Amitkumar Mehta, MD, Division of Hematology and Oncology, University of Alabama at Birmingham, USA
The 63rd Annual Meeting of the American Society of Hematology (ASH) took place as a hybrid event that hosted participants both online and on-site in Atlanta, Georgia, USA. Among the multitude of updates and new insights presented from December 11 to 14, 2021, results obtained for targeted therapies in B-cell malignancies including chronic lymphocytic leukemia, mantle cell lymphoma, Waldenström’s macroglobulinemia, and marginal zone lymphoma are summarized in this issue of memo inHaematology.
Clinical trials show that chemotherapy-free regimens based on the inhibition of targets such as BTK, BCL2, CD20 and PI3Kδ continue to induce superior outcomes compared to the previous chemo(immuno)therapy-based standards. BTK inhibitors have been a mainstay of treatment from the beginning of the targeted era. While later-generation representatives of this and other drug classes are being investigated as they offer improved efficacy and tolerability profiles over first-generation agents, other compounds such as bispecific antibodies and antibody-drug conjugates are gaining ground in various B-cell malignancies. Newer agents enable us to further increase patient responses even in later lines.
Potential advantages of modern targeted therapies include their ability to overcome unfavorable cytogenetics and the possibility of limited-duration treatment while providing long-term disease control. Approaches that are driven by the achievement of undetectable minimal residual disease might allow for tailored therapy in broad patient populations in the future, thus avoiding overtreatment and unnecessary health expenditures while addressing patient groups with the highest risk. From an economic point of view, adequate and timely treatment is important in these diseases that tend to relapse repeatedly over the course of years, with hospital treatment in particular incurring substantial costs. Local implementation of new insights in the best possible manner will enable us to reduce the significant burden of disease at both the patient and the societal level.