The LLS Blog

Another Win for Lymphoma Patients

By Andrea Greif | June, 2018

The U.S. Food and Drug Administration’s latest approval of a blood cancer therapy is encouraging news for a group of lymphoma patients with a very rare subset of the disease called primary mediastinal large B-cell lymphoma (PMBCL). The approval is for patients who have relapsed after two or more prior lines of therapy or who did not respond to therapy at all.

PMBCL is a type of diffuse large B-cell lymphoma that occurs in the thymus, a gland in the chest area that is part of the immune system. PMBCL accounts for about 2-3 percent of all non-Hodgkin lymphomas; more than 650,000 people are currently living with NHL in the U.S. PMBCL tends to impact younger adults in their 30s and 40s.

The therapy approved Wednesday by the FDA is called pembrolizumab (Keytruda ®), an immunotherapy known as a checkpoint inhibitor, that works by blocking a specific protein, PD1 that acts as a mask, preventing the body’s immune T cells from recognizing cancer cells. Targeting this protein unleashes the immune T cells so they can attack the cancer cells.

Pembrolizumab was previously approved in March 2017 for Hodgkin lymphoma patients.  Another checkpoint inhibitor, nivolumab (Opdivo ®), is also approved for Hodgkin lymphoma. Additional approved indications for pembrolizumab include solid tumor cancers such as melanoma, lung cancer, head and neck cancer, urothelial carcinoma, gastric cancer, cervical cancer, and microsatellite instability–high solid tumors.

While LLS did not directly support the trials leading to this latest approval, LLS supports many researchers investigating the utility of anti PD1 therapy in various types of lymphomas, including central nervous system lymphoma and follicular lymphoma. LLS has also supported research to other immunotherapeutic approaches to treating PMLBCL, and in fact, the approval of the Kite/Gilead CAR T-cell immunotherapy, Yescarta ®, last year was the outcome of the clinical trial supported by LLS.

Wednesday's approval is based on a clinical trial – Keynote-170 – involving 53 patients with relapsed/refractory PMBCL who were positive for PD1. The overall response rate was 45% with a complete response rate was 11%, and a partial response rate of 34%. The approval was under the FDA’s accelerated approval program, meaning further testing must still be conducted to received a full approval. To read more about this latest approval click here.

Less Is More and Don’t Eat Me! (#ASCO18)

By Andrea Greif | June, 2018

This post is one in a series of news updates from ASCO. Read more by clicking here and here.

The American Society of Clinical Oncology (#ASCO18) annual meeting is an opportunity to show the progress on investigational cancer therapies, better ways to use old medicines and improved methods of diagnosis.

One of the interesting themes to emerge over the past few days here in Chicago is the goal of giving less rather than more treatment. The quest to de-escalate treatment helps avoid both physical and financial toxicity. Precision medicine – using technology to identify a patient’s genetic profile and tailor treatment accordingly – is the key.

The big news of the day on Sunday was from a large study showing that many women with early-stage breast cancer can forego chemotherapy after surgery. The TAILORx trial involved more than 10,000 women and used a genetic test to identify their tumor type. The study found that women whose tumors respond to hormone therapy and test negative for the HER2 gene, which constitutes about half of all women with breast cancer, can safely skip chemotherapy after their tumor is removed. 

Key takeaway: Thousands of women may be able to skip chemotherapy – along with all of its damaging short and long-term side effects – and still have a good prognosis.

Precision Medicine: Hope and Hype #ASCO18

By Andrea Greif | June, 2018

Using genomics – analyzing a cancer patient’s genetic profile to identify what is causing the malignancy and then using a drug that will work best for that patient’s subtype of cancer – has been evolving over at least two decades. The approach has accelerated in recent years as the technology has improved.

And with it there have been stunning successes along with some disappointments.

On Saturday at the American Society of Clinical Oncology meeting (#ASCO18) in Chicago, results from a number of clinical trials of therapies that target specific genetic mutations were presented with varying outcomes for patients.