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1. Brentuximab vedotin plus AVD for Hodgkin lymphoma: incidence and management of peripheral neuropathy in a multisite cohort

Author

Bowers, Jackson T., Anna, Jacob, Bair, Steven M., Annunzio, Kaitlin, Epperla, Narendranath, Pullukkara, Jerrin Joy, Gaballa, Sameh, Spinner, Michael A., Li, Shuning, Messmer, Marcus R., Nguyen, Joseph, Ayers, Emily C., Wagner, Charlotte B., Hu, Boyu, Di, Mengyang, Huntington, Scott F., Furqan, Fateeha, Shah, Nirav N., Chen, Christina, Ballard, Hatcher J., Hughes, Mitchell E., Chong, Elise A., Nasta, Sunita D., Barta, Stefan K., Landsburg, Daniel J., and Svoboda, Jakub

Published
2023
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5. Single-route CNS prophylaxis for aggressive non-Hodgkin lymphomas: real-world outcomes from 21 US academic institutions

Author

Orellana-Noia, Victor Manuel, Reed, Daniel R., McCook, Ashley Alesia, Sen, Jeremy Michael, Barlow, Christian M., Malecek, Mary-Kate, Watkins, Marcus, Kahl, Brad S., Spinner, Michael A., Advani, Ranjana, Voorhees, Timothy J., Snow, Anson, Grover, Natalie Sophia, Ayers, Amy, Romancik, Jason, Liu, Yuxin, Huntington, Scott F., Chavez, Julio C., Saeed, Hayder, Lazaryan, Aleksandr, Raghunathan, Vikram, Spurgeon, Stephen E., Ollila, Thomas A., Del Prete, Christopher, Olszewski, Adam, Ayers, Emily C., Landsburg, Daniel J., Echalier, Benjamin, Lee, Jun, Kamdar, Manali, Caimi, Paolo F., Fu, Timothy, Liu, Jieqi, David, Kevin A., Alharthy, Hanan, Law, Jennie, Karmali, Reem, Shah, Harsh, Stephens, Deborah M., Major, Ajay, Rojek, Alexandra E., Smith, Sonali M., Yellala, Amulya, Kallam, Avyakta, Nakhoda, Shazi, Khan, Nadia, Sohail, Mohammad Ahsan, Hill, Brian T., Barrett-Campbell, Odeth, Lansigan, Frederick, Switchenko, Jeffrey, Cohen, Jonathon, and Portell, Craig A.

Published
2022
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9. Real‐world analysis of adverse event rates after initiation of ibrutinib among Medicare beneficiaries with chronic lymphocytic leukemia.

Author

Huntington, Scott F., de Nigris, Enrico, Puckett, Justin T., Kamal‐Bahl, Sachin, Farooqui, Mohammed, Ryland, Katherine, Sarpong, Eric M., Leng, Siyang, Yang, Xiaoqin, and Doshi, Jalpa A.

Subjects
*CHRONIC lymphocytic leukemia, *JOINT pain, *MEDICARE beneficiaries, *OLDER patients, *ATRIAL fibrillation
Abstract

Background: The first‐generation BTK inhibitor ibrutinib is a standard‐of‐care therapy in the treatment of chronic lymphocytic leukemia (CLL) despite potential side effects that often lead to discontinuation. Methods: This study used 2013–2019 claims data to describe the incidence rate of adverse events (AEs) among elderly Medicare beneficiaries newly initiating ibrutinib for CLL. Results: The final sample contained 11,870 Medicare beneficiaries with CLL (mean age 77.2) newly initiating ibrutinib, of whom 65.2% discontinued over mean follow‐up of 2.3 years. The overall incidence rate of AEs was 62.5 per 1000 patient‐months for all discontinuers and 32.9 per 1000 patient‐months for non‐discontinuers. Discontinuers had a higher incidence rate of AEs per 1000 patient‐months compared with non‐discontinuers for all AEs examined, including infection (22.8 vs. 14.5), atrial fibrillation (15.1 vs. 7.0), anemia (21.9 vs. 14.5), and arthralgia/myalgia (19.5 vs. 13.6). Conclusion: In this first real‐world study of a national sample of elderly US patients treated with ibrutinib, we found a clear unmet need for improved management of ibrutinib‐related AEs and/or new treatments to improve real‐world outcomes in patients with CLL. [ABSTRACT FROM AUTHOR]

Published
2024
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10. Statin use, survival and incidence of thrombosis among older patients with polycythemia vera and essential thrombocythemia.

