Highlights of ASH: Lymphoid Malignancies

I AM WRITING THIS column on the eve of the 66th American Society of Hematology (ASH) Annual Meeting and Exposition in San Diego, California. This year, the ASH meeting appears to be delivering quite a few practice-changing studies in lymphoid malignancies.

InMIND (NCT04680052): Patients with relapsed follicular lymphoma were randomly assigned to an investigational arm of tafasitamab (Monjuvi)/lenalidomide (Revlimid)/rituximab (Rituxan) vs a control arm of placebo/lenalidomide/ rituximab. The addition of tafasitamab markedly improved median progression- free survival (PFS; 57% reduction in risk of progression or death), duration of response, and time to next treatment.

TRIANGLE (NCT02858258): Two years ago, we learned from the TRIANGLE trial findings that the addition of ibrutinib (Imbruvica) to chemoimmunotherapy in previously untreated mantle cell lymphoma (MCL) improved failure-free survival. With this additional follow-up, the addition of ibrutinib prolongs overall survival and suggests that autologous hematopoietic cell transplantation is not necessary.

ECOG-ACRIN EA4181 (NCT04115631): In this frontline MCL trial, transplant- eligible patients were randomly assigned to bendamustine- rituximab (BR)/cytarabine-R, BR/cytarabine-R/acalabrutinib [Calquence], and BR/acalabrutinib. This trial raises the question of whether cytarabine is necessary.

EPCORE CLL-1 (NCT04623541): Patients with relapsed chronic lymphocytic leukemia (CLL) were treated with epcoritamab (Epkinly). The overall response rate of 61% and complete response rate of 39% are highly encouraging. However, the rate of cytokine release syndrome was not trivial at 71% to 96%.

Other studies include AMPLIFY (NCT03836261), which may establish the combination of acalabrutinib and venetoclax (Venclexta) for treatment-naive CLL, and BRUIN CLL 321 (NCT04666038), which confirms the efficacy of pirtobrutinib (Jaypirca) in relapsed/refractory CLL.