59th American Society of Hematology Annual Meeting & Exposition

The American Society of Hematology (ASH) has been the world’s leading professional society for medical practitioners treating patients with malignant and nonmalignant hematologic disorders since its founding in 1958. The organization currently counts more than 16,000 members from 100 nations, and their signature publication, Blood, is the world’s most highly cited hematologic journal.

The ASH Annual Meeting & Exposition, held every December, remains an exciting learning ground for advancements within the specialty. This year’s meeting—held in Atlanta, GA, from December 9 through December 12—featured more than 400 abstract presentations, lectures, panels, and discussions. The meeting also included the election of Stephanie Lee, MD, Fred Hutchinson Cancer Research Center (Seattle, WA), to a yearlong term as vice president of ASH, followed by successive terms as president-elect and president. Agnes Lee, MD, University of British Columbia (Vancouver, BC), and Joseph Mikhael, MD, Mayo Clinic (Phoenix, AZ), were each elected to 4-year terms as ASH councilors. 

“In this time of unprecedented scientific progress, ASH continues to play a leading role in ensuring that these research advances are translated to the bedside to improve the care of hematology patients,” said 2017 ASH President Kenneth C Anderson, MD, Lebow Institute for Myeloma Therapeutics and Jerome Lipper Myeloma Center at Dana-Farber Cancer Institute (Boston, MA). “It is exciting to have such a diverse and accomplished group of leaders helping to guide the Society as we work with policymakers, educators, researchers, clinicians, patients, and other stakeholders to shape the future of hematology and work toward our ultimate goal of conquering blood diseases worldwide.”

Staff from Journal of Clinical Pathways attended the meeting in order to provide the most comprehensive coverage available.

Toxicities Increased for Patients Receiving CLL Treatments in Real-World Settings

A recent study found that while treatment outcomes for a chronic lymphocytic leukemia (CLL) therapy are comparable in clinical trials and the real-world setting, adverse events are increased in the latter.

While ibrutinib is approved for all lines of therapy in CLL in the United States and Europe, front-line studies of the drug have mostly enrolled older patients with low-risk disease. This population of patients are not representative of patients seen in clinical practice, thus signifying that treatment patterns and outcomes may differ in clinical trials and in the real-world setting.

Anthony R Mato, MD, Center for CLL, University of Pennsylvania, Abramson Cancer Center, and colleagues studied the use of front-line ibrutinib in patients with CLL treated in the real-world setting. A total of 391 patients (85.5% of whom were high-risk) treated with ibrutinib across 19 academic and community sites were retrospectively analyzed. Researchers examined demographics, prognostic factors, dosing, discontinuation rates, adverse events, overall response rate (ORR), and survival outcomes.

The primary endpoint was progression-free survival (PFS), measured from the time of ibrutinib initiation until CLL progression, death, or last follow-up.

Results of the study showed that ORR was comparable in clinical trials to the real-world setting; PFS and overall survival in high-risk populations were similar to that in low-risk older populations.

However, adverse events profiles were different between the treatment settings. Patients in the real-world setting were more likely to have dose-reductions (17%) or necessitate dose interruption (median time off therapy, 12 days). High-risk populations were also more likely to initiate therapy at a lower dose than the Food and Drug Administration-indicated dosage.

Researchers noted that toxicity was the most common reason for treatment discontinuation, but many patients did not require immediate treatment following discontinuation, which indicated sustained response.

“Encouraging responses were observed following ibrutinib discontinuation with no clear standard treatment approach,” authors of the study wrote. “This underscores the need for trials studying best strategy post-ibrutinib.”

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