Author

Podoltsev, Nikolai A., Wang, Rong, Shallis, Rory M., Stempel, Jessica M., Di, Mengyang, Neparidze, Natalia, Zeidan, Amer M., Huntington, Scott F., Giri, Smith, Hull, Sarah C., Gore, Steven D., and Ma, Xiaomei

Subjects
OLDER patients, POLYCYTHEMIA vera, STATINS (Cardiovascular agents), THROMBOCYTOSIS, THROMBOSIS
Abstract

Background: Polycythemia vera (PV) and essential thrombocythemia (ET) are linked to increased risk of cardiovascular morbidity and mortality. In addition to the reduction in of arterial thrombotic events, statins may prevent venous thrombosis including among patients with cancer. As previous registry‐ and claims‐based studies revealed that the use of statins may improve the survival of patients with various malignancies we evaluated their impact on outcomes of older adults with PV and ET. Methods: We identified 4010 older adults (aged 66–99 years at diagnosis) with PV (n = 1809) and ET (n = 2201) in a population‐based cohort study using the Surveillance, Epidemiology, and End Results‐Medicare database with median follow‐up of 3.92 (interquartile range: 2.58–5.75) years. Propensity score matching (PSM) and inverse probability of treatment weighting (IPTW) approaches were utilized to assess potential association between statins and overall survival. Multivariable competing risk models with death as a competing risk were used to evaluate possible relationship between statins and the incidence of thrombosis. Results: 55.8% of the patients used statins within the first year after PV/ET diagnosis, and statin use was associated with a 22% reduction in all‐cause mortality (PSM: hazard ratio [HR] = 0.78, 95% confidence interval [CI]: 0.63–0.98, p = 0.03; IPTW: HR = 0.79, 95% CI: 0.64–0.97, p = 0.03). Statins also reduced the risk of thrombosis in this patient population (PSM: HR = 0.63, 95% CI: 0.51–0.78, p < 0.01; IPTW: HR = 0.57, 95% CI: 0.49–0.66, p < 0.01) as well as in PV and ET subgroups. Conclusions: These findings suggest that it may be important to incorporate statins into the therapeutic strategy for older adults with PV and ET. [ABSTRACT FROM AUTHOR]

Published
2023
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11. DTRMWXHS‐12, a novel Bruton tyrosine kinase inhibitor, in combination with everolimus and pomalidomide in patients with relapsed/refractory lymphomas: An open‐label, multicenter, phase 1a/1b study.

Author

Huntington, Scott F., Schuster, Stephen J., Ding, Wei, Koehler, Amber B., Brander, Danielle M., Rosenthal, Allison C., Leis, Jose F., Tun, Han W., Moustafa, Muhamad Alhaj, Iqbal, Madiha, He, Wei, Kearney, Albert S., McKinlay, Timothy P., Gui, Min, and Mato, Anthony R.

Published
2023
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17. COVID-19 in patients with CLL: improved survival outcomes and update on management strategies

Author

Roeker, Lindsey Elizabeth, Eyre, Toby Andrew, Thompson, Meghan C., Lamanna, Nicole, Coltoff, Alexander, Davids, Matthew S., Baker, Peter, Leslie, Lori A., Rogers, Kerry A., Allan, John N., Cordoba, Raul, Lopez-Garcia, Alberto, Antic, Darko, Pagel, John M., Martinez-Calle, Nicolás, Garcia-Marco, Jose Antonio, Hernández-Rivas, José-Ángel, Miras, Fatima, Coombs, Catherine C., Österborg, Anders, Seddon, Amanda N., López-Jiménez, Javier, Wilson, Matthew R., El-Sharkawi, Dima, Wojenski, Daniel, Ma, Shuo, Munir, Talha, Valenciano, Susana, Seymour, Erlene, Barr, Paul M., Pu, Jeffrey J, Patten, Piers EM, Perini, Guilherme Fleury, Huntington, Scott F, Parry, Helen, Sundaram, Suchitra, Skarbnik, Alan P, Kamdar, Manali, Jacobs, Ryan W, Walter, Harriet Sarah, Walewska, Renata, Broom, Angus, Lebowitz, Sonia, Isaac, Krista, Portell, Craig A, Ahn, Inhye E, Ujjani, Chaitra, Shadman, Mazyar, Skånland, Sigrid S, Chong, Elise A., and Mato, Anthony R.

