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ASH 2019 Post Wrap-Up

Results from TRANSCEND CLL 004 showed chimeric antigen receptor (CAR) T-cell treatment with lisocabtagene maraleucel in heavily pretreated patients with relapsed/refractory (R/R) chronic lymphocytic leukemia (CLL)/small lymphocytic lymphoma (SLL) who had failed ibrutinib was manageable and produced durable undetectable minimal residual disease responses.
Results from the 3-year update of the phase 2 AIM trial confirmed the effectiveness of ibrutinib + venetoclax therapy for patients with mantle-cell lymphoma, and indicated that treatment interruption was feasible for patients in minimal residual disease–negative complete remissions.
A large observational study showed increased first-line bendamustine-rituximab use among older patients with splenic or nodal marginal zone lymphoma was not associated with significant event-free survival or overall survival benefit versus single-agent rituximab, but led to increased toxicities and costs.
Updated results from a phase 1/2 trial indicate that acalabrutinib monotherapy was associated with a favorable safety profile and showed antileukemic activity in patients with chronic lymphocytic leukemia (CLL)/small lymphocytic lymphoma, irrespective of high-risk genomic features.
The results of this phase 3 study demonstrate a progression-free survival advantage for patients treated with acalabrutinib given alone or in combination with obinutuzumab versus those treated with obinutuzumab plus chlorambucil.
Use of a time-limited triplet combination of acalabrutinib, venetoclax, and obinutuzumab in patients with chronic lymphocytic leukemia offers high rates of undetectable minimal residual disease in bone marrow with acceptable tolerability.
For patients with chronic lymphocytic leukemia who are treated with acalabrutinib, disease progression is largely attributed to specific mutations in Bruton tyrosine kinase (BTK). Acalabrutinib resistance mechanisms are similar to those seen with ibrutinib.
In the minimal residual disease (MRD) cohort of the phase 2 CAPTIVATE study, first-line ibrutinib + venetoclax treatment resulted in high rates of undetectable MRD in both peripheral blood and bone marrow of patients with chronic lymphocytic leukemia (CLL).
The ongoing phase 1/2 HOVON 124/Ecwm-R2 trial showed the combination of ixazomib citrate, rituximab, and dexamethasone to be feasible, with promising efficacy and manageable toxicity in patients with relapsed or progressive Waldenström macroglobulinemia.
Extended follow-up of the E1912 trial showed a significant advantage for patients with chronic lymphocytic leukemia (CLL) treated with ibrutinib + rituximab compared with those treated with fludarabine, cyclophosphamide, and rituximab (FCR).

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