HEMATOLOGY

<br /> Farhad Ravandi-Kashani, MD, The University of Texas MD Anderson Cancer Center, discusses the rationale for targeting CD33 with AMG 330 in patients with relapsed/refractory acute myeloid leukemia.

Recent FDA drug approvals in hematologic malignancies have changed the treatment paradigm of many diseases and resulted in necessary updates to the National Comprehensive Cancer Network Clinical Practice Guidelines in Oncology.

Although there were a variety of encouraging data presented at the 2018 ASH Annual Meeting, CLL and multiple myeloma undoubtedly ruled the day, according to poll results. As these topics heated up on Twitter, a few experts took a moment to discuss their thoughts on some of the top abstracts that were presented.

Ajai Chari, MD, discusses the biggest challenge in treating patients with multiple myeloma.

According to data from the phase IIIb CASSINI trial presented at the 2018 ASH Annual Meeting, rivaroxaban could significantly reduce&nbsp;venous thromboembolism occurrence in patients currently receiving treatment with systemic therapy.

According to findings from the phase III ECHELON-2 trial presented at the 2018 ASH Annual Meeting, the use of brentuximab vedotin (Adcetris) in combination with chemotherapy demonstrated a clinically meaningful improvement in progression-free survival and overall survival in patients with CD30-expressing peripheral T-cell lymphoma. These data were also published online in&nbsp;<em>Lancet Oncology</em>.

A newly discovered recurrent mutation in the&nbsp;B-cell leukemia/lymphoma 2 protein&nbsp;in patients with chronic lymphocytic leukemia has been linked to venetoclax resistance.

Venetoclax monotherapy induced high rates of minimal residual disease in the peripheral blood and bone marrow in patients with&nbsp;relapsed/refractory chronic lymphoblastic leukemia in a pooled analysis of 2 clinical trials. Data from the analysis was reported during the poster session at the 2018 ASH Annual Meeting.

A look back at all the FDA news that happened in the month of November 2018, including several new approvals, priority reviews, a fast track designation, and an accelerated approval, across a variety of cancer types.

Two-year findings from the ZUMA-1 trial showed an overall survival rate of more than 50% from treatment with&nbsp;axicabtagene ciloleucel, a CD19-targeted CAR T-cell therapy&nbsp;in patients with&nbsp;refractory large B cell lymphoma; the median survival had not yet been reached. These data, representing a clear plateau in the survival curve, were presented at the 2018 ASH Annual Meeting.

An update on the pivotal phase III&nbsp;QuANTUM-R study presented at the 2018 ASH Annual Meeting demonstrated overall survival benefit across patient subgroups with&nbsp;quizartinib in patients with&nbsp;relapsed/refractory <em>FLT3</em>-ITD&ndash;mutated acute myeloid leukemia.&nbsp;

A significant reduction in the risk of&nbsp;disease progression or death was observed from treatment with the upfront combination of&nbsp;ibrutinib plus obinutuzumab in patients&nbsp;with chronic lymphocytic leukemia and small lymphocytic lymphoma compared with&nbsp;chlorambucil and obinutuzumab.&nbsp;

Lenalidomide in addition to rituximab, called the R² regimen, led to a significant increase in progression-free survival compared with rituximab alone in patients with&nbsp;relapsed/refractory indolent non-Hodgkin lymphoma in results from the phase III AUGMENT trial.

Initial results from a phase I study showed an objective response rate of 83.3% had been achieved in&nbsp;heavily pretreated patients with relapsed/refractory multiple myeloma who had been treated with the anti-BCMA CAR T-cell therapy bb21217.

The gold standard of predicting how long patients with&nbsp;myelodysplastic syndromes could live with the disease may soon be replaced by a new approach. According to Aziz Nazha, MD, this newer approach utilizes machine learning to&nbsp;analyze genomic and clinical data from patients to more accurately predict survival.

Mosunetuzumab, a&nbsp;CD3 and CD20 bispecific antibody, induced complete remission rates over 30% in patients with&nbsp;relapsed/refractory follicular lymphoma and&nbsp;relapsed/refractory diffuse large B-cell lymphoma or transformed follicular lymphoma, and demonstrated a tolerable safety profile, showing promise for these patients with&nbsp;B-cell indolent and aggressive non-Hodgkin lymphomas.&nbsp;

According to a presentation of findings from the&nbsp;phase II CLARITY study at the 2018 ASH Annual Meeting, ibrutinib in combination with&nbsp;venetoclax demonstrated tolerability among patients with relapsed/refractory chronic lymphocytic leukemia. The combination also induced minimal residual disease negativity in the marrow in&nbsp;39% of these patients after 12 months.

Among older patients with acute myeloid leukemia who were ineligible for intensive chemotherapy, preliminary findings demonstrated that more than 70% achieved complete responses to venetoclax in combination with hypomethylating agents.

Peter M. Voorhees, MD, investigator, department of hematologic oncology &amp; blood disorders, Levine Cancer Institute/Atrium Health, discusses efficacy and updated safety findings of a safety run-in cohort from the phase II Griffin trial, a randomized study of daratumumab, bortezomib, lenalidomide, and dexamethasone (Dara-Vrd) versus Vrd in patients with newly diagnosed multiple myeloma eligible for high-dose therapy and autologous stem cell transplantation, during the 2018 ASH Annual Meeting.

It may be possible for hematologists to determine subtypes of acute myeloid leukemia based on genetic analsysis of blood samples in 7 days or less. According to Amy Burd, PhD, this process could play an important role in diagnosing and treating patients.

Pembrolizumab in combination with&nbsp;umbralisib and ublituximab induced responses in 90% of patients&nbsp;with&nbsp;relapsed/refractory chronic lymphocytic leukemia, according to data from a phase I/II study presented at the&nbsp;2018 ASH Annual Meeting. Additionally, a&nbsp;50% response rate was also demonstrated in patients with&nbsp;Richter&rsquo;s transformation.

After 7 years of follow-up, single-agent ibrutinib demonstrated continued efficacy in&nbsp;the frontline and heavily pretreated, relapsed/refractory settings for patients with&nbsp;chronic lymphocytic leukemia and small lymphocytic lymphoma.

Lisocabtagene maraleucel induced an 81.3% best overall response rate and 43.8% complete response in high-risk patients with&nbsp;chronic lymphocytic leukemia who were heavily pretreated and had previously received ibrutinib, according to dose-finding results presented at the 2018 ASH Annual Meeting.&nbsp;

According to results from a small clinical study, checkpoint&nbsp;inhibitors in combination with&nbsp;chimeric antigen receptor T-cell therapy showed promise for improving CAR T-cell persistance in some patients with relapsed B-cell acute lymphoblastic leukemia. &nbsp; &nbsp;&nbsp;<br /> &nbsp;

Patients with&nbsp;acute lymphoblastic leukemia saw a reduction in the risk for recurrence after receiving a stem cell transplant for the first time following treatment with CD19 chimeric antigen receptor T-cell therapy.