Abstract

No abstract available

Published
2021

19. Worldwide Examination of Patients with CLL Hospitalized for COVID-19

Author

Roeker, Lindsey E, Scarfo, Lydia, Chatzikonstantinou, Thomas, Abrisqueta, Pau, Eyre, Toby A., Cordoba, Raul, Muntañola Prat, Ana, Villacampa, Guillermo, Leslie, Lori A., Koropsak, Michael, Quaresmini, Giulia, Allan, John N., Furman, Richard R., Bhavsar, Erica B, Pagel, John M., Hernandez-Rivas, Jose Angel, Patel, Krish, Motta, Marina, Bailey, Neil, Miras, Fatima, Lamanna, Nicole, Alonso, Rosalia, Osorio-Prendes, Santiago, Vitale, Candida, Kamdar, Manali, Baltasar, Patricia, Österborg, Anders, Hanson, Lotta, Baile, Mónica, Rodríguez-Hernández, Ines, Valenciano, Susana, Popov, Viola Maria, Barez Garcia, Abelardo, Alfayate, Ana, Oliveira, Ana C, Eichhorst, Barbara, Quaglia, Francesca M., Reda, Gianluigi, Lopez Jimenez, Javier, Varettoni, Marzia, Marchetti, Monia, Romero, Pilar, Riaza Grau, Rosalía, Munir, Talha, Zabalza, Amaya, Janssens, Ann, Niemann, Carsten U, Perini, Guilherme Fleury, Delgado, Julio, Yanez San Segundo, Lucrecia, Gómez Roncero, Ma Isabel, Wilson, Matthew, Patten, Piers, Marasca, Roberto, Iyengar, Sunil, Seddon, Amanda, Torres, Ana, Ferrari, Angela, Cuéllar-García, Carolina, Wojenski, Daniel, El-Sharkawi, Dima, Itchaki, Gilad, Parry, Helen, Mateos-Mazón, Juan José, Martinez-Calle, Nicolas, Ma, Shuo, Naya, Daniel, Van Der Spek, Ellen, Seymour, Erlene K., Gimeno Vázquez, Eva, Rigolin, Gian Matteo, Mauro, Francesca Romana, Walter, Harriet S, Labrador, Jorge, De Paoli, Lorenzo, Laurenti, Luca, Ruiz, Elena, Levin, Mark-David, Šimkovič, Martin, Špaček, Martin, Andreu, Rafa, Walewska, Renata, Perez-Gonzalez, Sonia, Sundaram, Suchitra, Wiestner, Adrian, Cuesta, Amalia, Broom, Angus, Kater, Arnon P., Muiña, Begoña, Velasquez, César A, Ujjani, Chaitra S., Seri, Cristina, Antic, Darko, Bron, Dominique, Vandenberghe, Elisabeth, Chong, Elise A., Lista, Enrico, García, Fiz Campoy, Del Poeta, Giovanni, Ahn, Inhye, Pu, Jeffrey J., Brown, Jennifer R, Soler Campos, Juan Alfonso, Malerba, Lara, Trentin, Livio, Orsucci, Lorella, Farina, Lucia, Villalon, Lucia, Vidal, Maria Jesus, Sanchez, Maria Jose, Terol, Maria Jose, De Paolis, Maria Rosaria, Gentile, Massimo, Davids, Matthew S., Shadman, Mazyar, Yassin, Mohamed A, Foglietta, Myriam, Jaksic, Ozren, Sportoletti, Paolo, Barr, Paul M., Ramos, Rafael, Santiago, Raquel, Ruchlemer, Rosa, Kersting, Sabina, Huntington, Scott F., Herold, Tobias, Herishanu, Yair, Thompson, Meghan C., Lebowitz, Sonia, Ryan, Christine, Jacobs, Ryan W., Portell, Craig A., Isaac, Krista, Rambaldi, Alessandro, Nabhan, Chadi, Brander, Danielle M., Montserrat, Emili, Rossi, Giuseppe, Garcia-Marco, Jose A., Sr., Coscia, Marta, Malakhov, Nikita, Fernandez-Escalada, Noemi, Skånland, Sigrid Strand, Coombs, Callie C., Ghione, Paola, Schuster, Stephen J., Foà, Robin, Cuneo, Antonio, Bosch, Francesc, Stamatopoulos, Kostas, Ghia, Paolo, Mato, Anthony R., and Patel, Meera

