Top 5 Most-Read Leukemia and Lymphoma Articles for 2020

Variety marks the leading articles in leukemia and lymphoma for the year, with readers favoring news about ibrutinib, the first chimeric antigen receptor (CAR) T-cell therapy in mantle cell lymphoma, and the effect of the pandemic on patients with chronic lymphocytic leukemia. Here are the top articles about leukemia and lymphoma for 2020:

5. MRD Negativity Indicative of Improved OS, DFS in AML, Study Says

This October review article made the case that minimal residual disease (MRD) is increasingly being recognized as an important prognostic marker in several cancers, including acute myeloid leukemia (AML). After evaluating results from more than 11,000 patients across 81 studies, the researchers found that MRD-negative patients had a 5-year overall survival (OS) of 68% while MRD-positive patients had 34% 5-year OS; MRD-negative patients had disease-free survival (DFS) of 64% and MRD-positive patients had DFS of 34% and MRD-positive patients had DFS of 25% at 5 years. Researchers argued that MRD negativity is associated with improved long-term survival and that MRD should be considered as a clinical trial endpoint—and at ASH 2020, several key trials in multiple myeloma featured MRD as an endpoint.

4. Case Report: Ibrutinib Might Protect Against Acute Lung Injury in Patients With CLL, COVID-19

This September report offered guidance to oncologists facing decisions on whether to suspend immunosuppressive therapy due to the risk of coronavirus disease 2019 (COVID-19). Investigators reporting in eJHaem described what happened when they continued ibrutinib (Imbruvica) in a patient who had chronic lymphocytic leukemia. The 77-year-old patient had developed a severe case of COVID-19, but was able to keep taking ibrutinib, and the authors said drug may have helped protect the patient. Initially they stopped ibrutinib, but elected to continue it on the day he was intubated, deciding that BTK inhibition of myeloid immune cells has been shown to reduce or even reverse influenza-mediated acute lung injury. The drug’s effect on T cells could have an effect on viral replication, and it has also been known to block the family of kinases that provoke cytokine response in the lungs. So, they increased the dose, Eventually the patient was discharged; his complex drug regimen makes it hard to say for certain what role ibrutinib played in his care.

3. New Study Offers First Direct Comparison Between Venetoclax, Ibrutinib in CLL

In an environment where patients with relapsing/remitting chronic lymphocytic leukemia (CLL) have a range of new therapeutic options, the study published in February in Haematologica was the first to directly compare 2 of the more prominent new therapies. Ibrutinib is a Bruton tyrosine kinase (BTK) inhibitor targeting B-cell receptor pathway signaling, which the authors note has shown significant benefit as a monotherapy for patients with relapsing CLL.

Venetoclax is a B-cell lymphoma 2 inhibitor is approved for use with or without rituximab. Investigators found 433 patients who received ibrutinib or venetoclax with or without CD20 as NA1. Of those progression-free survival (PFS) data were available for 417 patients. Median follow-up was 14 months for the patients on ibrutinib, and 13.5 months for the patients receiving venetoclax. The primary endpoints of the study were overall response rate (ORR) and PFS. Those on ibrutinib had an ORR of 71% and a PFS rate of 12%. Patients on venetoclax saw an ORR of 96% and a PFS rate of 56%. Discontinuation rates for 41% for ibrutinib and 25% for venetoclax. Venetoclax also had a superior complete response rate, but the advantage did not carry over to overall survival. Authors said that in the absence of randomized data comparing the two approaches, the data offers reassurance that either option remains a reasonable approach as NA1 in [relapsed/refractory] CLL.

2. FDA Approves CAR T-Cell Therapy for Adults With R/R Mantle Cell Lymphoma

In late July, FDA approved the third chimeric antigen receptor (CAR) T-cell therapy, granting a green light for Kite Pharma’s brexucabtagene autoleucel, the first cell-based gene therapy to treat relapsed or refractory mantle cell lymphoma (MCL). Sold as Tecartus, the therapy is indicated for adult patients with MCL who have relapsed or not responded to other treatments. FDA officials said approval was based on a multicenter trial of 60 adults with refractory or relapsed MCL who were followed for at least 6 months after their first objective disease response. The complete remission rate after treatment was 62%, and the objective response rate was 87%. This is the second CAR T-cell therapy approval for Kite Pharma. The company previously received approval for axicabtagene ciloleucel (Yescarta).

1. Age, Recent Treatment Appear to Influence Severity of COVID-19 in Patients With CLL

Patients with chronic lymphocytic leukemia (CLL) who contract coronavirus disease 2019 (COVID-19) face more severe symptoms if they are older, though recent treatment with antileukemic agents appears to help rather than do harm, according to a study that appeared in the journal Leukemia. The study also suggests that the presence of comorbidities does not lead to higher mortality rates. The retrospective analysis was based on 190 patients with CLL who had confirmed COVID-19 cases between late March and late May. The authors, from the Center for Research and Technology Hellas in Greece, added to the emerging consensus that the belief that anti-cancer treatments could hamper the body’s ability to fight off a virus like SARS-CoV-2 is possible but not a straightforward proposition. Therapies that target inflammation have been used and appear to be beneficial, they wrote.