February 2018, Vol 9, No 1 | Payers' Perspectives In Oncology: ASH 2017 Highlights

Atlanta, GA—Venetoclax (Venclexta) plus rituximab (Rituxan) achieved superior progression-free survival (PFS) and overall survival (OS) compared with standard-of-care bendamustine (Treanda/Bendeka) plus rituximab in patients with relapsed or refractory chronic lymphocytic leukemia (CLL). PFS improved by 81% and OS by 52% with venetoclax plus rituximab, and the depth of response was impressive—complete response and complete response with incomplete platelet recovery was 26.8%, and minimal residual disease negativity in peripheral blood was 83.5%.
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Atlanta, GA—More than 90% of patients with relapsed or refractory chronic lymphocytic leukemia (CLL) achieved objective responses with the new Bruton’s tyrosine kinase (BTK) inhibitor acalabrutinib (Calquence), updated data from an ongoing study showed. In most cases, the responses were durable, reported John C. Byrd, MD, Director, Division of Hematology, the Ohio State University Comprehensive Cancer Center, Columbus, at ASH 2017.
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Atlanta, GA—The past few years have witnessed significant progress in the treatment of several hematologic malignancies, and truly paradigm-changing therapies have recently emerged in acute lymphoblastic leukemia (ALL). At ASH 2017, Crystal L. Mackall, MD, Co-Director, Immunology & Immunotherapy of Cancer Program, Stanford University, CA, discussed the FDA approvals of 2 important treatments for patients with B-cell precursor ALL.
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Atlanta, GA—Ibrutinib (Imbruvica) plus venetoclax (Venclexta) led to an objective response rate of 100% in patients with relapsed or refractory chronic lymphocytic leukemia (CLL), with 47% in complete remission at 6 months. These high response rates were achieved with only 1 case of laboratory tumor lysis syndrome, said Peter Hillmen, MBChB, PhD, FRCP, FRCPath, Leader, Section of Experimental Haematology, Leeds Institute of Cancer and Pathology, United Kingdom, at ASH 2017.
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Atlanta, GA—A pair of recent studies from the Mayo Clinic underscore the serious symptom burden experienced by patients diagnosed with myeloproliferative neoplasms (MPNs), according to data presented at ASH 2017. Specifically, patients with MPNs are at high risk for depression, and those with Philadelphia chromosome–negative disease are afflicted with sleep and psychiatric disturbance as well.
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The combination of fludarabine, cyclophosphamide, and rituximab (FCR) has been the standard first-line treatment for young patients with chronic lymphocytic leukemia (CLL), with a complete remission (CR) rate after 6 cycles of 40% to 72%, and an undetectable bone marrow (BM) minimal residual disease (MRD) rate after 6 cycles of 43% to 58%.
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In patients with mantle-cell lymphoma (MCL), adverse events (AEs) can impair patient adherence to planned therapeutic regimens, and moderate-to-severe AEs generally require medical attention and are often associated with increased healthcare resource use (HRU) and costs. At ASH 2017, the authors presented the results of a retrospective cohort analysis designed to assess HRU and direct costs of MCL, examine variation in costs across treatment types, and document the economic burden associated with MCL treatment-related AEs.
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Ibrutinib (ibr) is a first-in-class oral inhibitor of Bruton’s tyrosine kinase approved for relapsed/refractory (R/R) mantle-cell lymphoma (MCL). The results of a pooled analysis of 370 patients with R/R MCL treated with ibr in the SPARK, RAY, and PCYC-1104 studies were previously reported (median follow-up, 24 months). At ASH 2017, the authors presented median 3.5-year follow-up in these patients, including additional exposure and follow-up of 87 patients across the 3 studies who enrolled in the long-term access study, CAN3001.
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ZUMA-1 is a pivotal, multicenter trial of axicabtagene ciloleucel (axi-cel), an autologous anti-CD19 chimeric antigen receptor (CAR) T-cell therapy, for the treatment of patients with refractory, aggressive non-Hodgkin lymphoma (NHL). The objective response rate (ORR) was 82% with a 54% rate of complete response (CR), and 44% of responses were ongoing at the time of the primary analysis. Grade ≥3 cytokine release syndrome (CRS) and neurologic events (NEs) occurred in 13% and 28% of patients, respectively.
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Brentuximab vedotin (BV), an antibody drug conjugate, selectively delivers the antitubulin agent, monomethyl auristatin E, to CD30+ cells. In a multicenter phase 2 trial in patients with relapsed/refractory (R/R) Hodgkin lymphoma (HL), BV showed an overall response rate (ORR) of 75%, a complete response (CR) rate of 34%, and a median duration of response (DOR) of 6.7 months.
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