BJH - volume 10, issue 8, december 2019
T. Feys MBA, MSc, J. Blokken PhD, PharmD
Bispecific T-cell engagers (BiTEs) are a class of immunotherapeutics that can redirect T cells to haematological malignancies. A key advantage of BiTEs over adoptive T-cell therapies, consists of the fact that a BiTE is an “off the shelf” meaning that the same product can be given to all patients. In contrast, adoptive T-cell therapies must be made from cells taken from each patient and as a result this strategy is more time consuming and potentially more expensive. The most successful BiTE to date is blinatumomab. This agent is made up of CD3 and CD19 single-chain variable regions linked by a glycine–serine linker. It binds selectively to CD3 expressing T cells and CD19 expressing B cells, leading to the formation of immune synapses between T cells and B cells. In doing so, blinatumomab redirects unstimulated cytotoxic T cells to specifically target and lyse CD19-positive B cells. Blinatumomab is currently approved for patients with relapsed/refractory and minimal residual disease positive B-cell precursor acute lymphoblastic leukaemia (B-ALL). This review will discuss the pivotal trials with this agent and will touch upon some of the additional BiTEs that are under clinical evaluation in haematological malignancies. Finally, some remaining challenges with respect to optimising the efficacy and safety of BiTEs will be addressed.
(BELG J HEMATOL 2019;10(8):332–8)
Read moreBJH - volume 10, issue 6, october 2019
T. Feys MBA, MSc
OVERVIEW OF BELGIAN REIMBURSEMENT NEWS
(BELG J HEMATOL 2019;10(6):258–60)
Read moreBJH - volume 10, issue 5, september 2019
T. Feys MBA, MSc
EHA 2019 featured several eagerly awaited presentations on Hodgkin lymphoma (HL). This included 3-year follow-up data of the ECHELON-1 trial in patients with high-risk features and longer follow-up data of CheckMate 2015 evaluating nivolumab plus doxorubicin, vinblastine, and dacarbazine in newly diagnosed advanced HL. In a third interesting HL abstract it was shown that foregoing radiotherapy in PET-negative patients with early-stage HL increases the risk of disease progression. In non-Hodgkin lymphoma (NHL), data were presented indicating that there is no benefit of rituximab maintenance beyond two years in patients with relapsed or refractory indolent NHL. In addition to this, interesting data were presented on the use of an obinutuzumab + DHAP combination in patients with untreated mantle cell lymphoma, with polatuzumab vedotin + obinutuzumab + lenalidomide in relapsed/refractory follicular lymphoma (FL) and with the anti-CD47 antibody Hu5F9-G4 in patients with refractory lymphoma.
(BELG J HEMATOL 2019;10(5):208–13)
Read moreBJH - volume 10, issue 5, september 2019
T. Feys MBA, MSc
OVERVIEW OF BELGIAN REIMBURSEMENT NEWS
(BELG J HEMATOL 2019;10(5):224)
Read moreBJH - volume 10, issue 3, may 2019
T. Feys MBA, MSc
OVERVIEW OF BELGIAN REIMBURSEMENT NEWS
(BELG J HEMATOL 2019;10(3):130–1)
Read moreBJH - volume 10, issue 2, march 2019
T. Feys MBA, MSc
OVERVIEW OF BELGIAN REIMBURSEMENT NEWS
(BELG J HEMATOL 2019;10(2):96–7)
Read moreBJH - volume 10, issue 1, february 2019
T. Feys MBA, MSc
The introduction of targeted agents revolutionized the care for patients with chronic lymphocytic leukemia (CLL). While these agents first proved their clinical benefit in the treatment of patients with relapsed/refractory (R/R) disease and in CLL patients with dismal prognostic features (e.g. del(17p), TP53 mutations) they were subsequently also tested in the first-line setting and in patients without high-risk cytogenetic characteristics. During the 2018 annual meeting of the American Society of Hematology (ASH), results were presented of several pivotal trials that will likely change the frontline treatment paradigm for CLL patients. A second hot topic in CLL that received lots of attention at ASH 2018 consists of minimal residual disease (MRD). Several studies were presented looking into the feasibility of obtaining a MRD negative status with (combinations of) novel targeted agents in CLL and look into the prognostic significance of obtaining MRD negativity. Finally, R/R disease continues to be the setting in which novel therapeutic options are being tested. During ASH 2018 results of several clinical trials evaluating combinations of existing targeted agents were presented in addition to data on completely new therapeutics (e.g. chimeric antigen receptor [CAR] T cell therapy) that try to make their mark in CLL. This article will summarize some of the key highlights in CLL presented at ASH 2018.
(BELG J HEMATOL 2019;10(1):11–7)
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