ResearchPad - hematologic-malignancies https://www.researchpad.co Default RSS Feed en-us © 2020 Newgen KnowledgeWorks <![CDATA[Renaissance of Radiotherapy in Intestinal Lymphoma? 10‐Year Efficacy and Tolerance in Multimodal Treatment of 134 Patients: Follow‐up of Two German Multicenter Consecutive Prospective Phase II Trials]]> https://www.researchpad.co/article/elastic_article_6608 This article reports the details of radiation therapy in the therapeutic multimodality approach for treatment of patients with intestinal lymphoma.

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<![CDATA[Follicular Lymphoma: Recent and Emerging Therapies, Treatment Strategies, and Remaining Unmet Needs]]> https://www.researchpad.co/article/N7a398851-26bc-430e-8974-6404fe55ba85

Therapeutic advances have improved prognosis for follicular lymphoma, although the disease is still incurable. This comprehensive clinical review considers prognostic approaches and the treatment landscape for follicular lymphoma, including emerging therapies and unmet needs.

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<![CDATA[Blinatumomab compared with standard of care for the treatment of adult patients with relapsed/refractory Philadelphia chromosome–positive B‐precursor acute lymphoblastic leukemia]]> https://www.researchpad.co/article/N62854cc1-17ac-4f50-b19d-28ff48833e91

Background

A single‐arm, phase 2 trial demonstrated the efficacy and safety of blinatumomab, a bispecific T‐cell–engaging antibody construct, in patients with relapsed/refractory (r/r) Philadelphia chromosome–positive (Ph+) acute lymphoblastic leukemia (ALL), a rare hematologic malignancy with limited treatment options. This study compared outcomes with blinatumomab with those of a historical control treated with the standard of care (SOC).

Methods

The blinatumomab trial enrolled adult patients with Ph+ ALL who were r/r to at least 1 second‐generation tyrosine kinase inhibitor (n = 45). Propensity score analysis (PSA) was used to compare outcomes with blinatumomab with those of an external cohort of similar patients receiving SOC chemotherapy (n = 55). The PSA mitigated confounding variables between studies by adjusting for imbalances in the age at diagnosis and start of treatment, sex, duration from diagnosis to most recent treatment, prior allogeneic hematopoietic stem cell transplantation, prior salvage therapy, and number of salvage therapies. Bayesian data augmentation was applied to improve power to 80% with data from a phase 3 blinatumomab study in r/r Philadelphia chromosome–negative ALL.

Results

In the PSA, the rate of complete remission or complete remission with partial hematologic recovery was 36% for blinatumomab and 25% for SOC, and this resulted in an odds ratio of 1.54 (95% confidence interval [CI], 0.61‐3.89) or 1.70 (95% credible interval [CrI], 0.94‐2.94) with Bayesian data augmentation. Overall survival favored blinatumomab over SOC, with a hazard ratio of 0.81 (95% CI, 0.57‐1.14) or 0.77 (95% CrI, 0.61‐0.96) with Bayesian data augmentation.

Conclusions

These results further support blinatumomab as a treatment option for patients with r/r Ph+ ALL.

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<![CDATA[Patient‐Reported Factors in Treatment Satisfaction in Patients with Relapsed/Refractory Multiple Myeloma (RRMM)]]> https://www.researchpad.co/article/Nfdd5adc1-7a36-4abe-aa96-680ed7098c6d

This article identifies factors associated with patient‐reported satisfaction with multiple myeloma therapy and the treatment‐related time burden and indirect costs among patients with relapsed or refractory multiple myeloma and their caregivers. Improved understanding of these variables will inform treatment decisions across this complex treatment landscape.

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<![CDATA[1q21 Gain Combined with High‐Risk Factors Is a Heterogeneous Prognostic Factor in Newly Diagnosed Multiple Myeloma: A Multicenter Study in China]]> https://www.researchpad.co/article/N683fc359-39b8-45eb-b872-ae285a98de50

The identification of prognostic factors for multiple myeloma is important. This article focuses on the prognostic value of 1q21 gain in a Chinese population according to different treatment regimens and accompanying high‐risk factors.

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<![CDATA[Tumor Lysis Syndrome in Chronic Lymphocytic Leukemia with Novel Targeted Agents]]> https://www.researchpad.co/article/5c11c06ad5eed0c484783f66

Tumor lysis syndrome is an uncommon but potentially life‐threatening complication associated with the treatment of some cancers. In this review, prevention strategies and management of patients with chronic lymphocytic leukemia who develop tumor lysis syndrome are described.

