Novel targeted therapies are currently being used to improve outcomes and quality of life for patients with advanced and difficult-to-treat hematologic malignancies, according to multiple studies presented at the 59th American Society of Hematology (ASH) Annual Meeting and Exposition (December 10, 2012; Atlanta, GA).
In a multinational, phase III trial, researchers led by Joseph M Connors, MD, clinical director, British Columbia Cancer Agency Centre for Lymphoid Cancer (Vancouver, Canada), assessed the efficacy of a multi-targeted regimen involving brentuximab vedotin in patients with advanced Hodgkin lymphoma. A total of 1334 patients with previously untreated advanced disease were randomly assigned to receive either doxorubicin, bleomycin, vinblastine, and dacarbazine (ABVD) or brentuximab vedotin plus doxorubicin, vinblastine, and dacarbazine (AVD), with up to 50 months of follow-up care.
Dr Connors and colleagues found that patients in the brentuximab vedotin arm had a 23% reduced risk of disease progression, death, or need for additional and intensive therapy. Furthermore, the brentuximab vedotin regimen did not escalate toxicity, thus representing the first successful regimen in over 30 years to improve outcomes in the first-line setting without increasing toxicity of patients with advanced Hodgkin lymphoma.
“The experimental combination with brentuximab vedotin more frequently got rid of all of the disease, and this was achieved with acceptable levels of adverse effects,” Dr Connors noted in a press briefing early Sunday morning. “Treatment with brentuximab vedotin was modestly more toxic, but when we added simple measures to improve patients’ blood counts, they were able to take it safely.”
Another phase III trial demonstrated the positive effects of a novel combination regimen in previously treated chronic lymphocytic leukemia (CLL). Peter Hillmen, MBChB, PhD, Leeds Institute of Cancer and Pathology (United Kingdom), and colleagues enrolled 50 patients with CLL that had relapsed or had not responded to prior treatment to receive eight weeks of ibrutinib followed by low-dose venetoclax.
Among the 36 patients who completed six months of this combination regimen, all demonstrated some level of response and 33% achieved deep remission, without any observable increases in the occurrence of tumor lysis syndrome. Safety and detectable disease data will be reported at a later time.
“These initial results are particularly impressive in a patient population for whom previous therapies have failed,” Dr Hillmen commented in his press briefing (December 10, 2017). “We have shown that the two drugs can be given in combination without obvious additional toxicity, and the inability to detect disease with the most sensitive tools we have is a very good sign that the combination is proving to be an effective treatment.”
These studies—along with a few other studies detailing investigational drugs leading to positive outcome and quality of life improvements in patients with hematologic malignancies—are a testament to the importance of further research regarding hematologic malignancies on a molecular level. “These studies illustrate how better scientific understanding of what drives cancer at the molecular level is leading to novel therapies capable of keeping patients’ cancers in check for extended periods of time, while also helping them achieve better quality of life,” said Laurie Sehn, MD, press briefing moderator and medical oncologist, British Columbia Cancer Agency (Canada).—Zachary Bessette