A lymph node diameter > 56.5 mm strongly predicts progression during venetoclax treatment in CLL

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Key clinical point: The presence of one or more lymph nodes >56.5 mm before starting venetoclax is an independent risk factor for early progression during venetoclax therapy in patients with relapsed or refractory chronic lymphocytic leukemia (CLL).

Major finding: After a median follow up of 14.3 months, the median progression-free survival (PFS) was not reached and the estimated 3‐year PFS rate was 54%. Multivariable analysis revealed a >56.5 mm diameter of at least one lymph node before therapy initiation to be a significant predictive factor for progression (adjusted hazard ratio 1.01; P =.005).

Study details: Findings are from a multicenter retrospective study including 128 patients with relapsed or refractory CLL treated with ibrutinib, idelalisib, or both who switched to venetoclax due to progression or adverse events, of which 28 patients experienced progressive disease.

Disclosures: This study did not receive any specific funding. The authors declared no conflicts of interest.

Source: Autore F et al. Lymphadenopathy as a predictor of progression during venetoclax treatment in chronic lymphocytic leukemia. A campus chronic lymphocytic leukemia study. Hematol Oncol. 2023 (Jul 1). Doi: 10.1002/hon.3199

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Key clinical point: The presence of one or more lymph nodes >56.5 mm before starting venetoclax is an independent risk factor for early progression during venetoclax therapy in patients with relapsed or refractory chronic lymphocytic leukemia (CLL).

Major finding: After a median follow up of 14.3 months, the median progression-free survival (PFS) was not reached and the estimated 3‐year PFS rate was 54%. Multivariable analysis revealed a >56.5 mm diameter of at least one lymph node before therapy initiation to be a significant predictive factor for progression (adjusted hazard ratio 1.01; P =.005).

Study details: Findings are from a multicenter retrospective study including 128 patients with relapsed or refractory CLL treated with ibrutinib, idelalisib, or both who switched to venetoclax due to progression or adverse events, of which 28 patients experienced progressive disease.

Disclosures: This study did not receive any specific funding. The authors declared no conflicts of interest.

Source: Autore F et al. Lymphadenopathy as a predictor of progression during venetoclax treatment in chronic lymphocytic leukemia. A campus chronic lymphocytic leukemia study. Hematol Oncol. 2023 (Jul 1). Doi: 10.1002/hon.3199

Key clinical point: The presence of one or more lymph nodes >56.5 mm before starting venetoclax is an independent risk factor for early progression during venetoclax therapy in patients with relapsed or refractory chronic lymphocytic leukemia (CLL).

Major finding: After a median follow up of 14.3 months, the median progression-free survival (PFS) was not reached and the estimated 3‐year PFS rate was 54%. Multivariable analysis revealed a >56.5 mm diameter of at least one lymph node before therapy initiation to be a significant predictive factor for progression (adjusted hazard ratio 1.01; P =.005).

Study details: Findings are from a multicenter retrospective study including 128 patients with relapsed or refractory CLL treated with ibrutinib, idelalisib, or both who switched to venetoclax due to progression or adverse events, of which 28 patients experienced progressive disease.

Disclosures: This study did not receive any specific funding. The authors declared no conflicts of interest.

Source: Autore F et al. Lymphadenopathy as a predictor of progression during venetoclax treatment in chronic lymphocytic leukemia. A campus chronic lymphocytic leukemia study. Hematol Oncol. 2023 (Jul 1). Doi: 10.1002/hon.3199

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Soluble CD163 holds prognostic value in chemoimmunotherapy- and targeted therapy-treated MCL

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Key clinical point: High serum levels of the M2 macrophage marker soluble CD163 could be used as an independent negative prognostic marker in patients with newly diagnosed or relapsed mantle cell lymphoma (MCL).

Major finding: Above-median levels of soluble CD163 (>3000 ng/mL) were significantly associated with shorter progression-free survival (adjusted hazard ratio [aHR] 3.48; P =.006) and overall survival (aHR 4.33; P =.016).

Study details: This study analyzed serum samples from 131 patients with newly diagnosed or relapsed MCL who received immunochemotherapy or targeted treatments (mainly rituximab, ibrutinib, and lenalidomide), respectively.

Disclosures: This study was supported by grants from the Swedish Cancer Society and others. Some authors declared serving as advisory board members or scientific advisors or receiving research funding or honoraria from various organizations.

Source: Nikkarinen A et al. Soluble CD163 predicts outcome in both chemoimmunotherapy and targeted therapy-treated mantle cell lymphoma. Blood Adv. 2023 (Jun 30). Doi: 10.1182/bloodadvances.2023010052

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Key clinical point: High serum levels of the M2 macrophage marker soluble CD163 could be used as an independent negative prognostic marker in patients with newly diagnosed or relapsed mantle cell lymphoma (MCL).

