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Lymphoma

Immunotherapy in B-Cell Non-Hodgkin Lymphomas: Off-the-Shelf Bispecific Antibodies

Chimeric antigen receptor (CAR) T-cell therapies are a significant advance, but they require careful patient selection, dependency on patients’ own T cells, lymphodepleting chemotherapy, possible bridging therapy, manufacturing timelines with extensive health-care coordination and cost, in...

lymphoma

Ann S. LaCasce, MD, MMSc, on Relapsed/Refractory Indolent Follicular Lymphoma: Management Updates

Ann S. LaCasce, MD, MMSc, of Dana-Farber Cancer Institute, discusses the various agents available to treat patients with indolent B-cell lymphomas: lenalidomide plus rituximab, which has a superior progression-free survival profile compared with rituximab monotherapy; the PI3K inhibitors copanlisib and umbralisib, which have similar efficacy yet distinct side-effect profiles; tazemetostat, which is active in both EZH2-mutant and Warthin’s tumor disease; and CAR T-cell therapy, which shows early activity.

Lymphoma

Mantle Cell Lymphoma Previously Treated With BTK Inhibitor May Respond to a Newer BTK Inhibitor

The next-generation inhibitor of Bruton’s tyrosine kinase (BTK) may be effective in mantle cell lymphoma for patients previously treated with an older BTK inhibitor, according to results from the phase I/II BRUIN trial. These findings were reported at the 2021 American Society of Hematology (ASH)...

Lymphoma

Novel Approach Using Off-the-Shelf Preactivated NK Cells Shows Efficacy in CD-30 Positive Lymphoma

Natural killer (NK) cells derived from donated umbilical cord blood and activated with a novel bispecific antibody known as AFM13 (which targets CD16A and CD30) were shown to be effective in patients with pretreated and refractory CD30-positive lymphoma. The overall response rate was 89% in...

Lymphoma
Immunotherapy

FDA Approves Axicabtagene Ciloleucel for the Second-Line Treatment of Large B-Cell Lymphoma

On April 1, the U.S. Food and Drug Administration (FDA) approved axicabtagene ciloleucel (Yescarta) for adult patients with large B-cell lymphoma (LBCL) who are refractory to first-line chemoimmunotherapy or who experienced relapse within 12 months of first-line chemoimmunotherapy. It is not...

Lymphoma
COVID-19

Third COVID-19 Vaccine Dose May Improve Immune Response in Patients With Lymphoma

New research has found that the weakened immune systems of patients with lymphoma may improve after they receive a third COVID-19 vaccination. Patients with lymphoma have defects in their immune system that restrict its response to vaccination; despite this, a study published by Lim et al in Nature ...

Hematologic Malignancies
Leukemia
Lymphoma
Myelodysplastic Syndromes

Allogeneic Transplantation for Hematologic Neoplasms in Adults

“The value of experience is not in seeing much, but in seeing wisely.” —Sir William Osler To complement The ASCO Post’s continued comprehensive coverage of the 2021 American Society of Hematology (ASH) Annual Meeting & Exposition, here are several abstracts selected from the meeting...

Lymphoma
Immunotherapy
Symptom Management

Early Intrathecal Therapy for High-Grade ICANS in Patients Receiving CAR T-Cell Therapy

In a single-institution retrospective review reported in JAMA Oncology, Zurko et al found that early intrathecal therapy with hydrocortisone with or without intrathecal chemotherapy was effective in treating grade ≥ 3 immune effector cell–associated neurotoxicity syndrome (ICANS) in patients...

Leukemia
Lymphoma

Addition of Bortezomib to Chemotherapy in Newly Diagnosed T-Cell Acute Lymphoblastic Leukemia and Lymphoma

As reported in the Journal of Clinical Oncology by Teachey et al, the phase III Children’s Oncology Group AALL1231 trial has shown that the addition of bortezomib to a modified augmented Berlin-Frankfurt-Münster (BFM) backbone improved survival outcomes in patients with newly diagnosed T-cell...

Lymphoma
Immunotherapy

Expert Point of View: Matthew Genyeh Mei, MD

American Society of Hematology (ASH) session co-moderator Matthew Genyeh Mei, MD, Associate Professor, Hematologic Malignancies and Stem Cell Transplantation Institute of City of Hope in Southern California, said the studies of checkpoint inhibitors in newly diagnosed and previously treated Hodgkin ...