Published
2020
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20. Umbralisib Plus Ublituximab (U2) Is Superior to Obinutuzumab Plus Chlorambucil (O+Chl) in Patients with Treatment Naïve (TN) and Relapsed/Refractory (R/R) Chronic Lymphocytic Leukemia (CLL): Results from the Phase 3 Unity-CLL Study

Author

Gribben, John G., Jurczak, Wojciech, Jacobs, Ryan W., Grosicki, Sebastian, Giannopoulos, Krzysztof, Wrobel, Tomasz, Zafar, Syed F., Cultrera, Jennifer L., Kambhampati, Suman, Danilov, Alexey, Burke, John M., Goldschmidt, Jerome, Beach, Douglas F., Huntington, Scott F., Pinilla Ibarz, Javier, Sharman, Jeff P, Siddiqi, Tanya, Brander, Danielle M., Pagel, John M., Kolibaba, Kathryn S., Dlugosz-Danecka, Monika, Ghosh, Nilanjan, Sportelli, Peter, Miskin, Hari P., O'Connor, Owen A., Weiss, Michael S., and Flinn, Ian W.

Published
2020
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29. Oncologist volume and outcomes in older adults diagnosed with diffuse large B cell lymphoma

Author

Huntington, Scott F., Hoag, Jessica R., Zhu, Weiwei, Wang, Rong, Zeidan, Amer M., Giri, Smith, Podoltsev, Nikolai A., Gore, Steven D., Ma, Xiaomei, Gross, Cary P., and Davidoff, Amy J.

Subjects
Aged, 80 and over, Male, Oncologists, Workload, Prognosis, Article, United States, Cohort Studies, Patient Outcome Assessment, Treatment Outcome, Humans, Female, Lymphoma, Large B-Cell, Diffuse, Aged, Quality of Health Care, Retrospective Studies, SEER Program
Abstract

Although provider-level volume is frequently associated with outcomes in cancers requiring complex surgeries, whether similar relations exist for cancers treated primarily with systemic therapy is unknown.Using a population-based cohort analysis of older adults diagnosed with diffuse large B cell lymphoma (DLBCL) during the years 2004-2011, we evaluated the association between oncologist volume and 4 clinical outcomes (receipt of any chemotherapy, receipt of an anthracycline-containing or equivalent regimen, early hospitalization, and overall survival). Our primary explanatory variable was lymphoma treatment volume, defined as the number of patients with newly diagnosed lymphoma for which an oncologist initiated therapy during a 12-month look-back period from each incident DLBCL case.We identified 8247 Medicare beneficiaries who were newly diagnosed with DLBCL. Chemotherapy was administered to 6202 (75.2%) beneficiaries, and 71.4% of cytotoxic regimens contained an anthracycline. Beneficiaries who were treated by higher-volume oncologists had increased odds of receiving chemotherapy (adjusted odds ratio [aOR], 1.45; 95% confidence interval [CI], 1.24-1.70; P.001) and of receiving an anthracycline-containing regimen (aOR, 1.26; 95% CI, 1.06-1.50; P = .009). Receiving care from a higher-volume provider was also associated with decreased hospitalization (aOR, 0.80; 95% CI, 0.69-0.95; P = .007) and improved survival (adjusted hazard ratio, 0.85; 95% CI, 0.79-0.92; P.001).In older adults diagnosed with DLBCL, receiving care from a provider with more experience treating lymphoma patients was associated with receipt of guideline-adherent therapy, reduced hospitalizations, and improved survival. Clinical volume may be an important factor in providing high-quality cancer care in the modern era.

Published
2018

30. Overall survival based on oncologist density in the United States: A retrospective cohort study.

Author

Siddappa Malleshappa, Sudeep K., Giri, Smith, Patel, Smit, Mehta, Tapan, Appleman, Leonard, Huntington, Scott F., Passero, Vida, Parikh, Rahul A., and Mehta, Kathan D.

