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ASCO 2018 | The Highlights 

Aug 1, 2018
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Did you miss ASCO 2018? The Lymphoma Hub has developed a downloadable resource which provides a summary of the key presentations in lymphoma and CLL at the ASCO 2018 annual meeting, Chicago, June 1-5 2018.

ASCO 2018 | The Highlights

If you would like to view the ASCO 2018 highlights or share the information with a colleague, please find a Lymphoma Hub summary resource below

Download Here

Follicular Lymphoma

  • PHASE III RELEVANCE study (abstract 7500) – Nathan Fowler
    • R2 (rituximab + lenalidomide) vs R-chemo followed by rituximab maintenance in patients with ND FL
    • 1,030 patients included
    • Efficacy results were similar (ORR, CRu, DoR)
    • No superiority of R2 vs R-chemo in terms of PFS at 120 weeks
    •  More Grade 3 / 4 neutropenia in the R-chemo arm (50%) compared with R2 (32%)
    • Longer follow-up needed for mature PFS and OS data
    • SummaryExpert’s interview
  • Current advances in FL – Sonali Smith
    • Results of the RELEVANCE trial: longer follow-up needed
    • New PI3K inhibitor approved in the US (copanlisib)
    • Expert’s interview
  • Polatuzumab vedotin in combination with BR (abstract 7507) – Laurie Sehn
    • Randomized controlled trial against BR – 80 R/R FL patients
    • Increase of low grade AEs (peripheral neuropathy) and grade 3-5 AEs (neutropenia, anemia and febrile neutropenia [but no infection])
    • No difference in CRR, mPFS and mOS
    •   Expert’s interview
  • Phase 1b/2 of Hu5F9-G4 (abstract 7504) – Ranjana Advani
    • Hu5F9-G4: first-in-class anti-CD47 antibody (5F9)
    • 7 patients with R/R FL
    • MTD not reached
    • In combination with rituximab: CRR = 43%, mDoR not reached
    • Summary 

DLBCL

  • TRANSCEND NHL 001 study (abstract 7505) – Jeremy Abramson
    • JCAR017 (lisocabtagene maraleucel)
    • 102 patients included with R/R aggressive NHL
    • DLBCL cohort: ORR = 80%, CRR = 59%
    • 93% patients in remission at 6 months remained in remission at the latest follow-up
    • Most important Grade 3 / 4 events = neutropenia and fatigue, CRS: 37%, NE: 23%
    •  Summary
  • Durable responses with axi-cel in R/R DLBCL in the ZUMA-1 trial (abstract 3003) – Frederick Locke
    • 108 patients treated with axi-cel (axicabtagene ciloleucel), follow-up: 15.4 months
    • ORR = 82%, CRR = 58%, mDoR = 11.1 months
    • Responders at 3 months have 80% chance to maintain their response at 1 year. Some PR converted into CR at 1 year
    • Summary - Expert’s interview
  • Polatuzumab vedotin in combination with BR (abstract 7507) – Laurie Sehn
    • Randomized controlled trial against BR – 80 R/R DLBCL patients
    • Increase of low grade AEs (peripheral neuropathy) and grade 3-5 AEs (neutropenia, anemia and febrile neutropenia [but no infection])
    • CRR: 40% (vs 15%), mPFS: >6 months (vs 2 months), mOS: >11 months (vs <5 months)
    •  Expert’s interview
  • Phase 1b/2 of Hu5F9-G4 (abstract 7504) – Ranjana Advani
    • Hu5F9-G4: first-in-class anti-CD47 antibody (5F9)
    • 15 patients with R/R FL
    • MTD not reached
    • In combination with rituximab: CRR = 33%, mDoR not reached
    • Summary

