Heinz Ludwig, MD, Director of the Wilhelminen Cancer Research Institute, Department of Medicine I, Center for Oncology, Hematology and Palliative Care, Wilhelminen Hospital, Vienna, Austria
The ASH Annual Meeting and Exposition is the premier event for presentation of novel data on malignant and non-malignant hematologic diseases, attracting up to 30,000 specialists from all over the world. The 62nd ASH Annual Meeting was planned to be held on December 5–8, 2020 in San Diego, California, but due to the COVID-19 pandemic had been transformed to an all-virtual event. Attendees had access to thousands of scientific abstracts highlighting cutting-edge research in hematology. This publication summarizes work presented in the field of B-cell malignancies with a focus on targeted therapies.
Inhibition of the Bruton’s tyrosine kinase (BTK) has been implemented as a mainstay of treatment in various types of hematologic malignancies, including Waldenström’s macroglobulinemia, chronic lymphocytic leukemia, marginal zone lymphoma, and mantle cell lymphoma. Later-generation BTK inhibitors designed to achieve optimized selectivity offer advantages with respect to tolerability and efficacy compared to first-generation BTK inhibition. Benefits have been observed with these agents irrespective of factors such as pretreatment or cytogenetic risk.
Progress is also ongoing regarding other drug classes such as PI3Kδ inhibitors and anti-CD20 antibodies that complement the armamentarium available for the treatment of various B-cell malignancies. Immune checkpoint inhibition might also play a role in the future, although a variety of inhibitory receptors apart from PD-1 and PD-L1 are still awaiting investigation in terms of their clinical usefulness as targets for drug therapy.
Naturally, combinations are a major area of research given the importance of achieving deep remission that allows for long-lasting disease-free survival. The wide range of drugs already established in the field of hematologic diseases enables the assessment of new regimens that might represent a major step forward in terms of patient life expectancy and quality of life.