Subjects
OVERALL survival, PROGRESSION-free survival, MEDICALLY underserved areas, DENSITY of states, HEALTH services accessibility, MEDICAL care, OLDER patients
Abstract

Medically underserved areas (MUA) or health professional shortage areas (HPSA) designations are based on primary care health services availability. These designations are used in recruiting international medical graduates (IMGs) trained in primary care or subspecialty (e.g., oncology) to areas of need. Whether the MUA/HPSA designation correlates with Oncologist Density (OD) and supports IMG oncologists' recruitment to areas of need is unknown. We evaluated the concordance of OD with the designation of MUAs/HPSAs and evaluated the impact of OD and MUA/HPSA status on overall survival. We conducted a retrospective cohort study of patients diagnosed with hematological malignancies or metastatic solid tumors in 2011 from the Surveillance Epidemiology and End Results (SEER) database. SEER was linked to the American Medical Association Masterfile to calculate OD, defined as the number of oncologists per 100,000 population at the county level. We calculated the proportion of counties with MUA or HPSA designation for each OD category. Overall survival was estimated using the Kaplan-Meier method and compared between the OD category using a log-rank test. We identified 68,699 adult patients with hematologic malignancies or metastatic solid cancers in 609 counties. The proportion of MUA/HPSA designation was similar across counties categorized by OD (93.2%, 95.4%, 90.3%, and 91.7% in counties with <2.9, 2.9–6.5, 6.5–8.4 and >8.4 oncologists per 100K population, p = 0.7). Patients' median survival in counties with the lowest OD was significantly lower compared to counties with the highest OD (8 vs. 11 months, p<0.0001). The difference remained statistically significant in multivariate and subgroup analysis. MUA/HPSA status was not associated with survival (HR 1.03, 95%CI 0.97–1.09, p = 0.3). MUA/HPSA designation based on primary care services is not concordant with OD. Patients in counties with lower OD correlated with inferior survival. Federal programs designed to recruit physicians in high-need areas should consider the availability of health care services beyond primary care. [ABSTRACT FROM AUTHOR]

Published
2021
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32. Challenges and Opportunities in the Management of Diffuse Large B‐Cell Lymphoma in Older Patients.

Author

Di, Mengyang, Huntington, Scott F, and Olszewski, Adam J.

Subjects
B cell lymphoma, QUALITY assurance, OLD age
Abstract

Most patients with diffuse large B‐cell lymphoma (DLBCL) are diagnosed at age 60 years or older. Challenges to effective therapy among older individuals include unfavorable biologic features of DLBCL, geriatric vulnerabilities, suboptimal treatment selection, and toxicities of cytotoxic chemotherapy. Wider application of geriatric assessments may help identify fit older patients who benefit from standard immunochemotherapy without unnecessary dose reductions. Conversely, attenuated regimens may provide a better balance of risk and benefit for selected unfit or frail patients. Supportive care with the use of corticosteroid‐based prephase, prophylactic growth factors, and early institution of supportive and palliative care can help maximize treatment tolerance. Several novel or emerging therapies have demonstrated favorable toxicity profiles, thus facilitating effective treatment for elderly patients. In the relapsed or refractory setting, patients who are not candidates for stem cell transplantation can benefit from newly approved options including polatuzumab vedotin‐based combinations or tafasitamab plus lenalidomide, which may have higher efficacy and/or lower toxicity than historical chemotherapy regimens. Chimeric antigen receptor T‐cell therapy has been successfully applied to older patients outside of clinical trials. In the first‐line setting, emerging immunotherapy options (bispecific antibodies) and targeted therapies (anti‐CD20 antibodies combined with lenalidomide and/or B‐cell receptor inhibitors) may provide chemotherapy‐free approaches for DLBCL. Enrolling older patients in clinical trials will be paramount to fully examine potential efficacy and toxicity of these strategies. In this review, we discuss recent advances in fitness stratification and therapy that have expanded curative options for older patients, as well as future opportunities to improve outcomes in this population. Implications for Practice: Management of diffuse large B‐cell lymphoma in older patients poses challenges due to aggressive disease biology and geriatric vulnerability. Although R‐CHOP remains standard first‐line treatment, geriatric assessment may help evaluate patients' fitness for immunochemotherapy. Corticosteroid prephase, prophylactic growth factors, and early palliative care can improve tolerance of treatment. Novel salvage options (polatuzumab vedotin‐based combinations, tafasitamab plus lenalidomide) or chimeric antigen receptor T‐cell therapy should be considered in the relapsed or refractory setting for patients ineligible for stem cell transplantation. Emerging immunotherapies (bispecific antibodies) and targeted therapies provide potential first‐line chemotherapy‐free approaches, which need to be rigorously assessed in clinical trials that involve geriatric patients. Diffuse large B‐cell lymphoma (DLBCL) is an aggressive but potentially curable cancer that mainly affects older individuals. This review presents recent advances in fitness stratification and therapy that have expanded curative options for older patients with DLBCL and future opportunities to improve outcomes in this population. [ABSTRACT FROM AUTHOR]

