Lymphoma Famous Commentary - The Latest Poster Interpretation of eHA Conference MCL.

Influenced by the covid-19 epidemic situation, the 25th European annual meeting of Hematology (EHA) was held online from June 11 to 21, 2020 for the first time.as the largest international conference in the field of Hematology in Europe, what achievements in lymphoma research will be presented in this year's EHA annual meeting? In this video, we have the honor to invite Professor Cai Qingqing from the Cancer Hospital of Sun Yat sen University to give a detailed interpretation of ibutilib's two poster Abstract ep689 and S228 studies.[Abstract: ep689] long term results of ibutilib in a phase I / IB study of infectious in combination with umbralisib in patients with relapsing / reconstructing CLL or MCL by Matthew Davids, Methods patients in the initial cohort were given ibutilib (420 mg CLL, 560 mg MCL) and umbralisib daily starting from 400 mg daily in the initial cohort, and were increased to 600 mg and 800 mg cohort by standard 3 + 3 design.the patient continued treatment with both drugs until the disease progressed or intolerable toxicity occurred.inclusion criteria: ≥ 1 previous treatment, treatment according to 2008 iwcll standard, ECoG PS ≤ 2, good hematology and organ function.previous use of BTK or PI3K inhibitors is permitted.in this ongoing study (nct02268851), CTCAE V4 and iwcll criteria were used to evaluate toxicity and efficacy.results 42 patients received treatment, 21 patients with CLL and 21 patients with MCL.the median age at admission was 68 years (range, 48-85 years).patients with both histologic types had previously received a median number of 2 lines of treatment (range 1-6, including 4 patients with previous ibutilinib treatment and 4 patients with CLL treated with PI3K inhibitors). Inpatients with CLL, 19% had del (17p) or TP53 mut, and 68% had no IGHV mutation.six MCL patients had received autosct before, and one patient had TP53 mutation.as previously reported, the recommended dose for stage II umbralisib is 800 mgqd when administered with a standard dose of ibuprotinib.as of February 8, 2020, the median follow-up time for survivors is 43.5 months (range, 8.4-61).no cumulative toxicity or repeated delayed toxicity was observed, including no new onset of atrial fibrillation (still 10%) and no grade 3 / 4 bleeding events.only one patient developed new hypertension (update rate was 14%).the incidence of increased transaminase inflammation increased from 24% to 38%, but all of these events were level 1 events except for the single level 3 event previously reported. no other new immune-mediated toxicity was found. The cumulative rate of grade 3 diarrhea was 7%. There was no colitis or grade 4 diarrhea. the other two cases of SAE: one patient was admitted to hospital with grade 2 gastroduodenal ulcer but his condition was controllable. One patient with CLL who had previously received FCR treatment achieved radiologic Cr and was diagnosed as grade 4 MDS about 3 years after the start of the study. in the updated efficacy analysis, the best orr of CLL and MCL increased to 95% and 71%, respectively. The optimal CR rate of CLL was still 29%, and MCL was increased to 24%. The median dor of CLL was 19.4 months. the duration of remission (A: CLL, B: MCL) is described histologically. in CLL, the median PFS and OS were not yet reached; the 4-year PFS and OS were estimated to be 78% and 90%, respectively. There was no difference in the efficacy of IGHV mutation. in MCL, the median PFS and OS were 10.8 months and 30.7 months, respectively. conclusion through long-term follow-up, ibutilinib combined with umbralisib continued to show good tolerance. In R / R CLL patients, PFS and OS were 78% and 90% respectively, which were similar to the expected efficacy of ibutilinib monotherapy in MCL. this combination therapy needs further study, especially in CLL patients receiving Btk inhibitors for the first time, including those who are intolerant or progressive to the venetoclax based regimen. [Abstract: S228] ibutinib, venetoclax combined with obinutuzumab in the treatment of newly diagnosed mantle cell lymphoma has good safety and high efficacy at the molecular level. It is the first clinical trial of the combination of three drugs as the first-line treatment of MCL. ibrutinib, venetoclax plus obiutuzumab in new diagnosed mantle cell lymphana patients by Steven Le goull, et al. ibutinib was administered at 560 mg / day from c1d2 until PD. the dose of venetoclax was 400 mg starting from C1 bis (to avoid tumor lysis syndrome [TLS]): C1 bis w1-20mg, C1 bis w2-50mg, C1 bis w3-100mg, C1 bis w4-200mg; c2-c23 400mg. responses were assessed at cycles 2, 4 and 6, and remission was assessed at cycle 6. at the end of cycle 3 and 6, MRD in blood and / or bone marrow was detected, and DLT (dose limiting toxicity) was evaluated 3 months before treatment. the results of the study included 15 untreated MCL patients. the median age was 65 years. Mipi score was 9,5,1 in high-risk group and low-risk group respectively. TP53 mutation and lghv mutation were found in 2 cases. grade 3-4 non hematological and hematological AE were 4 and 2 cases respectively. at the end of cycle 2, all patients had remission (including 8 Cr / UCR). at the end of the third cycle, all 12 cases were negative for MRD. 14 patients completed 6 cycles of treatment, 11 patients achieved CR and MRD negative, including patients with TP53 mutation. conclusion ibutilib, venetoclax combined with obinutuzumab in the treatment of newly diagnosed MCL patients has very good safety, and shows extremely high efficacy at the molecular level. Professor Cai Qingqing, doctoral supervisor, head of Lymphoma Group, oncology branch, Guangdong Medical Association, Cancer Hospital Affiliated to Sun Yat sen University; vice chairman of Youth Committee of oncology branch of Chinese Medical Association; vice chairman of lymphoma Professional Committee of Chinese Medical Education Association; vice chairman of lymphoma Professional Committee of Guangdong Women's Doctor Association; deputy director of Hematology Oncology Department of Guangdong anti cancer association Vice chairman of the Youth Committee of the committee vice chairman of the lymphoma immune Committee of Beijing Cancer Prevention and treatment society is only for the reference of medical and pharmaceutical professionals. It is strictly prohibited to reprint and spread "read the original text". We will make progress together