October 1, 2020

There are several indications for the use of allo-SCT in adults. With the implementation of targeted therapies, these are continuously changing.

Investigation of intensive chemotherapy regimens has unfortunately resulted in a lack of improvement in outcomes for patients with acute lymphoblastic leukemia in the second of the bimodal peaks.

“The landscape has completely changed as a consequence of COVID[-19]," says Robert Marcus, MA, FRCP, FRCPath.

On the treatment of adult patients with acute lymphoblastic leukemia, long-term cure rates in elderly populations, or those older than 55 to 60 years of age, are approximately 15% to 20% and represent a clinically unmet need in this hematologic cancer.

Building on the transformative impetus from the first FDA-approved JAK 1/2 inhibitor, ruxolitinib, in the clinical landscape of myeloproliferative neoplasms, we are entering a new era of multiple JAK inhibitors and other diverse classes of drugs in rapid clinical development.

Traditional frontline chemoimmunotherapy regimens used to be the gold standard for treating patients with newly diagnosed chronic lymphocytic leukemia. However, over time, targeted therapies have been inching out the use of chemoimmunotherapy to become the preferred approach in this setting.

In the past 5 years, 3 new options have emerged to treat patients with relapsed/ refractory acute lymphoblastic leukemia, providing hope for patients with this disease but also raising clinical questions.

The most recent updated World Health Organization classification of lymphoid neoplasms included a new category of mature B-cell neoplasms, high-grade B-cell lymphoma with MYC and BCL2 and/or BCL6 translocations.

In patients with advanced hepatocellular carcinoma treated in 2020, there was an observed decrease in planned treatment as well as significant delays noted as a result of the coronavirus disease 2019 pandemic, according to the results of a study of 6 academic referral centers.

Today’s patients diagnosed with chronic myeloid leukemia can look forward to a near-normal life expectancy, provided they have good access to treatment and monitoring and are properly managed, said Jorge Cortes, MD.

Neoadjuvant immunotherapy with nivolumab plus percutaneous electroporation has demonstrated early signals of promise in the treatment of patients with Barcelona Clinic Liver Cancer class A hepatocellular carcinoma, according to preliminary reports from the phase 2 NIVOLEP trial.

“We should look to reduce or limit radiation therapy or eliminate it if it’s not necessary. The major problem is the late toxicity associated with it."

In the wake of the enthusiasm around cancer immunotherapy trial results—with several positive trials presented annually at each American Society of Clinical Oncology meeting in more and more diseases over several years—setbacks have served as a grim reminder that our work is not finished.

Although the use of α-fetoprotein has long been established in hepatocellular carcinoma as a biomarker for screening and diagnosis, its role in treatment selection and prognosis following systemic therapy is a moving target.

Findings from the NASIR-HCC phase 2 clinical trial demonstrated the safety and tolerability of nivolumab administered with selective internal radiation therapy containing yttrium-90 resin in patients who were ineligible for transarterial chemoembolization.

Better response in survival were observed in patients with Child-Pugh B cirrhosis, a patient population that has limited treatment options, when given cabozantinib in the phase 3 CELESTIAL study.