ASH 2017 - CLL

The combination of brentuximab vedotin and ibrutinib was well-tolerated and resulted in an overall response rate of 69%, a complete response rate of 46%, and a disease control rate of 100% in patients with relapsed/refractory Hodgkin lymphoma.
In a cost-effectiveness and cost-utility analysis of ibrutinib versus allogeneic hematopoietic stem-cell transplantation (HSCT) in patients with relapsed/refractory CLL with del(17p), ibrutinib provides significantly greater clinical and economic value over the first 3 years of treatment, but the benefit declines beyond 3 years.
In an update of the phase 1/2 ACE-CL-001 study, patients with relapsed/refractory chronic lymphocytic leukemia (CLL)/small lymphocytic lymphoma treated with acalabrutinib monotherapy demonstrated high response rates (overall response, 85%; 18-month duration of response, 85%; 18-month progression-free survival, 88%), with an acceptable safety profile.
In a 1-year follow-up of the ZUMA-1 study, axicabtagene ciloleucel (axi-cel; anti-CD19 CAR T) demonstrated significant clinical benefit with manageable adverse events in patients with refractory, aggressive non-Hodgkin lymphoma (NHL) and no curative treatment options, but loss of CD19 and gain of PD-L1 expression in tumors were identified as possible mechanisms of resistance following axi-cel treatment.
The combination of ibrutinib plus nivolumab in patients with relapsed/refractory chronic lymphocytic leukemia (CLL)/small lymphocytic lymphoma, follicular lymphoma, and diffuse large B-cell lymphoma was safe but not more effective than ibrutinib alone. It did, however, demonstrate superior efficacy in patients with Richter’s transformation, although the study did not select patients with elevated PD-L1 levels.
Single-agent ibrutinib is associated with longer progression-free survival and a generally more favorable safety profile than chemoimmunotherapy in patients with treatment-naïve chronic lymphocytic leukemia (CLL).
In the RESONATE-2 study, treatment of older patients with chronic lymphocytic leukemia (CLL)/small lymphocytic leukemia resulted in significantly improved patient-reported outcomes (PROs), disease burden, quality of life, medical resource utilization, and quality-adjusted survival time compared with those treated with chlorambucil.
In a pooled analysis of 370 patients with relapsed/refractory mantle-cell lymphoma, treatment with ibrutinib for a median follow-up of 3.5 years resulted in 26% being progression-free and 45% still alive, with manageable toxicity.
When used in first-cycle therapy for chronic lymphocytic leukemia (CLL), rates of resource utilization and total costs of care were significantly lower for ibrutinib than for chemotherapy or chemoimmunotherapy, with ibrutinib-treated patients having lower emergency department and inpatient costs per month and less frequent office and outpatient visits than patients treated with chemotherapy or chemoimmunotherapy.
In patients with relapsed/refractory, aggressive non-Hodgkin lymphoma (NHL), use of prophylactic tocilizumab may reduce the incidence of severe cytokine release syndrome but not neurologic events in patients treated with chimeric antigen receptor T-cell therapy.
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