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<![CDATA[Prognostic value of sequencing-based minimal residual disease detection in patients with multiple myeloma who underwent autologous stem-cell transplantation]]> https://www.researchpad.co/article/5c0e114dd5eed0c484dda125

Abstract

Background

Most patients with multiple myeloma (MM) are considered to be incurable, and relapse owing to minimal residual disease (MRD) is the main cause of death among these patients. Therefore, new technologies to assess deeper response are required.

Patients and methods

We retrospectively analyzed 125 patients with MM who underwent high-dose melphalan plus autologous stem-cell transplantation (ASCT) to detect MRD in autograft/bone marrow (BM) cells using a next-generation sequencing (NGS)-based method and allele-specific oligonucleotide-polymerase chain reaction (ASO-PCR).

Results

NGS-based method was applicable to 90% and this method had at least one to two logs greater sensitivity compared to ASO-PCR. MRD negative by NGS [MRDNGS(−)] (defined as <10−6) in post-ASCT BM cases (n =26) showed a significantly better progression-free survival (PFS) (96% at 4 years, P < 0.001) and overall survival (OS) (100% at 4 years, P =0.04) than MRDNGS(+) in post-ASCT BM cases (n =25). When restricting the analysis to the 39 complete response cases, patients who were MRDNGS(−) (n =24) showed a significantly better PFS than those that were MRDNGS(+) (n =15) (P =0.02). Moreover, MRDNGS(−) in post-ASCT BM cases (n =12) showed significantly a better PFS than MRDNGS(+) cases (n =7) where MRD was not detected by ASO-PCR (P =0.001). Patients whose autografts were negative by NGS-based MRD assessment (<10−7) (n =19) had 92% PFS and 100% OS at 4 years post-ASCT. Conversely, the NGS-based MRD positive patients who received post-ASCT treatment using novel agents (n =49) had a significantly better PFS (P = 0.001) and tended to have a better OS (P= 0.214) than those that were untreated (n =33).

Conclusions

Low level MRD detected by NGS-based platform but not ASO-PCR has significant prognostic value when assessing either the autograft product or BM cells post-ASCT.

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<![CDATA[Phase IIa study of the CD19 antibody MOR208 in patients with relapsed or refractory B-cell non-Hodgkin’s lymphoma]]> https://www.researchpad.co/article/5c024092d5eed0c4843a71b3

Abstract

Background

This two-stage, phase IIa study investigated the antitumor activity and safety of MOR208, an Fc-engineered, humanized, CD19 antibody, in patients with relapsed or refractory (R-R) B-cell non-Hodgkin’s lymphoma (NHL). CD19 is broadly expressed across the B-lymphocyte lineage, including in B-cell malignancies, but not by hematological stem cells.

Patients and methods

Patients aged ≥18 years, with R-R NHL progressing after ≥1 prior rituximab-containing regimen were enrolled into subtype-specific cohorts: diffuse large B-cell lymphoma (DLBCL), follicular lymphoma (FL), other indolent (i)NHL and mantle cell lymphoma (MCL). Treatment was MOR208, 12 mg/kg intravenously, weekly, for 8 weeks. Patients with at least stable disease could continue treatment for an additional 4 weeks. Those with a partial or complete response after 12 weeks could receive extended MOR208 treatment (12 mg/kg, either monthly or every second week) until progression. The primary end point was overall response rate.

Results

Ninety-two patients were enrolled: DLBCL (n =35), FL (n =34), other iNHL (n =11) and MCL (n =12). Responses were observed in DLBCL, FL and other iNHL cohorts (26%, 29% and 27%, respectively). They lasted ≥12 months in 5/9 responding patients with DLBCL, 4/9 with FL and 2/3 with other iNHL. Responses in nine patients are ongoing (>26 months in five instances). Patients with rituximab refractory disease showed a similar response rate and progression-free survival time to patients with non-refractory disease. The most common adverse events (any grade) were infusion-related reactions (12%) and neutropenia (12%). One patient experienced a grade 4 infusion-related reaction and eight patients (9%) experienced grade 3/4 neutropenia. No treatment-related deaths were reported.

Conclusions

MOR208 monotherapy demonstrated promising clinical activity in patients with R-R DLBCL and R-R FL, including in patients with rituximab refractory tumors. These efficacy data and the favorable safety profile support further investigation of MOR208 in phase II/III combination therapy trials in R-R DLBCL.

ClinicalTrials.gov number

NCT01685008.

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