ASCO/EHA 2022
Lecture Board: Othman Al-Sawaf, MD; Chan Cheah, MBBS, DMSc.; Naval Daver, MD; Shirley D’Sa, MD; Harry P. Erba, MD, PhD.; Wojciech Jurczak, MD, PhD.; Michael Wang, MD; Moshe Yair Levy, MD
Medical Writer: Judith Moser, MD
Publishing Editor: Anna Fenzl, PhD
Preface – EHA 2022
After 2 years of the COVID-19 pandemic, the Annual Meeting of the American Society of Clinical Oncology, held in Chicago, USA, and virtually from 3rd–7th June 2022, featured nearly 250 oral as well as over 2,200 poster presentations. Shortly thereafter, the 27th Congress of the European Hematology Association 2022, held in Vienna, Austria, and virtually, from 9th–12th June 2022, saw leading experts from around the world gather again to further discuss the most exciting updates in the field of hematology with key updates summarized in 200 oral presentations and 1,400 posters.
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.
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.
Early-phase trials investigating novel agents in miscellaneous B-cell malignancies
The prognosis is still poor for most patients with relapsed or refractory large B-cell lymphoma (LBCL) irrespective of therapeutic advances that have recently been achieved. There is a need for convenient, efficacious, well-tolerated, and readily available treatment options.
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.
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.
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.
Tackling acute myeloid leukemia via diverse pathways
Mutations of FLT3 are found in approximately 30 % of patients with newly diagnosed acute myeloid leukemia (AML), with the internal tandem duplication (ITD) representing the most common type. FLT3-ITDhigh is associated with high leukemia burden and poor prognosis. Quizartinib has been developed as a potent and selective, second-generation type II FLT3 inhibitor.
EXPERT VIDEOS
All video interviews from ASCO/EHA 2022
Naval Daver overviews the most promising new agents in the treatment of AML, how existing drugs can blend into new regimens and how the prognosis of patients with AML will evolve in the years to come. Finally, he talks about risk factors for ICI-related pneumonitis development and if pneumonitis increases mortality in AML patients.
Jorge Castillo explains the most meaningful diagnostic criteria for WM, give insights into the “real-world” treatment of WM with zanubrutinib, bortezomib and other treatment strategies and how to sequence therapies in WM. He explains promising modes of action of new agents in the treatment of WM and depicts his personal highlights from this year’s EHA congress.
Wojciech Jurczak outlines what can be achieved with the current standard treatments in the setting of follicular lymphoma, which findings have been observed for PI3K inhibitor therapy in the TIDAL study and were we are today with respect to CAR-T cell therapy for patients with follicular lymphoma.
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.
Shirley D’Sa discusses how the treatment and especially the prognosis of patients with WM evolved over the last decades, which approaches can be used to successfully treat patients with MYD88WTWM, how the interaction between WM cells and the bone marrow microenvironment can be used to develop new ways to overcome treatment resistance and finally explains how often the Binge-Neel Syndrome happens, how its diagnosed and how it should be treated.