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36 citation(s) found for "Hajek, R".

Lynch Syndrome in the General Population: Clinical Phenotype of PMS2 Pathogenic Variants
Barrett, Kelly M. Schiabor , Hajek, Catherine, Lu, James T. , Lynch, Kate , Sturm, Amy C., Haldeman‐Englert, Chad , Stoller, Douglas , Chapman, Christopher N., Chahal, C. Anwar A. , Judge, Daniel P., Olson, Douglas A., Lee, William , Cirulli, Elizabeth T., Chahal, Choudhary Anwar A , Hajek, Catherine A. , Lynch, Kate, Senter, Leigha , Sturm, Amy C. , Stoller, Douglas A. , Judge, Daniel P. , Olson, Douglas A., Grzymski, Joseph J. , Cirulli, Elizabeth T. , Bolze, Alexandre

JCO Oncology Advances | May 12, 2026 | Volume: 3 | Issue: 2 | Pages: No page available

10.1200/oa-25-00075 Get It

PURPOSE The Lynch syndrome (LS) genes, MLH1 , MSH2 , MSH6 , and PMS2 , are considered to be some of the highest-priority genes to be tested for population genomic screening, with the aim to prevent and detect cancers early in those with a higher risk for such diagnoses. The objective of this study was to determine the risk of cancer associated with pathogenic variants in MLH1 , MSH2 , MSH6 , or PMS2 in the general population to build evidence-based guidelines for population genomic screening METHODS This retrospective case-control study uses Helix Research Network data from 230,159 participants across nine US health systems. Variant interpretation was performed following the American College of Medical Genetics and Association for Molecular Pathology guidelines. Clinical diagnoses were identified from electronic health records and claims data for 11 cancer types associated with LS, including colorectal and endometrial cancers. RESULTS Individuals with pathogenic variants in MLH1 , MSH2 , and MSH6 showed substantial risk for LS-related cancers compared with those without pathogenic variants. Conversely, individuals with pathogenic variants in PMS2 had no increase in risk for all 11 LS-associated cancers with hazard ratio (HR) of 1.0 (95% CI, 0.6 to 1.8) compared with those without a pathogenic variant. There was a small increase in risk when restricting the analysis to colorectal cancer with an HR of 3.5 (1.7-7.4). This increase in colorectal cancer risk was predominantly observed after age 60 years, 10 years after US Preventive Services Task Force guidelines recommend starting colonoscopies for the average population. Up to age 60 years, 2.6% of individuals with PMS2 pathogenic variants were diagnosed with colorectal cancer, closer to the general population (0.7%) than those with MLH1 (37.3%), MSH2 (28.9%), or MSH6 (6.7%) pathogenic variants. For 100,000 individuals screened for PMS2 , 854 additional colonoscopies would be performed, which would prevent or detect early 3.2 colorectal cancers. CONCLUSION This analysis across nine health systems highlights the clinical phenotypes of PMS2 pathogenic germline variants in the entire population.
Early mortality with bispecific antibody therapy in RRMM: an IMWG immunotherapy database real-world analysis
Tan, Carlyn Rose, Usmani, Saad Z., Derkach, Andriy , Corraes, Andre De Menezes Silva, Parrondo, Ricardo , Ailawadhi, S., Asoori, Sireesha, Dave, Mrugakshi, Popat, Rakesh, Morjaria, Oliver, Hajek, Roman , Htut, Myo , Kastritis, Efstathios, Dimopoulos, M A, Martínez-López, Joaquín, Nagarajan, Chandramouli, Bal, Susan, Costa, Luciano J., Einsele, Hermann, Steinbrunn, Torsten, Riedhammer, Christine , Banerjee, Rahul, Chng, Wee Joo, Tso, Allison CY, Lin, Yi, Martin, Tom, Mian, Hira, Martínez‐López, Joaquín , Mian, Hira , Tan, Carlyn R , de Meneze Silva Corraes, Andre, Mihalyova, Jana , Visram, Alissa , Kastritis, Efstathios , Martinez-Lopez, Joaquin , Nagarajan, Chandramouli , Bal, Susan , Costa, Luciano J , Waldschmidt, Johannes M , Banerjee, Rahul , Tso, Allison , Martin, Thomas , Mian, Hira , Parrondo, Ricardo D , Derkach, Andriy , Usmani, Saad Z. , Corraes, Andre De Menezes Silva , Ailawadhi, Sikander , Popat, Rakesh , Hájek, Roman , Janakiram, Murali , Visram, Alissa , Kastritis, Efstathios , Dimopoulos, Meletios Α. , Nagarajan, Chandramouli , Bal, Susan , Costa, Luciano J. , Steinbrunn, Torsten , Banerjee, Rahul , Chng, Wee Joo

