HEMATOLOGY

Andre Goy, MD, chief, Division of Lymphoma, chairman and director, John Theurer Cancer Center, discusses the progress made with immunotherapy for the treatment of hematologic malignancies over the last 5 years.

Neil E. Kay, MD, a professor of medicine at the Mayo Clinic, discusses the challenges that arise when treating a patient with relapsed chronic lymphocytic leukemia (CLL). Most times, responses in this setting are short lived.

Matthew S. Davids, MD, MMSc, discusses the findings with duvelisib plus fludarabine-cyclophosphamide-rituximab as a frontline therapy for younger patients with CLL, as well as the potential future for this agent in the treatment of patients with CLL.

Based on survival data from the phase III TOWER study, blinatumomab has been granted full marketing authorization by the European Commission for the treatment of adult patients with Philadelphia chromosome-negative relapsed/refractory B-cell precursor acute lymphoblastic leukemia, according to Amgen, the developer of the anti-CD19 immunotherapy.

Michael R. Grunwald, MD,&nbsp;discusses new and emerging agents in AML and ALL, as well as sequencing and toxicity challenges with these treatments.<br /> &nbsp;

Alexander Perl, MD, an associate professor of medicine at the University of Pennsylvania, discusses the current challenges with CAR T-cell therapy for the treatment of patients with acute myeloid leukemia

The biggest clinical unmet need in the treatment of patients with mantle cell lymphoma is overcoming resistance to BTK inhibitors, as patients who progress on treatment with ibrutinib&nbsp;(Imbruvica) and acalabrutinib (Calquence) are often incurable, according to Michael Wang, MD. Investigators are now challenged to find a new avenue of treatment.

An overall response rate of&nbsp;41.6% (95% CI, 32.9-50.8) was induced with the use of ivosidenib in patients with&nbsp;<em>IDH1</em>-positive relapsed/refractory acute myeloid leukemia, according to data presented at the 2018 ASCO Annual Meeting&nbsp;and published simultaneously online in the <em>New England Journal of Medicine</em>.

Pembrolizumab (Keytruda) has been granted&nbsp;an accelerated approval by the FDA&nbsp;for the treatment of adult and pediatric patients with refractory primary mediastinal large B-cell lymphoma (PMBCL), or those who have relapsed after 2 or more prior lines of therapy.&nbsp;The approval is based on results from 53 patients with relapsed/refractory PMBCL enrolled in the multicenter, open-label, single-arm KEYNOTE&#8209;170 trial.

Noa Biran, MD, physician, Multiple Myeloma Division, John Theurer Cancer Center, discusses the rationale for selecting stem cell transplant as treatment over a chemotherapy regimen for patients with multiple myeloma.

A supplemental new drug application adding overall survival data from the phase III ASPIRE trial to the label&nbsp;for carfilzomib (Kyprolis) has been approved by the FDA, according to Amgen, the manufacturer of the proteasome inhibitor.&nbsp; Carfilzomib is approved&nbsp;for use in patients with relapsed or refractory multiple myeloma.

Myelofibrosis is a myeloproliferative neoplasm characterized by&nbsp;splenomegaly, progressive cytopenias, and transformation to acute&nbsp;myeloid leukemia. This review&nbsp;will describe mutations detected in myelofibrosis and discuss how&nbsp;to incorporate mutation information into risk stratification and&nbsp;therapeutic decision making for patients with myelofibrosis.

In an ideal world, researchers conduct preclinical studies that generate a targeted therapy, which eventually makes its way through early, middle, and late-stage trial development and FDA approval. That smooth transition does not happen often, but early results involving an agent that affects 2 endogenous inhibitors of p53 look promising.

Noopur S. Raje, MD, a medical oncologist at Massachusetts General Hospital, discusses chimeric antigen receptor T-cell therapy in patients with multiple myeloma. This therapy has been an exciting advancement in both hematology as well as solid tumors, she notes.

Based on data from the phase III MURANO trial, venetoclax has been granted a regular approval by the FDA&nbsp;for the treatment of patients with chronic lymphocytic leukemia or small lymphocytic lymphoma, with or without 17p deletion, who has received at least 1 prior therapy.

An objective response rate was achieved in 18 of 37 patients with&nbsp;relapsed/refractory non-Hodgkin lymphoma who received the combination of&nbsp;the BTK inhibitor ibrutinib with the PI3K inhibitor buparlisib, according to findings of a phase I/II trial&nbsp;reported at the 2018 ASCO Annual Meeting.

Rafael Fonseca, MD, recently shared the treatment considerations and decisions he makes when treating patients with multiple myeloma. Fonseca, professor of medicine, chair, Department of Internal Medicine, Mayo Clinic, explained how he would treat these patients based on case scenarios during a <em>Targeted Oncology </em>live case-based peer perspectives presentation.

Durable complete remissions were seen in 46% of patients with&nbsp;high-risk diffuse large B-cell lymphoma treated with the CAR T-cell therapy lisocabtagene maraleucel at 6 months.&nbsp;These results come from the updated findings from the phase I, multicenter TRANSCEND trial that were presented at the 2018 ASCO Annual Meeting.

According to results presented at the 2018 ASCO Annual Meeting,&nbsp;moxetumomab pasudotox, a first-in-class recombinant immunotoxin targeting CD22, demonstrated deep and durable responses in a substantial proportion of pretreated patients with relapsed/refractory hairy cell leukemia.

Based on data reported at the 2018 ASCO Annual Meeting, the primary endpoint of the phase III RELEVANCE trial was not met with the combination of rituximab plus lenalidomide showing similar efficacy results compared with rituximab plus chemotherapy in treatment-naive patients with follicular lymphoma. The chemotherapy-free regimen, however, did show a more favorable toxicity profile.&nbsp;

According to initial results from a phase Ib/II study presented at the 2018 ASCO Annual Meeting, 50% of a small group of patients with relapsed or refractory non-Hodgkin lymphoma achieved responses from the combination of an anti-CD47 antibody plus rituximab.

Treatment-naive patients with chronic lymphocytic leukemia achieved high rates of&nbsp;minimal residual disease&ndash;negative status of 77% with peripheral blood testing after 6 cycles from treatment with ibrutinib (Imbruvica) and venetoclax (Venclexta). Additionally, patients in the CAPTIVATE trial, wihch was presented during the 2018 ASCO Annual Meeting, achieved an objective response rate of 100%.

An FDA analysis of data from 2 randomized clinical trials investigating pembrolizumab in multiple myeloma showed inconsistent results regarding the relationship between immune-related adverse events and objective responses. The KEYNOTE-183 and KEYNOTE-185 trials were reviewed during the 2018 ASCO Annual Meeting.

According to the phase III ARROW study, a prolonged progression-free survival was found when carfilzomib was administered with a new dosing schedule of 70 mg/m²&nbsp;once weekly with&nbsp;dexamethasone compared to the standard of care, a twice-weekly schedule, in patients with relapsed/refractory multiple myeloma.

Risk of disease progression or death decreased by 80% with the addition of&nbsp;ibrutinib to rituximab compared with rituximab alone for patients with Waldenstr&ouml;m macroglobulinemia.