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AVAHO 2023: Meeting the Challenges of Veterans' Healthcare
Sirisha Manyam, DO, shares highlights at the AVAHO 2023 conference, including the keynote address by Under Secretary for Health Shereef Elnahal, MD, and a presentation on the Close to Me program that services veterans residing in rural areas.
Dr Manyam found Dr Elnahal's address particularly compelling, with its emphasis on not only developing but also retaining an oncologic workforce formidable in its evidence-based approach and determined in its commitment to meet the current and coming challenges of veterans' healthcare.
Sirisha Manyam, DO, shares highlights at the AVAHO 2023 conference, including the keynote address by Under Secretary for Health Shereef Elnahal, MD, and a presentation on the Close to Me program that services veterans residing in rural areas.
Dr Manyam found Dr Elnahal's address particularly compelling, with its emphasis on not only developing but also retaining an oncologic workforce formidable in its evidence-based approach and determined in its commitment to meet the current and coming challenges of veterans' healthcare.
Sirisha Manyam, DO, shares highlights at the AVAHO 2023 conference, including the keynote address by Under Secretary for Health Shereef Elnahal, MD, and a presentation on the Close to Me program that services veterans residing in rural areas.
Dr Manyam found Dr Elnahal's address particularly compelling, with its emphasis on not only developing but also retaining an oncologic workforce formidable in its evidence-based approach and determined in its commitment to meet the current and coming challenges of veterans' healthcare.
AVAHO 2023 Takeaways: Elevating Cancer Care for Veterans
Soo Park, MD, reflects on the experience of attending the AVAHO 2023 conference and highlights several key takeaways. Dr Park emphasizes the progressive nature of the VA healthcare system, its impact on elevating cancer care for veterans, and the importance of teleoncology in reaching all veterans across the United States.
Dr Park details various presentations, such as the keynote address from Dr Shereef Elnahal, under secretary for health in the US Department of Veterans Affairs, and Dr Michael Kelley's discussion on the significance of clinical pathways for standardized care. Dr Park also highlights learnings from the conference, such as the VA's leadership in research efforts, particularly in prostate and lung cancer.
Soo Park, MD, reflects on the experience of attending the AVAHO 2023 conference and highlights several key takeaways. Dr Park emphasizes the progressive nature of the VA healthcare system, its impact on elevating cancer care for veterans, and the importance of teleoncology in reaching all veterans across the United States.
Dr Park details various presentations, such as the keynote address from Dr Shereef Elnahal, under secretary for health in the US Department of Veterans Affairs, and Dr Michael Kelley's discussion on the significance of clinical pathways for standardized care. Dr Park also highlights learnings from the conference, such as the VA's leadership in research efforts, particularly in prostate and lung cancer.
Soo Park, MD, reflects on the experience of attending the AVAHO 2023 conference and highlights several key takeaways. Dr Park emphasizes the progressive nature of the VA healthcare system, its impact on elevating cancer care for veterans, and the importance of teleoncology in reaching all veterans across the United States.
Dr Park details various presentations, such as the keynote address from Dr Shereef Elnahal, under secretary for health in the US Department of Veterans Affairs, and Dr Michael Kelley's discussion on the significance of clinical pathways for standardized care. Dr Park also highlights learnings from the conference, such as the VA's leadership in research efforts, particularly in prostate and lung cancer.
AVAHO 2023: Innovations in Cancer Care Delivery
Timothy O'Brien, MD, highlights several key updates from AVAHO 2023 in the areas of toxin-exposure assessment, cancer screening programs, and the expansion of cancer care delivery to remote areas.
Dr O'Brien shares notable examples from these areas like the PACT Act for veterans, successful lung cancer screening programs, the availability of new tests that measure minimal residual disease in patients with multiple myeloma, and initiatives like the Close to Me infusion program to improve healthcare access for veterans in rural areas.
Timothy O'Brien, MD, highlights several key updates from AVAHO 2023 in the areas of toxin-exposure assessment, cancer screening programs, and the expansion of cancer care delivery to remote areas.
