EHA 2022 – Constantine Tam

Constantine Tam highlights the most relevant findings presented at EHA 2022 as well as promising modes of action of new agents in the treatment of indolent lymphomas. He explains how resistance to BTK inhibitors can be addressed in B-cell malignancies while giving an outlook on a BTK protein degrader and finally summarizes the long-term results obtained with zanubrutinib compared to ibrutinib in the ASPEN trial in patients with WM.

Here is the full EHA 2022 report.

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New options in untreated and pretreated mantle cell lymphoma

Patients of an advanced age with previously untreated mantle cell lymphoma (MCL) usually receive chemoimmunotherapy regimens such as bendamustine/rituximab (BR), R-CHOP or bortezomib/rituximab/cyclophosphamide/doxorubicin/prednisone (VR-CAP), with BR having become the most commonly used first-line strategy.

Prolonging remission in relapsed and refractory follicular lymphoma

Follicular lymphoma (FL) is a common indolent form of non-Hodgkin lymphoma that accounts for 20-25 % of all new NHL cases in Western countries. Although patients with FL generally respond well to first-line anti-CD20-based chemotherapy regimens, recurrence is common.

BTK inhibition in Waldenström’s macroglobulinemia: trial updates and real-world insights

The open-label, multicenter, ran­domized phase III ASPEN trial was set up to assess the efficacy and safety of the potent, selective, irreversible next-generation BTK inhibitor zanubrutinib in Waldenström’s macroglobulinemia (WM). Cohort 1 of the study included patients with MYD88-mutated disease (n = 201); here, zanubrutinib was compared to ibrutinib after 1:1 randomization.

Marginal zone lymphoma: benefits of BTK inhibition in later lines

Patients with marginal zone lymphoma (MZL) usually show an indolent course of disease, although MZL remains largely incurable, particularly in the relapsed/refractory setting. BTK inhibition offers a potent treatment option in this situation. The single-arm, multicenter, phase II MAGNOLIA study tested the next-generation BTK inhibitor zanubrutinib in patients with relapsed/refractory MZL who had received ≥ 1 CD20-based regimen, demonstrating high response rates and durable disease control.

Updates and ancillary analyses in the setting of chronic lymphocytic leukemia

In fit patients with advanced CLL of favorable genetic risk, chemoimmunotherapy (CIT) consisting of fludarabine/cyclophosphamide/rituximab (FCR) or bendamustine/rituximab (BR) still represents the treatment standard. Another potential strategy, however, is time-limited therapy consisting of obinutuzumab plus venetoclax (GV) with or without a BTK inhibitor.