Lymphoma
Immunotherapy

Combinations Advance the Power of Pembrolizumab in Hodgkin Lymphoma

Pembrolizumab monotherapy is an established treatment strategy for relapsed or refractory classical Hodgkin lymphoma. In combination with chemotherapy, the checkpoint inhibitor is also showing value in the front-line setting and further boosting outcomes in the relapsed setting, according to...

Lymphoma

Mihir Gupta, MD, and Ganesh M. Shankar, MD, PhD, Offer Commentary on the Use of ctDNA to Detect CNS Lymphoma

Mihir Gupta, MD, a neurosurgery resident at the University of California San Diego and postdoctoral fellow at Massachusetts General Hospital Department of Neurosurgery, and Ganesh M. Shankar, MD, PhD, Assistant Professor of Neuro­surgery, Massachusetts General Hospital and Harvard Medical School,...

Lymphoma

Noninvasive Diagnosis of CNS Lymphoma Possible Through ctDNA

Circulating tumor DNA (ctDNA) is readily detectable in the plasma and cerebrospinal fluid of patients with central nervous system (CNS) lymphoma and is a strong prognostic biomarker for outcomes, a team of researchers from Germany and Stanford University reported at the 2021 American Society of...

Hematologic Malignancies
Lymphoma

CAR T-Cell Therapy as Second-Line Treatment in Large B-Cell Lymphomas

“The mind is not a vessel to be filled but a fire to be kindled.”                                                                                    —Plutarch About 30% to 40% of patients with newly diagnosed diffuse large B-cell lymphoma (DLBCL) experience relapse, and 10% are refractory to the...

Lymphoma
Immunotherapy

Axicabtagene Ciloleucel vs Standard of Care as Second-Line Treatment for Large B-cell Lymphoma

As reported in The New England Journal of Medicine by Frederick L. Locke, MD, and colleagues, the phase III ZUMA-7 trial of patients with large B-cell lymphoma has shown improved event-free survival with second-line axicabtagene ciloleucel vs chemoimmunotherapy with high-dose chemotherapy and...

Lymphoma
Immunotherapy

Mosunetuzumab Meets Primary Endpoint of Phase II Trial in Relapsed or Refractory Follicular Lymphoma

The bispecific antibody mosunetuzumab achieved deep and durable remissions as monotherapy in patients with relapsed or refractory follicular lymphoma, according to the results of a pivotal phase II trial presented at the 2021 American Society of Hematology (ASH) Annual Meeting & Exposition.1 In ...

Lymphoma
Immunotherapy

Expert Point of View: Laurie H. Sehn, MD, MPH, and Alex Herrera, MD

Laurie H. Sehn, MD, MPH, Clinical Professor with the BC Cancer Centre for Lymphoid Cancer and University of British Columbia, Vancouver, Canada, and Alex Herrera, MD, Associate Professor in Hematology and Hematopoietic Cell Transplantation at the Beckman Research Institute of City of Hope, Duarte,...

Lymphoma
Immunotherapy

ZUMA-7: Axicabtagene Ciloleucel Quadruples Event-Free Survival in Large B-Cell Lymphoma

In the primary analysis of the phase III ZUMA-7 trial, examining second-line therapy for relapsed or refractory large B-cell lymphoma, the CAR T-cell therapy axicabtagene ciloleucel led to a fourfold increase in event-free survival over the standard of care. These findings were presented at the...

Lymphoma
Immunotherapy

Expert Point of View: Laurie H. Sehn, MD, MPH

The moderator of the session, Laurie H. Sehn, MD, MPH, Clinical Professor at the BC Cancer Centre for Lymphoid Cancer and University of British Columbia, Vancouver, Canada, called the results of the TRANSFORM trial “quite remarkable” and said chimeric antigen receptor (CAR) T-cell therapy has the...

Lymphoma
Immunotherapy

TRANSFORM: Lisocabtagene Maraleucel Improves Outcomes in Relapsed or Refractory Large B-Cell Lymphoma

Chimeric antigen receptor (CAR) T-cell therapy with lisocabtagene maraleucel could prove to be the new standard-of-care treatment for patients with relapsed or refractory large B-cell lymphoma in the second-line setting, according to data presented at the 2021 American Society of Hematology (ASH)...

