ASCO/EHA/ICML 2021 – Christian Buske

Christian Buske relates to recent developments with respect to the role of BTK inhibitors and their potential future combination partners in the treatment of patients with Waldenström’s macroglobulinemia, the results of the iNNOVATE study and personalized treatment according to genotypes.

Here is the full ASCO/EHA/ICML 2021 report.

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Zanubrutinib in relapsed/refractory marginal zone lymphoma: MAGNOLIA

B-cell receptor-mediated signaling has been identified as a critical step in marginal zone lymphoma (MZL) pathogenesis. Accordingly, BTK inhibition is effective in the management of patients with relapsed/refractory MZL, as shown for the first-generation BTK inhibitor ibrutinib. The multicenter, single-arm, phase II MAGNOLIA study is evaluating the next-generation BTK inhibitor zanubrutinib 160 mg twice daily in patients with relapsed/refractory MZL including splenic, nodal and extra-nodal subtypes after pretreatment with ≥ 1 CD20-based regimen.

Mantle cell lymphoma: improving outcomes in difficult-to-treat patient populations

Mantle cell lymphoma (MCL) accounts for approximately 3–10 % of non-Hodgkin lymphomas and shows one of the poorest survival rates among the lymphomas. The combination of lenalidomide and rituximab (R2) has demonstrated activity in MCL patients in the frontline and relapsed/refractory settings, with overall response rates (ORRs) of 92 % and 57 %, respectively.

Extending anti-PD-1–based options in the setting of Hodgkin lymphoma

Patients with relapsed or refractory classical Hodgkin lymphoma (cHL) who have failed high-dose chemotherapy and autologous stem cell transplantation (HDT/ASCT) have poor prognosis, which also applies to those with chemotherapy-resistant disease who are ineligible for HDT/ASCT. The presence of chromosome 9p24.1 alterations in cHL provides a rationale for immune checkpoint inhibition as this leads to overexpression of the PD-L1 ligands.

Waldenström’s macroglobulinemia: outcome optimization via combinations

Ibrutinib is the only once-daily BTK inhibitor approved as a single agent or in combination with rituximab for patients with Waldenström’s macroglobulinemia (WM) across all lines of therapy. In the international, double-blind, ran­domized, phase III iNNOVATE trial, ibrutinib plus rituximab was tested against placebo plus rituximab in patients with rituximab-sensitive WM.

CLL/SLL: current perspectives across a range of potent agents

The introduction of effective inhibitors of B-cell receptor signaling such as the BTK inhibitor ibrutinib has transformed the treatment of patients with chronic lymphocytic leukemia (CLL) and small lymphocytic lymphoma (SLL). The irreversible, potent, next-generation BTK inhibitor zanubrutinib has been designed to maximize BTK occupancy and minimize off-target inhibition of other kinases.