Dr O'Brien shares notable examples from these areas like the PACT Act for veterans, successful lung cancer screening programs, the availability of new tests that measure minimal residual disease in patients with multiple myeloma, and initiatives like the Close to Me infusion program to improve healthcare access for veterans in rural areas.
Timothy O'Brien, MD, highlights several key updates from AVAHO 2023 in the areas of toxin-exposure assessment, cancer screening programs, and the expansion of cancer care delivery to remote areas.
Dr O'Brien shares notable examples from these areas like the PACT Act for veterans, successful lung cancer screening programs, the availability of new tests that measure minimal residual disease in patients with multiple myeloma, and initiatives like the Close to Me infusion program to improve healthcare access for veterans in rural areas.
Long-term exposure to trihalomethanes in drinking and swimming pool water increases the risk for CLL
Key clinical point: Long-term exposure to brominated trihalomethanes (THM) in drinking water and swimming pool water is associated with increased odds of developing chronic lymphocytic leukemia (CLL).
Major finding: The odds of developing CLL increased by 22% for every 10 μg/L increase in the level of brominated THM in drinking water (adjusted odds ratio [aOR] 1.22; 95% CI 1.14-1.31). Swimming pool users vs non-users (swimming pool attendance ≥ 10 times vs < 10 times in life) had significantly increased odds of CLL (aOR 2.38; 95% CI 1.61-3.52).
Study details: This multicentric multicase-control study included 170 patients with CLL (age 20-85 years) and 1442 matched population-based control individuals without CLL.
Disclosures: This study was funded by European Commission grants and others. The authors declared no conflicts of interest.
Source: Donat-Vargas C et al. Lifetime exposure to brominated trihalomethanes in drinking water and swimming pool attendance are associated with chronic lymphocytic leukemia: A multicase-control study in Spain (MCC-Spain). J Expo Sci Environ Epidemiol. 2023 (Sep 19). doi: 10.1038/s41370-023-00600-7
Key clinical point: Long-term exposure to brominated trihalomethanes (THM) in drinking water and swimming pool water is associated with increased odds of developing chronic lymphocytic leukemia (CLL).
Major finding: The odds of developing CLL increased by 22% for every 10 μg/L increase in the level of brominated THM in drinking water (adjusted odds ratio [aOR] 1.22; 95% CI 1.14-1.31). Swimming pool users vs non-users (swimming pool attendance ≥ 10 times vs < 10 times in life) had significantly increased odds of CLL (aOR 2.38; 95% CI 1.61-3.52).
Study details: This multicentric multicase-control study included 170 patients with CLL (age 20-85 years) and 1442 matched population-based control individuals without CLL.
Disclosures: This study was funded by European Commission grants and others. The authors declared no conflicts of interest.
Source: Donat-Vargas C et al. Lifetime exposure to brominated trihalomethanes in drinking water and swimming pool attendance are associated with chronic lymphocytic leukemia: A multicase-control study in Spain (MCC-Spain). J Expo Sci Environ Epidemiol. 2023 (Sep 19). doi: 10.1038/s41370-023-00600-7
Key clinical point: Long-term exposure to brominated trihalomethanes (THM) in drinking water and swimming pool water is associated with increased odds of developing chronic lymphocytic leukemia (CLL).
Major finding: The odds of developing CLL increased by 22% for every 10 μg/L increase in the level of brominated THM in drinking water (adjusted odds ratio [aOR] 1.22; 95% CI 1.14-1.31). Swimming pool users vs non-users (swimming pool attendance ≥ 10 times vs < 10 times in life) had significantly increased odds of CLL (aOR 2.38; 95% CI 1.61-3.52).
Study details: This multicentric multicase-control study included 170 patients with CLL (age 20-85 years) and 1442 matched population-based control individuals without CLL.
Disclosures: This study was funded by European Commission grants and others. The authors declared no conflicts of interest.
Source: Donat-Vargas C et al. Lifetime exposure to brominated trihalomethanes in drinking water and swimming pool attendance are associated with chronic lymphocytic leukemia: A multicase-control study in Spain (MCC-Spain). J Expo Sci Environ Epidemiol. 2023 (Sep 19). doi: 10.1038/s41370-023-00600-7
CAR T-cell therapy safe for older patients with relapsed or refractory DLBCL
Key clinical point: Chimeric antigen receptor (CAR) T-cell therapy is effective for and can be safely administered to older patients with relapsed or refractory diffuse large B-cell lymphoma (DLBCL) despite an increased infection rate.
