ASCO/EHA/ICML 2023
Lecture Board: Constantine Tam, MD; Catherine Thieblemont, MD, PhD; Jan Walewski MD, PhD
Medical Writer: Judith Moser, MD
Publishing Editor: Anna Fenzl, PhD
Preface – ASCO/EHA/ICML 2023
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.
Current insights into BTK inhibition and other targeted approaches in CLL
In the setting of early-stage, asymptomatic chronic lymphocytic leukemia (CLL), the concept of watch & wait in the era of targeted agents was challenged by the placebo-controlled, double-blind, phase III CLL12 study. This trial assessed the use of ibrutinib 420 mg OD (n = 182) vs. placebo (n = 181) until symptomatic disease progression in treatment-naïve patients with asymptomatic CLL Binet stage A who had an increased risk due to factors such as del(17p), IGHV mutation status, or age.
Follicular lymphoma: study results with bispecific antibodies and BTK inhibitors
Follicular lymphoma (FL) is the most common indolent non-Hodgkin lymphoma (NHL) subtype [1]. In general, it remains incurable with standard therapies, and most patients experience multiple relapses over time. Therefore, there remains a great need for innovative new regimens such as the first-in-class CD20xCD3 T-cell–engaging bispecific antibody mosunetuzumab that is being tested in a pivotal phase II trial in patients with relapsed/refractory grade 1-3a FL after ≥ 2 lines of therapy (including an anti-CD20 antibody and an alkylating agent).
Outcome improvements in relapsed and untreated marginal zone lymphoma
Systemic treatment for patients with advanced marginal zone lymphoma (MZL) is often based on regimens used in follicular lymphoma, although new agents and combinations are called for. As MZL depends on B-cell receptor signaling, treatment with BTK inhibitors is being investigated in clinical trials.
Waldenström macroglobulinemia: findings from ASPEN and BRUIN
In the management of patients with Waldenström macroglobulinemia (WM), BTK inhibitors have changed the therapeutic landscape and are considered preferred treatment options for the first and later lines. Compared to the first-in-class agent ibrutinib, the potent and irreversible BTK inhibitor zanubrutinib offers improved BTK selectivity that minimizes off-target effects and toxicities.
DLBCL: treatment of elderly patients and relapsed disease
Overall survival has improved considerably in the setting of diffuse large B-cell lymphoma (DLBCL). However, patients above the age of 80 years are an exception in terms of survival prolongation and therefore face an unmet clinical need [1]. At the same time, this is a group that constitutes an increasing proportion of DLBCL patients.
Updates on BTK- and Bcl-2–targeted treatment in various B-cell malignancies
Updates on BTK- and Bcl-2–targeted treatment in various B-cell malignancies Ibrutinib plus CIT: SELENE trial Survival outcomes typically deteriorate with repeated lines of chemoimmunotherapy (CIT) in patients with relapsed/refractory non-Hodgkin lymphoma. The randomized, double-blind phase III SELENE trial was conducted to determine whether the addition of the BTK inhibitor ibrutinib to CIT in patients with relapsed/refractory follicular lymphoma (FL) or marginal zone lymphoma (MZL) improve ...
Current insights into BTK inhibition and other targeted approaches in chronic lymphocytic leukemia
In the setting of early-stage, asymptomatic chronic lymphocytic leukemia (CLL), the concept of watch & wait in the era of targeted agents was challenged by the placebo-controlled, double-blind, phase III CLL12 study. This trial assessed the use of ibrutinib 420 mg OD (n = 182) vs. placebo (n = 181) until symptomatic disease progression in treatment-naïve patients with asymptomatic CLL Binet stage A who had an increased risk due to factors such as del(17p), IGHV mutation status, or age.
EXPERT VIDEOS
All video interviews from ASCO/EHA 2023
Alessandra Tedeschi gives insights into the health-related quality of life data from the ASPEN study conducted in patients with Waldenström macroglobulinemia, discusses the notable results from the extended follow-up of the SEQUOIA study in patients with treatment-naïve chronic lymphocytic leukemia as well as the clinical activity of zanubrutinib in the setting of R/R marginal zone lymphoma while finally depicting her personal highlights from this year’s EHA congress.
Anna Schuh talks about genetic aberrations in subclones in terms of the molecular dynamics of relapse in patients with CLL, the benefits of liquid biopsies as well as the current role and future application of whole-genome sequencing in precision hematology while ultimately depicting her personal highlights from this year’s EHA congress.
Paolo Strati overviews how patient outcomes can be optimized with current therapies in relapsed or refractory diffuse large B-cell lymphoma in later lines and outlines which innovative approaches might become available in the long run for the treatment of R/R DLBCL. Finally, he explains what can be achieved today in patients with follicular lymphoma and high tumor burden and depicts his personal highlights from this year’s EHA congress.
Philipp Staber explains the role of functional drug testing in the treatment of patients with hematologic diseases, shares the rationale of the EXALT-2 trial as well as his thoughts on future developments in the field of precision medicine. Finally, he gives insights in the current research topics of the EHA SWG-Precision Hematology and their goal for the next five years.
