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Key Studies: ASH 2018
Preview of Hot Topics at ASH 2018: Key Expert-Selected Studies

Released: November 27, 2018

Expiration: November 26, 2019

John M. Burke
John M. Burke, MD
Jeffrey P. DONOTUSESharman
Jeffrey P. DONOTUSESharman, MD
Shaji K. Kumar
Shaji K. Kumar, MD
Sagar Lonial
Sagar Lonial, MD, FACP
Keith W. Pratz
Keith W. Pratz, MD
Farhad Ravandi
Farhad Ravandi, MD
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At the 2018 ASH annual meeting, important results from many clinical trials in malignant and nonmalignant hematology will be reported. Below, hematology experts have highlighted their most anticipated abstracts, which we will cover online as a part of CCO’s Independent Conference Coverage of ASH 2018. As the ASH annual meeting unfolds, remember to check the CCO Web site often for downloadable slidesets summarizing the data from these studies and more and then again after the meeting for CME-certified online activities featuring expert analysis and perspective on the clinical implications of the data.

Top Picks: Lymphomas/Chronic Lymphocytic Leukemia
John M. Burke, MD, and Jeff P. Sharman, MD, have identified key studies in lymphomas and chronic lymphocytic leukemia (CLL) that they are eager to see at ASH 2018. In relapsed/refractory indolent non-Hodgkin lymphoma, potentially practice-changing results will be presented from the phase III AUGMENT study assessing lenalidomide plus rituximab vs standard rituximab in patients with previously treated grade 1-3a follicular lymphoma or marginal zone lymphoma. In the frontline setting for aggressive non-Hodgkin lymphoma, exciting results from the primary analysis of the phase III ECHELON-2 study will compare the CD30-targeting antibody–drug conjugate brentuximab vedotin plus CHP vs standard CHOP chemotherapy for CD30+ peripheral T-cell lymphoma. In CLL, there are multiple trials of interest being presented with the potential to have an impact on practice, including the phase III Alliance North American Intergroup Study A041202 exploring ibrutinib alone or in combination with rituximab vs standard chemoimmunotherapy with bendamustine plus rituximab for untreated patients 65 years of age or older; the phase III iLLUMINATE trial comparing the chemotherapy-free combination regimen of ibrutinib plus obinutuzumab vs chlorambucil plus obinutuzumab in the frontline setting, including for high-risk populations; and a late-breaking abstract on the phase III ECOG-ACRIN Cancer Research Group trial E1912 evaluating combination therapy with ibrutinib plus rituximab vs standard chemoimmunotherapy for untreated patients aged younger than 70 years.

Top Picks: Leukemias
Keith W. Pratz, MD, and Farhad Ravandi, MD, have identified several potentially clinically impactful studies at ASH 2018 for patients with leukemia. In acute lymphoblastic leukemia (ALL), results will be presented from the phase II SWOG 1318 trial evaluating the use of blinatumomab monotherapy as initial treatment followed by POMP (prednisone, vincristine, 6-mercaptopurine, methotrexate) maintenance therapy for elderly patients with newly diagnosed Ph-negative B-lineage ALL. Short and colleagues will present a study on the combination of inotuzumab ozogamicin plus mini-hyperCVD with or without blinatumomab in older patients with newly diagnosed Ph-negative B-lineage ALL. In acute myeloid leukemia (AML), Stein and colleagues will present a study on the use of the IDH inhibitors enasidenib and ivosidenib combined with chemotherapy as induction and consolidation treatment in older patients with newly diagnosed IDH2-mutated or IDH1-mutated AML, respectively. Pollyea and colleagues will present a phase Ib trial with exciting results using the combination of the BCL-2 inhibitor venetoclax with either azacitidine or decitabine in the challenging setting of treatment-naive patients with AML who are ineligible for intensive chemotherapy.

Top Picks: Multiple Myeloma
Shaji Kumar, MD, and Sagar Lonial, MD, have identified key studies in multiple myeloma (MM) that are highly anticipated at ASH 2018. The late-breaking abstract for the phase III MAIA trial will present interim results on the efficacy and safety of daratumumab plus Rd vs Rd alone in ASCT-ineligible patients with newly diagnosed MM. The online abstract suggests a significant PFS advantage with the addition of daratumumab to Rd in this setting. The phase III Tourmaline-MM3 clinical trial is assessing oral proteasome inhibitor–based maintenance therapy with ixazomib vs placebo in patients with newly diagnosed MM who achieved PR or better to induction with an IMiD and/or proteasome inhibitor followed by ASCT. A phase II clinical trial will report early efficacy and safety data for the combination of daratumumab plus the oral triplet regimen of IRd in patients with newly diagnosed MM. Finally, an abundance of data on various BCMA-targeted agents with promising efficacy and safety will be presented, including various CAR T-cell treatment options and an anti-BCMA BiTE construct.

Additional Studies
The CCO Conference Coverage of ASH 2018 will also include slidesets of key presented studies in other malignant and nonmalignant hematologic diseases that will likely have an impact on patient care. Among important studies covered in these settings will be:

  • Efficacy and safety data from the randomized CASSINI study of rivaroxaban thromboprophylaxis in ambulatory cancer patients
  • Results from the phase III BELIEVE and MEDALIST trials with luspatercept
  • Results from the phase II REACH1 study of ruxolitinib with corticosteroids for steroid-refractory acute GVHD

Remember to Check the CCO Web Site Often!
These are just a few of the interesting and important abstracts selected by our expert faculty from ASH 2018. Downloadable slideset summaries of these studies and more will be available on our Web site as the data are presented at ASH. After the meeting, comprehensive analyses by our expert faculty members will explore the clinical implications of the data in CME-certified text-based modules.

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