Major finding: At a median follow-up of 16.3 months, the objective response rate was 67%. Median progression-free and overall survival were 10.3 (95% CI 3.3-not reached) and 28.4 (95% CI 12.4-not reached) months, respectively. Patients age > 70 years and age ≤ 70 years had comparable progression-free (P = .6) and overall (P = .5) survival and comparable incidence rates of immune effector cell-associated neurotoxicity syndrome (P = .19); however, patients age > 70 years vs age ≤ 70 years had higher all-grade infection rates (79% vs 40%, respectively).
Study details: This single-center retrospective study included 66 patients with relapsed or refractory DLBCL who received either tisagenlecleucel or axicabtagene ciloleucel, of whom 21% were age > 70 years.
Disclosures: This study did not receive any specific funding. The authors declared no conflicts of interest.
Source: Trando A et al. Outcomes of chimeric antigen receptor (CAR) T-cell therapy in patients with large B-cell lymphoma (LBCL): A single-institution experience. Cancers. 2023; 15(18):4671 (Sep 21). doi: 10.3390/cancers15184671
Key clinical point: Chimeric antigen receptor (CAR) T-cell therapy is effective for and can be safely administered to older patients with relapsed or refractory diffuse large B-cell lymphoma (DLBCL) despite an increased infection rate.
Major finding: At a median follow-up of 16.3 months, the objective response rate was 67%. Median progression-free and overall survival were 10.3 (95% CI 3.3-not reached) and 28.4 (95% CI 12.4-not reached) months, respectively. Patients age > 70 years and age ≤ 70 years had comparable progression-free (P = .6) and overall (P = .5) survival and comparable incidence rates of immune effector cell-associated neurotoxicity syndrome (P = .19); however, patients age > 70 years vs age ≤ 70 years had higher all-grade infection rates (79% vs 40%, respectively).
Study details: This single-center retrospective study included 66 patients with relapsed or refractory DLBCL who received either tisagenlecleucel or axicabtagene ciloleucel, of whom 21% were age > 70 years.
Disclosures: This study did not receive any specific funding. The authors declared no conflicts of interest.
Source: Trando A et al. Outcomes of chimeric antigen receptor (CAR) T-cell therapy in patients with large B-cell lymphoma (LBCL): A single-institution experience. Cancers. 2023; 15(18):4671 (Sep 21). doi: 10.3390/cancers15184671
Key clinical point: Chimeric antigen receptor (CAR) T-cell therapy is effective for and can be safely administered to older patients with relapsed or refractory diffuse large B-cell lymphoma (DLBCL) despite an increased infection rate.
Major finding: At a median follow-up of 16.3 months, the objective response rate was 67%. Median progression-free and overall survival were 10.3 (95% CI 3.3-not reached) and 28.4 (95% CI 12.4-not reached) months, respectively. Patients age > 70 years and age ≤ 70 years had comparable progression-free (P = .6) and overall (P = .5) survival and comparable incidence rates of immune effector cell-associated neurotoxicity syndrome (P = .19); however, patients age > 70 years vs age ≤ 70 years had higher all-grade infection rates (79% vs 40%, respectively).
Study details: This single-center retrospective study included 66 patients with relapsed or refractory DLBCL who received either tisagenlecleucel or axicabtagene ciloleucel, of whom 21% were age > 70 years.
Disclosures: This study did not receive any specific funding. The authors declared no conflicts of interest.
Source: Trando A et al. Outcomes of chimeric antigen receptor (CAR) T-cell therapy in patients with large B-cell lymphoma (LBCL): A single-institution experience. Cancers. 2023; 15(18):4671 (Sep 21). doi: 10.3390/cancers15184671
Acalabrutinib and zanubrutinib have similar efficacy in CLL, shows a matching-adjusted indirect comparison
Key clinical point: Acalabrutinib and zanubrutinib showed similar efficacy and safety profiles in patients with relapsed or refractory chronic lymphocytic leukemia (CLL) after matching observed patient variables that are prognostic or predictive at baseline.
