HEMATOLOGY

Joshua R. Richter, MD, a hematologist/oncologist at John Theurer Cancer Center, discusses results from the Living with Cancer patient-reported outcomes (PROs) tool, which is a survey to record self-reported symptoms from patients. Richter used this tool to survey 239 patients with multiple myeloma on their symptoms and psychological distress.

The field of mantle cell lymphoma underwent a significant change with the FDA approval of ibrutinib in 2013. Now, the recent approval of acalabrutinib has similarly impacted the treatment landscape, as experts say it could be associated with slightly fewer adverse events than ibrutinib, according to Andre Goy, MD.

Alan Skarbnik, MD, director of the Chronic Lymphocytic Leukemia Program at John Theurer Cancer Center, discusses the possibility of triplet combinations for the treatment of hematologic malignances. The biggest challenge with this type of treatment regimen is the increased risk of adverse events.

Venetoclax induced a response in two-thirds of patients with relapsed/refractory chronic lymphocytic leukemia who had progressed after receiving prior therapy with idelalisib, according to findings of a phase II study recently published in <em>Blood</em>.

After findings from 2 randomized trials and an open-label extenstion study were released, fostamatinib (Tavalisse), anSYK inhibitor, was approved by the FDA as a second-line treatment following insufficient response to a previous therapy&nbsp;for patients with chronic immune thrombocytopenia.

Ruben A. Mesa, MD, recently discussed the treatment considerations and decisions he makes when treating patients with polycythemia vera. Mesa, director of the University of Texas Health Cancer Center, explained his treatment decisions based on 2 case scenarios during a <em>Targeted Oncology </em>live case-based peer perspectives presentation.

Jacqueline C. Barrientos, MD, associate professor of the Karches Center for Oncology Research at the Feinstein Institute for Medical Research, discusses which types of patients with chronic lymphocytic leukemia are the best candidates for treatment with ibrutinib

According to preliminary results of a phase II trial, the combination of obinutuzumab (Gazyva), ibrutinib (Imbruvica), and venetoclax (Venclexta) is a safe initial therapy for treatment-na&iuml;ve patients with chronic lymphocytic leukemia (CLL).

According to Neil E. Kay, MD, novel agents,&nbsp;such as&nbsp;ibrutinib (Imbruvica), venetoclax (Venclexta), idelalisib (Zydelig), and acalabrutinib (Calquence), are revolutionizing treatment for patients with chronic&nbsp;lymphocytic leukemia. However, the best way to sequence these agents to maximize the benefit to patients is still unclear.

There was a 16-week complete response rate of 42% per CT imaging with the combination of venetoclax (Venclexta) and ibrutinib (Imbruvica) in patients with previously untreated or relapsed/refractory mantle cell lymphoma, according to results from the phase II AIM study.

A new drug application seeking a full approval for duvelisib for the treatment of patients with relapsed/refractory chronic lymphocytic leukemia/small lymphocytic lymphoma and an accelerated approval for the treatment of patients with relapsed/refractory follicular lymphoma has been granted a priority review by the FDA.

Studies have shown that older patients with either active, relapsed, or refractory acute myeloid leukemia have had lower survival rates, poor risk assessments, and limited therapeutic options. The standard care of these patients is salvage chemotherapy. Investigators are pretreating patients in this high-risk population with Iomab-B, a novel radiolabeled antibody&ndash;drug conjugate&nbsp;as part of a stem cell transplantation regimen in hopes of improving remission and survival outcomes.

The treatment paradigm of chronic lymphocytic leukemia continues to advance, with many ongoing clinical trials investigating combinations seeking to build upon the success seen with Bruton&rsquo;s tyrosine kinase inhibitors. Such potential combination therapies for CLL include venetoclax (Venclexta) with either ibrutinib (Imbruvica) or acalabrutinib (Calquence).

According to results from an extended follow-up of the CheckMate-205 trial looking at patients with relapsed/refractory classical Hodgkin lymphoma after autologous hematopoietic cell transplantation,&nbsp;nivolumab (Opdivo) caused an overall objective response rate of 69%.