Major finding: Above-median levels of soluble CD163 (>3000 ng/mL) were significantly associated with shorter progression-free survival (adjusted hazard ratio [aHR] 3.48; P =.006) and overall survival (aHR 4.33; P =.016).

Study details: This study analyzed serum samples from 131 patients with newly diagnosed or relapsed MCL who received immunochemotherapy or targeted treatments (mainly rituximab, ibrutinib, and lenalidomide), respectively.

Disclosures: This study was supported by grants from the Swedish Cancer Society and others. Some authors declared serving as advisory board members or scientific advisors or receiving research funding or honoraria from various organizations.

Source: Nikkarinen A et al. Soluble CD163 predicts outcome in both chemoimmunotherapy and targeted therapy-treated mantle cell lymphoma. Blood Adv. 2023 (Jun 30). Doi: 10.1182/bloodadvances.2023010052

Key clinical point: High serum levels of the M2 macrophage marker soluble CD163 could be used as an independent negative prognostic marker in patients with newly diagnosed or relapsed mantle cell lymphoma (MCL).

Major finding: Above-median levels of soluble CD163 (>3000 ng/mL) were significantly associated with shorter progression-free survival (adjusted hazard ratio [aHR] 3.48; P =.006) and overall survival (aHR 4.33; P =.016).

Study details: This study analyzed serum samples from 131 patients with newly diagnosed or relapsed MCL who received immunochemotherapy or targeted treatments (mainly rituximab, ibrutinib, and lenalidomide), respectively.

Disclosures: This study was supported by grants from the Swedish Cancer Society and others. Some authors declared serving as advisory board members or scientific advisors or receiving research funding or honoraria from various organizations.

Source: Nikkarinen A et al. Soluble CD163 predicts outcome in both chemoimmunotherapy and targeted therapy-treated mantle cell lymphoma. Blood Adv. 2023 (Jun 30). Doi: 10.1182/bloodadvances.2023010052

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First-line ibrutinib an effective treatment for patients with CLL carrying TP53 aberrations

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Key clinical point: Ibrutinib showed efficacy in a real-world cohort of patients with previously untreated high-risk chronic lymphocytic leukemia (CLL) carrying 17p- or TP53 mutations (TP53 aberrations).

Major finding: At 24 months, the median overall survival was not reached; the estimated treatment persistence and survival rates were 63.4% (95% CI 60.0%-67.0%) and 82.6% (95% CI 79.9%-85.4%), respectively. The median time to treatment discontinuation was 37.4 months (95% CI 34.8-42.2 months). Disease progression or death were the reasons for discontinuation in 45.8% of patients.

Study details: This real-world registry study analyzed the data of 747 patients with CLL and TP53 aberrations treated with first-line ibrutinib.

Disclosures: This study was funded by the University of Ferrara, Italy, and others. Some authors, including the lead author, declared receiving research support, travel grants, or honoraria for speakers’ bureau or advisory board participation from various sources.

Source: Rigolin GM et al. Outcomes in patients with chronic lymphocytic leukemia and TP53 aberration who received first-line ibrutinib: A nationwide registry study from the Italian Medicines Agency. Blood Cancer J. 2023;13:99 (Jun 28). Doi: 10.1038/s41408-023-00865-z

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Key clinical point: Ibrutinib showed efficacy in a real-world cohort of patients with previously untreated high-risk chronic lymphocytic leukemia (CLL) carrying 17p- or TP53 mutations (TP53 aberrations).

Major finding: At 24 months, the median overall survival was not reached; the estimated treatment persistence and survival rates were 63.4% (95% CI 60.0%-67.0%) and 82.6% (95% CI 79.9%-85.4%), respectively. The median time to treatment discontinuation was 37.4 months (95% CI 34.8-42.2 months). Disease progression or death were the reasons for discontinuation in 45.8% of patients.

Study details: This real-world registry study analyzed the data of 747 patients with CLL and TP53 aberrations treated with first-line ibrutinib.

Disclosures: This study was funded by the University of Ferrara, Italy, and others. Some authors, including the lead author, declared receiving research support, travel grants, or honoraria for speakers’ bureau or advisory board participation from various sources.

Source: Rigolin GM et al. Outcomes in patients with chronic lymphocytic leukemia and TP53 aberration who received first-line ibrutinib: A nationwide registry study from the Italian Medicines Agency. Blood Cancer J. 2023;13:99 (Jun 28). Doi: 10.1038/s41408-023-00865-z

Key clinical point: Ibrutinib showed efficacy in a real-world cohort of patients with previously untreated high-risk chronic lymphocytic leukemia (CLL) carrying 17p- or TP53 mutations (TP53 aberrations).