Major finding: Acalabrutinib and zanubrutinib treatments resulted in comparable investigator-assessed progression-free survival outcomes (adjusted hazard ratio 0.90; 95% CI 0.60-1.36) and comparable risks for grade ≥3 adverse events (adjusted odds ratio 0.66; 95% CI 0.41-1.05).
Study details: This unanchored indirect comparison study included patients with relapsed or refractory CLL and matched the individual patient-level data of those who received acalabrutinib in the ASCEND trial (n = 149) with the aggregate data of those who received zanubrutinib in the ALPINE trial (n = 327).
Disclosures: This study was funded by AstraZeneca, USA. Some authors declared serving as consultants, advisors, or speakers for or receiving research funding or consulting fees from various sources, including AstraZeneca. Six authors declared being employees of AstraZeneca, USA, or holding stocks in AstraZeneca.
Source: Kittai AS, Skarbnick A, et al. A matching-adjusted indirect comparison of acalabrutinib versus zanubrutinib in relapsed or refractory chronic lymphocytic leukemia. Am J Hematol. 2023 (Oct 9). doi: 10.1002/ajh.27110
Key clinical point: Acalabrutinib and zanubrutinib showed similar efficacy and safety profiles in patients with relapsed or refractory chronic lymphocytic leukemia (CLL) after matching observed patient variables that are prognostic or predictive at baseline.
Major finding: Acalabrutinib and zanubrutinib treatments resulted in comparable investigator-assessed progression-free survival outcomes (adjusted hazard ratio 0.90; 95% CI 0.60-1.36) and comparable risks for grade ≥3 adverse events (adjusted odds ratio 0.66; 95% CI 0.41-1.05).
Study details: This unanchored indirect comparison study included patients with relapsed or refractory CLL and matched the individual patient-level data of those who received acalabrutinib in the ASCEND trial (n = 149) with the aggregate data of those who received zanubrutinib in the ALPINE trial (n = 327).
Disclosures: This study was funded by AstraZeneca, USA. Some authors declared serving as consultants, advisors, or speakers for or receiving research funding or consulting fees from various sources, including AstraZeneca. Six authors declared being employees of AstraZeneca, USA, or holding stocks in AstraZeneca.
Source: Kittai AS, Skarbnick A, et al. A matching-adjusted indirect comparison of acalabrutinib versus zanubrutinib in relapsed or refractory chronic lymphocytic leukemia. Am J Hematol. 2023 (Oct 9). doi: 10.1002/ajh.27110
Key clinical point: Acalabrutinib and zanubrutinib showed similar efficacy and safety profiles in patients with relapsed or refractory chronic lymphocytic leukemia (CLL) after matching observed patient variables that are prognostic or predictive at baseline.
Major finding: Acalabrutinib and zanubrutinib treatments resulted in comparable investigator-assessed progression-free survival outcomes (adjusted hazard ratio 0.90; 95% CI 0.60-1.36) and comparable risks for grade ≥3 adverse events (adjusted odds ratio 0.66; 95% CI 0.41-1.05).
Study details: This unanchored indirect comparison study included patients with relapsed or refractory CLL and matched the individual patient-level data of those who received acalabrutinib in the ASCEND trial (n = 149) with the aggregate data of those who received zanubrutinib in the ALPINE trial (n = 327).
Disclosures: This study was funded by AstraZeneca, USA. Some authors declared serving as consultants, advisors, or speakers for or receiving research funding or consulting fees from various sources, including AstraZeneca. Six authors declared being employees of AstraZeneca, USA, or holding stocks in AstraZeneca.
Source: Kittai AS, Skarbnick A, et al. A matching-adjusted indirect comparison of acalabrutinib versus zanubrutinib in relapsed or refractory chronic lymphocytic leukemia. Am J Hematol. 2023 (Oct 9). doi: 10.1002/ajh.27110
Upfront ASCT overcomes the survival advantage provided by pre-transplant HDAC induction in MCL
Key clinical point: High-dose cytarabine (HDAC)-based pre-autologous stem cell transplantation (ASCT) induction regimens were not associated with improved survival but led to higher overall response rates (ORR) and lower rates of early relapses in ASCT-eligible patients with mantle cell lymphoma (MCL).
