SPECIALS

Towards a chemotherapy-free future for patients with follicular lymphoma

Follicular lymphoma (FL) is the most common B-cell non-Hodgkin lymphoma (NHL) and typically follows an indolent disease course. While some patients do not require treatment until certain criteria are met, others may progress to an aggressive lymphoma phenotype requiring a different treatment approach. The current standard initial treatment for FL consists of chemo-immunotherapy in which cytotoxic chemotherapy is combined with an anti-CD20 antibody. In general, this treatment strategy is highly effective, significantly delaying disease progression and postponing the need for additional therapy for many years. However, a proportion of patients may experience chemotherapy-related toxicities, while others prove to be chemotherapy-refractory. For these patients, an effective chemotherapy-free treatment approach is sought. This article provides a concise overview of the mechanisms of action of potential targeted therapies for FL and briefly discusses the available clinical trial data.¹

Expanding the therapeutic armamentarium in relapsed/refractory Diffuse Large B-cell Lymphoma

In recent years, the treatment landscape of patients with relapsed or refractory diffuse-large B-cell lymphoma (R/R DLBCL) has changed dramatically. This mini review will briefly discuss the clinical trial data that were obtained with these different options.

Medical need for patients with resistance to covalent Bruton tyrosine kinase inhibitors

Bruton tyrosine kinase inhibitors (BTKis) have revolutionised the treatment landscape for patients with chronic lymphocytic leukaemia (CLL) and several non-Hodgkin lymphoma (NHL) subtypes, including mantle cell lymphoma (MCL). Despite the efficacy of covalent BTKis (cBTKis), the development of resistance mutations leads to poor outcomes in patients who relapse after a cBTKi-based therapy. Non-covalent BTKis (ncBTKis), such as pirtobrutinib, have a different mode of action than cBTKis allowing them to overcome this acquired resistance. In recent years, several clinical trials have yielded promising results with pirtobrutinib and other ncBTKis in patients progressing on a cBTKi. This article zooms in on the unmet clinical needs of cBTKi-resistant patients, exploring pivotal findings from clinical trials assessing pirtobrutinib in this context, alongside other prospective strategies.

Fixed-duration therapies for CLL

Chemoimmunotherapy (CIT) has been the long-standing cornerstone of the first line treatment for patients with chronic lymphocytic leukaemia (CLL). More recently, however, continuous treatment with Bruton’s tyrosine kinase inhibitors (BTKis) emerged as a new standard of care frontline treatment for the majority of CLL patients. However, the continuous nature of this treatment modality is associated with a considerable treatment burden, long-term toxicity and potential clonal selection. Therefore, research efforts have focused on the development of new, time-limited and chemotherapy-free first line treatment regimens for patients with CLL.¹ In this mini review, the main clinical trial results with these different fixed-duration regimens are summarised.

PHARMA NEWS

In this section, we cover the recent EMA approval of zanubrutinib for multiple indications, explore the promising outcomes of fixed-duration ibrutinib + venetoclax in untreated CLL/SLL patients and delve into the long-term benefits of acalabrutinib in first-line CLL treatment. Additionally, we report the approval of Pirtobrutinib (Jaypirca®) for relapsed/refractory mantle cell lymphoma, and the emergence of axicabtagene ciloleucel as the new standard of care for second-line treatment in DLBCL patients.

Stay informed with the latest developments and dive into our Pharma News section!

Moving from salvage chemotherapy to immunotherapy in patients with B-cell acute lymphoblastic leukemia

About half of the adult patients with acute B-cell lymphoblastic leukemia (B-ALL) who do not achieve a molecular complete remission or who subsequently relapse cannot be cured with the current chemotherapy or targeted agents. In recent years, however, we have witnessed the emergence of different immune-based therapies in this setting. This includes monoclonal antibodies, bispecific T-cell engagers (BiTEs), antibodydrug conjugates (ADCs), and chimeric antigen receptor T-cells (CARs).

Real-world evidence in the treatment of high-risk acute myeloid leukemia

Based on the results of the phase III Study 301, Vyxeos Liposomal was approved in Europe in 2018 for the treatment of adult patients with newly diagnosed therapy-related acute myeloid leukaemia (AML) and AML with myelodysplasia-related changes. Since then, various real-world studies have assessed the safety and efficacy of this drug in routine clinical practice. The real-world evidence that was obtained not only supports the results from the clinical trial but also addresses an important data gap in terms of the achievement of minimal residual disease (MRD) negativity. Below we summarize the real-world experience with Vyxeos Liposomal in patients with high-risk AML.