The annual meeting of the American Society of Hematology was held from Dec. 11 to 14 in Atlanta and attracted participants from around the world, including hematology specialists as well as clinical practitioners and other health care professionals. The conference featured presentations focusing on the diagnosis, treatment, and prevention of disorders affecting blood, bone marrow, and the immunologic, hemostatic, and vascular systems.
In a phase 2 expansion cohort study, L. Elizabeth Budde, M.D., Ph.D., of the City of Hope Comprehensive Cancer Center in Duarte, California, and colleagues found that mosunetuzumab, a T-cell based bispecific antibody, is active in the outpatient setting among patients with relapsed or refractory follicular lymphoma who have received at least two prior lines of therapy.
The authors enrolled and treated 90 patients with follicular lymphoma with mosunetuzumab intravenously in a fixed duration, with one dose given every three cycles for eight cycles among patients who received a complete response and up to 17 cycles for patients who had a partial response or stable disease. Mosunetuzumab was administered using a step-up dosing strategy. The authors found mosunetuzumab demonstrated a complete response rate of 60 percent and an overall response rate of 80 percent. With a median follow up of 18.3 months, median progression-free survival was 17.3 months. The authors noted that most adverse events were of a low grade and transient.
“Mosunetuzumab has the potential to change the landscape of relapsed or refractory follicular lymphoma management,” Budde said. “It can be administered in the community setting with proper education and bring a pure immunotherapy to more patients.”
Several authors disclosed financial ties to pharmaceutical and biotechnology companies, including Genentech, which manufactures mosunetuzumab.
As part of the PROMISE study, Habib El-Khoury, M.D., of the Dana-Farber Cancer Institute in Boston, and colleagues found that screening using a higher-sensitivity novel approach allows for the detection of higher numbers of individuals with multiple myeloma, especially individuals who either self-identify as Black or have a family history of hematologic malignancy.
The authors analyzed blood samples from individuals ages 40 to 75 years who were considered at a higher risk for multiple myeloma because they were Black or had a family history of hematologic malignancy. Interim screening findings for 7,622 participants, including 2,439 Black individuals, were presented. The researchers found that higher-sensitivity novel matrix-assisted laser desorption ionization-time of flight (MALDI-TOF) mass spectrometry (MS) performed better than conventional testing methods of serum protein electrophoresis and immunofixation at determining the prevalence of monoclonal gammopathy of undetermined significance (MGUS), a precursor condition to myeloma. The investigators found that the prevalence of MGUS in those at high risk older than 50 years of age was estimated to be around 13 percent by MALDI-TOF MS, which is higher than with conventional methods.
“In addition, using the higher-sensitivity MS, lower-level monoclonal gammopathies were detected (termed MGIP [monoclonal gammopathies of indeterminate potential]), which were lower than the limit of detection identified for the conventional methods (<0.2 g/L)," El-Khoury said. "Finally, the new pool of MGUS detected by MS, termed MS-MGUS (13 percent), and the higher MGIP, termed MGIP-high (28 to 29 percent in either low- or high-risk participants), showed a significant association with decreased overall survival from all-cause mortality. The fate of MGIP remains under investigation, and the clinical associations seen with survival and other comorbidities for MS-MGUS and MGIP will encourage future studies."
Several authors disclosed financial ties to the pharmaceutical and biotechnology industries.
In the TRANSFORM study, Manali Kamdar, M.D., of the University of Colorado Cancer Center in Denver, and colleagues found that lisocabtagene maraleucel (liso-cel), a CD19-directed chimeric antigen receptor T-cell therapy, significantly improves event-free survival (EFS) compared with standard of care among adults with relapsed or refractory large B-cell lymphoma (LBCL).
In a randomized, multicenter, phase 3 study, the authors evaluated liso-cel as a second-line treatment in adults with LBCL. Liso-cel was compared to salvage chemotherapy followed by high-dose chemotherapy plus autologous hematopoietic stem cell transplant, which has been the standard of care for second-line treatment of relapsed or refractory LBCL for more than 20 years. The researchers found that compared with the standard of care, liso-cel demonstrated statistically significant and clinically meaningful improvements in EFS, complete response rates, and progression-free survival. Median EFS was 10.1 months for liso-cel and 2.3 months for standard of care. No new safety signals for liso-cel were observed in the second-line setting.
“These results are potentially practice changing, as they challenge the treatment paradigm that has been in place for more than 20 years. The majority of patients who relapse after or are refractory to first-line LBCL treatment have poor outcomes with standard of care, with only 25 percent of transplant-eligible patients achieving long-term remission,” Kamdar said. “Results from TRANSFORM support the potential use of liso-cel as a new standard of care for the second-line treatment of patients with relapsed or refractory LBCL.”
Several authors disclosed financial ties to pharmaceutical and biotechnology companies, including Bristol Myers Squibb, the developer of liso-cel.
ASH: Axicabtagene Ciloleucel Slows Large B-Cell Lymphoma
TUESDAY, Dec. 21, 2021 (HealthDay News) — For patients with refractory or relapsed large B-cell lymphoma, axicabtagene ciloleucel leads to improvements in event-free survival and response compared with standard care, according to a study published online Dec. 11 in the New England Journal of Medicine and presented at the annual meeting of the American Society of Hematology, held from Dec. 11 to 14 in Atlanta.
ASH: Modified Regimen Slows Diffuse Large B-Cell Lymphoma
TUESDAY, Dec. 14, 2021 (HealthDay News) — For patients with diffuse large B-cell lymphoma, a modification of the regimen of rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone, in which vincristine is replaced with polatuzumab vedotin, results in a lower risk for disease progression, relapse, or death, according to a study published online Dec. 14 in the New England Journal of Medicine. The research was published to coincide with the annual meeting of the American Society of Hematology, held from Dec. 11 to 14 in Atlanta.
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