LYMPHOMAS

Perspective on Treating Advanced Marginal Zone Lymphoma

During a presentation at the American Association for Cancer Research’s inaugural Advances in Malignant Lymphoma meeting, Mehta-Shah, associate professor in the Department of Medicine with Washington University School of Medicine in St. Louis, presented preliminary data showing how new pathway-dependent strategies using novel agent combinations may represent a new way to treat patients with T-cell lymphomas.

Targeting EZH2, the catalytic subunit of the multiprotein PRC2, may represent an attractive therapeutic objective in malignant lymphoma, Vincent Ribrag, MD, told his audience at the American Association for Cancer Research’s inaugural Advances in Malignant Lymphoma meeting.

Julie M. Vose, MD, MBA, Chief in the Division of Oncology/Hematology at the University of Nebraska Medical Center, discusses strategies for overcoming resistance in lymphoma during the 2018 Pan Pacific Lymphoma Conference. 

Mogamulizumab-kpkc (Poteligeo) has been approved by the FDA as a treatment for patients with cutaneous T-cell lymphoma who have received at least 1 prior systemic therapy.

Now that chimeric antigen receptor T-cell therapies have received FDA approval for diffuse large B-cell lymphoma (DLBCL) after moving quickly through early phase clinical trials, research is now exploring ways to shift these agents earlier in the treatment paradigm, according to a discussion at the 2nd Annual Live Medical Crossfire on Hematologic Malignancies.

Michael Wang, MD, discusses what he hopes to find in the ZUMA-2 trial and his belief that MCL can be cured in his lifetime.

Progression-free survival was not improved by combining pixantrone with rituximab compared with gemcitabine plus rituximab in patients with aggressive B-cell non-Hodgkin lymphoma enrolled in the phase III PIX306 trial, according to CTI BioPharma, the manufacturer of pixantrone.

An overall response rate of 60% was induced with venetoclax (Venclexta) monotherapy in patients with poor-risk relapsed/refractory mantle cell lymphoma who were previously treated with a BTK inhibitor, according to results presented at the 2018 European Hematology Association Congress. Of the responding patients, 20% had a complete response.

In patients with untreated advanced-stage classical Hodgkin lymphoma, PET can be safely used to guide treatment after 2 cycles of upfront de-escalated BEACOPP, according to the final analysis of the phase III LYSA study presented at the 2018 European Hematology Association Congress.

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.

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 (Imbruvica) and acalabrutinib (Calquence) are often incurable, according to Michael Wang, MD. Investigators are now challenged to find a new avenue of treatment.

Pembrolizumab (Keytruda) has been granted an accelerated approval by the FDA 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. The approval is based on results from 53 patients with relapsed/refractory PMBCL enrolled in the multicenter, open-label, single-arm KEYNOTE‑170 trial.

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

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

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. 

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.