I'm still sifting through some of the commentaries that people are posting about what they saw and learned about Follicular Lymphoma at the ASH meeting. Today's commentary is a video, posted by the website MedScape, called "Charting New Horizons: Emerging Data and Novel Therapies in Relapsed/Refractory Follicular Lymphoma."
I guess it's technically a video, since it's posted on YouTube. But really, it's more like a podcast -- audio commentary without any real visual element. There is the option of seeing a transcript. You'll find a button in the description box below the video.
The post features two Lymphoma experts, Dr. Lori Sen from the University of British Columbia, and Dr. Cammy Maddox from Ohio State University. Their focus is on presentations from ASH that present data from studies on Relapsed and Refractory Follicular Lymphoma.
Of course, the first one they describe is the one that everyone is talking about: Tafasitamab and R-Squared. I've seen it called a "triumph" and a "practice-changer." Dr. Sen and Dr. Maddox seem equally impressed. They point out that the study was very wide, taking place in multiple countries. It was double-blind, meaning there was a direct comparison between two treatments. It had excellent results and good safety. And it showed that it is possible to combine two monoclonal antibodies -- one that targets CD 19 and one that targets CD20 -- and have good effectiveness and safety. I have to say, the more I read about it, the more impressed I am. I'm still not sure it will be the "game-changer" that some seem to think it will be. But that's more about asking oncologists to break old habits than anything about how good the treatment is.
The next presentation they describe is "337 Loncastuximab Tesirine with Rituximab Induces Robust and Durable Complete Metabolic Responses in High-Risk Relapsed/Refractory Follicular Lymphoma." Loncastuximab is an antibody conjugate. Basically, it's like Rituxan, targeting a protein on the surface of the lymphoma cell (CD19), but attached to it is a small drop of a chemotherapy drug. This allows the chemo to go directly to the cancer cell. In theory, this results in fewer side effects and better effectiveness. The Overall Response Rate was 97.1% after 12 weeks, with a Complete Response of 68.6%. For the FL patients in the study, the ORR was 100% and the Cr was 80%. Safety was good. A wider study is ongoing, so we may hear more about this one soon.
The next presentation they look at is Epcoritimab with R-Squared, another one that has gotten lots of commentary since the meeting ended. I was curious about what they had to say about the possible safety issues with this treatment combination. They do mention that the study happened during the Covid pandemic, which likely affected things negatively (since the combination would affect immunity). There were no new side effects -- nothing unexpected.
They finish by talking about how the data will affect clinical practice. Again, Tafasitamab and R-Squared have a prominent place here. In general, they seem to agree that the various presentations at ASH that excited them most are more proof that we are moving away from traditional chemotherapy and towards treatments that involve the immune system and that target lymphoma cells specifically. This has certainly been the trend for a while, and it's a good thing. They also agree that using these newer treatments effectively takes some learning on the part of oncologists. They will require active surveillance of side effects so things like Cytokine Release Syndrome don't become too dangerous.
It's an interesting video/audio, and it reaffirms a lot of what I've been reading and hearing so far.
Still a few more commentaries to sift through. If there's something good in them, I'll be sure to share.
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