Article

Key clinical point: Data from a multi-institutional US database of more than 2.5 million screening mammograms showed that digital breast tomosynthesis (DBT) was superior to digital mammography (DM) for the purpose of breast cancer (BC) screening.

Major finding: Compared with DM, DBT led to significantly higher cancer detection rates (adjusted odds ratio [OR] 1.24), biopsy rate (adjusted OR 1.33), and positive predictive value of recall (adjusted OR 1.33; all P < .001).

Study details: Findings are from a retrospective study including 2,528,063 screening mammograms in 1,100,447 women aged 40-79 years.

Disclosures: This study did not report the source of funding. Some authors declared receiving grants, travel support, consulting fees, or payments from various sources.

Source: Conant EF et al. Mammographic screening in routine practice: Multisite study of digital breast tomosynthesis and digital mammography screenings. Radiology. 2023 (Mar 14). Doi: 10.1148/radiol.221571

Key clinical point: Data from a multi-institutional US database of more than 2.5 million screening mammograms showed that digital breast tomosynthesis (DBT) was superior to digital mammography (DM) for the purpose of breast cancer (BC) screening.

Major finding: Compared with DM, DBT led to significantly higher cancer detection rates (adjusted odds ratio [OR] 1.24), biopsy rate (adjusted OR 1.33), and positive predictive value of recall (adjusted OR 1.33; all P < .001).

Study details: Findings are from a retrospective study including 2,528,063 screening mammograms in 1,100,447 women aged 40-79 years.

Disclosures: This study did not report the source of funding. Some authors declared receiving grants, travel support, consulting fees, or payments from various sources.

Source: Conant EF et al. Mammographic screening in routine practice: Multisite study of digital breast tomosynthesis and digital mammography screenings. Radiology. 2023 (Mar 14). Doi: 10.1148/radiol.221571

Key clinical point: Data from a multi-institutional US database of more than 2.5 million screening mammograms showed that digital breast tomosynthesis (DBT) was superior to digital mammography (DM) for the purpose of breast cancer (BC) screening.

Major finding: Compared with DM, DBT led to significantly higher cancer detection rates (adjusted odds ratio [OR] 1.24), biopsy rate (adjusted OR 1.33), and positive predictive value of recall (adjusted OR 1.33; all P < .001).

Study details: Findings are from a retrospective study including 2,528,063 screening mammograms in 1,100,447 women aged 40-79 years.

Disclosures: This study did not report the source of funding. Some authors declared receiving grants, travel support, consulting fees, or payments from various sources.

Source: Conant EF et al. Mammographic screening in routine practice: Multisite study of digital breast tomosynthesis and digital mammography screenings. Radiology. 2023 (Mar 14). Doi: 10.1148/radiol.221571

Key clinical point: In patients with early, operable breast cancer (BC), peritumoral injection of a local anesthetic (lidocaine) prior to surgery improved survival outcomes.

Major finding: Peritumoral infiltration of lidocaine at the time of surgery led to 26% improvement in disease-free survival (hazard ratio [HR] 0.74; P = .017) and 29% improvement in overall survival (HR 0.71; P = .019) at a median follow-up of 68 months. No adverse events related to injection of lidocaine were reported.

Study details: Findings are from the phase 3 study including 1583 patients with early, operable BC who did not receive prior neoadjuvant treatment and were randomly assigned to undergo surgery with or without a peritumoral injection of 0.5% lidocaine 7-10 minutes preoperatively.

Disclosures: This study was supported by Department of Atomic Energy, India. Dr. Sudeep Gupta declared receiving research funding from several sources.

Source: Badwe RA et al. Effect of peritumoral infiltration of local anesthetic before surgery on survival in early breast cancer. J Clin Oncol. 2023 (Apr 6). Doi: 10.1200/JCO.22.01966

Key clinical point: In patients with early, operable breast cancer (BC), peritumoral injection of a local anesthetic (lidocaine) prior to surgery improved survival outcomes.

Major finding: Peritumoral infiltration of lidocaine at the time of surgery led to 26% improvement in disease-free survival (hazard ratio [HR] 0.74; P = .017) and 29% improvement in overall survival (HR 0.71; P = .019) at a median follow-up of 68 months. No adverse events related to injection of lidocaine were reported.

Study details: Findings are from the phase 3 study including 1583 patients with early, operable BC who did not receive prior neoadjuvant treatment and were randomly assigned to undergo surgery with or without a peritumoral injection of 0.5% lidocaine 7-10 minutes preoperatively.

Disclosures: This study was supported by Department of Atomic Energy, India. Dr. Sudeep Gupta declared receiving research funding from several sources.

