IWWM-12: What were the key takeaways?

During the 12th International Workshop on Waldenström's Macroglobulinemia (IWWM-12), the Lymphoma Hub was pleased to speak to Stephen Ansell, Mayo Clinic, Rochester, US. We asked, What were the key takeaways from IWWM-12?

In this interview, Ansell provides an update on the latest findings in Waldenstrom’s macroglobulinemia (WM) and the key takeaways from the data presented at IWWM-12. He highlights significant advancements in the understanding of WM biology and the progress in clinical trials. This interview covers genomic and epigenetic research in WM and emerging treatment strategies, including the use of Bruton’s tyrosine kinase (BTK) inhibitors in combination therapies. 

Key points

Biological insights

• Significant advances have been made in the genomic, transcriptomic, and epigenetic analysis of WM.
• There are two subtypes of WM: one with a memory B cell phenotype and the other with a plasma cell phenotype.
• Memory B cell-like tumors exhibit inflammatory biology, while plasma cell-like tumors become more autonomous.
  • Disrupting these processes presents an opportunity for therapeutic advancements.
• New data have improved understanding of the tumor microenvironment, with key insights into stromal elements that encourage tumor cell development and drive epigenetic and transcriptomic changes.

Clinical developments

• Progress has been made with chemotherapies, particularly those involving bendamustine and rituximab-based treatments.
• The use of BTK inhibitors is a key topic in WM treatment, including novel approaches that combine BTK inhibitors with chemotherapy agents.
  • Ibrutinib was the first approved BTK inhibitor, and was followed by newer and investigational therapies, including zanubrutinib, pirtobrutinib, and acalabrutinib.
  • New data have shown promising outcomes with BTK inhibitors in combination with bendamustine and rituximab.
• There has been an increasing incidence of patients achieving complete responses with minimal residual disease, raising hopes for durable remissions and potential cures in the future.

This educational resource is independently supported by BeiGene. All content is developed by SES in collaboration with an expert steering committee; funders are allowed no influence on the content of this resource.