After the EHA meeting, the big celebrities gather to talk about new developments in myeloma & lymphoma

On the afternoon of July 1, 2021, the "2021 EHA Post-EHA Express Myeloma & Lymphoma Special" organized by the Xi'an Janssen Medical Department was successfully held, attracting nearly a thousand doctors to watch it online
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The meeting was co-chaired by Professor Zhou Jianfeng from Tongji Hospital Affiliated to Tongji Medical College of Huazhong University of Science and Technology, and Professor Li Jianyong from Jiangsu Provincial People’s Hospital.
Professor Jin Fengyan from Bethune First Hospital of Jilin University, Professor Xu Wei from Jiangsu Provincial People’s Hospital, and Professor Li Jian from Peking Union Medical College Hospital.
Professor Gao Guangxun from Xijing Hospital of the Air Force Military Medical University, Professor Mi Jianqing from Ruijin Hospital Affiliated to Shanghai Jiaotong University School of Medicine, and Professor Qian Wenbin from the Second Affiliated Hospital of Zhejiang University School of Medicine gathered online to focus on the field of myeloma and lymphoma, interpret and share this year’s EHA annual meeting The latest developments in myeloma & lymphoma
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Professor Jin Fengyan, a strategist with a high-level and far-reaching new diagnosis of myeloma, first introduced the prognostic factors of newly diagnosed multiple myeloma (NDMM) and the treatment options for NDMM
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Professor Jin Fengyan said that there are many risk factors that affect the prognosis of NDMM.
Among them, persistent minimal residual disease (MRD) negative can make patients live longer
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In terms of treatment options, this year’s EHA meeting announced the 5-year follow-up data of the MAIA study, showing that daratumomab (Dara) combined with Rd (DRd) for the treatment of NDMM patients who are not suitable for transplantation can bring significant survival benefits, support DRd as the first-line new standard treatment
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The study showed that the 5-year overall survival (OS) rate of the DRd group was 66.
3%, and that of the Rd group was 53.
1%, which significantly improved the median OS of the patient group (P=0.
0013) and reduced the risk of death by 32%; the 5-year PFS of the DRd group The rate was 52.
5%, and the Rd group was only 28.
7%, which reduced the risk of disease progression or death by 47%
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Regarding the maintenance treatment of NDMM, CASSIOPEIA study PART 2 data showed that maintenance treatment with daratumumab significantly improved the PFS of patients with VTd induction/consolidation treatment, and the CR rate and MRD negative rate were higher
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In addition, the OCTANS study, LYRA study, MAX Dara and other research data were updated at this EHA meeting, and they all proved that the induction, consolidation and maintenance treatment plan containing daratumumab can prolong survival for patients who are suitable or unsuitable for transplantation.
Period, deepen the remission, and the safety and tolerability are good
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After riding the wind and breaking the waves, Professor Xu Wei, a new era in the diagnosis and treatment of chronic lymphocytic leukemia, shared the progress of the treatment of chronic lymphocytic leukemia (CLL)
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RESONATE-2 is the longest follow-up period (up to 7 years) of the first-line phase III clinical study using BTKi.
At 6.
5 years of follow-up, PFS and OS continued to benefit.
The estimated PFS and OS in the ibrutinib group were 61% and 61%, respectively.
78%, the median PFS and OS were not reached
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Over time, the response to ibrutinib gradually increased, with an ORR of 92% and a CR/CRi of 34%
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The patient tolerated well, and no new adverse events were observed during long-term follow-up
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The efficacy of ibrutinib in the first-line treatment of CLL has also been confirmed in real-world studies
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Campus CLL is the largest real-world study of the treatment of untreated CLL with abnormal TP53 using Ibrutinib
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The ORR of CLL patients with abnormal TP53 treated by ibrutinib was 79%.
At a median follow-up of 24 months, the PFS rates at 12, 24, and 36 months were 91%, 82%, and 75%, respectively, and the OS rate was 96%, respectively.
