LEUKEMIAS

Pinkal Desai, MD, discusses the factors a practicing physician should consider when selecting an appropriate induction therapy for patients with acute myeloid leukemia.

In an interview with Targeted Oncology, Eytan M. Stein, MD, reviews the current treatment landscape of acute myeloid leukemia, underscores the importance of molecular monitoring, and highlights where the field is headed.

A number of promising biologic therapies are beginning to transform the treatment of adult patients with acute lymphoblastic leukemia, with the greatest potential seen with blinatumomab and inotuzumab ozogamicin in combination with chemotherapy, according to a presentation by Hagop M. Kantarjian, MD, at the 37th Annual CFS.<br /> &nbsp;

Detailed results of the phase III ADMIRAL trial, which evaluated the use of gilteritinib in adult patients with FLT3 mutation&ndash;positive relapsed or refractory acute myeloid leukemia, have been published in the New England Journal of Medicine and reaffirm the improved overall survival rate seen with gilteritinib compared with chemotherapy in these patients, according to a press release from Astellas Pharma Inc.

In October 2019, the FDA approved a new treatment option for patients with advanced ovarian, fallopian tube, or primary peritoneal cancer, as well as a new dosing regimen for patients receiving moderately emetogenic chemotherapy. Additionally, the FDA granted breakthrough therapy designations to 2 therapies, as well as an orphan drug designation, a priority review, and 2 fast track designations.

In the phase II biomarker-driven trial combining retinoic acid receptor alpha agonist SY-145 with azacitidine, newly diagnosed adult patients with RARA-positive acute myeloid leukemia who were unfit for intensive chemotherapy continued to show responses to the combination and demonstrate tolerability of the regimen, according to a press release from Syros Pharmaceuticals.

Ublituximab in combination with ibrutinib demonstrated a benefit in progression-free survival over ibrutinib monotherapy, as assessed by an independent review committee, in patients with high-risk relapsed or refractory chronic lymphocytic leukemia in the final long-term results of the phase III GENUINE trial.

John DiPersio, MD, PhD, discusses targeted therapies for myeloid malignancies using DARTs, Bites, and antibody&ndash;drug conjugates, a topic he presented during the 2019 Society for Hematologic Oncology Annual Meeting.

Bemcentinib, a first-in-class AXL inhibitor, has been approved for a fast track designation by the FDA for the treatment of elderly patients with relapsed or refractory acute myeloid leukemia, according to a press release from BerGenBio.<br /> &nbsp;

Ivosidenib in combination with azacitidine demonstrated promising efficacy in addition to being well tolerated in patients with newly diagnosed <em>IDH1</em>-mutant acute myeloid leukemia who were ineligible for intensive chemotherapy.

Among patients with acute myeloid leukemia and myelodysplastic syndrome who completed myeloablative allogeneic hematopoietic stem cell transplantation, the predictive utility of testing circulating tumor DNA was comparable with that of mutation persistence evaluation in matched bone marrow samples, according to a study published recently in Blood.

William G. Wierda, MD, PhD, shares a message with community oncologists about the evolving treatment landscape for patients with chronic lymphocytic leukemia.

The advent of an era of targeted immunotherapy and CAR T-cell therapies for the treatment of adult patients with acute lymphoblastic leukemia may reduce the need for hematopoietic stem cell transplant in certain cases.<br /> &nbsp;

Marcelo C. Pasquini, MD, discusses the rationale for analyzing real-world data for the use of tisagenlecleucel, a chimeric antigen receptor T-cell therapy, as a treatment for patients with acute lymphoblastic leukemia and diffuse large B-cell lymphoma. This CD19 CAR T cell was approved 2 years ago for use in both ALL and DLBCL.

Due to treatment benefit observed in pediatric patients with acute lymphoblastic leukemia,&nbsp;2 clinical trials investigating blinatumomab (Blincyto) versus chemotherapy were stopped early, according to the drug developer Amgen.

Umbralisib and ublituximab in combination with pembrolizumab was well tolerated among patients with relapsed/refractory chronic lymphocytic leukemia and Richter&rsquo;s transformation, according to a phase I/II trial presented at the 18th International Workshop on CLL. Responses were durable in high-risk patients who are BTK-refractory, including 2 complete responses in patients with RT.

In an interview with&nbsp;<em>Targeted Oncology</em>, Marcelo C. Pasquini, MD, discussed the importance of obtaining real-world data and establishing registries for collecting patient outcomes, and how real-world data compare with data from pivotal trials. He also explained the challenges with accessibility to CAR T-cell therapies.

The PI3K-delta inhibitor umbralisib demonstrated a favorable toxicity profile as treatment for patients with chronic lymphocytic leukemia who have become intolerant to a prior kinase inhibitor, of either BTK or PI3K inhibition, according to results from a phase II study presented at the 18th International Workshop on CLL.

In an interview with <em>Targeted Oncology</em>, Neil P. Shah, MD, PhD, discussed the latest advancements in the treatment landscape of chronic myeloid leukemia, including the introduction of tyrosine kinase inhibitors. He also addressed some of the challenges both oncologists and patients face in this space.<br /> &nbsp;

Gail Roboz, MD, discusses the use of FLT3 inhibitors as treatment of patients with acute myeloid leukemia, which can be a heterogenous and difficult-to-treat disease. There is a lot of optimism for new drugs and targets in AML, but the disease itself remains tough to treat, according to Roboz.

Tanya Siddiqi, MD, discusses how she sees acalabrutinib fitting into the treatment landscape for patients with chronic lymphocytic leukemia following the results from the phase III ASCEND trial.

The presence of novel combinations and oral targeted therapies are rising in the frontline treatment setting for patients with chronic lymphocytic leukemia, regardless of age. According to Nitin Jain, MD, ongoing phase III trials will bring additional modifications to the treatment landscape.

In an interview with&nbsp;<em>Targeted Oncology </em>during the 2019 SOHO Annual Meeting, John F. DiPersio, MD, PhD, discussed the challenges in research surrounding immunotherapies for AML, including DARTs, BiTEs, ADCs, and CARs.

In the phase III QUAZAR AML-001 trial, an investigational oral azacitidine therapy, CC-486, induced a statistically significant improvement in overall survival compared with placebo when used as a maintenance therapy in the treatment of patients with newly diagnosed acute myeloid leukemia who achieved a complete response or CR with incomplete blood count recovery following treatment with induction chemotherapy.

To improve the efficacy of chimeric antigen receptor T-cell therapies, Nirali N. Shah, MD, MHSc, suggested including new constructs that target more than 1 antigen in patients with acute lymphoblastic leukemia, during a presentation at the 2019 SOHO Annual Meeting.<br /> &nbsp;