HL

  • Final analysis of the AHL2011 LYSA trial (abstract 7503) – Olivier Casasnovas
    • 823 patients included with untreated HL – early PET-driven treatment de-escalation after 2 cycles of BEACOPPesc vs not PET-     monitored strategy
    • mFU: 50.4 months – 4-y PFS: 87.1% vs 87.4%; 5-y PFS: 85.7% vs 86.2%; 4-y OS: 97.1% vs 96.9%; 5-y OS: 96.4% vs 95.2%
    • SummaryExpert’s interviewG. Salles’s interview
  • Novel therapies for R/R HL beyond transplant – Catherine Diefenbach
    • Not all relapsed patients are the same
    • 1st relapse and ASCT = SoC but for patients in CR2
    • BV: 35% CRR in 2nd line salvage prior to SCT, effective in consolidation post AST (mPFS: 42.9% vs 24.1%, but no difference in mOS)
    • BV + B: CRR: 76%, 18-months PFS: 75%
    • Nivolumab: CRR between 9% and 17%
    • BV + ipi: CRR = 48%, 1-y PFS = 58%
    • BV + nivo: CRR = 67%, 6-months PFS = 93%
    • Other new agents tested (mTORi, HDACi)
    • Allo-SCT: 3-y OS = 50% but 20% mortality
    •   Expert’s interview
  • Risk-adapted treatment strategies for advanced-stage HL – Joseph Connors
    • Brentuximab vedotin improves effectiveness of CT (improvement of curability?)
    • New agents tested in poorest prognostic patients
    • Expert’s interview

CLL

  • Ibrutinib and venetoclax in treatment-naïve CLL (abstract 7502) – William Wierda
  • High and durable MRD- with venetoclax and rituximab in R/R CLL (abstract 7508) – Peter Hillmen
    • MRD-: VenR = 84% vs BR = 23%
    • 83% of patients maintained MRD-, regardless of risk features
    • Expert’s interview
  • The potential of venetoclax for patients with 17p deletion – Michael Hallek
    • Studied in high-risk patients (17p deleted. P53 mutated or complex karyotype)
    • Venetoclax in combination with rituximab (Murano trial) or ibrutinib (Captivate trial) or obinutuzumab induce long-lasting remissions (several years in the Murano trial) and MRD-
    •  Expert’s interview
  • Role of chemo-immunotherapy in CLL – Susan O’Brien
  • Relapse setting;
    • no role for chemotherapy
    • Retreatment with FCR or BR
    • Ibrutinib for 17p and 11q deleted patients
    • VenR
  • Front-line setting: SoC = FCR
    • Patients with IgVH mutation: FCR
    • Fit unmutated and elderly patients : ibrutinib
  • Expert’s interview

MISCELLANEOUS

FL

  • Retrospective analysis on biopsy-proven FL transformation in the rituximab era – Marek Trnĕný
    • 1200 patients with FL, 546 relapses, 370 tFL; risk of transformation is ≈10%
    • Rituximab might reduce the risk of transformation
    • Expert’s interview
  • Definition and management of high-risk FL patients – Stefano Luminari
    • The most important prognostic factor is the duration of response
    • Early relapses have to be considered as aggressive disease (intensified treatment with ASCT)
    •   Expert’s interview

DLBCL

  • Real-time CoO subtype identification by genetic profiling (abstract 7548) – Greg Nowakowski
    • Feasible on a global scale (mean time: 2.6 days) – ROBUST phase III trial
    • Incidence of ABC (355-38% in the US, 40% in Europe and 60% in Asia)
    • Expert’s interview
  • Tailored therapy for aged patients with aggressive lymphoma – Raoul Cordoba
    • 3 different prognostic factors identified: age, IPI and co-morbidities to define 3 risk-groups: robust (to be treated as younger patients), vulnerable or frail
    •   Expert’s interview

DLBCL, FL

  • Overview of immunotherapy – Carol Jacobson
    • TRANSCEND study: CRR = 50%
    • Phase I monoclonal antibody anti CD47 + rituximab in FL, DLBCL
    • ORR = 50%, CR in 1/3 of patients. Very good safety profile
    • Expert’s interview

CTCL

  • Novel therapies for CTCL – Francine Foss
    • BV (ALCANZA trial) efficient even in patients with very low expression of CD30
    • Mogamulizumab (anti CCR4), especially efficient in SZ
    • Other investigational agents (targeting CD25 or mRNA155)
    • Expert’s interview

WM

  • Acalabrutinib in monotherapy (abstract 7501) – Roger Owen
    • Efficient in treatment-naïve patients: 93% ORR, 24-months duration of response rate = 90%, 90% 24-m PFS, 24-m OS = 92%
    • Activity in R/R patients: 93% ORR, 24-months duration of response rate = 84%, 82% 24-m PFS, 24-m OS = 89%
    • Most common grade ≥3 AEs: neutropenia, pneumonia and low respiratory tract infection
    • Summary

CLL, FL and WM

  • Potential for CT-free future – Bruce Cheson
    • FL: R2 regimen; WM: acalabrutinib; CLL: doublets with rituximab idelalisib, ibrutinib or venetoclax
    • Expert’s interview
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