing predictive biomarkers (Abstract 71).
Tycel J. Phillips, MD, of the City of Hope National Medical Center, discusses data that showed fixed-duration glofitamab monotherapy induced high and durable complete response rates in patients with mantle cell lymphoma (MCL) who received obinutuzumab pretreatment. This is one of the largest data sets and longest follow-ups reported with a CD20/CD3 bispecific monoclonal antibody for patients with relapsed or refractory MCL (Abstract 74).
Paolo F. Caimi, MD, of the Taussig Cancer Institute, Cleveland Clinic, discusses new findings showing that patients with diffuse large B-cell lymphoma (DLBCL) who achieve a complete response after salvage therapy with rituximab, ifosfamide, carboplatin, and etoposide (R-ICE) can achieve long-term disease control, regardless of the time to relapse from initial therapy, particularly if they proceed to autologous stem cell transplant (ASCT). These results suggest that second-line chemotherapy followed by ASCT and/or CAR T-cell therapy for chemosensitive and chemorefractory patients may maximize patient outcomes, regardless of time to relapse (Abstract 156).
In a recent trial of the European MCL Network, people with mantle cell lymphoma who received the Bruton’s tyrosine kinase inhibitor ibrutinib had rates of progression-free survival and overall survival that were on par with the current standard of care (high-dose immunochemotherapy followed by...
The incidence of anaplastic large cell lymphoma (ALCL) has surged in recent years—possibly because of the growing use of textured breast implants. Considering this trend, some patients with breast cancer who undergo mastectomy may wonder if the benefits of getting reconstructive implants are worth...
Preclinical research has shown that mantle cell lymphoma is so critically dependent on the FOXO1 protein that by blocking its activity with an experimental drug, the cancer’s growth may be slowed, according to a new study published by Jang et al in the Journal of Clinical Investigation....
In a study reported in the Journal of Clinical Oncology, Vijenthira et al found that front-line polatuzumab vedotin-piiq plus rituximab, cyclophosphamide, doxorubicin, and prednisone (R-CHP), second-line chimeric antigen receptor (CAR) T-cell therapy, or the combination would not be likely to be...
On November 18, the U.S. Food and Drug Administration (FDA) approved a new Monday/Wednesday/Friday dosing regimen for asparaginase erwinia chrysanthemi (recombinant)-rywn (Rylaze). Under the new regimen, patients should receive 25 mg/m2 intramuscularly on Monday and Wednesday mornings and 50 mg/m2...
In a cost-effective analysis reported in the Journal of Clinical Oncology, Wong et al found that only the mammography component of the Children’s Oncology Group (COG) breast cancer screening guidelines for chest-irradiated Hodgkin lymphoma survivors was cost-effective; magnetic resonance imaging...
On November 10, the U.S. Food and Drug Administration (FDA) approved the CD30-directed antibody-drug conjugate brentuximab vedotin (Adcetris) in combination with doxorubicin, vincristine, etoposide, prednisone, and cyclophosphamide for pediatric patients aged 2 years and older with previously...
As reported in The Lancet by Manali Kamdar, MD, of the University of Colorado Cancer Center, Aurora, and colleagues, an interim analysis of the phase III TRANSFORM trial has shown significantly improved event-free survival with second-line lisocabtagene maraleucel vs standard-of-care salvage...
The results of ECHELON-1 were presented by David J. Straus, MD, of Memorial Sloan Kettering Cancer Center, New York, at the 2022 National Comprehensive Cancer Network (NCCN) Annual Congress: Hematologic Malignancies. Dr. Straus said: “It is a great honor and privilege to present updated results...
Which is the preferred second-line treatment option for patients with relapsed or refractory diffuse large B-cell lymphoma (DLBCL): high-dose chemotherapy and autologous stem cell transplantation (ASCT) or chimeric antigen receptor (CAR) T-cell therapy? This was the subject of a debate at the...
As reported in The Lancet by Kamdar et al,1 and summarized in this issue of The ASCO Post, the international phase III TRANSFORM trial was completed in 184 patients with primary refractory or early (≤ 12 months) relapsed large B-cell lymphoma (LBCL). Patients were randomly assigned to receive...