Source: Badwe RA et al. Effect of peritumoral infiltration of local anesthetic before surgery on survival in early breast cancer. J Clin Oncol. 2023 (Apr 6). Doi: 10.1200/JCO.22.01966

Key clinical point: In patients with early, operable breast cancer (BC), peritumoral injection of a local anesthetic (lidocaine) prior to surgery improved survival outcomes.

Major finding: Peritumoral infiltration of lidocaine at the time of surgery led to 26% improvement in disease-free survival (hazard ratio [HR] 0.74; P = .017) and 29% improvement in overall survival (HR 0.71; P = .019) at a median follow-up of 68 months. No adverse events related to injection of lidocaine were reported.

Study details: Findings are from the phase 3 study including 1583 patients with early, operable BC who did not receive prior neoadjuvant treatment and were randomly assigned to undergo surgery with or without a peritumoral injection of 0.5% lidocaine 7-10 minutes preoperatively.

Disclosures: This study was supported by Department of Atomic Energy, India. Dr. Sudeep Gupta declared receiving research funding from several sources.

Source: Badwe RA et al. Effect of peritumoral infiltration of local anesthetic before surgery on survival in early breast cancer. J Clin Oncol. 2023 (Apr 6). Doi: 10.1200/JCO.22.01966

Key clinical point: In women with 2-3 ipsilateral foci of breast cancer (BC), breast-conserving surgery (BCS; lumpectomy plus adjuvant radiation) resulted in a local recurrence rate that was below the a priori determined clinically acceptable threshold of 8%.

Major finding: BCS resulted in a highly acceptable 5-year local recurrence rate of 3.1% (95% CI 1.3%-6.4%) in patients with multiple ipsilateral BC.

Study details: Findings are from the phase 2 American College of Surgeons Oncology Group Z11102 (Alliance) trial including 204 women aged ≥40 years with multiple ipsilateral BC who underwent BCS.

Disclosures: This study was supported by the US National Institutes of Health. Some authors declared owning stocks; serving on editorial boards, in leadership positions, or as employees; receiving research funding, honoraria, or travel and accommodation expenses; or having other ties with various sources.

Source: Boughey JC et al. Local recurrence after breast-conserving therapy in patients with multiple ipsilateral breast cancer: Results from ACOSOG Z11102 (Alliance). J Clin Oncol. 2023 (Mar 28). Doi: 10.1200/JCO.22.02553

Key clinical point: In women with 2-3 ipsilateral foci of breast cancer (BC), breast-conserving surgery (BCS; lumpectomy plus adjuvant radiation) resulted in a local recurrence rate that was below the a priori determined clinically acceptable threshold of 8%.

Major finding: BCS resulted in a highly acceptable 5-year local recurrence rate of 3.1% (95% CI 1.3%-6.4%) in patients with multiple ipsilateral BC.

Study details: Findings are from the phase 2 American College of Surgeons Oncology Group Z11102 (Alliance) trial including 204 women aged ≥40 years with multiple ipsilateral BC who underwent BCS.

Disclosures: This study was supported by the US National Institutes of Health. Some authors declared owning stocks; serving on editorial boards, in leadership positions, or as employees; receiving research funding, honoraria, or travel and accommodation expenses; or having other ties with various sources.

Source: Boughey JC et al. Local recurrence after breast-conserving therapy in patients with multiple ipsilateral breast cancer: Results from ACOSOG Z11102 (Alliance). J Clin Oncol. 2023 (Mar 28). Doi: 10.1200/JCO.22.02553

Key clinical point: In women with 2-3 ipsilateral foci of breast cancer (BC), breast-conserving surgery (BCS; lumpectomy plus adjuvant radiation) resulted in a local recurrence rate that was below the a priori determined clinically acceptable threshold of 8%.

Major finding: BCS resulted in a highly acceptable 5-year local recurrence rate of 3.1% (95% CI 1.3%-6.4%) in patients with multiple ipsilateral BC.

Study details: Findings are from the phase 2 American College of Surgeons Oncology Group Z11102 (Alliance) trial including 204 women aged ≥40 years with multiple ipsilateral BC who underwent BCS.

Disclosures: This study was supported by the US National Institutes of Health. Some authors declared owning stocks; serving on editorial boards, in leadership positions, or as employees; receiving research funding, honoraria, or travel and accommodation expenses; or having other ties with various sources.

Source: Boughey JC et al. Local recurrence after breast-conserving therapy in patients with multiple ipsilateral breast cancer: Results from ACOSOG Z11102 (Alliance). J Clin Oncol. 2023 (Mar 28). Doi: 10.1200/JCO.22.02553

Key clinical point: A dose of 25 mg exemestane 3 times weekly was noninferior to the standard once-daily dose in decreasing serum estradiol levels in postmenopausal women with stage 0-II estrogen receptor-positive (ER+) breast cancer (BC).