Major finding: Patients receiving rituximab + HDAC (R-HDAC)-based regimens vs rituximab + cyclophosphamide, doxorubicin, vincristine, and prednisolone (R-CHOP) had significantly higher ORR (85.9% vs 65.7%; P = .007), lower 24-month progression rates (61.9% vs 80.4%; P = .043), and lower mortality (43.9% vs 68.6%; P = .004). However, the 2-year overall survival rates were similar between the R-HADC + ASCT and R-CHOP + ASCT groups (88.7% and 78.8%, respectively; P = .289).
Study details: This retrospective single-center study included 165 ASCT-eligible adult patients with MCL, of whom 136 patients received pre-ASCT induction immunochemotherapy with R-CHOP-like or regimens based on R-HDAC and 50 patients received consolidation with high-dose therapy and ASCT.
Disclosures: This study did not receive any specific funding. The authors declared no conflicts of interest.
Source: de Pádua Covas Lage LA et al. Up-front ASCT overcomes the survival benefit provided by HDAC-based induction regimens in mantle cell lymphoma: Data from a real-life and long-term cohort. Cancers. 2023; 15(19):4759 (Sep 28). doi: 10.3390/cancers15194759
Key clinical point: High-dose cytarabine (HDAC)-based pre-autologous stem cell transplantation (ASCT) induction regimens were not associated with improved survival but led to higher overall response rates (ORR) and lower rates of early relapses in ASCT-eligible patients with mantle cell lymphoma (MCL).
Major finding: Patients receiving rituximab + HDAC (R-HDAC)-based regimens vs rituximab + cyclophosphamide, doxorubicin, vincristine, and prednisolone (R-CHOP) had significantly higher ORR (85.9% vs 65.7%; P = .007), lower 24-month progression rates (61.9% vs 80.4%; P = .043), and lower mortality (43.9% vs 68.6%; P = .004). However, the 2-year overall survival rates were similar between the R-HADC + ASCT and R-CHOP + ASCT groups (88.7% and 78.8%, respectively; P = .289).
Study details: This retrospective single-center study included 165 ASCT-eligible adult patients with MCL, of whom 136 patients received pre-ASCT induction immunochemotherapy with R-CHOP-like or regimens based on R-HDAC and 50 patients received consolidation with high-dose therapy and ASCT.
Disclosures: This study did not receive any specific funding. The authors declared no conflicts of interest.
Source: de Pádua Covas Lage LA et al. Up-front ASCT overcomes the survival benefit provided by HDAC-based induction regimens in mantle cell lymphoma: Data from a real-life and long-term cohort. Cancers. 2023; 15(19):4759 (Sep 28). doi: 10.3390/cancers15194759
Key clinical point: High-dose cytarabine (HDAC)-based pre-autologous stem cell transplantation (ASCT) induction regimens were not associated with improved survival but led to higher overall response rates (ORR) and lower rates of early relapses in ASCT-eligible patients with mantle cell lymphoma (MCL).
Major finding: Patients receiving rituximab + HDAC (R-HDAC)-based regimens vs rituximab + cyclophosphamide, doxorubicin, vincristine, and prednisolone (R-CHOP) had significantly higher ORR (85.9% vs 65.7%; P = .007), lower 24-month progression rates (61.9% vs 80.4%; P = .043), and lower mortality (43.9% vs 68.6%; P = .004). However, the 2-year overall survival rates were similar between the R-HADC + ASCT and R-CHOP + ASCT groups (88.7% and 78.8%, respectively; P = .289).
Study details: This retrospective single-center study included 165 ASCT-eligible adult patients with MCL, of whom 136 patients received pre-ASCT induction immunochemotherapy with R-CHOP-like or regimens based on R-HDAC and 50 patients received consolidation with high-dose therapy and ASCT.
Disclosures: This study did not receive any specific funding. The authors declared no conflicts of interest.
