Leukemia

The BCL2 Gly101Val mutation is the first genomic alteration to be identified as responsible for resistance to venetoclax (Venclexta), 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.
The combination of the targeted therapy ibrutinib (Imbruvica), a protein kinase inhibitor, and the monoclonal antibody rituximab (Rituxan) extends disease-free survival by 65% and overall survival (OS) by 83% compared with standard-of-care chemotherapy with the fludarabine plus cyclophosphamide and rituximab (FCR) regimen as first-line therapy in patients with chronic lymphocytic leukemia (CLL) under age 70, according to results of the phase 3 ECOG-ACRIN 1912 trial presented at a late-breaking abstract session at the 2018 American Society of Hematology meeting. In addition, patients who received the chemotherapy-free, pill-based ibrutinib plus rituximab regimen had fewer adverse events than the patients who received FCR.
Chicago, IL—Moving nelarabine (Arranon), a T-cell–specific drug, up front combined with backbone chemotherapy (ie, COG-augmented Berlin-Frankfurt-Münster [aBFM]) improved ­survival by approximately 10% in the largest-­ever randomized clinical trial enrolling newly diagnosed children and young adults with T-cell acute lymphoblastic leukemia (T-ALL) and T-cell lymphoblastic lymphoma (T-LL).

New results from the phase 3 QuANTUM-R trial showed that quizartinib, an oral, selective FLT3 inhibitor, significantly extended overall survival compared with chemotherapy in patients with relapsed/refractory acute myeloid leukemia (AML) and the FLT3-ITD mutation.

Acute lymphoblastic leukemia (ALL) is a cancer of the blood and bone marrow that affects the white blood cells (lymphocytes). In 2017, 5970 new patients were estimated to be diagnosed with ALL and 1440 individuals to die from this disease. ALL is diagnosed most often in children, adolescents, and young adults, with a median age of 15 years at diagnosis.
Acute myeloid leukemia (AML) is a rare but deadly cancer. Approximately 21,400 new cases of AML were diagnosed in 2017 in the United States, and nearly 10,600 people died from the disease. Approximately 60% to 70% of adults with AML respond to initial treatment with cytotoxic chemotherapy. However, the 5-year survival rate for patients with AML remains poor at approximately 27%.

At the 2018 Hematology/Oncology Pharmacy Association Annual Conference, Dr Seddon provided attendees with an overview of FLT3-mutated AML, including currently available treatments, mechanisms of resistance, and future directions.

In April 2017, midostaurin (Rydapt) was approved for the treatment of adults with newly diagnosed FLT3-positive AML in combination with standard intensive induction consolidation chemotherapy.

Acalabrutinib received FDA approval on October 31, 2017, for patients with mantle-cell lymphoma but not for patients with CLL. It is only the second BTK inhibitor to receive approval by the FDA.

Findings from an interim analysis of the phase 3 MURANO study show venetoclax plus rituximab achieved superior progression-free survival and overall survival compared with standard-of-care bendamustine plus rituximab in patients with relapsed or refractory chronic lymphocytic leukemia.

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