David J. Andorsky, MD, is a medical oncologist and hematologist at Rocky Mountain Cancer Centers; as well as the associate chair of US Oncology Hematology Research.

Dr Andorsky on Molecular Responses With Second-Line Asciminib in CP-CML

"We found that 42.9% of patients experienced a MMR…in the second-line [cohort], and we thought those were very positive results."

David J. Andorsky, MD, a medical oncologist and hematologist at Rocky Mountain Cancer Centers; as well as the associate chair of US Oncology Hematology Research, discusses interim results from the phase 2 ASC2ESCALATE study (NCT05384587) evaluating asciminib (Scemblix) dose escalation in patients with chronic myeloid leukemia in chronic phase (CP-CML) previously treated with 1 TKI.

The single-arm, open-label ASC2ESCALATE study enrolled adult patients with CP-CML who were either newly diagnosed or had received 1 prior ATP-competitive TKI. The primary end point of the study was major molecular response (MMR) at 48 weeks. This interim analysis focused on second-line patients who enrolled in the trial and received at least 1 dose of asciminib on or before the data cutoff date, with an earlier time evaluation point of molecular response rate at 24 weeks.

 demonstrated high molecular response rates with asciminib at 24 weeks and early deep molecular responses (MR

), with consistent safety and tolerability. Andorsky reported that 42.9% of patients achieved MMR at 24 weeks, with a BCR::ABL1

 levels of 0.1% or less on the international scale, which is considered the critical threshold to prevent disease progression or transition into accelerated phase, according to Andorsky. For a second-line trial, these results were promising, Andorsky emphasized.

Moreover, only 2 of 28 patients eligible for escalation to the next dose level required dose adjustment, Andorsky added. Most patients performed well and experienced benefit with the 80-mg daily starting dose, which is the current FDA-approved dose for asciminib, Andorsky stated. These results suggest that asciminib may be a beneficial treatment option with a manageable dosing regimen for patients with CP-CML receiving second-line therapy, Andorsky concluded.

Videos

David J. Andorsky, MD, discusses molecular responses achieved with asciminib dose escalation in patients with CP-CML who had received 1 prior TKI.

Treatment With Tazemetostat, Lenalidomide, and Rituximab in Follicular Lymphoma

Dr Andorsky on Treatment With Tazemetostat, Lenalidomide, and Rituximab in Follicular Lymphoma

David J. Andorsky, MD, medical oncologist and hematologist, Rocky Mountain Cancer Centers, associate chair, US Oncology Hematology Research, discusses recently observed patterns of care with BTK inhibitors in patients with chronic lymphocytic leukemia (CLL) or small lymphocytic lymphoma (SLL) in the community setting in the United States, and how social determinants of health may have affected these outcomes. 

David J. Andorsky, MD, discusses recently observed patterns of care with BTK inhibitors in patients with chronic lymphocytic leukemia or small lymphocytic lymphoma in the community setting in the United States, and how social determinants of health may have affected these outcomes.

Dr Andorsky on Real-World Treatment Patterns With BTK Inhibitors in CLL/SLL

David J. Andorsky, MD, medical oncologist/hematologist, Rocky Mountain Cancer Centers, discusses the results of a subgroup analysis of the phase 3b MAGNIFY trial in relapsed/refractory non-Hodgkin lymphoma (NHL).

The MAGNIFY trial evaluated induction rituximab (Rituxan) plus lenalidomide (Revlimid; R

) followed by lenalidomide versus rituximab maintenance therapy for patients with relapsed/refractory follicular lymphoma, marginal zone lymphoma, or mantle cell lymphoma. During the 2020 ASH Annual Meeting & Exposition, findings from subgroup analyses of the MAGNIFY trial were presented virtually and showed similar responses in elderly patients aged 70 or older and younger patients, says Andorsky.

Patients within the older population were a median age of 76; 29% of patients were 80 years or older, explains Andorsky. Additionally, older patients had lower incidences of high-risk features and early relapse compared with the general population. 

The overall response rate in the older and younger populations was 75%; the complete response rate was 39% in the older population and 47% in the younger population. The median progression-free survival was similar between groups, at 40.1 months and 41.6 months, respectively. Finally, the regimen was found to be well tolerated among older patients, with similar rates of neutropenia observed compared with the younger population, concludes Andorsky. 

David J. Andorsky, MD, discusses the results of a subgroup analysis of the phase 3b MAGNIFY trial in relapsed/refractory non-Hodgkin lymphoma.  



Dr. Andorsky on the Results of a Subgroup Analysis of the MAGNIFY Trial in NHL 

David J. Andorsky, MD, medical oncology/hematology, Rocky Mountain Cancer Centers, discusses the next steps of the phase IIIb randomized MAGNIFY study of lenalidomide (Revlimid) plus rituximab (Rituxan) followed by maintenance therapy in relapsed/refractory non-Hodgkin lymphoma, focusing on a cohort of patients with follicular lymphoma.

Enrollment to this trial is still ongoing; it is about halfway there, Andorsky explains, and investigators are anticipating another 2 years of enrollment. Researchers will be investigating the durability of these responses; the median duration of response has not yet been reached. It is questionable whether it will go beyond 2 years. Because this is an immunotherapy, it is logical that these will be longer responses, he adds.

The other cohorts of this trial, which are comprised of marginal zone lymphoma and mantle cell lymphoma, are continuing to accrue, as well.

Dr. Andorsky on Next Steps Following MAGNIFY Trial in Follicular Lymphoma

David J. Andorsky, MD, medical oncology/hematology, Rocky Mountain Cancer Centers, discusses the phase IIIb randomized MAGNIFY study of lenalidomide (Revlimid) plus rituximab (Rituxan) followed by maintenance therapy in relapsed/refractory non-Hodgkin lymphoma, focusing on a cohort of patients with follicular lymphoma.

This trial was open to all patients with indolent non-Hodgkin lymphoma. All patients received 12 cycles of induction therapy, consisting of 20 mg daily of lenalidomide and also treatment with rituximab, Andorsky explains. After that 1-year period, patients with stable disease or better were randomized to receive either maintenance therapy with the combination or rituximab alone, which is the standard of care.

In the follicular lymphoma cohort, 160 patients were enrolled, and 50 patients were early relapsers who are known to have a worse prognosis. Double-refractory patients were another 50-or so patients enrolled in this study, he adds. At a median follow-up of 10 months, results showed that for the follicular lymphoma cohort, the overall response rate (ORR) was 66%. For early relapsers and double-refractory patients, the ORR was 45%.

David J. Andorsky, MD

Articles

Dr Andorsky on Molecular Responses With Second-Line Asciminib in CP-CML

Dr Andorsky on Real-World Treatment Patterns With BTK Inhibitors in CLL/SLL

Dr. Andorsky on the Results of a Subgroup Analysis of the MAGNIFY Trial in NHL

Dr. Andorsky on Next Steps Following MAGNIFY Trial in Follicular Lymphoma

Dr. Andorsky on the MAGNIFY Trial in Follicular Lymphoma