Onco-hematology
RCT | Early oral antibiotic switch in low-risk neutropenic sepsis shows mixed results
3 Aug, 2023 | 13:15h | UTC
Phase 1 Trial | NI006 shows potential for cardiac amyloid depletion in transthyretin amyloid cardiomyopathy
1 Aug, 2023 | 14:17h | UTCPhase 1 Trial of Antibody NI006 for Depletion of Cardiac Transthyretin Amyloid – New England Journal of Medicine (link to abstract – $ for full-text)
Commentaries:
Amyloid Removal Looks Possible in ATTR Cardiomyopathy Imaging Trial – TCTMD
Antibody NI006 for Depletion of Cardiac Transthyretin Amyloid – American College of cardiology
Phase 1–2 study | Liso-cel shows effectiveness against resistant CLL/SLL post BTK inhibitor, venetoclax treatment
20 Jul, 2023 | 10:58h | UTCLisocabtagene maraleucel in chronic lymphocytic leukaemia and small lymphocytic lymphoma (TRANSCEND CLL 004): a multicentre, open-label, single-arm, phase 1–2 study – The Lancet (link to abstract – $ for full-text)
News Release: Immunotherapy Improves Remission for Relapsed, Refractory Leukemia – Northwestern Medicine
Review | Guiding the use of invasive cardiac interventions in patients with advanced malignancies
17 Jul, 2023 | 13:23h | UTC
Clinical Trial Update | 5-year follow-up validates efficacy of sorafenib maintenance in FLT3-ITD AML
11 Jul, 2023 | 13:37h | UTCSorafenib maintenance after allogeneic haemopoietic stem-cell transplantation in patients with FLT3-ITD acute myeloid leukaemia: long-term follow-up of an open-label, multicentre, randomised, phase 3 trial – The Lancet Haematology (link to abstract – $ for full-text)
Commentary on Twitter
NEW: with over 5 years of follow-up, sorafenib maintenance is associated with improved outcomes compared w/ non-maintenance in patients w/ FLT3-ITD AML undergoing allogeneic HSCT in a multicentre, randomised, ph 3 trial #leusm #bmtsm https://t.co/JK190vS0Ql pic.twitter.com/SBP887hgEu
— The Lancet Haematology (@TheLancetHaem) July 5, 2023
Single-arm study | Pirtobrutinib exhibits efficacy in CLL patients after failure of covalent BTK inhibitor treatment
7 Jul, 2023 | 16:14h | UTCPirtobrutinib after a Covalent BTK Inhibitor in Chronic Lymphocytic Leukemia – New England Journal of Medicine (link to abstract – $ for full-text)
News release from the manufacturer: New England Journal of Medicine Publishes BRUIN Phase 1/2 Trial Data for Pirtobrutinib in BTK Inhibitor Pre-Treated Adult Patients with Chronic Lymphocytic Leukemia or Small Lymphocytic Lymphoma – Lilly
Myelodysplastic syndromes: 2023 update on diagnosis, risk-stratification, and management
5 Jul, 2023 | 01:00h | UTC
SR | Polyclonal anti‐thymocyte globulins for the prophylaxis of GVHD after allogeneic stem cell or bone marrow transplantation
3 Jul, 2023 | 14:16h | UTC
RCT | Luspatercept outperforms epoetin alfa in interim analysis, shows promise for lower-risk myelodysplastic syndromes
30 Jun, 2023 | 14:42h | UTCEfficacy and safety of luspatercept versus epoetin alfa in erythropoiesis-stimulating agent-naive, transfusion-dependent, lower-risk myelodysplastic syndromes (COMMANDS): interim analysis of a phase 3, open-label, randomised controlled trial – The Lancet (link to abstract – $ for full-text)
RCT | Cyclophosphamide-based regimen enhances GVHD-free survival after hematopoietic stem-cell transplantation
27 Jun, 2023 | 13:54h | UTCSummary: The article details a phase 3 trial comparing the efficacy of two graft-versus-host disease (GVHD) prophylactic regimens in hematologic cancer patients undergoing allogeneic hematopoietic stem-cell transplantation (HSCT). The experimental group received cyclophosphamide–tacrolimus–mycophenolate mofetil, and the standard group received tacrolimus–methotrexate. The patients, a total of 431, underwent HSCT from an HLA-matched related donor or a matched or 7/8 mismatched unrelated donor.