, 92% and 87%
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The limited treatment plan for CLL is also being actively explored
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The Glow study is the first fixed-course Ibrutinib+Venecla (I+V) randomized controlled phase III clinical study for first-line CLL/SLL
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Compared with the chlorambucil + otuzumab (Clb+O) regimen, the I+V regimen, which is oral, once a day, no chemotherapy, and a fixed course of treatment, has better PFS, which significantly improves the depth and duration of remission , Extended TTNT
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The Captivate study showed that in the first-line treatment of CLL/SLL with ibrutinib and venecla, the CR/CRi was 56%, and there were similar high CR/CRi rates and uMRD rates in high-risk patients, and the 2-year PFS and OS exceeded 95%
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Professor Xu Wei finally stated that the long-term follow-up of ibrutinib and real-world data prove that ibrutinib can bring continuous benefits to CLL patients and is safe
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The fixed course of treatment of ibrutinib combined with venecla is being actively explored
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Pioneering and innovative, searching up and down indolent lymphoma disease and treatment progress Professor Li Jian introduced the latest developments in indolent lymphoma, especially Waldenstrom's macroglobulinemia (WM) and follicular lymphoma (FL)
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A real-world study from 35 Chinese hospitals showed that due to the rarity of the disease and different clinical manifestations, the first-line treatment options for WM are widely heterogeneous; the researchers verified for the first time that most of the established prognostic factors in rIPSS (age >65 years old; LDH≥250IU/L; serum albumin<3.
5g/dl; β-2 microglobulin concentration≥4mg/L; platelets≤100×109/L) suggesting that WM has a poor prognosis
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Professor Li Jian said that Ibrutinib is the first BTKi approved for the treatment of WM, and its combined effects with other drugs are also amazing
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The final analysis of the 5-year follow-up of the iNNOVATE study showed that after 63 months of overall follow-up, the median PFS of WM patients treated with ibrutinib and rituximab (IR) did not reach, and the main response rate in the IR group was 76%.
Placebo- The R group is 31%
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Moreover, the combination of IR can shorten the onset time of CXCR4mut patients and overcome the poor prognosis.
Patients with different genotypes can achieve high remission, and PFS can benefit; no new safety events have been observed
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The EHA meeting also updated two studies on the risk stratification and disease prognosis of FL patients.
These studies may provide valuable reference information for high-risk identification.
High-risk factors and risk assessment systems need to be further explored
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See Weizhi's book, Qianfan competes for RRMM treatment challenges and opportunities.
After that, Professor Guangxun Gao discussed and shared the topic of RRMM treatment challenges and opportunities
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Professor Gao Guangxun said that in the immunotherapy era, most patients have been treated with PI and IMiDs in the first line, and the addition of monoclonal antibodies can make up for the lack of treatment mechanisms when relapse/refractory occurs
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CASTOR, POLLUX, and LEPUS studies have confirmed that adding daratumomab therapy to the Vd/Rd regimen can significantly improve the benefits of RRMM patients
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This year's EHA meeting updated the latest research progress of RRMM
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The CANDOR study showed that compared with the Kd regimen, the DKd regimen can improve the median PFS of RRMM patients (28.
6 months in the DKd group vs.
15.
2 months in the Kd group).
These improvements are in the subgroups of lenalidomide exposure and/or refractory The results are consistent
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Another DARIA study showed that the ORR of DId used in the second-line treatment of MM patients was 57.
5%, the median PFS reached 10.
4 months, and rapid remission (median to PR or better remission time was not more than 1 month), and Security is very good
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In addition, the phase II trial of MM-014 showed that in the subgroup of RRMM patients who had previously received lenalidomide and a PI treatment, DPd treatment was performed immediately after lenalidomide treatment failed, the ORR reached 78.
7%, and the 1-year PFS rate It was 74.