Major finding: At 24 months, the median overall survival was not reached; the estimated treatment persistence and survival rates were 63.4% (95% CI 60.0%-67.0%) and 82.6% (95% CI 79.9%-85.4%), respectively. The median time to treatment discontinuation was 37.4 months (95% CI 34.8-42.2 months). Disease progression or death were the reasons for discontinuation in 45.8% of patients.

Study details: This real-world registry study analyzed the data of 747 patients with CLL and TP53 aberrations treated with first-line ibrutinib.

Disclosures: This study was funded by the University of Ferrara, Italy, and others. Some authors, including the lead author, declared receiving research support, travel grants, or honoraria for speakers’ bureau or advisory board participation from various sources.

Source: Rigolin GM et al. Outcomes in patients with chronic lymphocytic leukemia and TP53 aberration who received first-line ibrutinib: A nationwide registry study from the Italian Medicines Agency. Blood Cancer J. 2023;13:99 (Jun 28). Doi: 10.1038/s41408-023-00865-z

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Front-line rituximab+lenalidomide an up-and-coming therapy for elderly frail patients with DLBCL

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Key clinical point: Front-line chemo-free combination therapy with rituximab and lenalidomide was moderately active in elderly frail patients with diffuse large B-cell lymphoma (DLBCL) who were ineligible for conventional cytotoxic therapy.

Major finding: The overall response rate was 50.8% (95% CI 38.1%-63.4%), with 27.7% of patients achieving a complete response. After a 24-month median follow-up, the median progression-free survival was 14.0 months (95% CI 6.8-not reached) and the 2-year duration of response rate was 64.6% (95% CI 42.1%-80.1%). The grade ≥3 extra-hematological toxicity event rate was 52.3%.

Study details: Findings are from the prospective phase 2 FIL_ReRi trial including 65 frail patients aged ≥70 years with untreated DLBCL who received ≤6 cycles of lenalidomide+rituximab; patients with partial or complete response at cycle 6 received lenalidomide for 12 cycles or until progression or unacceptable toxicity.

Disclosures: This study was sponsored by Fondazione Italiana Linfomi (FIL), Alessandria, Italy. Some authors declared participating on data safety monitoring or advisory boards of, serving in leadership roles in, or receiving consulting fees or speaker honoraria from various sources, including FIL.

Source: Gini G et al. Lenalidomide plus rituximab for the initial treatment of elderly frail patients with DLBCL: The FIL_ReRi phase 2 study. Blood. 2023 (Jul 7). Doi: 10.1182/blood.2022019173

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Key clinical point: Front-line chemo-free combination therapy with rituximab and lenalidomide was moderately active in elderly frail patients with diffuse large B-cell lymphoma (DLBCL) who were ineligible for conventional cytotoxic therapy.

Major finding: The overall response rate was 50.8% (95% CI 38.1%-63.4%), with 27.7% of patients achieving a complete response. After a 24-month median follow-up, the median progression-free survival was 14.0 months (95% CI 6.8-not reached) and the 2-year duration of response rate was 64.6% (95% CI 42.1%-80.1%). The grade ≥3 extra-hematological toxicity event rate was 52.3%.

Study details: Findings are from the prospective phase 2 FIL_ReRi trial including 65 frail patients aged ≥70 years with untreated DLBCL who received ≤6 cycles of lenalidomide+rituximab; patients with partial or complete response at cycle 6 received lenalidomide for 12 cycles or until progression or unacceptable toxicity.

Disclosures: This study was sponsored by Fondazione Italiana Linfomi (FIL), Alessandria, Italy. Some authors declared participating on data safety monitoring or advisory boards of, serving in leadership roles in, or receiving consulting fees or speaker honoraria from various sources, including FIL.

Source: Gini G et al. Lenalidomide plus rituximab for the initial treatment of elderly frail patients with DLBCL: The FIL_ReRi phase 2 study. Blood. 2023 (Jul 7). Doi: 10.1182/blood.2022019173

Key clinical point: Front-line chemo-free combination therapy with rituximab and lenalidomide was moderately active in elderly frail patients with diffuse large B-cell lymphoma (DLBCL) who were ineligible for conventional cytotoxic therapy.

Major finding: The overall response rate was 50.8% (95% CI 38.1%-63.4%), with 27.7% of patients achieving a complete response. After a 24-month median follow-up, the median progression-free survival was 14.0 months (95% CI 6.8-not reached) and the 2-year duration of response rate was 64.6% (95% CI 42.1%-80.1%). The grade ≥3 extra-hematological toxicity event rate was 52.3%.

Study details: Findings are from the prospective phase 2 FIL_ReRi trial including 65 frail patients aged ≥70 years with untreated DLBCL who received ≤6 cycles of lenalidomide+rituximab; patients with partial or complete response at cycle 6 received lenalidomide for 12 cycles or until progression or unacceptable toxicity.