Major finding: Compared with once-daily exemestane, 3-times-weekly exemestane was noninferior (difference in percentage change 2.0%; P for noninferiority = .02) whereas once-weekly exemestane was less effective in decreasing serum estradiol levels in participants who received ≥80% of the active scheduled pills and underwent blood testing as per protocol. The adverse event rate was similar across all treatment arms.

Study details: This phase 2b trial included 180 postmenopausal women with stage 0-II, ER+ BC who were randomly assigned to receive 25 mg exemestane once daily, 3 times weekly, or once weekly for 4-6 weeks before surgery.

Disclosures: This study was supported by the US National Cancer Institute and other sources. Two authors declared being principal investigators, holding stocks, or receiving partial salary support or personal fees from various sources.

Source: Serrano D et al. Efficacy of alternative dose regimens of exemestane in postmenopausal women with stage 0 to II estrogen receptor-positive breast cancer: A randomized clinical trial. JAMA Oncol. 2023 (Mar 23). Doi: 10.1001/jamaoncol.2023.0089

Key clinical point: A dose of 25 mg exemestane 3 times weekly was noninferior to the standard once-daily dose in decreasing serum estradiol levels in postmenopausal women with stage 0-II estrogen receptor-positive (ER+) breast cancer (BC).

Major finding: Compared with once-daily exemestane, 3-times-weekly exemestane was noninferior (difference in percentage change 2.0%; P for noninferiority = .02) whereas once-weekly exemestane was less effective in decreasing serum estradiol levels in participants who received ≥80% of the active scheduled pills and underwent blood testing as per protocol. The adverse event rate was similar across all treatment arms.

Study details: This phase 2b trial included 180 postmenopausal women with stage 0-II, ER+ BC who were randomly assigned to receive 25 mg exemestane once daily, 3 times weekly, or once weekly for 4-6 weeks before surgery.

Disclosures: This study was supported by the US National Cancer Institute and other sources. Two authors declared being principal investigators, holding stocks, or receiving partial salary support or personal fees from various sources.

Source: Serrano D et al. Efficacy of alternative dose regimens of exemestane in postmenopausal women with stage 0 to II estrogen receptor-positive breast cancer: A randomized clinical trial. JAMA Oncol. 2023 (Mar 23). Doi: 10.1001/jamaoncol.2023.0089

Key clinical point: A dose of 25 mg exemestane 3 times weekly was noninferior to the standard once-daily dose in decreasing serum estradiol levels in postmenopausal women with stage 0-II estrogen receptor-positive (ER+) breast cancer (BC).

Major finding: Compared with once-daily exemestane, 3-times-weekly exemestane was noninferior (difference in percentage change 2.0%; P for noninferiority = .02) whereas once-weekly exemestane was less effective in decreasing serum estradiol levels in participants who received ≥80% of the active scheduled pills and underwent blood testing as per protocol. The adverse event rate was similar across all treatment arms.

Study details: This phase 2b trial included 180 postmenopausal women with stage 0-II, ER+ BC who were randomly assigned to receive 25 mg exemestane once daily, 3 times weekly, or once weekly for 4-6 weeks before surgery.

Disclosures: This study was supported by the US National Cancer Institute and other sources. Two authors declared being principal investigators, holding stocks, or receiving partial salary support or personal fees from various sources.

Source: Serrano D et al. Efficacy of alternative dose regimens of exemestane in postmenopausal women with stage 0 to II estrogen receptor-positive breast cancer: A randomized clinical trial. JAMA Oncol. 2023 (Mar 23). Doi: 10.1001/jamaoncol.2023.0089

Key clinical point: Polatuzumab vedotin (Pola)-rituximab-cyclophosphamide, doxorubicin, and prednisone (R-CHP) compared with other novel regimens prolongs progression-free survival (PFS) in patients with previously untreated activated B-cell (ABC)-type diffuse large B-cell lymphoma (DLBCL).

Major finding: Pola-R-CHP prolonged PFS in patients with ABC-type DLBCL compared with rituximab-cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP)+bortezomib (hazard ratio [HR] 0.52; P  =  .02); R-CHOP+ibrutinib (HR 0.43; P  =  .001), R-CHOP+lenalidomide (HR 0.51; P  =  .009), obinutuzumab-CHOP (HR 0.46; P  =  .008), R-CHOP (HR 0.40; P < .001), and bortezomib, rituximab, and cyclophosphamide (HR 0.44; P  =  .07). Pola-R-CHP had no PFS benefit in patients with germinal center B-cell (GCB)-type DLBCL.

Study details: This was a network meta-analysis of 12 randomized controlled trials involving 8376 patients with previously untreated ABC- or GCB-type DLBCL who received Pola-R-CHP or other regimens.

Disclosures: This study did not report the funding source. The authors declared no conflicts of interest.