According to results published in <em>The&nbsp;New England Journal of Medicine</em>, molecular minimal residual disease was associated with a higher rate of relapse and a lower rate of relapse-free survival and overall survival for patients with newly-diagnosed acute myeloid leukemia.

Moxetumomab pasudotox has been granted a priority review by the FDA for the treatment of adult patients with hairy cell leukemia (HCL) who have received at least 2 prior lines of therapy, according to AstraZeneca (MedImmune),&nbsp;the developer of the anti-CD22 recombinant immunotoxin.

Miguel-Angel Perales, MD, deputy chief of Adult Bone Marrow Transplant Service at Memorial Sloan Kettering Cancer Center, discusses what experts are expecting to change in the treatment landscape of non-Hodgkin&rsquo;s lymphoma in the next year. Perales says by the end of 2018, there may be 3 CAR T-cell therapies approved for the treatment of non-Hodgkin&rsquo;s lymphoma.

Several new indications were approved by the FDA in March, including blinatumomab (Blincyto)&nbsp;for MRD+ ALL, brentuximab vedotin (Adcetris) for Hodgkin lymphoma, and a 4-week nivolumab (Opdivo) dosing schedule across several indications. Here&rsquo;s a look back on the FDA happenings for the month of March 2018.

Stuart L. Goldberg, MD,&nbsp;discussed the management of patients with acute myeloid leukemia as well as those with myelodysplastic syndrome.

Blinatumomab (Blincyto) has been granted an accelerated approval by the FDA for the&nbsp;treatment of patients with B-cell precursor acute lymphoblastic leukemia who are in remission but still have minimal residual disease.

According to findings from the phase III MURANO trial recently published in the<em> New England Journal of Medicine, </em>the venetoclax&nbsp;(Venclexta) plus rituximab&nbsp;(Rituxan) regimen lowered the risk of disease progression or death by 83% in comparison with bendamustine (Treanda) plus rituximab&nbsp;(Rituxan) in patients with relapsed or refractory chronic lymphocytic leukemia<em>.</em>

Frederick Locke, MD, co-leader of the Department of Blood and Marrow Transplant and Cellular Immunotherapy Program at Moffitt Cancer Center, discussed the long-term follow-up results of the pivotal ZUMA-1 trial. These updated findings were presented at the 2017 ASH Annual Meeting, showing promise in the treatment of patients with non-Hodgkin lymphoma.

Based on data from 2 clinical trials, nilotinib&nbsp;(Tasigna) has been approved by the FDA for the first- and second-line treatment of&nbsp;pediatric patients aged 1 year and older with Philadelphia chromosome&ndash;positive chronic myeloid leukemia in the chronic phase.&nbsp;

Since the identification of the role of the JAK kinase family&nbsp;in the late 1980s, awareness of this&nbsp;has grown significantly. These tyrosine<br /> kinases have been proven to transmit a variety of signals into the cells with many biological consequences, adding to the interest in the targetability of the JAK pathway. However,&nbsp;better understanding of the complexities of JAK signaling are being evaluated in clinical trials.

Based on findings from the phase III ECHELON-1 trial,&nbsp;brentuximab vedotin (Adcetris) has been approved by the FDA for use in&nbsp;combination with chemotherapy as a frontline treatment for adult patients with stage III or IV classical Hodgkin lymphoma,&nbsp;according to a statement from Seattle Genetics, the manufacturer of the CD30-targeted antibody-drug conjugate.

Responses to lisocabtagene maraleucel have been potent and durable in the&nbsp;treatment of patients with relapsed/refractory diffuse large B-cell lymphoma.&nbsp;Separate exploratory&nbsp;analyses of this population treated with liso-cel found that high tumor burden and a series of in ammatory biomarkers were associated with high chimeric antigen receptor T-cell expansion and higher rates of cytokine release syndrome and neurotoxicity.