CONGRESS NEWS

Immunotherapy: a new era in the management of lymphoma and multiple myeloma?

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Harnessing the body’s own immune system to fight cancer has long been a dream. After decades of disappointments, the tide has recently changed due to the success of recent proof-of-concept clinical trials. Most notably have been the advances made with CTLA4 and PD-1 inhibition in patients with advanced melanoma. These findings formed the spark for a flood of clinical trials evaluating a plethora of immunotherapeutic agents in all imaginable tumor types. During the 2015 annual meeting of the European Hematology Association, Bristol-Myers Squibb organized a satellite symposium assessing the potential of immunotherapy in the treatment of lymphoma and multiple myeloma.

(BELG J HEMATOL 2015;6(3): 108–10)

Nivolumab is safe and effective in patients with relapsed/refractory lymphoid malignancies and classical Hodgkin lymphoma

(BELG J HEMATOL 2015;6(3):111–2)

Multiple myeloma is different in elderly patients

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With a median age of approximately 70 years, multiple myeloma is a disease of the elderly. However, there are age-related differences in the frequency of early cytogenetic events, bone marrow microenvironment and immune system, as Niels van de Donk, MD, PhD (VU Medical Centre, Amsterdam) pointed out at the 2015 annual EHA meeting in Vienna.

(BELG J HEMATOL 2015;6(3):113

Adding elotuzumab to standard treatment for multiple myeloma delays disease progression

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Elotuzumab is a humanized antibody directed against signaling lymphocytic activation F7 (SLAMF7), a molecule that is selectively expressed on myeloma and natural killer (NK) cells but not on normal tissues. As a result, elotuzumab has a twofold mechanism: it enhances NK-cell activation directly via SLAMF7 and indirectly via CD16, and it induces targeted killing of SLAMF7-positive myeloma cells by antibody-dependent cellular cytotoxicity. In theory, these two effects collectively enable killing of myeloma cells without collateral damage to normal cells.^1–3 In an open-label, phase 1b/2 study, the combination of elotuzumab with len-dex resulted in high response rates and promising PFS findings. This formed the basis for the open-label, international, randomized, multicenter, phase III ELOQUENT-2 study, randomizing 646 patients with relapsed-refractory multiple myeloma (RRMM) who received 1–3 prior treatment lines to elotuzumab plus len-dex, or len-dex alone. The co-primary endpoints of the study were PFS and overall response rate (ORR), while OS, duration of response, quality of life and safety were secondary objectives.^4,5 The PFS and response data of this study were presented during the plenary session of the 2015 annual meeting of the European Hematology Association (EHA).

(BELG J HEMATOL 2015;6(3):114–5)

Carfilzomib-dexamethasone: a new ‘best in class’ in multiple myeloma

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While survival times have increased over the last decade, most patients with multiple myeloma eventually relapse and become refractory to therapy. The treatment of patients with relapsed and/or refractory multiple myeloma is frequently further complicated by the presence of pre-existing comorbidities that arise from an advanced disease state and toxicities stemming from prior anti-myeloma treatment. The advent of second-generation immunomodulatory drugs like pomalidomide and more recently, the second-generation proteasome inhibitor carfilzomib, have the potential to improve the outcome of these patients. During the 2015 annual meeting of the European Hematology Association (EHA), results of the phase III ENDEAVOR study, assessing the combination of carfilzomib with dexamethasone were presented.

(BELG J HEMATOL 2015;6(3):116–7)

Luspatercept increases hemoglobin and decreases the transfusion need in patients with low-, and intermediate-1 myelodysplastic syndrome

(BELG J HEMATOL 2015;6(3):118)

JAK2 inhibitor pacritinib significantly benefits patient reported outcomes in myelofibrosis

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The PERSIST-1 trial compares best available treatment (BAT) with the JAK2 inhibitor pacritinib in patients with myelofibrosis. During the 2015 EHA meeting in Vienna, Dr. Ruben Mesa (Mayo Clinic, Scottsdale, Arizona, US) presented the patient reported outcomes of this trial.

(BELG J HEMATOL 2015;6(3):119–20)