Lymphoma
Immunotherapy

Expert Point of View: Jane N. Winter, MD, and Christopher R. Flowers, MD, MS

Jane N. Winter, MD, Professor of Medicine at Northwestern University’s Feinberg School of Medicine and 2022 President of the American Society of Hematology (ASH), and Christopher R. Flowers, MD, MS, Chair of the Department of Lymphoma/Myeloma at The University of Texas MD Anderson Cancer Center,...

Lymphoma
Immunotherapy

POLARIX: Addition of Polatuzumab Vedotin-piiq to Standard of Care Significantly Reduces Progression of Diffuse Large B-Cell Lymphoma

As a first-line treatment of inter­mediate- or high-risk diffuse large B-cell lymphoma, the addition of the antibody-drug conjugate polatuzumab vedotin-piiq to standard-of-care therapy resulted in a 27% reduction in the relative risk of disease progression, relapse, or death, with a similar safety...

Lymphoma

(My) German Hodgkin Story

Nearly 200 years ago, Thomas Hodgkin for the first time described a peculiar disease with undulating fever, enlarged lymph nodes, and a big spleen. Its nature was obscure. It was a fatal illness, affecting mainly young adults and children. In 1865, Samuel Wilks named this illness Hodgkin’s...

Lymphoma

BELINDA: CAR T-Cell Therapy Fails to Improve Outcomes in Aggressive Non-Hodgkin Lymphoma

The autologous chimeric antigen receptor (CAR) T-cell therapy tisagenlecleucel failed to improve event-free survival vs standard-of-care treatment strategies in patients with aggressive, relapsed or refractory non-Hodgkin lymphoma (NHL), according to the results of the phase III BELINDA trial,...

Lymphoma

Ibrutinib/Rituximab Induction Followed by R-HCVAD in Front-Line Treatment of Patients Aged 65 and Younger With Mantle Cell Lymphoma

In the single-institution phase II WINDOW-1 trial reported in The Lancet Oncology, Michael L. Wang, MD, and colleagues found that 12 cycles of induction ibrutinib/rituximab produced objective response in nearly all patients aged ≤ 65 years with mantle cell lymphoma, allowing a reduction in cycles...

Lymphoma

FDA Investigating Possible Increased Risk of Death With Lymphoma Treatment Umbralisib

The U.S. Food and Drug Administration (FDA) is investigating a possible increased risk of death associated with umbralisib (Ukoniq), a kinase inhibitor including PI3K-delta and CK1-epsilon, approved to treat marginal zone and follicular lymphomas. The FDA determined that initial findings from the...

Lymphoma

Ibrutinib/Rituximab for Indolent Clinical Types of Mantle Cell Lymphoma

In a Spanish phase II trial (IMLC-2015) reported in the Journal of Clinical Oncology, Giné et al found that the combination of ibrutinib and rituximab produced a high complete response rate in previously untreated patients with indolent clinical types of mantle cell lymphoma. Study Details In the...

Lymphoma

Long-Term Morbidity in Patients With Stage I to IIA Classical Hodgkin Lymphoma Treated With ABVD and Limited-Field Radiotherapy

In a Swedish study reported in the Journal of Clinical Oncology, Lagerlöf et al identified rates of long-term morbidity in a more contemporary cohort of patients with stage I to IIA classical Hodgkin lymphoma treated with ABVD (doxorubicin, bleomycin, vinblastine, and dacarbazine) and the more...

Lymphoma
Immunotherapy

FDA Approves New Label Update for CAR T-Cell Therapy Axicabtagene Ciloleucel

On January 31, the FDA approved an update to the prescribing information for axicabtagene ciloleucel (Yescarta) to include use of prophylactic corticosteroids across all approved indications. Axicabtagene ciloleucel is now the first and only chimeric antigen receptor (CAR) T-cell therapy with...

Lymphoma

PET-Based De-escalation Strategy for Previously Untreated Advanced Hodgkin Lymphoma

As reported in the Journal of Clinical Oncology by Casasnovas et al, final results of the phase III AHL2011 Lymphoma Association Study showed continued similarity of progression-free and overall survival over long-term follow-up with positron-emission tomography (PET)-based de-escalation of...