Source: Sheng Z et al. Superiority of polatuzumab vedotin over other novel agents in previously untreated ABC‑type diffuse large B‑cell lymphoma: A network meta‑analysis of 20 RCTs. Ann Hematol. 2023;102:1011-1017 (Mar 22). Doi: 10.1007/s00277-023-05161-1

Key clinical point: Polatuzumab vedotin (Pola)-rituximab-cyclophosphamide, doxorubicin, and prednisone (R-CHP) compared with other novel regimens prolongs progression-free survival (PFS) in patients with previously untreated activated B-cell (ABC)-type diffuse large B-cell lymphoma (DLBCL).

Major finding: Pola-R-CHP prolonged PFS in patients with ABC-type DLBCL compared with rituximab-cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP)+bortezomib (hazard ratio [HR] 0.52; P  =  .02); R-CHOP+ibrutinib (HR 0.43; P  =  .001), R-CHOP+lenalidomide (HR 0.51; P  =  .009), obinutuzumab-CHOP (HR 0.46; P  =  .008), R-CHOP (HR 0.40; P < .001), and bortezomib, rituximab, and cyclophosphamide (HR 0.44; P  =  .07). Pola-R-CHP had no PFS benefit in patients with germinal center B-cell (GCB)-type DLBCL.

Study details: This was a network meta-analysis of 12 randomized controlled trials involving 8376 patients with previously untreated ABC- or GCB-type DLBCL who received Pola-R-CHP or other regimens.

Disclosures: This study did not report the funding source. The authors declared no conflicts of interest.

Source: Sheng Z et al. Superiority of polatuzumab vedotin over other novel agents in previously untreated ABC‑type diffuse large B‑cell lymphoma: A network meta‑analysis of 20 RCTs. Ann Hematol. 2023;102:1011-1017 (Mar 22). Doi: 10.1007/s00277-023-05161-1

Key clinical point: Polatuzumab vedotin (Pola)-rituximab-cyclophosphamide, doxorubicin, and prednisone (R-CHP) compared with other novel regimens prolongs progression-free survival (PFS) in patients with previously untreated activated B-cell (ABC)-type diffuse large B-cell lymphoma (DLBCL).

Major finding: Pola-R-CHP prolonged PFS in patients with ABC-type DLBCL compared with rituximab-cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP)+bortezomib (hazard ratio [HR] 0.52; P  =  .02); R-CHOP+ibrutinib (HR 0.43; P  =  .001), R-CHOP+lenalidomide (HR 0.51; P  =  .009), obinutuzumab-CHOP (HR 0.46; P  =  .008), R-CHOP (HR 0.40; P < .001), and bortezomib, rituximab, and cyclophosphamide (HR 0.44; P  =  .07). Pola-R-CHP had no PFS benefit in patients with germinal center B-cell (GCB)-type DLBCL.

Study details: This was a network meta-analysis of 12 randomized controlled trials involving 8376 patients with previously untreated ABC- or GCB-type DLBCL who received Pola-R-CHP or other regimens.

Disclosures: This study did not report the funding source. The authors declared no conflicts of interest.

Source: Sheng Z et al. Superiority of polatuzumab vedotin over other novel agents in previously untreated ABC‑type diffuse large B‑cell lymphoma: A network meta‑analysis of 20 RCTs. Ann Hematol. 2023;102:1011-1017 (Mar 22). Doi: 10.1007/s00277-023-05161-1

Key clinical point: The addition of bortezomib to rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisolone (R-CHOP) confers a survival advantage over R-CHOP in patients with activated B-cell (ABC)- and molecular high grade (MHG)-type diffuse large B-cell lymphoma (DLBCL).

Major finding: Bortezomib-R-CHOP vs R-CHOP significantly improved 60-month progression-free survival (PFS) in the ABC (adjusted hazard ratio [aHR] 0.65; P  =  .041) and MHG (aHR 0.46; P  =  .011) groups, and overall survival (OS) in the ABC group (aHR 0.58; P  =  .032). The germinal center B-cell (GCB) group showed no significant difference in PFS or OS.

Study details: This updated retrospective analysis of the phase 3 REMoDL-B study included 801 adult patients with DLBCL (ABC, MHG, or GCB subtype) who were randomly assigned to receive 2-6 cycles of R-CHOP (n = 407) or bortezomib-R-CHOP (n = 394) after one cycle of R-CHOP.

Disclosures: This study was supported by a grant from Janssen-Cilag and Cancer Research UK. Some authors reported ties with various organizations, including Janssen.

