© Dirk Gillissen – Arnon P. Kater, MD, PhD, Department of Hematology, Cancer Center Amsterdam, Amsterdam University Medical Center, University of Amsterdam, Amsterdam, Netherlands
Cutting-edge updates in the diagnosis and treatment of hematological malignancies were discussed by world-leading experts at the Annual Meeting of the American Society of Clinical Oncology (ASCO) in Chicago, USA, 2nd–6th June 2023, the European Hematology Association (EHA) congress in Frankfurt, Germany, 8th–11th June 2023, and the 17th International Conference on Malignant Lymphoma (ICML) in Lugano, Switzerland, 13th–17th June 2023.
Over the last decade, the treatment of chronic lymphocytic leukemia has dramatically evolved due to the introduction of targeted therapies, but questions remain. In treatment-naïve asymptomatic disease, the watch & wait concept was challenged but appears to be superior to early BTK inhibitor treatment. Chemotherapy-free fixed-duration regimens have shown clinically meaningful benefits and deep, durable responses and are an attractive alternative to continuous treatment, avoiding long-term toxicity, high-costs and potentially inevitable development of resistant clones. At the same time, the results provide the rationale for the implementation of MRD-guided strategies to further improve patient prognosis. The next-generation BTK inhibitor zanubrutinib has become a new first-line treatment in the elderly, in patients with comorbidities, and in those with adverse genetic setup. In relapsed/refractory CLL, the feasibility of venetoclax/rituximab retreatment in the context of fixed-duration strategies has been demonstrated. Also, data show that some BTK inhibitors offer advantages over others in the presence of intolerability and BTK mutations.
Bispecific antibodies are on the rise in hematological malignancies, which is highlighted in this report by findings obtained in the setting of follicular lymphoma and diffuse large B-cell lymphoma. Nevertheless, BTK inhibition remains a mainstay of treatment in hematological diseases such as marginal zone lymphoma and Waldenström macroglobulinemia. In elderly patients with diffuse large B-cell lymphoma, the antibody-drug conjugate polatuzumab vedotin has yielded encouraging efficacy combined with chemotherapy. Moreover, promising findings have been observed with novel agents targeting BTK and Bcl-2 in various B-cell malignancies.
Once again, experts shared groundbreaking results in the field of hematological oncology by presenting impressive long-term follow-up data as well as innovative treatment strategies at this year’s ASCO, EHA and ICML meeting. Leaving Chicago, Frankfurt and/or Lugano, we all feel excited and inspired to share our newly acquired knowledge not only with you, as a reader of this special issue, but also with our patients since science creates knowledge and saves lives.