Disclosures: This study was sponsored by Fondazione Italiana Linfomi (FIL), Alessandria, Italy. Some authors declared participating on data safety monitoring or advisory boards of, serving in leadership roles in, or receiving consulting fees or speaker honoraria from various sources, including FIL.

Source: Gini G et al. Lenalidomide plus rituximab for the initial treatment of elderly frail patients with DLBCL: The FIL_ReRi phase 2 study. Blood. 2023 (Jul 7). Doi: 10.1182/blood.2022019173

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Nivolumab+brentuximab vedotin offers a salvage treatment option for relapsed or refractory PMBL

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Key clinical point: Nivolumab+brentuximab vedotin (BV) showed long-term efficacy and safety in patients with treatment-resistant relapsed or refractory (R/R) primary mediastinal large B-cell lymphoma (PMBL).

Major finding: After a median follow-up of 39.6 months, the objective response rate was 73.3% (95% CI 54.1%-87.7%), with 40.0% and 33.3% of patients achieving complete and partial responses, respectively. The median duration of response or overall survival was not reached, and the median progression-free survival was 26.0 (95% CI 2.6-not reached) months. No new safety signals were reported.

Study details: This 3-year follow-up study of phase 1/2 CheckMate 436 trial included 30 patients age ≥15 years with R/R PMBL previously treated with high-dose chemotherapy+autologous hematopoietic cell transplantation or ≥2 prior multiagent chemotherapies who received 240 mg nivolumab and 1.8 mg/kg BV once every 3 weeks.

Disclosures: This study was supported by Bristol Myers Squibb (BMS) and Seagen. Some authors declared serving as advisory board members and receiving consulting fees, honoraria, or research grants from BMS, Seagen, and others. Three authors declared being employees of or holding stocks in BMS or Seagen.

Source: Zinzani PL et al. Nivolumab combined with brentuximab vedotin for R/R primary mediastinal large B-cell lymphoma: A 3-year follow-up. Blood Adv. 2023 (Jun 23). Doi: 10.1182/bloodadvances.2023010254

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Key clinical point: Nivolumab+brentuximab vedotin (BV) showed long-term efficacy and safety in patients with treatment-resistant relapsed or refractory (R/R) primary mediastinal large B-cell lymphoma (PMBL).

Major finding: After a median follow-up of 39.6 months, the objective response rate was 73.3% (95% CI 54.1%-87.7%), with 40.0% and 33.3% of patients achieving complete and partial responses, respectively. The median duration of response or overall survival was not reached, and the median progression-free survival was 26.0 (95% CI 2.6-not reached) months. No new safety signals were reported.

Study details: This 3-year follow-up study of phase 1/2 CheckMate 436 trial included 30 patients age ≥15 years with R/R PMBL previously treated with high-dose chemotherapy+autologous hematopoietic cell transplantation or ≥2 prior multiagent chemotherapies who received 240 mg nivolumab and 1.8 mg/kg BV once every 3 weeks.

Disclosures: This study was supported by Bristol Myers Squibb (BMS) and Seagen. Some authors declared serving as advisory board members and receiving consulting fees, honoraria, or research grants from BMS, Seagen, and others. Three authors declared being employees of or holding stocks in BMS or Seagen.

Source: Zinzani PL et al. Nivolumab combined with brentuximab vedotin for R/R primary mediastinal large B-cell lymphoma: A 3-year follow-up. Blood Adv. 2023 (Jun 23). Doi: 10.1182/bloodadvances.2023010254

Key clinical point: Nivolumab+brentuximab vedotin (BV) showed long-term efficacy and safety in patients with treatment-resistant relapsed or refractory (R/R) primary mediastinal large B-cell lymphoma (PMBL).

Major finding: After a median follow-up of 39.6 months, the objective response rate was 73.3% (95% CI 54.1%-87.7%), with 40.0% and 33.3% of patients achieving complete and partial responses, respectively. The median duration of response or overall survival was not reached, and the median progression-free survival was 26.0 (95% CI 2.6-not reached) months. No new safety signals were reported.

Study details: This 3-year follow-up study of phase 1/2 CheckMate 436 trial included 30 patients age ≥15 years with R/R PMBL previously treated with high-dose chemotherapy+autologous hematopoietic cell transplantation or ≥2 prior multiagent chemotherapies who received 240 mg nivolumab and 1.8 mg/kg BV once every 3 weeks.

Disclosures: This study was supported by Bristol Myers Squibb (BMS) and Seagen. Some authors declared serving as advisory board members and receiving consulting fees, honoraria, or research grants from BMS, Seagen, and others. Three authors declared being employees of or holding stocks in BMS or Seagen.