Published
2021
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35. Favorable Outcomes for Patients Treated with U2 with Co-Morbidities or Concomitant Medications: A Retrospective Analysis of Unity-CLL Phase 3 Trial

Author

Pinilla Ibarz, Javier, Jurczak, Wojciech, Kambhampati, Suman, Lech Maranda, Ewa, Wróbel, Tomasz, Sharman, Jeff P., Zafar, Syed F., Hoffmann, Marc, Huntington, Scott F., Jacobs, Ryan, Bairey, Osnat, Rowland, Chris, Miskin, Hari P., Sportelli, Peter, Weiss, Michael S., O'Connor, Owen A., and Flinn, Ian W.

Published
2021
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36. Efficacy and Safety of Ublituximab in Combination with Umbralisib (U2) in Patients with Chronic Lymphocytic Leukemia (CLL) By Treatment Status: A Sub-Analysis of the Phase 3 Unity-CLL Study

Author

Jacobs, Ryan, Jurczak, Wojciech, Flinn, Ian W., Grosicki, Sebastian, Giannopoulos, Krzysztof, Wróbel, Tomasz, Zafar, Syed F., Cultrera, Jennifer L., Kambhampati, Suman, Danilov, Alexey V., Burke, John M., Goldschmidt, Jerome, Beach, Douglas F., Huntington, Scott F., Pinilla Ibarz, Javier, Sharman, Jeff P., Siddiqi, Tanya, Brander, Danielle M., Shadman, Mazyar, Pagel, John M., Dlugosz-Danecka, Monika, Ghosh, Nilanjan, Kolibaba, Kathryn S., Sportelli, Peter, Miskin, Hari P., O'Connor, Owen A., Weiss, Michael S., and Gribben, John G.

Published
2021
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44. CNS Prophylaxis during Front-Line Therapy in Aggressive Non-Hodgkin Lymphomas: Real-World Outcomes and Practice Patterns from 19 US Academic Institutions

Author

Orellana-Noia, Victor M., Reed, Daniel R, Sen, Jeremy M, Barlow, Christian, Malecek, Mary-Kate, Kahl, Brad S., Spinner, Michael A, Advani, Ranjana, Voorhees, Timothy J, Snow, Anson, Grover, Natalie S, Ayers, Amy, Romancik, Jason T., Liu, Yuxin, Huntington, Scott F., Chavez, Julio C., Saeed, Hayder, Lazaryan, Aleksandr, Raghunathan, Vikram, Spurgeon, Stephen E., Ollila, Thomas A, Del Prete, Christopher, Olszewski, Adam J, Ayers, Emily C., Landsburg, Daniel J., Echalier, Benjamin, Lee, Jun, Kamdar, Manali, Caimi, Paolo F, Fu, Timothy, Liu, Jieqi, David, Kevin A., Alharthy, Hanan, Law, Jennie Y., Karmali, Reem, Shah, Harsh, Stephens, Deborah M., Major, Ajay, Rojek, Alexandra E, Smith, Sonali M., Yellala, Amulya, Kallam, Avyakta, Nakhoda, Shazia, Khan, Nadia, Cohen, Jonathon B., and Portell, Craig A.

Published
2020
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45. Isolated Trisomy 11 in Patients with Myeloid Malignancies - Is the Prognosis Not As Grim As Previously Thought?

Author

Bewersdorf, Jan Philipp, Shallis, Rory M, Diadamo, Autumn, Gowda, Lohith, Podoltsev, Nikolai A., Gore, Steven D., Prebet, Thomas, Halene, Stephanie, Isufi, Iris, Foss, Francine M., Huntington, Scott F., Kim, Tae Kon, Pillai, Manoj M, Parker, Terri L, Neparidze, Natalia, Bar, Noffar, Seropian, Stuart, Siddon, Alexa J., and Zeidan, Amer M.