Source: de Pádua Covas Lage LA et al. Up-front ASCT overcomes the survival benefit provided by HDAC-based induction regimens in mantle cell lymphoma: Data from a real-life and long-term cohort. Cancers. 2023; 15(19):4759 (Sep 28). doi: 10.3390/cancers15194759
Cumulative airborne dioxin exposure increases CLL and SLL risk
Key clinical point: Cumulative airborne dioxin exposure is significantly associated with an increased risk for non-Hodgkin's lymphoma (NHL), particularly for combined chronic lymphocytic leukemia (CLL) and small lymphocytic lymphoma (SLL).
Major finding: A significant association was observed between log-transformed cumulative dioxin exposure index scores and the risk for NHL (adjusted odds ratio [aOR] 1.2; 95% CI 1.0-1.4), especially in case of the CLL and SLL subtypes (aOR 1.6; 95% CI 1.1-2.3), for a 4.4 log µg-toxic equivalent quantity/m2 increase corresponding to a standard deviation.
Study details: This case-control study was nested within the prospective French National Institute for Health and Medical Research E3N cohort and included 368 women with NHL and 368 matched control women without NHL.
Disclosures: The E3N cohort was established and maintained with the support of the Mutuelle Générale de l'Education Nationale, France, and other sources. The authors declared no conflicts of interest.
Source: Gaspard E et al. Association between cumulative airborne dioxin exposure and non-Hodgkin's lymphoma risk in a nested case-control study within the French E3N cohort. Sci Total Environ. 2023;906:167330 (Sep 29). doi: 10.1016/j.scitotenv.2023.167330
Key clinical point: Cumulative airborne dioxin exposure is significantly associated with an increased risk for non-Hodgkin's lymphoma (NHL), particularly for combined chronic lymphocytic leukemia (CLL) and small lymphocytic lymphoma (SLL).
Major finding: A significant association was observed between log-transformed cumulative dioxin exposure index scores and the risk for NHL (adjusted odds ratio [aOR] 1.2; 95% CI 1.0-1.4), especially in case of the CLL and SLL subtypes (aOR 1.6; 95% CI 1.1-2.3), for a 4.4 log µg-toxic equivalent quantity/m2 increase corresponding to a standard deviation.
Study details: This case-control study was nested within the prospective French National Institute for Health and Medical Research E3N cohort and included 368 women with NHL and 368 matched control women without NHL.
Disclosures: The E3N cohort was established and maintained with the support of the Mutuelle Générale de l'Education Nationale, France, and other sources. The authors declared no conflicts of interest.
Source: Gaspard E et al. Association between cumulative airborne dioxin exposure and non-Hodgkin's lymphoma risk in a nested case-control study within the French E3N cohort. Sci Total Environ. 2023;906:167330 (Sep 29). doi: 10.1016/j.scitotenv.2023.167330
Key clinical point: Cumulative airborne dioxin exposure is significantly associated with an increased risk for non-Hodgkin's lymphoma (NHL), particularly for combined chronic lymphocytic leukemia (CLL) and small lymphocytic lymphoma (SLL).
Major finding: A significant association was observed between log-transformed cumulative dioxin exposure index scores and the risk for NHL (adjusted odds ratio [aOR] 1.2; 95% CI 1.0-1.4), especially in case of the CLL and SLL subtypes (aOR 1.6; 95% CI 1.1-2.3), for a 4.4 log µg-toxic equivalent quantity/m2 increase corresponding to a standard deviation.
Study details: This case-control study was nested within the prospective French National Institute for Health and Medical Research E3N cohort and included 368 women with NHL and 368 matched control women without NHL.
Disclosures: The E3N cohort was established and maintained with the support of the Mutuelle Générale de l'Education Nationale, France, and other sources. The authors declared no conflicts of interest.
Source: Gaspard E et al. Association between cumulative airborne dioxin exposure and non-Hodgkin's lymphoma risk in a nested case-control study within the French E3N cohort. Sci Total Environ. 2023;906:167330 (Sep 29). doi: 10.1016/j.scitotenv.2023.167330
Ibrutinib and bortezomib combo durably effective in relapsed or refractory MCL with high-risk features
Key clinical point: The ibrutinib + bortezomib combination shows durable efficacy and manageable safety in patients with relapsed or refractory (R/R) mantle cell lymphoma (MCL), including high-risk patients.