Source: Davies AJ et al. Differential efficacy from the addition of bortezomib to r-chop in diffuse large B-cell lymphoma according to the molecular subgroup in the REMoDL-B study with a 5-year follow-up. J Clin Oncol. 2023 (Mar 27). Doi: 10.1200/JCO.23.00033

Key clinical point: The addition of bortezomib to rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisolone (R-CHOP) confers a survival advantage over R-CHOP in patients with activated B-cell (ABC)- and molecular high grade (MHG)-type diffuse large B-cell lymphoma (DLBCL).

Major finding: Bortezomib-R-CHOP vs R-CHOP significantly improved 60-month progression-free survival (PFS) in the ABC (adjusted hazard ratio [aHR] 0.65; P  =  .041) and MHG (aHR 0.46; P  =  .011) groups, and overall survival (OS) in the ABC group (aHR 0.58; P  =  .032). The germinal center B-cell (GCB) group showed no significant difference in PFS or OS.

Study details: This updated retrospective analysis of the phase 3 REMoDL-B study included 801 adult patients with DLBCL (ABC, MHG, or GCB subtype) who were randomly assigned to receive 2-6 cycles of R-CHOP (n = 407) or bortezomib-R-CHOP (n = 394) after one cycle of R-CHOP.

Disclosures: This study was supported by a grant from Janssen-Cilag and Cancer Research UK. Some authors reported ties with various organizations, including Janssen.

Source: Davies AJ et al. Differential efficacy from the addition of bortezomib to r-chop in diffuse large B-cell lymphoma according to the molecular subgroup in the REMoDL-B study with a 5-year follow-up. J Clin Oncol. 2023 (Mar 27). Doi: 10.1200/JCO.23.00033

Key clinical point: The addition of bortezomib to rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisolone (R-CHOP) confers a survival advantage over R-CHOP in patients with activated B-cell (ABC)- and molecular high grade (MHG)-type diffuse large B-cell lymphoma (DLBCL).

Major finding: Bortezomib-R-CHOP vs R-CHOP significantly improved 60-month progression-free survival (PFS) in the ABC (adjusted hazard ratio [aHR] 0.65; P  =  .041) and MHG (aHR 0.46; P  =  .011) groups, and overall survival (OS) in the ABC group (aHR 0.58; P  =  .032). The germinal center B-cell (GCB) group showed no significant difference in PFS or OS.

Study details: This updated retrospective analysis of the phase 3 REMoDL-B study included 801 adult patients with DLBCL (ABC, MHG, or GCB subtype) who were randomly assigned to receive 2-6 cycles of R-CHOP (n = 407) or bortezomib-R-CHOP (n = 394) after one cycle of R-CHOP.

Disclosures: This study was supported by a grant from Janssen-Cilag and Cancer Research UK. Some authors reported ties with various organizations, including Janssen.

Source: Davies AJ et al. Differential efficacy from the addition of bortezomib to r-chop in diffuse large B-cell lymphoma according to the molecular subgroup in the REMoDL-B study with a 5-year follow-up. J Clin Oncol. 2023 (Mar 27). Doi: 10.1200/JCO.23.00033

Key clinical point: Compared with idelalisib+rituximab (R-idela), ibrutinib significantly prolonged survival and was associated with lower treatment discontinuation rates in patients with relapsed or refractory chronic lymphocytic leukemia (CLL) in routine practice.

Major finding: The ibrutinib vs R-idela group had significantly longer median progression-free survival (40.5 vs 22.0 months; hazard ratio [HR] 0.55; P < .001) and overall survival (54.4 vs 37.7 months; HR 0.73; P  =  .040) and lower rates of treatment discontinuation due to toxicity (22.5% vs 39.8%) and CLL progression (11.1% vs 27.5%).

Study details: This real-world retrospective study included 415 patients with relapsed or refractory CLL from the Chronic Lymphocytic Leukemia Patients Registry who received R-idela (n = 171) or ibrutinib (n = 244).

Disclosures: This study was funded by grants from the Ministry of Health, Czech Republic, and Programme Cooperation, Research Area ONCO. Some authors reported ties with various organizations.

Source: Spacek M et al for the Czech CLL Study Group. Idelalisib plus rituximab versus ibrutinib in the treatment of relapsed/refractory chronic lymphocytic leukaemia: A real-world analysis from the Chronic Lymphocytic Leukemia Patients Registry (CLLEAR). Br J Haematol. 2023 (Mar 27). Doi: 10.1111/bjh.18736

Key clinical point: Compared with idelalisib+rituximab (R-idela), ibrutinib significantly prolonged survival and was associated with lower treatment discontinuation rates in patients with relapsed or refractory chronic lymphocytic leukemia (CLL) in routine practice.

Major finding: The ibrutinib vs R-idela group had significantly longer median progression-free survival (40.5 vs 22.0 months; hazard ratio [HR] 0.55; P < .001) and overall survival (54.4 vs 37.7 months; HR 0.73; P  =  .040) and lower rates of treatment discontinuation due to toxicity (22.5% vs 39.8%) and CLL progression (11.1% vs 27.5%).

