Advances in blood cancer treatment presented at ASH meeting

Researchers from MD Anderson Cancer Center presented their latest findings involving drug treatments for blood cancers at the American Society of Hematology’s (ASH) Annual Meeting and Exposition Dec. 8-12 in Atlanta.

“There can be no doubt that we are in an exciting new era of treatment of blood cancers as evidenced by key presentations by MD Anderson researchers at this year’s ASH meeting,” said Patrick Hwu, M.D., head of the institution’s Cancer Medicine division. “These studies are part of MD Anderson’s clinical trials program, the largest in the U.S., which is vital to our mission of ending cancer.”

The following MD Anderson studies revealed significant advances in patient survival, and were presented at the meeting:

CAR-T cell therapy study shows significant remission rates at 15-month follow-up

A study involving the recently approved CD19-targeting chimeric antigen receptor (CAR) T cell therapy shows that 42% of patients with aggressive large B-cell lymphoma remained in remission at 15 months following treatment with axi-cel (marketed as Yescarta™).

The study, named ZUMA-1, also reported measurable responses in 82% of patients and complete responses in 54%. Fifty-six percent were alive at 15 months following therapy, with some remaining cancer free two years post-treatment.

The findings were reported in the Dec. 10 online issue of The New England Journal of Medicine, and presented at ASH’s annual meeting. They resulted from a 22-institution study led by Sattva Neelapu, M.D., professor of Lymphoma & Myeloma at MD Anderson, and Frederick Locke, M.D., vice chair and associate member of the Department of Blood and Marrow Transplant and Cellular Immunotherapy at Moffitt Cancer Center.

“With the FDA’s recent approval of this therapy, we believe this is a major advance in the treatment of patients with relapsed or refractory large B-cell lymphoma, and is likely to save or prolong lives of many patients,” said Neelapu. “This study demonstrated that axi-cel provides remarkable improvement in outcomes over existing therapies for these patients who have no curative options.”

The study, which began in April 2015, administered axi-cel to 108 patients who had failed prior chemotherapy and autologous stem cell transplantation. In some cases, the patients who had received chemotherapy were too far progressed to undergo stem cell transplantation and were placed on the trial following chemotherapy. The patients’ T-cells were extracted through a process called leukapheresis and genetically reengineered with CAR molecules that help T-cells attack cancer cells. The reengineered T cells are infused back into the patient.

Read more about the study and the patients involved in MD Anderson’s Newsroom.

Combination targeted therapy yields high response rates for AML patients

Initial findings from a multi-national open-label phase Ib study of inhibitory drug therapy for relapsed or refractory acute myeloid leukemia (AML) have demonstrated a complete response in up to 50% of patients, according to researchers at MD Anderson Cancer Center.

The patients, age 60 years or older, received a combination therapy of venetoclax with cobimetinib or idasanutlin. The clinical trial followed patients who were treated for a prior blood disease and who were not eligible for cytotoxic therapy.

Preliminary results from the ongoing dose-escalation study, which demonstrated that the combination therapies can be safely administered with minimal side effects, were presented at the American Society of Hematology’s (ASH) Annual Meeting & Exposition in Atlanta. The trial is headed by Marina Konopleva, M.D., Ph.D. and Michael Andreeff, M.D, Ph.D., both professors of Leukemia, as well as Naval Daver, M.D., associate professor of Leukemia.

“This is the first clinical study evaluating new oral combinations with venetoclax in AML patients,” said Konopleva. “This is significant as effective treatment options for patients with relapsed and/or refractory AML are limited.”

Venetoclax, which inhibits the B-cell lymphoma protein (BCL-2) that makes cancer cells resistant to therapy, was previously FDA-approved for treatment of chronic lymphocytic leukemia (CLL). Idasanutlin is an investigational drug targeting a protein called MDM2, which impacts the tumor suppressor gene p53, while cobimetinib targets a protein known as MEK within the cancer cell and is FDA-approved for treatment of advanced melanoma with BRAF mutation.

Andreeff and Konopleva also led the pre-clinical investigation resulting in the clinical trial. Findings from that research were published in the Dec. 11 online issue of Cancer Cell.

Read more about the study in MD Anderson’s Newsroom.

Other MD Anderson studies presented at ASH included:

Phase III results for progression-free survival in multiple myeloma patients comparing standard of care and combination chemotherapy

Muzaffar Qazilbash, M.D., professor of Stem Cell Transplantation and Cellular Therapy, presented findings from a trial comparing a two-drug combination – busulfan and melphalan – for multiple myeloma patients undergoing an autologous stem cell transplant – compared to melphalan alone, the current standard of care. The combination therapy proved safe and patients’ disease did not progress for almost five and a half years, compared with almost three years for those who took melphalan alone. 

Phase II updated findings on newly approved FDA drug acalabrutinib for mantle cell lymphoma

Michael Wang, M.D., professor of Lymphoma and Myeloma, discussed his study of the drug acalabrutinib, which recently received accelerated FDA approval for the treatment of mantle cell lymphoma. Forty percent of patients had a complete response, pointing to acalabrutinib as a promising treatment option.

Phase II study results of combined chemo-immunotherapy in CLL patients 

Nitin Jain, M.B.B.S., assistant professor of Leukemia, reported on a combination chemo-immunotherapy using ibrutinib, fludarabine, cyclophosphamide and obinutuzumab as a targeted therapy in patients with previously untreated chronic lymphocytic leukemia. Forty-six percent of patients achieved a complete response by three months, and 86% had no evidence of disease in the bone marrow within the same time frame.