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ASH 2018 Highlights

Patients with relapsed, refractory, or high-risk hematologic malignancies obtained durable benefits with the combined checkpoint inhibition with nivolumab and ipilimumab as consolidation therapy after stem-cell transplant, according to results of a small prospective study presented at ASH 2018.
A 2-year duration of combination immunotherapy with ven­etoclax and rituximab improved survival compared with standard-of-care chemoimmunotherapy combination with bendamustine plus rituximab in patients with relapsed or refractory chronic lymphocytic leukemia (CLL), according to follow-up data from the MURANO clinical trial presented at ASH 2018. Early results were first presented at ASH 2017.
The BCL2 Gly101Val mutation is the first genomic alteration to be identified as responsible for resistance to venetoclax, a potent and effective medication indicated for the treatment of chronic lymphocytic leukemia (CLL). The BCL2 Gly101Val mutation is unique to CLL and so far has not been described in other cancers.
Although chimeric antigen receptor (CAR) T-cell therapy has achieved remarkable long-lasting remissions in B-cell malignancies, in approximately 60% of the cases, the initial response wanes over time because of “immune exhaustion.” The use of a checkpoint inhibitor to boost immune response to CAR T-cell therapy is gaining traction as an attractive approach, according to 2 early studies presented at ASH 2018.
Longer-term follow-up of 2 large pivotal clinical trials in B-cell malignancies has demonstrated continuing remissions after chimeric antigen receptor (CAR) T-cell therapy: the ELIANA study in pediatric patients and young adults with relapsed or refractory B-acute lymphoblastic leukemia (B-ALL) and the JULIET study in adult patients with diffuse large B-cell lymphoma (DLBCL). Both updates were presented at a press conference at ASH 2018.
Front-line ibrutinib therapy results in a lower rate of disease progression or death than the current standard-of-care chemoimmunotherapy with bendamustine and rituximab in older patients with chronic lymphocytic leukemia (CLL). Adding rituximab to ibrutinib did not improve outcomes compared with ibrutinib alone, reported Jennifer A. Woyach, MD, Associate Professor, Ohio State University Comprehensive Cancer Center, Columbus, at ASH 2018.

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