Source: Zinzani PL et al. Nivolumab combined with brentuximab vedotin for R/R primary mediastinal large B-cell lymphoma: A 3-year follow-up. Blood Adv. 2023 (Jun 23). Doi: 10.1182/bloodadvances.2023010254

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BCL6+ immunophenotype has prognostic value in mantle cell lymphoma

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Key clinical point: BCL6 positivity is associated with worse survival outcomes and a higher Ki67 index and shows a positive correlation with CD10 positivity in patients with mantle cell lymphoma (MCL).

Major finding: A positive vs negative expression of BCL6 was associated with a significantly shorter median overall survival (14 vs 43 months; P =.01) and was significantly correlated with CD10 positivity (odds ratio 5.11; P =.0000286) and a higher Ki67 index (P =.0094).

Study details: The data come from a systematic review and meta-analysis of 10 studies that involved 102 patients with MCL and reported BCL6- and CD10-positive or -negative MCL and Ki67% in BCL6-positive or -negative MCL.

Disclosures: This study received no external funding. The authors declared no conflicts of interest.

Source: Castillo DR et al. Unveiling the prognostic significance of BCL6+/CD10+ mantle cell lymphoma: Meta-analysis of individual patients and systematic review. Int J Mol Sci. 2023;24(12):10207 (Jun 16). Doi: 10.3390/ijms241210207

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Key clinical point: BCL6 positivity is associated with worse survival outcomes and a higher Ki67 index and shows a positive correlation with CD10 positivity in patients with mantle cell lymphoma (MCL).

Major finding: A positive vs negative expression of BCL6 was associated with a significantly shorter median overall survival (14 vs 43 months; P =.01) and was significantly correlated with CD10 positivity (odds ratio 5.11; P =.0000286) and a higher Ki67 index (P =.0094).

Study details: The data come from a systematic review and meta-analysis of 10 studies that involved 102 patients with MCL and reported BCL6- and CD10-positive or -negative MCL and Ki67% in BCL6-positive or -negative MCL.

Disclosures: This study received no external funding. The authors declared no conflicts of interest.

Source: Castillo DR et al. Unveiling the prognostic significance of BCL6+/CD10+ mantle cell lymphoma: Meta-analysis of individual patients and systematic review. Int J Mol Sci. 2023;24(12):10207 (Jun 16). Doi: 10.3390/ijms241210207

Key clinical point: BCL6 positivity is associated with worse survival outcomes and a higher Ki67 index and shows a positive correlation with CD10 positivity in patients with mantle cell lymphoma (MCL).

Major finding: A positive vs negative expression of BCL6 was associated with a significantly shorter median overall survival (14 vs 43 months; P =.01) and was significantly correlated with CD10 positivity (odds ratio 5.11; P =.0000286) and a higher Ki67 index (P =.0094).

Study details: The data come from a systematic review and meta-analysis of 10 studies that involved 102 patients with MCL and reported BCL6- and CD10-positive or -negative MCL and Ki67% in BCL6-positive or -negative MCL.

Disclosures: This study received no external funding. The authors declared no conflicts of interest.

Source: Castillo DR et al. Unveiling the prognostic significance of BCL6+/CD10+ mantle cell lymphoma: Meta-analysis of individual patients and systematic review. Int J Mol Sci. 2023;24(12):10207 (Jun 16). Doi: 10.3390/ijms241210207

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A patient subgroup with high-risk features shows early bendamustine treatment failure in mantle cell lymphoma

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Key clinical point: Among patients receiving the bendamustine-rituximab regimen for newly diagnosed mantle cell lymphoma (MCL), selected patients with high-risk disease may require CD19-directed autologous chimeric antigen receptor-T cell therapy within 6 months of bendamustine exposure.

Major finding: The cumulative incidences of the first and second MCL progression were 14% (95% CI 8%-20%) and 6% (95% CI 3%-11%), respectively, at 6 months from the last bendamustine dose. Ki67 ≥ 50% was a significant risk factor for the occurrence of the first MCL progression within 6 months of bendamustine exposure (adjusted sub-hazard ratio 3.38; P =.022).

Study details: Findings are from retrospective population-based study including 118 adult patients with newly diagnosed MCL who received bendamustine-rituximab induction therapy with or without high-dose cytarabine and autologous stem cell transplantation followed by maintenance rituximab therapy.

Disclosures: This study did not receive any funding. All authors declared receiving honoraria from various sources.

Source: Puckrin R et al. Estimating the impact of early bendamustine failure on feasibility of subsequent CAR-T cell therapy in mantle cell lymphoma. Leuk Lymphoma. 2023 (Jun 20). Doi: 10.1080/10428194.2023.2226278

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Key clinical point: Among patients receiving the bendamustine-rituximab regimen for newly diagnosed mantle cell lymphoma (MCL), selected patients with high-risk disease may require CD19-directed autologous chimeric antigen receptor-T cell therapy within 6 months of bendamustine exposure.