The primary end point was GVHD-free, relapse-free survival at 1 year. Results indicated a significantly higher incidence of this outcome in the experimental group (hazard ratio, 0.64; 95% confidence interval [CI], 0.49 to 0.83; P=0.001). At 1 year, adjusted GVHD-free, relapse-free survival was 52.7% (95% CI, 45.8 to 59.2) in the experimental group, compared to 34.9% (95% CI, 28.6 to 41.3) in the standard group.
Notably, patients in the experimental-prophylaxis group appeared to have less severe acute or chronic GVHD and a higher incidence of immunosuppression-free survival at 1 year. Overall survival, disease-free survival, relapse, transplantation-related death, and engraftment did not show a substantial difference between the groups. These results suggest that cyclophosphamide–tacrolimus–mycophenolate mofetil may offer a more effective prophylaxis against GVHD in HSCT patients.
Article: Post-Transplantation Cyclophosphamide-Based Graft-versus-Host Disease Prophylaxis – New England Journal of Medicine (link to abstract – $ for full-text)
News Release: Study Sets New Standard for Graft-Versus-Host Disease Prevention After Stem Cell Transplant – Johns Hopkins Medicine
Commentary on Twitter
In this trial, 1-year GVHD-free, relapse-free survival after stem-cell transplantation was 52.7% in the cyclophosphamide–tacrolimus–mycophenolate mofetil group and 34.9% in the tacrolimus–methotrexate group. https://t.co/wCdvP1LChu
— NEJM (@NEJM) June 21, 2023
Consensus Paper | Primary prophylaxis of invasive fungal diseases in patients with hematological malignancies
23 Jun, 2023 | 13:23h | UTC
Consensus Paper | Management of febrile neutropenia in pediatric hematology and oncology patients
20 Jun, 2023 | 12:38h | UTC
Review | Updates in immunohistochemistry for hematopoietic and lymphoid neoplasms
20 Jun, 2023 | 12:36h | UTC
RCT | Avapritinib superior to placebo in reducing symptoms, mast-cell burden in indolent systemic mastocytosis patients
20 Jun, 2023 | 12:34h | UTCAvapritinib versus Placebo in Indolent Systemic Mastocytosis – NEJM Evidence
Commentary on Twitter
“…in this 24-week blinded phase of the PIONEER trial, avapritinib demonstrated superiority to placebo in improving symptoms in patients with moderate to severe symptomatic ISM [indolent systemic mastocytosis]….”#Oncology #ClinicalTrials @StanfordDeptMed @ProfMaurer
— NEJM Evidence (@NEJMEvidence) June 15, 2023
Review | Antifungal stewardship interventions in patients with hematologic malignancies
16 Jun, 2023 | 13:47h | UTCAntifungal Stewardship Interventions in Patients with Hematologic Malignancies
RCT | Second-line treatment with Axi-cel results in increased overall survival in large B-cell lymphoma
14 Jun, 2023 | 14:25h | UTCSurvival with Axicabtagene Ciloleucel in Large B-Cell Lymphoma – New England Journal of Medicine (link to abstract – $ for full-text)
Commentary on Twitter
Late breaking at #ASCO23: In the phase 3 ZUMA-7 trial, patients with relapsed or refractory large B-cell lymphoma who received axi-cel (CD19-specific CAR T cells) had a 27.4% lower risk of death than patients who received standard therapy. Full trial results:
— NEJM (@NEJM) June 5, 2023
RCT | Cilta-cel shows superior progression-free survival over standard care in lenalidomide-refractory multiple myeloma
14 Jun, 2023 | 14:22h | UTCCilta-cel or Standard Care in Lenalidomide-Refractory Multiple Myeloma – New England Journal of Medicine (link to abstract – $ for full-text)
Commentary on Twitter
Original Article: Cilta-cel or Standard Care in Lenalidomide-Refractory Multiple Myeloma (CARTITUDE-4) https://t.co/Wag2UTKOfH#ASCO23
— NEJM (@NEJM) June 6, 2023
Review | Acute graft-versus-host disease
14 Jun, 2023 | 14:20h | UTCAcute graft-versus-host disease – Nature Reviews Disease Primers (if the link is paywalled, try this one)
Commentary on Twitter
Tissue damage resulting from allogenic hematopoietic cell transplantation conditioning regimens triggers cellular interactions and #inflammatory cascades that lead to acute #GraftVersusHost disease symptoms https://t.co/iHyUVoV75J pic.twitter.com/ob9X7zQWB8
— Nature Reviews Disease Primers (@DiseasePrimers) June 11, 2023
RCT | Noninferiority shown between DOACs and LMWH for recurrent VTE prevention in cancer patients
5 Jun, 2023 | 13:50h | UTCSummary: This unblinded, pragmatic, noninferiority randomized clinical trial aimed to assess the efficacy of direct oral anticoagulants (DOACs) against low-molecular-weight heparin (LMWH) in preventing recurrent venous thromboembolism (VTE) in patients with cancer. The study included 671 patients from 67 oncology centers, with a new clinical or radiological diagnosis of VTE.