Leukemia
Lymphoma
Immunotherapy

Rituximab Plus Chemotherapy for Pediatric Mature B-Cell Non-Hodgkin Lymphoma and Mature B-Cell Acute Leukemia

On December 2, 2021, rituximab was approved for use in combination with chemotherapy for pediatric patients (≥ 6 months to 18 years) with previously untreated, advanced-stage, CD20-positive diffuse large B-cell lymphoma, Burkitt lymphoma, Burkitt-like lymphoma, or mature B-cell acute leukemia.1...

Lymphoma
Immunotherapy

BELINDA Trial: CAR T-Cell Therapy Fails to Improve Outcomes in Aggressive Non-Hodgkin Lymphoma

The autologous chimeric antigen receptor (CAR) T-cell therapy tisagenlecleucel failed to improve event-free survival vs standard-of-care treatment strategies in patients with aggressive, relapsed or refractory non-Hodgkin lymphoma (NHL), according to results of the phase III BELINDA trial,...

Lymphoma

Mosunetuzumab Meets Primary Endpoint of Phase II Trial in Relapsed or Refractory Follicular Lymphoma

The bispecific antibody mosunetuzumab achieved deep and durable remissions as monotherapy in patients with relapsed or refractory follicular lymphoma, according to the results of a pivotal phase II trial presented at the 2021 American Society of Hematology (ASH) Annual Meeting & Exposition.1 In ...

Lymphoma

POLARIX: Addition of Polatuzumab Vedotin-piiq to Standard of Care Significantly Reduces Progression of Diffuse Large B-Cell Lymphoma

As a first-line treatment of inter-mediate- or high-risk diffuse large B-cell lymphoma, the addition of the antibody-drug conjugate polatuzumab vedotin-piiq to standard-of-care therapy resulted in a 27% reduction in the relative risk of disease progression, relapse, or death, with a similar safety...

Lymphoma

Lisocabtagene Maraleucel Improves Outcomes in Relapsed or Refractory Large B-Cell Lymphoma

Chimeric antigen receptor (CAR) T-cell therapy with lisocabtagene maraleucel could prove to be the new standard-of-care treatment for patients with relapsed or refractory large B-cell lymphoma in the second-line setting, according to data presented at the 2021 American Society of Hematology (ASH)...

Lymphoma

ZUMA-7: Axicabtagene Ciloleucel Quadruples Event-Free Survival in Large B-Cell Lymphoma

In the primary analysis of the phase III ZUMA-7 trial, examining second-line therapy for relapsed or refractory large B-cell lymphoma, the CAR T-cell therapy axicabtagene ciloleucel led to a fourfold increase in event-free survival over the standard of care. These findings were presented at the...

lymphoma

Tycel Phillips, MD, on Marginal Zone Lymphoma: Efficacy and Safety of Parsaclisib

Tycel Phillips, MD, of the Rogel Cancer Center, University of Michigan, discusses phase II findings from the CITADEL-204 study of parsaclisib, a next-generation inhibitor of phosphatidylinositol 3-kinase. The agent, used as a monotherapy, appeared to benefit patients with relapsed or refractory marginal zone lymphoma who had a rapid and durable clinical response (Abstract 44).

lymphoma
immunotherapy

Manali Kamdar, MD, on Large B-Cell Lymphoma: Lisocabtagene Maraleucel vs the Standard of Care

Manali Kamdar, MD, of the University of Colorado Cancer Center, discusses phase III results from the TRANSFORM study, which suggest that lisocabtagene maraleucel, a CD19-directed CAR T-cell therapy, improved outcomes with a favorable safety profile and may be a potential new standard of care for second-line treatment of patients with relapsed or refractory large B-cell lymphoma (Abstract 91).

Lymphoma

Response-Adapted Omission of Radiotherapy and Comparison of Consolidation Therapy in Pediatric Classical Hodgkin Lymphoma

In analyses from the European EuroNet-PHL-C1 study reported in The Lancet Oncology, Mauz-Körholz et al found that radiotherapy could be omitted in pediatric patients with intermediate- or advanced-stage classical Hodgkin lymphoma who had adequate response to induction with OEPA (vincristine,...

Lymphoma
Immunotherapy

Bispecific Antibody Mosunetuzumab in Relapsed or Refractory B-Cell Lymphomas

In a phase I study reported in the Journal of Clinical Oncology, L. Elizabeth Budde, MD, PhD, and colleagues found that the CD20-CD3 bispecific antibody mosunetuzumab produced durable responses in patients with relapsed or refractory aggressive and indolent B-cell non-Hodgkin lymphomas....

lymphoma
genomics/genetics

Joe Schroers-Martin, MD, on Follicular Lymphoma: Precursor Mutations May Be Detectable Years Before Diagnosis

Joe Schroers-Martin, MD, of Stanford University, discusses his latest study findings, which show that follicular lymphoma driver mutations are detectable in blood and saliva years prior to a clinical diagnosis. These data build on previous work and suggest that researchers may be able to stratify people at elevated risk of clinical malignancy (Abstract 709).