Major finding: The cumulative incidences of the first and second MCL progression were 14% (95% CI 8%-20%) and 6% (95% CI 3%-11%), respectively, at 6 months from the last bendamustine dose. Ki67 ≥ 50% was a significant risk factor for the occurrence of the first MCL progression within 6 months of bendamustine exposure (adjusted sub-hazard ratio 3.38; P =.022).

Study details: Findings are from retrospective population-based study including 118 adult patients with newly diagnosed MCL who received bendamustine-rituximab induction therapy with or without high-dose cytarabine and autologous stem cell transplantation followed by maintenance rituximab therapy.

Disclosures: This study did not receive any funding. All authors declared receiving honoraria from various sources.

Source: Puckrin R et al. Estimating the impact of early bendamustine failure on feasibility of subsequent CAR-T cell therapy in mantle cell lymphoma. Leuk Lymphoma. 2023 (Jun 20). Doi: 10.1080/10428194.2023.2226278

Key clinical point: Among patients receiving the bendamustine-rituximab regimen for newly diagnosed mantle cell lymphoma (MCL), selected patients with high-risk disease may require CD19-directed autologous chimeric antigen receptor-T cell therapy within 6 months of bendamustine exposure.

Major finding: The cumulative incidences of the first and second MCL progression were 14% (95% CI 8%-20%) and 6% (95% CI 3%-11%), respectively, at 6 months from the last bendamustine dose. Ki67 ≥ 50% was a significant risk factor for the occurrence of the first MCL progression within 6 months of bendamustine exposure (adjusted sub-hazard ratio 3.38; P =.022).

Study details: Findings are from retrospective population-based study including 118 adult patients with newly diagnosed MCL who received bendamustine-rituximab induction therapy with or without high-dose cytarabine and autologous stem cell transplantation followed by maintenance rituximab therapy.

Disclosures: This study did not receive any funding. All authors declared receiving honoraria from various sources.

Source: Puckrin R et al. Estimating the impact of early bendamustine failure on feasibility of subsequent CAR-T cell therapy in mantle cell lymphoma. Leuk Lymphoma. 2023 (Jun 20). Doi: 10.1080/10428194.2023.2226278

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Time to disease progression drives outcomes after second-line BTKi therapy in relapsed or refractory MCL

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Key clinical point: Time to progression of disease (POD), defined as the time between first-line rituximab‐based therapy initiation and disease progression before second-line Bruton tyrosine kinase inhibitor (BTKi) therapy initiation, is associated with survival outcomes in patients with relapsed or refractory mantle cell lymphoma (MCL) receiving second-line BTKi therapy.

Major finding: After initiating second-line BTKi therapy, patients with POD within vs after 24 months of first-line therapy had significantly shorter median progression‐free survival (0.45 vs 2.3 years; P < .001) and overall survival (0.9 vs 5.5 years; P < .001).

Study details: This multicenter retrospective observational study included 360 adult patients with relapsed or refractory MCL who initiated second-line BTKi therapy after first-line rituximab-based therapy.

Disclosures: No information on the source of funding was provided. Some authors declared serving as consultants or advisors and receiving research funding, speaker fees, or honoraria from various sources.

Source: Villa D et al. Time to progression of disease and outcomes with second-line BTK inhibitors in relapsed/refractory mantle cell lymphoma. Blood Adv. 2023 (Jun 12). Doi: 10.1182/bloodadvances.2023009804

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Key clinical point: Time to progression of disease (POD), defined as the time between first-line rituximab‐based therapy initiation and disease progression before second-line Bruton tyrosine kinase inhibitor (BTKi) therapy initiation, is associated with survival outcomes in patients with relapsed or refractory mantle cell lymphoma (MCL) receiving second-line BTKi therapy.

Major finding: After initiating second-line BTKi therapy, patients with POD within vs after 24 months of first-line therapy had significantly shorter median progression‐free survival (0.45 vs 2.3 years; P < .001) and overall survival (0.9 vs 5.5 years; P < .001).

Study details: This multicenter retrospective observational study included 360 adult patients with relapsed or refractory MCL who initiated second-line BTKi therapy after first-line rituximab-based therapy.

Disclosures: No information on the source of funding was provided. Some authors declared serving as consultants or advisors and receiving research funding, speaker fees, or honoraria from various sources.

Source: Villa D et al. Time to progression of disease and outcomes with second-line BTK inhibitors in relapsed/refractory mantle cell lymphoma. Blood Adv. 2023 (Jun 12). Doi: 10.1182/bloodadvances.2023009804

Key clinical point: Time to progression of disease (POD), defined as the time between first-line rituximab‐based therapy initiation and disease progression before second-line Bruton tyrosine kinase inhibitor (BTKi) therapy initiation, is associated with survival outcomes in patients with relapsed or refractory mantle cell lymphoma (MCL) receiving second-line BTKi therapy.