Study details: This real-world retrospective study included 415 patients with relapsed or refractory CLL from the Chronic Lymphocytic Leukemia Patients Registry who received R-idela (n = 171) or ibrutinib (n = 244).

Disclosures: This study was funded by grants from the Ministry of Health, Czech Republic, and Programme Cooperation, Research Area ONCO. Some authors reported ties with various organizations.

Source: Spacek M et al for the Czech CLL Study Group. Idelalisib plus rituximab versus ibrutinib in the treatment of relapsed/refractory chronic lymphocytic leukaemia: A real-world analysis from the Chronic Lymphocytic Leukemia Patients Registry (CLLEAR). Br J Haematol. 2023 (Mar 27). Doi: 10.1111/bjh.18736

Key clinical point: Compared with idelalisib+rituximab (R-idela), ibrutinib significantly prolonged survival and was associated with lower treatment discontinuation rates in patients with relapsed or refractory chronic lymphocytic leukemia (CLL) in routine practice.

Major finding: The ibrutinib vs R-idela group had significantly longer median progression-free survival (40.5 vs 22.0 months; hazard ratio [HR] 0.55; P < .001) and overall survival (54.4 vs 37.7 months; HR 0.73; P  =  .040) and lower rates of treatment discontinuation due to toxicity (22.5% vs 39.8%) and CLL progression (11.1% vs 27.5%).

Study details: This real-world retrospective study included 415 patients with relapsed or refractory CLL from the Chronic Lymphocytic Leukemia Patients Registry who received R-idela (n = 171) or ibrutinib (n = 244).

Disclosures: This study was funded by grants from the Ministry of Health, Czech Republic, and Programme Cooperation, Research Area ONCO. Some authors reported ties with various organizations.

Source: Spacek M et al for the Czech CLL Study Group. Idelalisib plus rituximab versus ibrutinib in the treatment of relapsed/refractory chronic lymphocytic leukaemia: A real-world analysis from the Chronic Lymphocytic Leukemia Patients Registry (CLLEAR). Br J Haematol. 2023 (Mar 27). Doi: 10.1111/bjh.18736

Key clinical point: Chimeric antigen receptor (CAR)-T cell therapy after lymphodepletion led to similar survival outcomes and toxicity rates in patients with nodal (ND) and extra nodal (EN) diffuse large B-cell lymphoma (DLBCL), with outcomes being significantly worse in patients with >2 vs <3 EN sites at lymphodepletion.

Major finding: After a median follow-up of 7.5 months, patients with EN and ND DLBCL had similar median progression-free survival (PFS; 10.76 and 14.1 months, respectively; P  =  .126), overall survival (OS; 15.36 and 18.4 months, respectively; P  =  .100), and treatment-related toxicity rates. Patients with <3 vs >2 EN sites had significantly longer median PFS (P  =  .01) and OS (P  =  .05).

Study details: This real-world retrospective multicenter study included 126 patients with DLBCL of EN (n = 72) or ND (n = 42) origin who underwent lymphodepletion followed by CAR-T cell infusion with tisagenlecleucel or axicabtagene ciloleucel.

Disclosures: No information on the source of funding was provided. The authors declared no conflicts of interest.

Source: Katz OB et al. Response rates of extra-nodal diffuse large B cell lymphoma to anti CD19-CAR T cells: A real word retrospective multi-center study. Eur J Haematol. 2023 (Mar 25). Doi: 10.1111/ejh.13968

Key clinical point: Chimeric antigen receptor (CAR)-T cell therapy after lymphodepletion led to similar survival outcomes and toxicity rates in patients with nodal (ND) and extra nodal (EN) diffuse large B-cell lymphoma (DLBCL), with outcomes being significantly worse in patients with >2 vs <3 EN sites at lymphodepletion.

Major finding: After a median follow-up of 7.5 months, patients with EN and ND DLBCL had similar median progression-free survival (PFS; 10.76 and 14.1 months, respectively; P  =  .126), overall survival (OS; 15.36 and 18.4 months, respectively; P  =  .100), and treatment-related toxicity rates. Patients with <3 vs >2 EN sites had significantly longer median PFS (P  =  .01) and OS (P  =  .05).

Study details: This real-world retrospective multicenter study included 126 patients with DLBCL of EN (n = 72) or ND (n = 42) origin who underwent lymphodepletion followed by CAR-T cell infusion with tisagenlecleucel or axicabtagene ciloleucel.

Disclosures: No information on the source of funding was provided. The authors declared no conflicts of interest.

