Expert Perspective on the Top Hematologic Malignancy Studies From the 2016 Clinical Oncology Meeting

Shaji K. Kumar, MD

Mark and Judy Mullins Professor of Hematological Malignancies
Myeloma Amyloidosis Dysproteinemia Group
Consultant, Division of Hematology
Mayo Clinic
Rochester, Minnesota

Shaji Kumar, MD, has disclosed that he has received funds for contracted research from Celgene, Janssen, Merck, Novartis, Sanofi, and Takeda; and has served as a consultant for Kesios, Noxxon, and Skyline.

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Released: May 31, 2016

Expert Perspective on the Top Hematologic Malignancy Studies From the 2016 Clinical Oncology Meeting

ASCO 2016 has a lot to offer with exciting clinical data in hematologic malignancies. Below are a few of the highlights as noted by our panel of experts. Much of the data from these abstracts will soon be available as downloadable summary slidesets and a CME-certified online activity where our experts will discuss the clinical implications of the data after the ASCO annual meeting.

Acute Leukemias—Elias Jabbour, MD
Outcomes are poor for elderly patients with acute myeloid leukemia, which is addressed in 2 studies with promising results with frontline therapy for this group: phase III results from a study of CPX-351, a liposomal combination of daunorubicin plus cytarabine, vs standard of care treatment and results from a phase Ib/II study of the selective BCL-2 inhibitor venetoclax with low-dose cytarabine in treatment-naive patients 65 years of age or older. In acute lymphoblastic leukemia (ALL), we will discuss a trial of adult patients with relapsed/refractory ALL that examined the efficacy and safety of varied dosing approaches with CTL109, a CAR T-cell therapy. In Philadelphia chromosome (Ph)–positive ALL, combining a TKI with chemotherapy has become standard of care. But which TKI? We will review this question with results from an analysis examining the combination of the TKI ponatinib plus hyper-CVAD vs dasatinib plus hyper-CVAD in Ph-positive ALL.

Lymphomas—John M. Burke, MD
This ASCO conference presents a variety of treatment approaches for patients with lymphoma. The novel BCL-2 inhibitor, venetoclax, was recently approved by the FDA for the treatment of patients with relapsed or refractory chronic lymphocytic leukemia (CLL) with 17p deletion, based on a study in which patients had not received previous ibrutinib or idelalisib. An ongoing phase II study examines patients treated with venetoclax whose CLL had relapsed or were refractory to ibrutinib or idelalisib. A second-generation BTK inhibitor, acalabrutinib, has shown strong efficacy in relapsed/refractory CLL; researchers will discuss results of acalabrutinib therapy in a current trial of patients with previously untreated CLL. Results of a trial of the anti-CCR4 monoclonal antibody mogamulizumab vs physician’s choice of chemotherapy in adult T-cell leukemia/lymphoma will be presented, as well as results from a small phase I trial using lenalidomide with rituximab in patients with recurrent CNS lymphoma.

Multiple Myeloma—Shaji Kumar, MD
There are a lot of exciting studies in myeloma treatment at ASCO this year, with perhaps one of the more anticipated being the phase III results from the CASTOR study, exploring the benefit of adding the monoclonal antibody daratumumab to bortezomib and dexamethasone in patients with relapsed/refractory myeloma. Other noteworthy presentations include updated results of a phase II trial combining pembrolizumab with lenalidomide in relapsed/refractory myeloma, phase III results from the European Myeloma Network of the continued role of upfront autologous stem cell transplantation (ASCT) in this era of novel agents, studies of carfilzomib in relapsed/refractory myeloma in combination with pomalidomide and dexamethasone as well as an economic evaluation of carfilzomib plus lenalidomide/dexamethasone vs lenalidomide/dexamethasone alone, a meta-analysis of the impact of lenalidomide maintenance after ASCT in myeloma, and early-phase results of venetoclax combined with bortezomib and dexamethasone in relapsed/refractory myeloma.

Myeloproliferative Neoplasms—Rami Komrokji, MD
This year’s ASCO offers limited abstracts affecting the treatment of myeloproliferative neoplasms, but one study particularly worth reviewing is the 5-year follow-up of the COMFORT-1 trial examining the long-term impact of ruxolitinib treatment in patients with myelofibrosis.

Your Thoughts?
What are you most looking forward to at ASCO 2016 in hematologic malignancies? Please share your thoughts in the comment box below.

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