1%
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Looking at the current large-scale clinical research data, the daratumomab-based regimen is still the best choice for the treatment of RRMM
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Ingenuity, a new pattern of treatment for AL in the immune era in the future Professor Mi Jianqing pointed out that the goal of treatment for AL amyloidosis is to quickly achieve deep hematological remission and organ remission
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With the emergence of new drugs and the continuous deepening of clinical research, the treatment pattern of AL amyloidosis has gradually changed
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This year’s EHA meeting updated the data of the ANDROMEDA study with a median follow-up of 20.
3 months.
Compared with VCd, D-VCd significantly improved the hematological remission rate (ORR: 92% vs 77%; CR rate: 59% vs 19%), and the remission rate varied with Deepen with the passage of time
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In terms of organ remission rate, the heart and kidney remission rate doubled in the D-VCd group at 12 months
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Professor Mi Jianqing added that D-VCd has now been approved in the United States, Brazil, Switzerland and Canada.
These data support D-VCd as a new standard treatment for patients with AL amyloidosis
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Another EMN22 phase II study showed that daratumomab can achieve a deep and rapid hematological remission with a single-agent treatment of stage IIIb AL amyloidosis, with an ORR of 64%, and a median time to first remission of 7 days , Security is good
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Moreover, in European real-world studies, the OS of specific populations treated with daratumumab was significantly prolonged (7 months vs.
not reached), and daratumumab significantly improved patients with R/R AL amyloidosis The prognosis
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Professor Mi Jianqing said that in the real world of Europe, the V-based program is the most commonly used program.
The launch of daratumumab has changed the European treatment landscape and significantly improved the OS of patients with AL amyloidosis
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In addition, the new therapies CAEL-101 and BCMA CAR-T provide new treatment options for patients with AL amyloidosis, and we look forward to more clinical trial data to illustrate their safety and efficacy
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Based on the current situation and looking forward to the future, explore the new pattern of mantle cell lymphoma treatment
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Professor Qian Wenbin finally introduced the research progress of mantle cell lymphoma (MCL) treatment .

US real-world data (Flatiron study) shows that the actual clinical treatment model of MCL is different from the recommendations of clinical trials
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In this study, BR is the most commonly used first-line regimen for MCL patients, and some young patients can benefit from chemotherapy only without stem cell transplantation (SCT)
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The study also showed that R-maintenance treatment after receiving BR and R-CHOP is related to prolonging rwTTNT and rwOS; the first-line use of BR+R maintenance group has the highest rate of rwTTNT in 3 years
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Professor Qian Wenbin said that these data emphasize the need to explore new treatment options for MCL, which can be effectively implemented in daily and community practice and do not need to be based on SCT
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The SHINE study is currently evaluating whether the BR regimen is added to the treatment of ibrutinib and the maintenance of R can increase the PFS rate of patients in the early treatment of MCL patients.
The data is worth looking forward to
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For elderly MCL patients who are not suitable for standard immunochemotherapy, a study from the United Kingdom and Ireland showed that the PFS and OS results of first-line reduced-dose immunochemotherapy were not satisfactory
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Professor Qian Wenbin pointed out that in this special clinical environment, it is necessary to study clinical trials of new drugs such as BTK and BCL2 inhibitors.

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Professor Qian Wenbin finally introduced the active exploration of combined treatment options for MCL, such as ibrutinib combined with bortezomib and ibrutinib combined with rituximab and CAR-T based on ibrutinib.
Both show significant and long-lasting curative effects
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Summarizing the rich content of this conference, experts made wonderful reports on the latest progress in the two diseases of myeloma and lymphoma in the EHA conference in 2021, and brought the most cutting-edge information
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During the meeting, everyone had a wonderful discussion on hot issues in the treatment of myeloma and lymphoma.
Each collision of thinking contained great energy, guiding the direction for better young doctors in the future
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Finally, the chairman of the conference expressed his heartfelt thanks to the hematology experts and online audience who participated in the conference.
The conference ended successfully! To watch the live broadcast, please scan the QR code stamp below to read the original text, and we will make progress together