Source: Katz OB et al. Response rates of extra-nodal diffuse large B cell lymphoma to anti CD19-CAR T cells: A real word retrospective multi-center study. Eur J Haematol. 2023 (Mar 25). Doi: 10.1111/ejh.13968

Key clinical point: Chimeric antigen receptor (CAR)-T cell therapy after lymphodepletion led to similar survival outcomes and toxicity rates in patients with nodal (ND) and extra nodal (EN) diffuse large B-cell lymphoma (DLBCL), with outcomes being significantly worse in patients with >2 vs <3 EN sites at lymphodepletion.

Major finding: After a median follow-up of 7.5 months, patients with EN and ND DLBCL had similar median progression-free survival (PFS; 10.76 and 14.1 months, respectively; P  =  .126), overall survival (OS; 15.36 and 18.4 months, respectively; P  =  .100), and treatment-related toxicity rates. Patients with <3 vs >2 EN sites had significantly longer median PFS (P  =  .01) and OS (P  =  .05).

Study details: This real-world retrospective multicenter study included 126 patients with DLBCL of EN (n = 72) or ND (n = 42) origin who underwent lymphodepletion followed by CAR-T cell infusion with tisagenlecleucel or axicabtagene ciloleucel.

Disclosures: No information on the source of funding was provided. The authors declared no conflicts of interest.

Source: Katz OB et al. Response rates of extra-nodal diffuse large B cell lymphoma to anti CD19-CAR T cells: A real word retrospective multi-center study. Eur J Haematol. 2023 (Mar 25). Doi: 10.1111/ejh.13968

Key clinical point: Sufficiently fit older patients with high-risk diffuse large B-cell lymphoma (DLBCL) achieve favorable outcomes with dose-adjusted etoposide, prednisone, vincristine, cyclophosphamide, doxorubicin, and rituximab (DA-EPOCH-R); patients with a poor performance status (PS) develop unacceptable toxicity and require less intensive therapy.

Major finding: At 3 years, the progression-free survival (PFS) and overall survival (OS) rates were 53% and 58%, respectively, and the treatment-related mortality (TRM) rate was 13%. The 3-year PFS (58% vs 32%; P < .001) and OS (64% vs 33%; P  =  .007) rates were significantly higher and TRM rates were significantly lower (6% vs 43%; P < .001) among patients with PS 0-2 vs 3-4.

Study details: This multicenter retrospective real-life study included 120 patients aged ≥60 years with newly diagnosed high-risk DLBCL treated with a median of 6 DA-EPOCH-R cycles per patient.

Disclosures: No information on the source of funding or conflicts of interest was provided.

Source: Mitrovic Z et al. Dose-adjusted EPOCH and rituximab (DA-EPOCH-R) in older patients with high-risk aggressive diffuse large B-cell lymphoma: A real-life multicenter study by the Croatian Cooperative Group for Hematologic diseases (KroHem). Eur J Haematol. 2023 (Mar 20). Doi: 10.1111/ejh.13957

Key clinical point: Sufficiently fit older patients with high-risk diffuse large B-cell lymphoma (DLBCL) achieve favorable outcomes with dose-adjusted etoposide, prednisone, vincristine, cyclophosphamide, doxorubicin, and rituximab (DA-EPOCH-R); patients with a poor performance status (PS) develop unacceptable toxicity and require less intensive therapy.

Major finding: At 3 years, the progression-free survival (PFS) and overall survival (OS) rates were 53% and 58%, respectively, and the treatment-related mortality (TRM) rate was 13%. The 3-year PFS (58% vs 32%; P < .001) and OS (64% vs 33%; P  =  .007) rates were significantly higher and TRM rates were significantly lower (6% vs 43%; P < .001) among patients with PS 0-2 vs 3-4.

Study details: This multicenter retrospective real-life study included 120 patients aged ≥60 years with newly diagnosed high-risk DLBCL treated with a median of 6 DA-EPOCH-R cycles per patient.

Disclosures: No information on the source of funding or conflicts of interest was provided.

Source: Mitrovic Z et al. Dose-adjusted EPOCH and rituximab (DA-EPOCH-R) in older patients with high-risk aggressive diffuse large B-cell lymphoma: A real-life multicenter study by the Croatian Cooperative Group for Hematologic diseases (KroHem). Eur J Haematol. 2023 (Mar 20). Doi: 10.1111/ejh.13957

Key clinical point: Sufficiently fit older patients with high-risk diffuse large B-cell lymphoma (DLBCL) achieve favorable outcomes with dose-adjusted etoposide, prednisone, vincristine, cyclophosphamide, doxorubicin, and rituximab (DA-EPOCH-R); patients with a poor performance status (PS) develop unacceptable toxicity and require less intensive therapy.