Major finding: After initiating second-line BTKi therapy, patients with POD within vs after 24 months of first-line therapy had significantly shorter median progression‐free survival (0.45 vs 2.3 years; P < .001) and overall survival (0.9 vs 5.5 years; P < .001).

Study details: This multicenter retrospective observational study included 360 adult patients with relapsed or refractory MCL who initiated second-line BTKi therapy after first-line rituximab-based therapy.

Disclosures: No information on the source of funding was provided. Some authors declared serving as consultants or advisors and receiving research funding, speaker fees, or honoraria from various sources.

Source: Villa D et al. Time to progression of disease and outcomes with second-line BTK inhibitors in relapsed/refractory mantle cell lymphoma. Blood Adv. 2023 (Jun 12). Doi: 10.1182/bloodadvances.2023009804

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Pirtobrutinib shows promise in BTK inhibitor pretreated CLL

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Wed, 08/02/2023 - 15:43

Key clinical point: The noncovalent Bruton’s tyrosine kinase inhibitor (BTKi) pirtobrutinib was efficacious in patients with relapsed or refractory chronic lymphocytic leukemia (CLL) or small lymphocytic lymphoma (SLL) who had previously received BTKi therapy.

Major finding: An overall response was achieved by 73.3% (95% CI 67.3%-78.7%) of patients previously treated with BTKi therapy and by 82.2% (95% CI 76.8%-86.7%) of patients when partial response with lymphocytosis was included. At a 19.4-month median follow-up, the median progression-free survival was 19.6 (95% CI 16.9-22.1) months. Only 2.8% of patients discontinued pirtobrutinib permanently due to treatment-related adverse events.

Study details: Findings are from the phase 1-2 BRUIN trial including 317 patients with relapsed or refractory CLL or SLL who received pirtobrutinib, of which 247 had previously received ≥1 BTK inhibitor.

Disclosures: This study was supported by Loxo Oncology, a subsidiary of Eli Lilly. Some authors, including the lead author, declared serving as consultants or speakers for or receiving advisory board honoraria, travel support, or research funding from Loxo/Lilly. Seven authors declared being employees or stockholders of Loxo/Lilly.

Source: Mato AR et al. Pirtobrutinib after a covalent BTK inhibitor in chronic lymphocytic leukemia. N Engl J Med. 2023;389:33-44 (Jul 6). Doi: 10.1056/NEJMoa2300696

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Key clinical point: The noncovalent Bruton’s tyrosine kinase inhibitor (BTKi) pirtobrutinib was efficacious in patients with relapsed or refractory chronic lymphocytic leukemia (CLL) or small lymphocytic lymphoma (SLL) who had previously received BTKi therapy.

Major finding: An overall response was achieved by 73.3% (95% CI 67.3%-78.7%) of patients previously treated with BTKi therapy and by 82.2% (95% CI 76.8%-86.7%) of patients when partial response with lymphocytosis was included. At a 19.4-month median follow-up, the median progression-free survival was 19.6 (95% CI 16.9-22.1) months. Only 2.8% of patients discontinued pirtobrutinib permanently due to treatment-related adverse events.

Study details: Findings are from the phase 1-2 BRUIN trial including 317 patients with relapsed or refractory CLL or SLL who received pirtobrutinib, of which 247 had previously received ≥1 BTK inhibitor.

Disclosures: This study was supported by Loxo Oncology, a subsidiary of Eli Lilly. Some authors, including the lead author, declared serving as consultants or speakers for or receiving advisory board honoraria, travel support, or research funding from Loxo/Lilly. Seven authors declared being employees or stockholders of Loxo/Lilly.

Source: Mato AR et al. Pirtobrutinib after a covalent BTK inhibitor in chronic lymphocytic leukemia. N Engl J Med. 2023;389:33-44 (Jul 6). Doi: 10.1056/NEJMoa2300696

Key clinical point: The noncovalent Bruton’s tyrosine kinase inhibitor (BTKi) pirtobrutinib was efficacious in patients with relapsed or refractory chronic lymphocytic leukemia (CLL) or small lymphocytic lymphoma (SLL) who had previously received BTKi therapy.

Major finding: An overall response was achieved by 73.3% (95% CI 67.3%-78.7%) of patients previously treated with BTKi therapy and by 82.2% (95% CI 76.8%-86.7%) of patients when partial response with lymphocytosis was included. At a 19.4-month median follow-up, the median progression-free survival was 19.6 (95% CI 16.9-22.1) months. Only 2.8% of patients discontinued pirtobrutinib permanently due to treatment-related adverse events.