Major finding: The combination led to an objective response rate of 81.8% (90% CI 71.1%-89.8%), which increased to 87.3% (90% CI 77.4%-93.9%) with ibrutinib maintenance. At a 25.4-month median follow-up, the median duration of response and progression-free survival were 22.7 (95% CI 12.3-not achieved) and 18.6 (95% CI 12.5-not achieved) months, respectively. The adverse event profile was consistent with the known safety profiles of individual drugs.
Study details: This phase 2 trial included 55 ibrutinib-naive and bortezomib-naive patients with R/R MCL previously treated with ≤2 lines of chemotherapy (of whom 75.6% had ≥1 high-risk features) who received 6 cycles of ibrutinib + bortezomib followed by ibrutinib maintenance.
Disclosures: This study was supported by Janssen and others. Some authors declared serving on the advisory boards of or receiving research funding, consulting fees, honoraria, or meeting or travel support from various sources, including Janssen.
Source: Novak U et al. Combined therapy with ibrutinib and bortezomib followed by ibrutinib maintenance in relapsed or refractory mantle cell lymphoma and high-risk features: A phase 1/2 trial of the European MCL network (SAKK 36/13). EClinicalMedicine. 2023;64:102221 (Sep 21). doi: 10.1016/j.eclinm.2023.102221
Key clinical point: The ibrutinib + bortezomib combination shows durable efficacy and manageable safety in patients with relapsed or refractory (R/R) mantle cell lymphoma (MCL), including high-risk patients.
Major finding: The combination led to an objective response rate of 81.8% (90% CI 71.1%-89.8%), which increased to 87.3% (90% CI 77.4%-93.9%) with ibrutinib maintenance. At a 25.4-month median follow-up, the median duration of response and progression-free survival were 22.7 (95% CI 12.3-not achieved) and 18.6 (95% CI 12.5-not achieved) months, respectively. The adverse event profile was consistent with the known safety profiles of individual drugs.
Study details: This phase 2 trial included 55 ibrutinib-naive and bortezomib-naive patients with R/R MCL previously treated with ≤2 lines of chemotherapy (of whom 75.6% had ≥1 high-risk features) who received 6 cycles of ibrutinib + bortezomib followed by ibrutinib maintenance.
Disclosures: This study was supported by Janssen and others. Some authors declared serving on the advisory boards of or receiving research funding, consulting fees, honoraria, or meeting or travel support from various sources, including Janssen.
Source: Novak U et al. Combined therapy with ibrutinib and bortezomib followed by ibrutinib maintenance in relapsed or refractory mantle cell lymphoma and high-risk features: A phase 1/2 trial of the European MCL network (SAKK 36/13). EClinicalMedicine. 2023;64:102221 (Sep 21). doi: 10.1016/j.eclinm.2023.102221
Key clinical point: The ibrutinib + bortezomib combination shows durable efficacy and manageable safety in patients with relapsed or refractory (R/R) mantle cell lymphoma (MCL), including high-risk patients.
Major finding: The combination led to an objective response rate of 81.8% (90% CI 71.1%-89.8%), which increased to 87.3% (90% CI 77.4%-93.9%) with ibrutinib maintenance. At a 25.4-month median follow-up, the median duration of response and progression-free survival were 22.7 (95% CI 12.3-not achieved) and 18.6 (95% CI 12.5-not achieved) months, respectively. The adverse event profile was consistent with the known safety profiles of individual drugs.
Study details: This phase 2 trial included 55 ibrutinib-naive and bortezomib-naive patients with R/R MCL previously treated with ≤2 lines of chemotherapy (of whom 75.6% had ≥1 high-risk features) who received 6 cycles of ibrutinib + bortezomib followed by ibrutinib maintenance.
Disclosures: This study was supported by Janssen and others. Some authors declared serving on the advisory boards of or receiving research funding, consulting fees, honoraria, or meeting or travel support from various sources, including Janssen.
