PHARMACOTHERAPY

Novel JAK inhibitors for the treatment of myelofibrosis

BJH - volume 15, issue 4, june 2022

N. Granacher MD

SUMMARY

Myelofibrosis (MF) is a rare Philadelphia chromosome negative myeloproliferative bone marrow disorder characterised by a high symptom burden due to splenomegaly, inflammatory status and cytopenias. Until recently, the only approved and reimbursed pharmacotherapy for non-haematopoietic stem cell transplant candidates in Belgium was ruxolitinib. However, as of September 1st, 2023, the novel JAK (janus kinase) 1/2 inhibitor (JAKi) fedratinib has obtained its reimbursement in second line. The other FDA approved JAKi, momelotinib and pacritinib, play an important role in patient-tailored JAKi treatment but are not yet reimbursed in Belgium.

(BELG J HEMATOL 2024;15(4):165–71)

Read more

Magrolimab: A new weapon against cancer cells

BJH - volume 14, issue 6, october 2023

A. De Voeght MD

SUMMARY

Magrolimab is a first-in-class monoclonal antibody that targets and inhibits CD47, a “don’t eat me” signal overexpressed on the surface of cancer cells that allows them to evade the innate immune response. Blocking CD47 leads to increased recognition and phagocytosis of cancer cells. Since its initial description and promising data in pre-clinical and clinical studies, three phase III studies investigating magrolimab in AML patients are ongoing in Belgium and worldwide.

(BELG J HEMATOL 2023;14(6):250–4)

Read more

Bispecific antibodies for the treatment of lymphomas

BJH - volume 14, issue 2, march 2023

J. Brijs MD, J. Neefs PharmD, A. Janssens MD, PhD

SUMMARY

Lymphomas are the most common haematological malignancy and represent a heterogenous group of lymphoproliferative diseases with a variable prognosis. Chemotherapy and radiotherapy, and anti-CD20 immunotherapy for B-cell lymphomas, currently form the basis of lymphoma treatment. New agents, especially new forms of cancer immunotherapy, such as bispecific antibodies (bsAbs), have expanded therapeutic approaches in the last years. bsAbs have two different antigen binding sites, which enables them to simultaneously target tumour cells and immune effector cells (T-cells). By binding and activating T-cells in the proximity of tumour cells, an effective T-cell mediated anti-tumour response can be achieved. Target antigens in lymphomas are mostly CD19 or CD20 on the malignant B-cell and CD3 on the T-cell. This article will briefly review the basic principles and mechanisms of action of bsAbs, discuss the molecules approved or in advanced clinical development for lymphomas with their most relevant (dose-escalation/dose-expansion) trials, and pay attention to possible adverse events and future perspectives of bsAbs.

(BELG J HEMATOL 2023;14(2):67–72)

Read more

A novel treatment option in chronic myeloid leukaemia: Asciminib

BJH - volume 13, issue 6, october 2022

D. Mazure MD

SUMMARY

Despite the success of tyrosine kinase inhibitors in the treatment of chronic myeloid leukaemia, there are some patients who fail these drugs because of intolerance or lack of efficacy. Asciminib is a first-in-class STAMP-inhibitor (Specifically Targeting the ABL Myristoyl Pocket) and has a different mode of action as the classical tyrosine kinase inhibitors. Clinical trials, most recently the phase III ASCEMBL trial, show clinical activity in heavily pre-treated patients with an acceptable safety profile. Asciminib therefore forms a promising treatment option for those patients failing the currently available drugs.

(BELG J HEMATOL 2022;13(6):243–8)

Read more

Acalabrutinib, a next-generation Bruton’s tyrosine kinase inhibitor

BJH - volume 13, issue 4, june 2022

T. Van Nieuwenhuyse PharmD, A. Janssens MD, PhD

SUMMARY

Bruton’s tyrosine kinase (BTK) inhibitors have demonstrated impressive clinical activity and tolerability in several B-cell malignancies, both as single agent or in combination with anti-CD20 monoclonal antibodies. Acalabrutinib, a next-generation BTK inhibitor, has been reimbursed recently by the Belgian national public health insurance for the treatment of chronic lymphocytic leukaemia (CLL). This review describes mechanism of action, dosage and administration, efficacy, and tolerability.

(BELG J HEMATOL 2022;13(4):156–64)

Read more

The role of venetoclax in the current treatment paradigm for patients with acute myeloid leukaemia

BJH - volume 13, issue 3, may 2022

D.A. Breems MD, PhD

SUMMARY

With the publication of improved survival results of previously untreated patients with acute myeloid leukaemia ineligible for intensive chemotherapy treated with the combination of venetoclax and a hypomethylating agent, the treatment paradigm for patients with AML has been changed. This paper discusses the past, present and future of AML therapy with venetoclax.

(BELG J HEMATOL 2022;13(3):124–7)

Read more

Bispecific antibodies: New hope in multiple myeloma

BJH - volume 13, issue 2, march 2022

M. Vercruyssen MD

SUMMARY

Multiple myeloma is the second most common haematological cancer in adults, reaching 1.8% of all neoplasms. Despite a dramatic improvement in the treatment, multiple myeloma is still an incurable disease with a median overall survival of five years. Therefore, new therapeutic approaches are needed to further improve outcomes, especially for high-risk myeloma that are often refractory, rapidly relapsing, and/or harbouring more aggressive features. Bispecific antibodies simultaneously target tumour cells and patient’s own effector immune cells, activating the latter close to the former leading to the killing of myeloma cells. Various targets on myeloma cells have been selected and are now part of clinical trials with very promising results. This review reports the latest data of the main ongoing studies and proposes a place for this new treatment in the large armamentarium against multiple myeloma.

(BELG J HEMATOL 2022;13(2):81–3)

Read more