Lymphoma
Immunotherapy

Polatuzumab Vedotin-piiq Plus R-CHP vs R-CHOP for Previously Untreated Patients With DLBCL

In the phase III POLARIX trial reported in The New England Journal of Medicine, Tilly et al found that polatuzumab vedotin-piiq plus R-CHP (rituximab, cyclophosphamide, doxorubicin, and prednisone) significantly improved progression-free survival vs R-CHOP (rituximab, cyclophosphamide, doxorubicin, ...

Lymphoma
Immunotherapy

Second-Line Tisagenlecleucel vs Standard of Care in Aggressive B-Cell Lymphoma

As reported in The New England Journal of Medicine by Bishop et al, the phase III BELINDA trial showed no improvement in event-free survival with second-line tisagenlecleucel vs standard of care including salvage chemotherapy and autologous hematopoietic stem cell transplantation (HSCT) in patients ...

Lymphoma
Genomics/Genetics
Immunotherapy

Effect of TP53 Alterations on Outcomes of CD19-Targeted CAR T-Cell Therapy for Patients With Large B-Cell Lymphoma

In a single-center retrospective study reported in the Journal of Clinical Oncology, Shouval et al found that the presence of TP53 alterations was associated with poorer outcomes in patients treated with CD19-targeted chimeric antigen receptor (CAR) T-cell therapy (CD19–CAR-T) for relapsed or...

lymphoma
immunotherapy

Roni Shouval, MD, PhD, on TP53-Mutant Large B-Cell Lymphoma and CAR T-Cell Therapy

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).

lymphoma
immunotherapy

Michael R. Bishop, MD, on Aggressive B-Cell NHL: Tisagenlecleucel vs Standard of Care as Second-Line Therapy

Michael R. Bishop, MD, of the University of Chicago, discusses insights from findings of the phase III BELINDA study, which may inform the design of future CAR T-cell trials, as well as the use of second-line tisagenlecleucel therapy in patients with relapsed or refractory aggressive B-cell non-Hodgkin lymphoma (Abstract LBA-6).

Lymphoma
Immunotherapy

ZUMA-5 Trial: Axicabtagene Ciloleucel in Relapsed or Refractory Indolent Non-Hodgkin Lymphoma

As reported in The Lancet Oncology by Caron A. Jacobson, MD, and colleagues, the phase II ZUMA-5 trial showed that axicabtagene ciloleucel, an autologous anti-CD19 chimeric antigen receptor (CAR) T-cell therapy, produced high rates of durable responses in patients with relapsed or refractory...

Lymphoma

POLARIX: Pola-R-CHP vs R-CHOP for Previously Untreated Patients With DLBCL

The POLARIX study found patients with diffuse large B-cell lymphoma (DLBCL) had a significantly higher likelihood of survival without disease progression 2 years after receiving a new drug combination known as pola-R-CHP (polatuzumab vedotin-piiq with rituximab, cyclophosphamide, doxorubicin, and...

Lymphoma
Immunotherapy

BELINDA Study: Second-Line Tisagenlecleucel Equivalent to Standard of Care for Relapsed or Refractory Aggressive B-Cell Non-Hodgkin Lymphoma

In an analysis of the phase III BELINDA trial presented by Bishop et al during the 2021 American Society of Hematology (ASH) Annual Meeting & Exposition (Abstract LBA-6), the chimeric antigen receptor (CAR) T-cell therapy tisagenlecleucel was not found to improve event-free survival over the...

Lymphoma

ZUMA-7 Primary Analysis: Second-Line Axicabtagene Ciloleucel Quadruples Event-Free Survival in Large B-Cell Lymphoma

In the primary analysis of the phase III ZUMA-7 trial, the chimeric antigen receptor (CAR) T-cell therapy axicabtagene ciloleucel led to a fourfold increase in event-free survival over the standard of care in the second-line treatment of relapsed or refractory large B-cell lymphoma, according to...

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