HEMATOLOGY

Venetoclax (Venclexta) has been granted an accelerated approval by the FDA for combined use with azacitidine or decitabine or low-dose cytarabine as a treatment for adult patients with newly-diagnosed acute myeloid leukemia who are aged 75 years or older, or who have comorbidities that preclude use of intensive induction chemotherapy.

<br /> Mary-Beth Percival, MD, discusses the ongoing development of FLT3 inhibitors and other current research in patients with AML.

Mutations in 8 high-risk genes are associated with an acute myeloid leukemia (AML) diagnosis, according to a deep sequencing analysis. Hetty Carraway, MD, said that these findings lay the ground work for upcoming research on early detection and novel treatment strategies.

Patients with acute myeloid leukemia now have more treatment options available than ever, due to some major changes to the field over the last year. With 2 drugs already approved for patients with <em>IDH</em> mutations and 4 new drugs expected to receive approval in the next year, it is a more hopeful time than ever for this patient population.

Ajai Chari, MD, discusses the rationale for using combination therapy in patients with multiple myeloma.&nbsp;

Alexander E. Perl, MD, discusses the use of antibody-drug conjugates in acute myeloid leukemia. Gemtuzumab ozogamicin has already been approved for this patient population.

Blinatumomab has received support from the European Medicines Agency&rsquo;s Committee for Medicinal Products for Human Use. The agent has been recommended for approval as a treatment of adult patients with&nbsp;B-cell precursor acute lymphoblastic leukemia who are in remission but still have minimal residual disease of at least 0.1%.

Julie M. Vose, MD, MBA, discusses the importance of conducting genetic testing on all patients with diffuse large B-cell lymphoma to better understand their disease and treat the disease properly.

During a presentation at the National Comprehensive Cancer Network 13th Annual Conference: Hematologic Malignancies Phillippe Armand, MD, PhD, discusses how novel agents could be used in the future either to postpone, permit, or even replace allogeneic stem cell transplantation.

The approval of&nbsp;eltrombopag (Promacta) in combination with standard immunosuppressive therapy has been expanded by the FDA to include&nbsp;newly diagnosed adult and pediatric patients 2 years and older with severe aplastic anemia, according to Novartis, the manufacturer of eltrombopag.^&nbsp;Eltrombopag was also granted a breakthrough therapy designation&nbsp;as a counter measure for hematopoietic sub-syndrome of acute radiation syndrome.

A greater understanding of molecular pathogenesis in non-Hodgkin lymphoma has led to the identification of rational targets for novel small molecule inhibitors, according to Andrew D. Zelenetz, MD, PhD.&nbsp;Combinations of these therapies may also provide greater responses and the potential for therapy&nbsp;discontinuation.

Brentuximab vedotin (Adcetris) has been granted FDA approval for&nbsp;use in combination with chemotherapy for the frontline treatment of patients with CD30-expressing peripheral T-cell lymphoma, based on findings from the phase III ECHELON-2 trial.

Susan M. O&rsquo;Brien, MD, discusses the challenges with the 3 oral agents approved in chronic lymphocytic leukemia.

During the 2018 Association of Community Cancer Centers National Oncology Conference, Olalekan Oluwole, MBBS, MPH, discusses some of the challenges he has encountered with chimeric antigen receptor T-cell therapy.

CLL is a malignant disease characterized by progressive accumulation of immature, immunophenotypically distinct lymphocytes in the blood, bone marrow, and lymphatic tissues. Although the clinical course of CLL can be unpredictable, this disease is typically slow-progressing and occurs most often in patients &ge;65 years of age.&nbsp;As such, treatment, if indicated, is typically conservative.&nbsp;Current CLL treatments are not considered to be curative; however, long-term remission can be achieved in some patients using allogenic stem cell transplantation.

Chronic lymphocytic leukemia is characterized by the clonal proliferation and accumulation of small, mature-appearing CD5-positive B lymphocytes in the blood, bone marrow, and secondary lymphoid tissues.&nbsp;A CLL diagnosis is established by the presence of more than 5x109/L peripheral lymphocytes co-expressing CD5, CD19, and CD23, and weakly expressing CD20, CD79b, and surface immunoglobulin.&nbsp;Small lymphocytic lymphoma represents a clinical variant of CLL and is similarly managed.

Sarah Holstein, MD, PhD, explains her rationale for choosing a triplet regimen over a quadruplet in patients with multiple myeloma.&nbsp;

A supplemental new drug application (sNDA)&nbsp;for avatrombopag (Doptelet) as a treatment for patients with chronic immune thrombocytopenia (ITP) who have had an inadequate response to prior treatment has been accepted for review by the FDA.

Richard Furman, MD, discusses how survival times for patients with chronic lymphocytic leukemia have increased dramatically in the past decade, thanks to an ever-expanding armamentarium of novel agents and more patients now being diagnosed earlier.

Based on findings from the phase III ECHELON-2 trial, brentuximab vedotin (Adcetris) has been submitted to the FDA for approval&nbsp;in combination with chemotherapy for the frontline treatment of patients with CD30-expressing peripheral T-cell lymphoma.

A look back at all the&nbsp;FDA news&nbsp;that happened in the month of&nbsp;October 2018, including several new FDA approvals, priority reviews, a breakthrough therapy designation, and more, in a variety of cancer types.<br /> &nbsp;

Treatment-na&iuml;ve patients with chronic lymphocytic leukemia who had comorbidities saw a reduction in the risk of disease progression or death after treatment with venetoclax combined with obinutuzumab versus obinutuzumab plus chlorambucil.

James L. Wade III, MD, FACP, FASCO, discusses the importance of clinical trials in the community.

I think one of the most important advancements in biomedical technology that has improved our understanding of the complexities of cancer is the ability to sequence the cancer genome for any individual patient, in a rapid and cost-effective manner, to help us make treatment decisions in the clinic.

Groundbreaking developments in cancer therapies can change lives, extending survival and sending patients who previously thought their chances were slim into remission. But these therapies come at a cost, and many patients reel at the prospect of heavy financial burdens. To help patients and programs meet the challenges of affording cancer treatments, community cancer centers are expanding the role of financial advocates in their organizations.

Thomas A. Gallo, MS, MDA, president of the Association of Community Cancer Centers, discusses his mission as president to &ldquo;reflect, renew, and reignite&rdquo; in order to create a more resilient oncology team for the community.

Larotrectinib induced an objective response rate of 80% in patients with advanced solid tumors who harbored&nbsp;<em>NTRK&nbsp;</em>gene fusions, according to results pooled from 3 small trials of the TRK inhibitor. Results were presented during the 2018 ESMO Congress.

Rising prescription drug prices continue to add to the burden of paying for quality healthcare. In an effort to confront such costs, the Centers for Medicare &amp; Medicaid Services has rescinded a prohibition on step therapy for Medicare Advantage plans. But some contend such a policy will reduce patient access to optimal medication.

Sarah K. Tasian, MD, discusses what she finds most interesting about Philadelphia chromosome (Ph-like) acute lymphoblastic leukemia.

Julie M. Vose, MD, MBA, discusses resistance to BTK inhibitors in patients with non-Hodgkin lymphoma.