Published
2019
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46. Clinical Outcomes of Patients (pts) with TP53-Mutated Acute Myeloid Leukemia (AML) or Myelodysplastic Syndromes (MDS): A Single Center Experience

Author

Bewersdorf, Jan Philipp, Shallis, Rory M, Gowda, Lohith, Hager, Karl, Podoltsev, Nikolai A., Gore, Steven D., Prebet, Thomas, Halene, Stephanie, Isufi, Iris, Foss, Francine M., Huntington, Scott F., Kim, Tae Kon, Pillai, Manoj M, Parker, Terri L, Neparidze, Natalia, Bar, Noffar, Seropian, Stuart, Siddon, Alexa J., and Zeidan, Amer M.

Published
2019
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50. Outcomes and Toxicities of Programmed Death‐1 (PD‐1) Inhibitors in Hodgkin Lymphoma Patients in the United States: A Real‐World, Multicenter Retrospective Analysis.

Author

Bair, Steven M., Strelec, Lauren E., Feldman, Tatyana A., Ahmed, Gulrayz, Armand, Philippe, Shah, Nirav N., Singavi, Arun N., Reddy, Nishitha, Khan, Nadia, Andreadis, Charalambos, Vu, Khoan, Huntington, Scott F., Giri, Smith, Ujjani, Chaitra, Howlett, Christina, Faheem, Malik, Youngman, Matthew R., Nasta, Sunita D., Landsburg, Daniel J., and Schuster, Stephen J.

Subjects
ANTIGENS, DRUG tolerance, DRUG toxicity, HODGKIN'S disease, MEDICAL cooperation, RESEARCH, SURVIVAL, TERMINATION of treatment, TREATMENT effectiveness, RETROSPECTIVE studies, DISEASE progression, THERAPEUTICS
Abstract

Background: Although classical Hodgkin lymphoma (cHL) is highly curable, 20%–30% of patients will not be cured with conventional treatments. The programmed death‐1 (PD‐1) inhibitors (PD‐1i) nivolumab and pembrolizumab have been Food and Drug Administration‐approved for relapsed/refractory (R/R) cHL. There is limited data on the real‐world experience with PD‐1i in cHL and it is unknown whether fewer selected patients treated with PD‐1i derive benefits similar to those observed in published trials. Materials and Methods: We performed a multicenter, retrospective analysis of R/R cHL patients treated with PD‐1i in the nontrial setting. The primary objective was to describe progression‐free survival (PFS) and overall survival (OS) in this population. Secondary objectives were to characterize response rates, toxicities, discontinuation patterns, and post‐PD‐1i therapies. Results: The study included 53 patients from nine U.S. centers. Overall response rate (ORR), complete response (CR), and partial response (PR) to PD‐1i were 68%, 45%, and 23%, respectively. Twelve‐month OS and PFS were 89% and 75%, respectively; median PFS was 29 months. Ninety‐six percent of patients with CR continue to respond at a median follow‐up of 20 months. Toxicities were similar to those previously described. Seventy percent of patients treated with systemic therapy after PD‐1i demonstrated objective responses. Conclusion: To our knowledge, this analysis is the first describing real‐world experience with PD‐1i in cHL patients in the U.S. Here, we demonstrate similar response rates compared to prior studies. The toxicity profile of PD‐1i was similar to that seen in previous studies; we further describe toxicity patterns in those with prior autoimmune disease or allogeneic transplant. Post‐PD‐1i systemic therapies appear active. These results support the effectiveness and tolerability of PD‐1i therapy in R/R cHL in a real‐world setting. Implications for Practice: Two PD‐1 inhibitors have recently been approved for patients with relapsed/refractory classical Hodgkin lymphoma based on results from nonrandomized clinical trials. However, to date, there have been no studies evaluating the effectiveness and toxicity profile of these drugs in the real‐world setting in the U.S. The present study demonstrates that patients treated in a real‐world context experience similar rates of overall effectiveness compared with published clinical trials. Patients who discontinue PD‐1 inhibitors may experience clinical responses to subsequent treatment with systemic chemotherapy or targeted therapy. This study provides clinicians with further insight into the effectiveness and tolerability of PD‐1 inhibitors and suggests that when patients progress while on these drugs, conventional systemic chemotherapy may be an effective treatment option. Until now, no studies have evaluated the effectiveness of PD‐1 inhibitors in classical Hodgkin lymphoma in a real‐world context (outside the context of study protocols). This article reports on clinical response to PD‐1 inhibitors, progression‐free and overall survival, and the prevalence and management of immune‐related adverse events in a population of patients with relapsed or refractory Hodgkin lymphoma treated with PD‐1 inhibitors. [ABSTRACT FROM AUTHOR]

Published
2019
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