Studies presented at the 66th American Society of Hematology (ASH) Annual Meeting and Exposition showcase significant strides in preventing and treating blood cancers and pre-cancerous conditions. The research spans from early intervention strategies to novel therapies and addresses disparities in access to care.
Daratumumab Reduces Progression Risk in Smoldering Multiple Myeloma
A phase 3 randomized study (AQUILA) revealed that daratumumab monotherapy significantly reduces the risk of disease progression in patients with high-risk smoldering multiple myeloma. Patients receiving daratumumab experienced a 51% reduction in disease progression compared to those under active monitoring. After a median follow-up of 65.2 months, 63.1% of patients on daratumumab did not progress to active multiple myeloma at five years, compared to 40.8% in the active monitoring group. The overall response rate in the daratumumab group was 63.4%, versus 2.0% in the active monitoring group. Meletios A. Dimopoulos, MD, noted the findings offer a new option for high-risk patients when considering treatment versus active monitoring. The study was funded by Janssen Research & Development.
Acalabrutinib and Venetoclax Improve Outcomes in Untreated CLL
In previously untreated chronic lymphocytic leukemia (CLL) patients, a combination of acalabrutinib and venetoclax demonstrated superior progression-free survival (PFS) compared to standard chemoimmunotherapy regimens. The AMPLIFY trial, a phase 3 study, also showed fewer serious adverse events with the oral drug combination. Jennifer R. Brown, MD, PhD, highlighted the regimen's simplicity and manageable safety profile. After a median follow-up of 41 months, the AV regimen showed a statistically significant improvement in PFS compared with the control regimen of FCR or BR. An estimated 76.8% of patients who received AV were free of disease progression at three years, compared with 66.5% of patients who received FCR or BR. The study was funded by AstraZeneca.
Epcoritamab Shows Promise in Relapsed/Refractory CLL
Early results from the EPCORE CLL-1 trial indicate that epcoritamab, a bispecific T-cell engager, shows a high overall response rate and manageable safety profile in heavily pretreated relapsed or refractory CLL patients. Alexey Danilov, MD, PhD, emphasized the unmet need for effective treatments after failure of both BTK and BCL2 inhibitors. In the EXP cohort, after a median follow-up period of 22.8 months, the ORR was 61%. Among responding patients, 39% had a complete response. The study was funded by GenMab and AbbVie.
Socioeconomic Factors Limit Access to Stem Cell Transplants in AML
A prospective study revealed that socioeconomic factors significantly impact access to allogeneic hematopoietic cell transplantation (HCT) for acute myeloid leukemia (AML) patients. Patients residing in neighborhoods with lower education levels, higher poverty rates, or greater reliance on federal assistance programs were less likely to receive HCT and more likely to die without it. Natalie Wuliji, DO, noted that these barriers have a greater impact on the ability to receive a transplant or on the risk of death before transplant than on outcomes after the transplant. The study, which followed 692 adult patients for a median of 4.5 years, was funded by the Patient-Centered Outcomes Research Institute, the American Cancer Society, and the American Society of Hematology.
