News

Thousands of hematologists gathered in San Diego on Dec. 3 for the 58th Annual Meeting of the American Society of Hematology (ASH), and Weill Cornell Medicine/NewYork-Presbyterian was well represented, with dozens of presentations.

Here are some of the highlights of research presented:

Researchers aim for ‘home run’ with ibrutinib–palbociclib combination for mantle cell lymphoma

Peter Martin, M.D. Ibrutinib (Imbruvica) has demonstrated efficacy for patients with mantle cell lymphoma and is well tolerated. However, approximately one-third of patients do not respond to the agent, and some patients who do respond ultimately relapse. 

In an attempt to build on ibrutinib’s activity and safety profile, Peter Martin, M.D., and colleagues evaluated ibrutinib in combination with palbociclib (Ibrance) in 20 patients with previously treated mantle cell lymphoma.

The results of the Phase I trial were promising, and a multicenter phase 2 clinical trial is now planned, Martin told HemOnc Today, MDLinx and AJMC. 

Watch a video interview here.

R-CHOP remains standard of care in DLBCL

Chemoimmunotherapy with R-CHOP — rituximab (Rituxan, Genentech) plus cyclophosphamide, doxorubicin, vincristine and prednisone — has been the standard therapy for DLBCL for several years.

A modified version called "dose-adjusted R-EPOCH" -- involving four-day infusions, an added drug called etoposide, and some dose adjustments with each cycle depending on the treatment effect -- is also in use, and John Leonard, M.D. reported on the results of a phase 3 multicenter study comparing the two regimens.

As Leonard told HemOnc Today, results suggested that R-CHOP should remain the standard, as it demonstrated similar efficacy, and is more user-friendly for the patient and the physician.

Watch a video interview here.

Ibrutinib in combination with Lenalidomide and Rituximab displays improvement for patients with relapsed or refractory DLBCL

Diffuse large B-cell lymphoma (DLBCL) is the most common form of non-Hodgkin lymphoma. While 50-60% of patients are cured with the standard R-CHOP chemotherapy, only 10-20% of patients who fail R-CHOP experience improvements and long-term remission with other therapies. Current treatments options for DLBCL after R-CHOP include high-dose chemotherapy or autologous stem cell transplant (ASCT). However, patients are often ineligible to receive these treatments due to their advanced age or other health problems. Younger patients with relapsed DLBCL may not be able to move onto transplant due to refractory disease. This highlights the unmet medical need to explore additional treatment options for high risk patients whose DLBCL is refractory or relapsed (R/R) within 12 months of diagnosis.

As reported in the New Developments in Lymphoma blog, Jia Ruan, M.D., Ph.D., shared the promising results of an early trial into a new combination of ibrutinib and lenalidomide.

Prevalence of FAT1 mutations in CLL

John Allan, M.D. As explained in the New Developments in Lymphoma blog, there is limited information regarding the clinical impact of some less common gene mutations in the treatment of chronic lymphocytic leukemia (CLL), despite recent strides in mapping its mutational landscape. John Allan, M.D., discussed his findings regarding mutations of the FAT1 gene, which plays a role in regulating WNT signaling and tumor suppression and mutations have previously been associated with leukemia.

His investigations found a higher prevalence of FAT1 mutations in untreated CLL patients than previously reported, and the challenge now is to uncover its clinical implications. 

Initial mutation assessments important in MDS patients

Sangmin Lee, M.D. Initial molecular mutations are known to be important in myelodysplastic syndromes (MDS) in terms of prognostic information.

Currently, it is not standard of care to be monitoring for change in mutations over time throughout the course of MDS patients. But curious about how frequently mutations are gained and lost, and how it may impact clinical practice, the MDS Clinical Research Consortium examined the pattern of MDS mutations over time in patients through serial mutation monitoring.

As reported in MDLinx, Sangmin Lee, M.D., (presenting on behalf of the group) said they found several significant changes in mutations in many patient, but further study is needed before recommending serial monitoring as part of routine clinical practice.

Venetoclax for relapsed/refractory CLL patients 

Patients with CLL who relapse after or become refractory to treatments like ibrutinib or idelalisib have poor outcomes. Venetoclax (also known as ABT-199) is an oral inhibitor of the BCL-2 (B-cell lymphoma 2) protein. The BCL-2 protein plays a critical role in preventing cells from undergoing apoptosis (cell death), in healthy cells and in CLL cells. In a recent study presented at the 2016 annual ASH meeting, Richard Furman, M.D., presented his evaluation into the effectiveness of venetoclax in treating people who relapsed after or were refractory to ibrutinib or idelalisib. Read more on the New Developments in Lymphoma blog. 

Additional coverage:

• Dr. Leonard spoke to the ASCO Post about the results of the GALLIUM study, which suggested that induction and maintenance therapies with obinutuzumab (Gazyva) were superior to rituximab (Rituxan) induction and maintenance in patients with untreated follicular lymphoma.
• He was also featured on the Novel Targets podcast, discussing his #LeonardList
• Dr. Martin spoke to HemOnc Today about the RBAC500 combination -- the addition of intermediate-dose cytarabine to first-line bendamustine–rituximab -- which has yielded ‘essentially unprecedented’ response rate in mantle cell lymphoma.
• Dr. Duane Hassane spoke to AML Today about Minimal Residual Disease (MRD) testing in AML.