Articles related to BLOOD CANCERS

The International Consensus Classification (ICC) of myeloid neoplasms and acute leukemia was developed as a result of the recent advances in doctors’ understanding of the biology of hematologic malignancies, the experience with the use of the 2016 WHO classification in clinical practice, and the results of clinical trials.

Dr. Mohyudding summarizes key findings ASCO reports, including updates on teclistamab in CAR-T, the DETERMINATION trial assessing auto-transplantation, cilta-cel (covered by HCN here), and the ATLAS study evaluating carfilzomib with lenalidomide and dexamethasone as maintenance vs. lenalidomide alone.

This report provides longer-term results from the CARTITUDE-1 trial of ciltacabtagene autoleucel (cilta-cel) in heavily pretreated patients with relapsed/refractory multiple myeloma. This update covers 97 patients at a median follow up of ~28 months. The overall response rate was 97.9%, with an 82% stringent complete response across both standard and high-risk subgroups. These longer-term data from CARTITUDE-1 in triple-class exposed patients with RRMM demonstrate deep and durable responses to cilta-cel over time, including in high-risk subgroups.

CAR T-cell therapy has changed the treatment paradigm for relapsed/refractory aggressive B-cell NHL. The approach has seen strong response rates and durable remission in those whose disease has progressed despite multiple prior treatments. This review outlines current indications for CAR T-cell therapy, major toxicities, novel CARs under investigation, CARs for various hematologic malignancies, and future directions.

An FDA expert panel voted 16-0, with one abstention, recommending that future FDA approvals of PI3K inhibitors be supported by randomized data. The four currently-approved PI3K inhibitors for treating hematologic malignancies received FDA approval based on single-arm data. Although these drugs have offered durable ORR and improvements in PFS, randomized data presented at the hearing showed they are associated with higher rates of serious adverse events, including fatality.

In an integrated analysis of mutations and clinical outcomes, comprising 2,200 patients with TP53-mutated myelodysplastic syndrome (MDS) with excess blasts (EB) or TP53-mutated acute myeloid leukemia (AML), the authors state that mutant TP53 AML and MDS-EB “do not differ with respect to molecular characteristics and survival” and argue these entities should be considered a single molecular disease entity. In a commentary to the above paper, TP53 and the star-crossed lovers MDS and AML, John Welch, MD, PhD of Washington University School of Medicine writes, “As a junior Hematology/Oncology fellow, I was told there were two types of physicians: splitters and mergers. That is, clinicians either seek to diagnose increasingly homogenously narrow groups of patients based on increasingly refined, shared characteristics, or they seek to find broad, overarching patterns that unite diagnostic classifications. Hematologic malignancies have been fertile ground for the diagnostic splitters of the world. On the other hand, there have been some noteworthy exceptions. Sometimes it is a technological advance that allows for the synthesis of disparate diagnoses.”