ASH Highlights

Atlanta, GA—A pair of recent studies from the Mayo Clinic underscore the serious symptom burden experienced by patients diagnosed with myeloproliferative neoplasms (MPNs), according to data presented at ASH 2017. Specifically, patients with MPNs are at high risk for depression, and those with Philadelphia chromosome–negative disease are afflicted with sleep and psychiatric disturbance as well.

The combination of fludarabine, cyclophosphamide, and rituximab (FCR) has been the standard first-line treatment for young patients with chronic lymphocytic leukemia (CLL), with a complete remission (CR) rate after 6 cycles of 40% to 72%, and an undetectable bone marrow (BM) minimal residual disease (MRD) rate after 6 cycles of 43% to 58%.

In patients with mantle-cell lymphoma (MCL), adverse events (AEs) can impair patient adherence to planned therapeutic regimens, and moderate-to-severe AEs generally require medical attention and are often associated with increased healthcare resource use (HRU) and costs. At ASH 2017, the authors presented the results of a retrospective cohort analysis designed to assess HRU and direct costs of MCL, examine variation in costs across treatment types, and document the economic burden associated with MCL treatment-related AEs.

Ibrutinib (ibr) is a first-in-class oral inhibitor of Bruton’s tyrosine kinase approved for relapsed/refractory (R/R) mantle-cell lymphoma (MCL). The results of a pooled analysis of 370 patients with R/R MCL treated with ibr in the SPARK, RAY, and PCYC-1104 studies were previously reported (median follow-up, 24 months). At ASH 2017, the authors presented median 3.5-year follow-up in these patients, including additional exposure and follow-up of 87 patients across the 3 studies who enrolled in the long-term access study, CAN3001.

ZUMA-1 is a pivotal, multicenter trial of axicabtagene ciloleucel (axi-cel), an autologous anti-CD19 chimeric antigen receptor (CAR) T-cell therapy, for the treatment of patients with refractory, aggressive non-Hodgkin lymphoma (NHL). The objective response rate (ORR) was 82% with a 54% rate of complete response (CR), and 44% of responses were ongoing at the time of the primary analysis. Grade ≥3 cytokine release syndrome (CRS) and neurologic events (NEs) occurred in 13% and 28% of patients, respectively.

Brentuximab vedotin (BV), an antibody drug conjugate, selectively delivers the antitubulin agent, monomethyl auristatin E, to CD30+ cells. In a multicenter phase 2 trial in patients with relapsed/refractory (R/R) Hodgkin lymphoma (HL), BV showed an overall response rate (ORR) of 75%, a complete response (CR) rate of 34%, and a median duration of response (DOR) of 6.7 months.

Atlanta, GA—More than 25,000 attendees converged on Atlanta during the middle of a rare winter snowstorm to attend ASH 2017, which featured nearly 5000 scientific abstract presentations ranging from cutting-edge advances in gene therapy and personalized medicine to practice-changing discoveries in immunotherapies.

Combination treatment with nivolumab plus azacitidine produced encouraging response rates in patients with relapsed or refractory (R/R) acute myeloid leukemia (AML) with poor-risk features, and in elderly patients as frontline therapy.

A phase 1 dose-escalation study of FLX925, a dual FLT3 and CDK4/6 inhibitor, showed modest antileukemic activity in adult patients with relapsed or refractory acute myeloid leukemia (AML).

An analysis of response and survival outcomes from the phase 1/2 AG221-C-001 study showed that continued treatment with enasidenib resulted in improved survival and response times in patients with mutant-IDH2 relapsed or refractory (R/R) acute myeloid leukemia (AML).