Article
Hematology
Noelle Frey
Summary: Brexucabtagene autoleucel has become the first anti-CD19 chimeric antigen receptor T-cell product approved by the FDA for the treatment of relapsed and refractory B-cell acute lymphoblastic leukemia, significantly expanding treatment options for patients.
Article
Oncology
Anthony Mato
Summary: Significant progress has been made in the treatment of relapsed/refractory CLL and SLL, with targeted therapies replacing traditional chemotherapy as the standard of care for most patients.
JOURNAL OF THE NATIONAL COMPREHENSIVE CANCER NETWORK
(2022)
Article
Medicine, General & Internal
Edoardo Benedetti, Claudia Barate, Fabrizio Mavilia, Emilia Bramanti, Riccardo Morganti, Valentina Guerri, Giulia Cervetti, Enrico Capochiani, Ilaria Bertaggia, Salvatore Massimo Stella, Ginevra Traverso, Benedetto Bruno, Sara Galimberti
Summary: Fixed duration VenR treatment showed significant improvements in PFS and uMRD compared to bendamustine-rituximab in relapsed/refractory CLL patients. Ultrasonography and palpation were suggested as possible techniques to evaluate visceral and superficial lymph node involvement outside of clinical trials.
JOURNAL OF CLINICAL MEDICINE
(2023)
Article
Oncology
Max S. Topp, Nicola Goekbuget, Gerhard Zugmaier, Anthony S. Stein, Herve Dombret, Yuqi Chen, Josep-Maria Ribera, Ralf C. Bargou, Heinz-August Horst, Hagop M. Kantarjian
Summary: This study analyzed long-term follow-up data from two clinical trials involving blinatumomab, finding that one-third of patients with relapsed and/or refractory B-cell precursor acute lymphoblastic leukemia achieving a deep response with blinatumomab lived for 3 years or longer. These results suggest that long-term survival is possible after treatment with blinatumomab, with some patients even undergoing stem cell transplantation showing improved survival outcomes.
Review
Oncology
Maria Chiara Barbanti, Niamh Appleby, Murali Kesavan, Toby Andrew Eyre
Summary: Cellular therapy, such as allogenic stem cell transplantation and chimeric antigen receptor T-cell therapy, continues to be explored in high-risk chronic lymphocytic leukemia and Richter syndrome. However, these treatment modalities have limitations and specific placement in treatment algorithms.
FRONTIERS IN ONCOLOGY
(2022)
Article
Hematology
Shivani Handa, Jeong-Ok Lee, Andriy Derkach, Richard M. Stone, Alan Saven, Jessica K. Altman, Michael R. Grever, Kanti R. Rai, Madhulika Shukla, Shreya Vemuri, Skye Montoya, Justin Taylor, Omar Abdel-Wahab, Martin S. Tallman, Jae H. Park
Summary: In patients with relapsed/refractory hairy cell leukemia (HCL), vemurafenib has shown high response rates. This study reports that the overall response rate was 86% in 36 patients treated with vemurafenib, with 33% complete response and 53% partial response. Relapses occurred in 68% of responders, but retreatment with vemurafenib showed a 86% complete hematologic response rate.
Article
Medicine, General & Internal
J. R. Brown, B. Eichhorst, P. Hillmen, W. Jurczak, M. Kazmierczak, N. Lamanna, S. M. O'Brien, C. S. Tam, L. Qiu, K. Zhou, M. Simkovic, J. Mayer, A. Gillespie-Twardy, A. Ferrajoli, P. S. Ganly, R. Weinkove, S. Grosicki, A. Mital, T. Robak, A. Osterborg, H. A. Yimer, T. Salmi, M. -D. -Y. Wang, L. Fu, J. Li, K. Wu, A. Cohen, M. Shadman
Summary: In a multinational phase 3 trial, zanubrutinib was found to be superior to ibrutinib in treating relapsed or refractory CLL or SLL, with better efficacy and fewer side effects.
NEW ENGLAND JOURNAL OF MEDICINE
(2023)
Review
Hematology
Jennifer A. Woyach
Summary: The therapeutic landscape for CLL has changed dramatically with the development of oral therapies targeting key drivers, posing challenges in sequencing available treatments and raising questions on how to improve treatment continuously.
AMERICAN JOURNAL OF HEMATOLOGY
(2022)
Article
Oncology
Yuqin Song, Keshu Zhou, Shenmiao Yang, Jianda Hu, Dehui Zou, Sujun Gao, Ling Pan, Tingyu Wang, Haiyan Yang, Huilai Zhang, Daobin Zhou, Jie Ji, Wei Xu, Ru Feng, Jie Jin, Fangfang Lv, Haiwen Huang, Xiaosi Fan, Sheng Xu, Jun Zhu
Summary: We conducted two indirect comparisons to estimate the efficacy of zanubrutinib versus orelabrutinib in Chinese patients with relapsed or refractory CLL/SLL or MCL. The results showed that zanubrutinib demonstrated favorable PFS over orelabrutinib in R/R CLL/SLL patients and had favorable PFS and higher CR rate than orelabrutinib in R/R MCL patients.