Major finding: At 3 years, the progression-free survival (PFS) and overall survival (OS) rates were 53% and 58%, respectively, and the treatment-related mortality (TRM) rate was 13%. The 3-year PFS (58% vs 32%; P < .001) and OS (64% vs 33%; P  =  .007) rates were significantly higher and TRM rates were significantly lower (6% vs 43%; P < .001) among patients with PS 0-2 vs 3-4.

Study details: This multicenter retrospective real-life study included 120 patients aged ≥60 years with newly diagnosed high-risk DLBCL treated with a median of 6 DA-EPOCH-R cycles per patient.

Disclosures: No information on the source of funding or conflicts of interest was provided.

Source: Mitrovic Z et al. Dose-adjusted EPOCH and rituximab (DA-EPOCH-R) in older patients with high-risk aggressive diffuse large B-cell lymphoma: A real-life multicenter study by the Croatian Cooperative Group for Hematologic diseases (KroHem). Eur J Haematol. 2023 (Mar 20). Doi: 10.1111/ejh.13957

Key clinical point: Axicabtagene ciloleucel (axi-cel) is an effective second-line curative-intent therapy with a manageable safety profile for patients aged ≥65 years with relapsed or refractory large B-cell lymphoma (LBCL).

Major finding: At a median follow-up of 24.3 months, the median event-free survival was significantly longer with axi-cel vs standard of care (SOC; 21.5 vs 2.5 months; hazard ratio 0.276; descriptive P < .0001). The grade ≥3 treatment-emergent adverse event rates were 94% and 82% with axi-cel and SOC, respectively.

Study details: Findings are from a preplanned analysis of 109 patients aged ≥65 years with relapsed or refractory LBCL from the ZUMA-7 trial who were randomly assigned to receive second-line axi-cel (n = 51) or SOC (n = 58; 2-3 cycles of chemoimmunotherapy followed by high-dose chemotherapy with autologous stem-cell transplantation).

Disclosures: This study was supported by Kite, a Gilead Company. Some authors reported ties with various organizations, including Kite and Gilead.

Source: Westin JR et al. Safety and efficacy of axicabtagene ciloleucel versus standard of care in patients 65 years of age or older with relapsed/refractory large B-cell lymphoma. Clin Cancer Res. 2023 (Mar 31). Doi: 10.1158/1078-0432.CCR-22-3136

Key clinical point: Axicabtagene ciloleucel (axi-cel) is an effective second-line curative-intent therapy with a manageable safety profile for patients aged ≥65 years with relapsed or refractory large B-cell lymphoma (LBCL).

Major finding: At a median follow-up of 24.3 months, the median event-free survival was significantly longer with axi-cel vs standard of care (SOC; 21.5 vs 2.5 months; hazard ratio 0.276; descriptive P < .0001). The grade ≥3 treatment-emergent adverse event rates were 94% and 82% with axi-cel and SOC, respectively.

Study details: Findings are from a preplanned analysis of 109 patients aged ≥65 years with relapsed or refractory LBCL from the ZUMA-7 trial who were randomly assigned to receive second-line axi-cel (n = 51) or SOC (n = 58; 2-3 cycles of chemoimmunotherapy followed by high-dose chemotherapy with autologous stem-cell transplantation).

Disclosures: This study was supported by Kite, a Gilead Company. Some authors reported ties with various organizations, including Kite and Gilead.

Source: Westin JR et al. Safety and efficacy of axicabtagene ciloleucel versus standard of care in patients 65 years of age or older with relapsed/refractory large B-cell lymphoma. Clin Cancer Res. 2023 (Mar 31). Doi: 10.1158/1078-0432.CCR-22-3136

Key clinical point: Axicabtagene ciloleucel (axi-cel) is an effective second-line curative-intent therapy with a manageable safety profile for patients aged ≥65 years with relapsed or refractory large B-cell lymphoma (LBCL).

Major finding: At a median follow-up of 24.3 months, the median event-free survival was significantly longer with axi-cel vs standard of care (SOC; 21.5 vs 2.5 months; hazard ratio 0.276; descriptive P < .0001). The grade ≥3 treatment-emergent adverse event rates were 94% and 82% with axi-cel and SOC, respectively.

Study details: Findings are from a preplanned analysis of 109 patients aged ≥65 years with relapsed or refractory LBCL from the ZUMA-7 trial who were randomly assigned to receive second-line axi-cel (n = 51) or SOC (n = 58; 2-3 cycles of chemoimmunotherapy followed by high-dose chemotherapy with autologous stem-cell transplantation).

Disclosures: This study was supported by Kite, a Gilead Company. Some authors reported ties with various organizations, including Kite and Gilead.

Source: Westin JR et al. Safety and efficacy of axicabtagene ciloleucel versus standard of care in patients 65 years of age or older with relapsed/refractory large B-cell lymphoma. Clin Cancer Res. 2023 (Mar 31). Doi: 10.1158/1078-0432.CCR-22-3136