As reported in The New England Journal of Medicine by Castellino et al, the phase III Children’s Oncology Group (COG) AHOD1331 trial showed improved event-free survival with brentuximab vedotin plus chemotherapy vs standard chemotherapy in previously untreated pediatric patients with high-risk...
As reported in the Journal of Clinical Oncology by Ann S. LaCasce, MD, MMSc, and colleagues, the phase II CALGB 50801/Alliance trial has shown that a positron-emission tomography (PET)-adapted treatment strategy allowed many patients with bulky stage I/II classical Hodgkin lymphoma to avoid...
Using a novel response-adapted ultra–low dose radiation therapy strategy, researchers at The University of Texas MD Anderson Cancer Center observed a 90% complete response rate in patients with orbital indolent B-cell lymphomas. Results were presented by Pinnix et al at the 2022 American Society...
Although standard therapies may provide long-lasting remissions for many patients with various subtypes of lymphoma, there is a critical need for new strategies for the sizable high-risk subset. At the 2022 Pan Pacific Lymphoma Conference, four experts in the field described future therapies for...
Primary central nervous system lymphoma (PCNSL) accounts for less than 1% of all non-Hodgkin lymphomas and between 3% and 4% of all brain tumors, with an age-adjusted incidence rate of four cases per million persons per year. Approximately 1,500 new cases are diagnosed each year in the United...
Despite a significant potential for cure, relapsed and refractory large B-cell lymphomas (LBCL) comprise the most common cause of lymphoma-related mortality. Sequential relapses reflect the limits of repeated exposure to chemotherapy, even when delivered at high doses. More than 30 years ago,...
The incorporation of blood-based measurements—ie, “liquid biopsies”—into imaging assessment may refine the accuracy of prognosis in aggressive lymphomas, as described by David Kurtz, MD, PhD, Assistant Professor in the Division of Oncology, Stanford University Medical Center, in a talk at the 2022...
As reported in The New England Journal of Medicine by Frederick L. Locke, MD, of the Department of Blood and Marrow Transplant and Cellular Immunotherapy, H. Lee Moffitt Cancer Center, Tampa, Florida, and colleagues, the phase III ZUMA-7 trial in large B-cell lymphoma has shown improved event-free...
In a study reported in a research letter in JAMA Oncology, Cai et al found that the incidence of cutaneous T-cell lymphoma increased in the United States between 2000 and 2018. The study involved data from 18 Surveillance, Epidemiology, and End Results (SEER) Program registries for 2000 to 2018. A...
I was just 31 and about to give birth to my fourth child, Yitzchok, when I received a diagnosis of primary mediastinal large B-cell lymphoma. The news was terrifying and crippling. For months, I had been experiencing shortness of breath, coughing, and a pain in my left shoulder, all of which were...
On August 26, the U.S. Food and Drug Administration (FDA) approved pemigatinib (Pemazyre), a selective fibroblast growth factor receptor (FGFR) inhibitor, for the treatment of adults with relapsed or refractory myeloid/lymphoid neoplasms with FGFR1 rearrangement. Myeloid/lymphoid neoplasms with...
On May 27, 2022, tisagenlecleucel, a CD19 chimeric antigen receptor (CAR) T-cell therapy, was granted accelerated approval for adults with relapsed or refractory follicular lymphoma after two or more lines of systemic therapy.1 Supporting Efficacy Data Approval was based on the multicenter ELARA...
Anna Sureda, MD, PhD, of the University of Barcelona and the Catalan Institute of Oncology, discusses phase III clinical and patient-reported outcomes from the ZUMA-7 trial, which showed that axicabtagene ciloleucel was superior to second-line standard-of-care treatment in patients 65 years or older with relapsed or refractory large B-cell lymphoma (Abstract S211).
In a single-institution phase II trial (Smart Start) reported in the Journal of Clinical Oncology, Jason Westin, MD, MS, and colleagues found that initiating treatment with rituximab, lenalidomide, and ibrutinib (RLI) followed by the sequential addition of chemotherapy resulted in high response...
On June 24, 2022, lisocabtagene maraleucel was approved for adults with large B-cell lymphoma (LBCL) who have (1) refractory disease to first-line chemoimmunotherapy or relapse within 12 months of first-line chemoimmunotherapy; or (2) refractory disease to first-line chemoimmunotherapy or relapse...