Source: Novak U et al. Combined therapy with ibrutinib and bortezomib followed by ibrutinib maintenance in relapsed or refractory mantle cell lymphoma and high-risk features: A phase 1/2 trial of the European MCL network (SAKK 36/13). EClinicalMedicine. 2023;64:102221 (Sep 21). doi: 10.1016/j.eclinm.2023.102221
Ibrutinib maintenance after frontline induction is effective in mantle cell lymphoma
Key clinical point: Ibrutinib maintenance (I-M; dose 560 mg daily) for 4 years is effective in patients with treatment-naive mantle cell lymphoma (MCL) who are responsive to frontline chemo-immunotherapy with significant but manageable toxicities.
Major finding: The 3-year progression-free survival (PFS) and overall survival (OS) rates were 94% and 97%, whereas the 5-year PFS and OS rates were 89% and 91%, respectively. In patients with prior autologous stem cell transplantation (autoSCT), the 5-year PFS and OS rates were 100% each. The most common treatment-related adverse event was infection (86%; grades 1-2), and the most common grade 3-4 toxicities were hematologic.
Study details: This multicenter phase 2 study included patients with treatment-naive MCL who achieved a complete or partial response to frontline intensive induction chemo-immunotherapy with or without autoSCT and received 560 mg I-M daily for 4 years.
Disclosures: This study was supported by Pharmacyclics and Janssen. R Karmali and B Pro declared serving as consultants, speakers, or advisory board members for or receiving research funding or honoraria from various sources.
Source: Karmali R et al. Ibrutinib maintenance following frontline treatment in patients with mantle cell lymphoma. Blood Adv. 2023 (Sep 27). doi: 10.1182/bloodadvances.2023011271
Key clinical point: Ibrutinib maintenance (I-M; dose 560 mg daily) for 4 years is effective in patients with treatment-naive mantle cell lymphoma (MCL) who are responsive to frontline chemo-immunotherapy with significant but manageable toxicities.
Major finding: The 3-year progression-free survival (PFS) and overall survival (OS) rates were 94% and 97%, whereas the 5-year PFS and OS rates were 89% and 91%, respectively. In patients with prior autologous stem cell transplantation (autoSCT), the 5-year PFS and OS rates were 100% each. The most common treatment-related adverse event was infection (86%; grades 1-2), and the most common grade 3-4 toxicities were hematologic.
Study details: This multicenter phase 2 study included patients with treatment-naive MCL who achieved a complete or partial response to frontline intensive induction chemo-immunotherapy with or without autoSCT and received 560 mg I-M daily for 4 years.
Disclosures: This study was supported by Pharmacyclics and Janssen. R Karmali and B Pro declared serving as consultants, speakers, or advisory board members for or receiving research funding or honoraria from various sources.
Source: Karmali R et al. Ibrutinib maintenance following frontline treatment in patients with mantle cell lymphoma. Blood Adv. 2023 (Sep 27). doi: 10.1182/bloodadvances.2023011271
Key clinical point: Ibrutinib maintenance (I-M; dose 560 mg daily) for 4 years is effective in patients with treatment-naive mantle cell lymphoma (MCL) who are responsive to frontline chemo-immunotherapy with significant but manageable toxicities.
Major finding: The 3-year progression-free survival (PFS) and overall survival (OS) rates were 94% and 97%, whereas the 5-year PFS and OS rates were 89% and 91%, respectively. In patients with prior autologous stem cell transplantation (autoSCT), the 5-year PFS and OS rates were 100% each. The most common treatment-related adverse event was infection (86%; grades 1-2), and the most common grade 3-4 toxicities were hematologic.
Study details: This multicenter phase 2 study included patients with treatment-naive MCL who achieved a complete or partial response to frontline intensive induction chemo-immunotherapy with or without autoSCT and received 560 mg I-M daily for 4 years.
Disclosures: This study was supported by Pharmacyclics and Janssen. R Karmali and B Pro declared serving as consultants, speakers, or advisory board members for or receiving research funding or honoraria from various sources.
Source: Karmali R et al. Ibrutinib maintenance following frontline treatment in patients with mantle cell lymphoma. Blood Adv. 2023 (Sep 27). doi: 10.1182/bloodadvances.2023011271