Participants were randomly assigned to receive either a DOAC or LMWH for 6 months, and treating physicians selected and prescribed the drugs based on considerations like availability and drug-drug interactions. The primary outcome was the rate of recurrent VTE at 6 months. Findings revealed that the DOAC group had a recurrent VTE rate of 6.1% as compared to 8.8% in the LMWH group, showing noninferiority. Both groups had statistically similar rates of major bleeding and severe adverse events.
This pragmatic study included patients with advanced cancer and brain metastases, impaired performance status, and reduced liver or kidney function, making it more representative of routine oncology practice. Moreover, patient adherence to DOAC treatment was significantly higher than to LMWH. Nevertheless, the study had limitations, including the lack of blinding and underrepresentation of certain racial and ethnic groups.
In conclusion, this trial suggests that DOACs were noninferior to LMWH for preventing recurrent VTE in patients with cancer over a 6-month follow-up period, supporting the use of DOACs in this population for VTE prevention. Further research is needed to confirm these results and investigate long-term outcomes.
Article: Direct Oral Anticoagulants vs Low-Molecular-Weight Heparin and Recurrent VTE in Patients With Cancer: A Randomized Clinical Trial – JAMA (free for a limited period)
See also: Visual abstract
Commentary on Twitter
Among adults with cancer and VTE, direct oral anticoagulants were noninferior to low-molecular-weight heparin for preventing recurrent VTE over 6-month follow-up. #ASCO23 https://t.co/DP5RvlSYxe pic.twitter.com/rBJ99plopK
— JAMA (@JAMA_current) June 2, 2023
Review | Prevention of venous thromboembolism in patients with cancer
5 Jun, 2023 | 13:48h | UTCPrevention of venous thromboembolism in patients with cancer – The BMJ
Cardiac toxicities in multiple myeloma: an updated and a deeper look into the effect of different medications and novel therapies
1 Jun, 2023 | 11:48h | UTC
RCT | Ruxolitinib achieves greater molecular response and EFS in hydroxycarbamide-resistant Polycythemia Vera
22 May, 2023 | 13:35h | UTCCommentary: Ruxolitinib Appears to Yields Superior Responses in Polycythemia Vera Subtype – Cancer Network
RCT | Superior progression-free survival with Venetoclax-based regimens in first-line CLL treatment
22 May, 2023 | 13:32h | UTCFirst-Line Venetoclax Combinations in Chronic Lymphocytic Leukemia – New England Journal of Medicine (link to abstract – $ for full-text)
Commentary: First-Line Venetoclax Combinations vs Chemoimmunotherapy in Fit Patients With CLL – The ASCO Post
Commentary on Twitter
Venetoclax with obinutuzumab or rituximab as first-line treatment for pts with CLL & coexisting conditions has resulted in a large percentage of pts with undetectable minimal residual disease & long progression-free survival.
Read the Research Summary: https://t.co/2i45QN55Hz
— NEJM (@NEJM) May 14, 2023
RCT | The addition of Quizartinib to chemotherapy improves overall survival vs placebo in FLT3-ITD-positive AML patients
18 May, 2023 | 13:40h | UTCQuizartinib plus chemotherapy in newly diagnosed patients with FLT3-internal-tandem-duplication-positive acute myeloid leukaemia (QuANTUM-First): a randomised, double-blind, placebo-controlled, phase 3 trial – The Lancet (link to abstract – $ for full-text)
Commentary on Twitter (thread – click for more)
Acute myeloid leukaemia (AML) is a genetically heterogeneous disease with poor clinical outcomes.
A new study assessed the effect of quizartinib on overall survival in patients with FLT3-ITD-positive newly diagnosed AML, in addition to chemotherapy. https://t.co/MGOoVF5QOa
— The Lancet (@TheLancet) April 27, 2023
Phase 2 RCT | Ropeginterferon shows better results in hematocrit control vs phlebotomy alone in patients withr polycythemia vera
18 May, 2023 | 13:37h | UTCRopeginterferon versus Standard Therapy for Low-Risk Patients with Polycythemia Vera – NEJM Evidence