Study details: Findings are from the phase 1-2 BRUIN trial including 317 patients with relapsed or refractory CLL or SLL who received pirtobrutinib, of which 247 had previously received ≥1 BTK inhibitor.

Disclosures: This study was supported by Loxo Oncology, a subsidiary of Eli Lilly. Some authors, including the lead author, declared serving as consultants or speakers for or receiving advisory board honoraria, travel support, or research funding from Loxo/Lilly. Seven authors declared being employees or stockholders of Loxo/Lilly.

Source: Mato AR et al. Pirtobrutinib after a covalent BTK inhibitor in chronic lymphocytic leukemia. N Engl J Med. 2023;389:33-44 (Jul 6). Doi: 10.1056/NEJMoa2300696

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Switch from anti-CGRP receptor to anti-CGRP ligand mAb offers promise in treatment-refractory chronic migraine

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Wed, 08/09/2023 - 22:23

Key clinical point: Nearly one third of patients with treatment-refractory chronic migraine (CM) who did not respond to anti-calcitonin gene-related peptide (CGRP) receptor monoclonal antibodies (mAb) showed a meaningful response to anti-CGRP ligand mAb.

Major finding: Overall, 25.6% of patients achieved ≥30% reduction in monthly migraine days (MMD) after 3 months of initiating fremanezumab and were considered responders, with the mean MMD significantly reducing from 21.4 days at baseline to 15.0 days at 3 months (P = .007), 8.6 days at 6 months (P = .007), and 8.6 days at the last follow-up (P = .001). Treatment-related side effects were generally mild.

Study details: This long-term prospective real-world analysis included 39 patients with treatment-refractory CM who did not achieve a meaningful response to erenumab and switched to fremanezumab.

Disclosures: This study did not disclose the funding source. Some authors declared receiving research grants, funding for travel, personal fees as speakers or advisors, or honoraria for participation in advisory boards from various sources.

Source: Lambru G et al. Long-term effect of switching from an anti-CGRP receptor to an anti-CGRP ligand antibody in treatment-refractory chronic migraine: A prospective real-world analysis. Neurotherapeutics. 2023 (Jul 10). Doi: 10.1007/s13311-023-01394-0

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Key clinical point: Nearly one third of patients with treatment-refractory chronic migraine (CM) who did not respond to anti-calcitonin gene-related peptide (CGRP) receptor monoclonal antibodies (mAb) showed a meaningful response to anti-CGRP ligand mAb.

Major finding: Overall, 25.6% of patients achieved ≥30% reduction in monthly migraine days (MMD) after 3 months of initiating fremanezumab and were considered responders, with the mean MMD significantly reducing from 21.4 days at baseline to 15.0 days at 3 months (P = .007), 8.6 days at 6 months (P = .007), and 8.6 days at the last follow-up (P = .001). Treatment-related side effects were generally mild.

Study details: This long-term prospective real-world analysis included 39 patients with treatment-refractory CM who did not achieve a meaningful response to erenumab and switched to fremanezumab.

Disclosures: This study did not disclose the funding source. Some authors declared receiving research grants, funding for travel, personal fees as speakers or advisors, or honoraria for participation in advisory boards from various sources.

Source: Lambru G et al. Long-term effect of switching from an anti-CGRP receptor to an anti-CGRP ligand antibody in treatment-refractory chronic migraine: A prospective real-world analysis. Neurotherapeutics. 2023 (Jul 10). Doi: 10.1007/s13311-023-01394-0

Key clinical point: Nearly one third of patients with treatment-refractory chronic migraine (CM) who did not respond to anti-calcitonin gene-related peptide (CGRP) receptor monoclonal antibodies (mAb) showed a meaningful response to anti-CGRP ligand mAb.

Major finding: Overall, 25.6% of patients achieved ≥30% reduction in monthly migraine days (MMD) after 3 months of initiating fremanezumab and were considered responders, with the mean MMD significantly reducing from 21.4 days at baseline to 15.0 days at 3 months (P = .007), 8.6 days at 6 months (P = .007), and 8.6 days at the last follow-up (P = .001). Treatment-related side effects were generally mild.

Study details: This long-term prospective real-world analysis included 39 patients with treatment-refractory CM who did not achieve a meaningful response to erenumab and switched to fremanezumab.

Disclosures: This study did not disclose the funding source. Some authors declared receiving research grants, funding for travel, personal fees as speakers or advisors, or honoraria for participation in advisory boards from various sources.

Source: Lambru G et al. Long-term effect of switching from an anti-CGRP receptor to an anti-CGRP ligand antibody in treatment-refractory chronic migraine: A prospective real-world analysis. Neurotherapeutics. 2023 (Jul 10). Doi: 10.1007/s13311-023-01394-0

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