INVESTIGATIONAL NEW DRUGS
(2023)
Review
Oncology
Oluwatobi Odetola, Shuo Ma
Summary: This review emphasizes that the purpose of treatment for relapsed/refractory CLL is disease control and delay of progression rather than cure. The article reviews the concept of relapsed CLL, factors predisposing to relapse, and available therapeutic options. Recent findings show that targeted therapies such as continuous BTK inhibitors or fixed duration venetoclax plus anti-CD20 monoclonal antibody therapy have established superiority over chemoimmunotherapy in relapsed CLL and are now the preferred standard of care treatment.
CURRENT HEMATOLOGIC MALIGNANCY REPORTS
(2023)
Article
Hematology
Marcin M. Machnicki, Patryk Gorniak, Monika Pepek, Agnieszka Szymczyk, Elzbieta Iskierka-Jazdzewska, Pawel Steckiewicz, Aleksandra Bluszcz, Malgorzata Rydzanicz, Marek Hus, Rafal Ploski, Hanna Makuch-Lasica, Grazyna Nowak, Przemyslaw Juszczynski, Krzysztof Jamroziak, Tomasz Stoklosa, Bartosz Pula
Summary: Ibrutinib, an inhibitor of BTK, shows high efficacy in treating RR-CLL patients. This study analyzed the mutational status of 30 genes in 45 RR-CLL patients, with TP53, NOTCH1, and SF3B1 showing the highest mutation rates. The analyzed molecular factors did not impact PFS and OS in these patients.
EUROPEAN JOURNAL OF HAEMATOLOGY
(2021)
Article
Oncology
Regina Muehleck, Sebastian Scholl, Inken Hilgendorf, Karin Schrenk, Jakob Hammersen, Jochen J. Frietsch, Maximilian Fleischmann, Herbert G. Sayer, Anita Glaser, Andreas Hochhaus, Ulf Schnetzke
Summary: The Mito-FLAG salvage protocol is an effective and feasible treatment regimen for patients with r/r AML, with a high rate of achieving remission and successful transition to allogeneic hematopoietic stem cell transplantation for long-term disease-free survival.
JOURNAL OF CANCER RESEARCH AND CLINICAL ONCOLOGY
(2022)
Article
Hematology
Yazan Numan, Zaid Abdel Rahman, Justin Grenet, Stephanie Boisclair, Jan Philipp Bewersdorf, Cailin Collins, Dylan Barth, Martina Fraga, Dale L. Bixby, Amer M. Zeidan, Musa Yilmaz, Pankil Desai, Gabriel Mannis, Yehuda E. Deutsch, Yasmin Abaza, Shira Dinner, Olga Frankfurt, Mark Litzow, Aref Al-Kali, James M. Foran, Lisa Z. Sproat, Borko Jovanovic, Naval Daver, Alexander E. Perl, Jessica K. Altman
Summary: This research analyzed 113 patients with relapsed/refractory FLT3(mut+) AML who received gilteritinib treatment and found a CRc rate of 48.7%. Among patients who received 7+3 and midostaurin treatment, the CRc rate after gilteritinib treatment was 58% with a median survival of 7.8 months. Patients who achieved CR, especially those with a cMRD negative response, had the longest survival.
AMERICAN JOURNAL OF HEMATOLOGY
(2022)
Article
Hematology
Csaba Bodor, Lili Kotmayer, Tamas Laszlo, Ferenc Takacs, Gabor Barna, Richard Kiss, Endre Sebestyen, Tibor Nagy, Lajos Laszlo Hegyi, Gabor Mikala, Sandor Fekete, Peter Farkas, Alexandra Balogh, Tamas Masszi, Judit Demeter, Julia Weisinger, Hussain Alizadeh, Bela Kajtar, Zoltan Kohl, Robert Szasz, Lajos Gergely, Timea Gurbity Palfi, Adrienn Sulak, Balazs Kollar, Miklos Egyed, Mark Plander, Laszlo Rejto, Laszlo Szerafin, Peter Ilonczai, Peter Tamaska, Piroska Pettendi, Dora Levai, Tamas Schneider, Anna Sebestyen, Peter Csermely, Andras Matolcsy, Zoltan Matrai, Donat Alpar
Summary: The study found that the BTKC481S mutation is common in CLL patients and is associated with disease progression, appearing months before clinical relapse symptoms. Subsequent Bcl-2 inhibition therapy in patients with BTKC481S and progressing on ibrutinib treatment resulted in clinical and molecular remission.
BRITISH JOURNAL OF HAEMATOLOGY
(2021)
Review
Oncology
Prioty Islam
Summary: The treatment of relapsed and refractory chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL) has undergone significant changes in the past decade with the development of oral targeted agents. The choice of treatment depends on prior exposure to novel therapies. Patients with no prior exposure are offered BTK or BCL2-based regimens, while those with prior BTK inhibitor exposure may receive a BCL2 inhibitor and vice versa. For intolerant patients, an alternative BTK inhibitor may be considered. Limited data support re-treatment with a BCL2 inhibitor-based regimen for patients who have maintained a response for more than 12-24 months. Clinical trials are preferred for patients who have failed both BTK and BCL2 inhibitors. High-risk populations may be considered for combination cytotoxic chemotherapy, allogeneic hematopoietic stem cell transplant, or cellular therapy, with the need for novel approaches and clinical trial enrollment.
CURRENT TREATMENT OPTIONS IN ONCOLOGY
(2023)
