Lymphoma
Mantle cell lymphoma: optimizing responses in treatment-naïve and difficult-to-treat patients
The three-arm, randomized, phase III TRIANGLE trial has set a new first-line standard in younger patients with mantle cell lymphoma (MCL), showing that the addition of ibrutinib to standard immunochemotherapy improves efficacy [1]. Previously untreated patients aged 18-65 years who were eligible for autologous stem cell transplantation (ASCT) were randomized to either induction treatment with R-CHOP and R-DHAP followed by ASCT (group A; n = 288) or one of two experimental arms: In group A+I (n = 292), ibrutinib was added to R-CHOP and was administered as fixed-duration maintenance for two years after ASCT.
Advancing care in Waldenström macroglobulinemia: Clinical and real-world perspectives
Recent advances have transformed the management of Waldenström macroglobulinemia (WM), particularly with the advent of targeted therapies such as Bruton tyrosine kinase (BTK) inhibitors. These innovations have addressed longstanding challenges including resistance, intolerance, and the need for personalized approaches (enabling therapy also for those deemed unfit for chemotherapy).
Follicular lymphoma: Efficacy and safety updates
In the context of follicular lymphoma treatment, there is a clear unmet need for patients who have experienced early progression (progression within 24 months of front-line therapy, POD24), as well as those who are refractory to treatment and present with other high-risk features. At ASH 2024, promising efficacy and safety data were reported for the five molecules nemtabrutinib, zanubrutinib, BGB-16673, epcoritamab, and mosunetuzumab [1-6].
Pushing the boundaries further in the management of CLL
In patients with treatment-naïve chronic lymphocytic leukemia (CLL), the multicenter, open-label, randomized, phase III AMPLIFY trial was initiated to evaluate fixed-duration treatment with acalabrutinib plus venetoclax ± obinutuzumab compared to investigator’s choice of chemoimmunotherapy (CIT).
Innovative agents in marginal zone lymphoma and other B-cell malignancies
Relapses are common in patients with marginal zone lymphoma (MZL), and sequential therapy is often necessary. At ASH 2023, Tedeschi et al. reported findings for 22 patients with relapsed/refractory MZL who received the oral second-generation Bcl-2 inhibitor sonrotoclax at different dose levels (i.e., 40 mg, 160 mg, 320 mg, 640 mg OD) in the first-in-human, phase I, multicenter BGB-11417-101 study.
Exploring chemotherapy-free approaches in the treatment of DLBCL
For decades, the CHOP regimen has been the first-line standard of care for patients with newly diagnosed diffuse large B-cell lymphoma (DLBCL). Significant improvement was achieved through the addition of rituximab (R-CHOP). Ever since, however, multiple clinical trials investigating expanded or alternative treatment regimens have not succeeded in further improving patient outcomes.
Updated findings in CLL with a focus on BTK- and Bcl-2–targeted therapies
Personalization of treatment duration of ibrutinib plus venetoclax using measurable residual disease (MRD) was explored in fit patients with previously untreated chronic lymphocytic leukemia (CLL) in the multicenter, randomized, open-label, phase III FLAIR trial. At ASH 2023, Hillmen et al. presented the results for the comparison of ibrutinib plus venetoclax (n = 260) with 6 cycles of fludarabine, cyclophosphamide, and rituximab (FCR; n = 263).
Follicular lymphoma: BTK inhibition and bispecific antibodies
With respect to the treatment of newly diagnosed follicular lymphoma (FL), there is room for improvement as many patients relapse after first-line chemoimmunotherapy. The frontline use of lenalidomide and rituximab (R2) has proven highly active in patients with FL. A single-arm phase II study investigated the addition of the BTK inhibitor acalabrutinib to R2 in patients with untreated FL based on the hypothesis that this combination will increase efficacy due to beneficial effects on the immune microenvironment.