Blood Advances | February 24, 2026 | Volume: 10 | Issue: 9 | Pages: 2937-2946

10.1182/bloodadvances.2025019231 | PMID 41734378 Get It

Abstract Recent therapeutic advances, including bispecific antibodies (bsAbs), have improved outcomes for patients with relapsed/refractory multiple myeloma (RRMM). However, early mortality (EM) remains a significant challenge, even in the era of novel immunotherapies. We conducted a multicenter, retrospective analysis of real-world patients with RRMM treated with commercial bsAbs to evaluate the incidence and causes of EM. Between May 2022 and June 2025, a total of 441 patients were treated across 7 countries. EM, defined as death within 12 months of therapy initiation, occurred in 148 patients (34%), with a median time from bsAb initiation to death of 2.87 months (interquartile range, 1.38-6.85). The leading cause of EM was progressive disease (72%), followed by infection (13%); regardless of the cause of death, 82% had active disease at the time of death. Our findings highlight that despite encouraging efficacy, EM remains high among real-world bsAb recipients, emphasizing the need for improved disease control strategies and supportive care interventions.
Genomic mechanisms of resistance to venetoclax in multiple myeloma with t(11;14)( CCND1 ; IGH )
Wiedmeier-Nutor, Julia Erin, Jelinek, Tomas, Shivaram, Suganti, Tang, Hongwei , Owens, Rebecca W, Tereza, Ševčíková, Fonseca, Rodrigo , Zhao, Logan, Zhu, Yuan Xiao, Matulis, Shannon M. , Mitsiades, C., Hajek, R, Chesi, M., Bergsagel, P. Leif, Esteban, Braggio, Kumar, Shaji , Wiedmeier, Julia E. , Wiedmeier-Nutor, J Erin, Fonseca, Rodrigo , Durante, Michael , Diamond, Benjamin T , Zhu, Yuan X , Landgren, C Ola , Chesi, Marta , Bergsagel, P. Leif , Braggio, Esteban , Boise, Lawrence H , Fonseca, Rafael , Kumar, Shaji K , Maura, Francesco , Wiedmeier-Nutor, Julia E , Kaddoura, Marcella , Gupta, Vikas A. , Ziccheddu, Bachisio , Shivaram, Suganti, Sevcikova, Tereza, Durante, Michael , Diamond, Benjamin , Shi, Chang-Xin , Mitsiades, Constantine S. , Landgren, Ola , Usmani, Saad Z. , Hájek, Roman , Chesi, Marta , Bergsagel, P. Leif , Braggio, Esteban , Boise, Lawrence , Fonseca, Rafaël , Maura, Francesco , Baughn, Linda B.

Blood | January 2, 2026 | Volume: 147 | Issue: 14 | Pages: 1598-1610

10.1182/blood.2025029996 | PMID 41481388 Get It

Abstract Multiple myeloma (MM) with t(11;14)(CCND1;IGH) remains the only subset sensitive to the BCL2 inhibitor venetoclax. However, not all patients with t(11;14)(CCND1;IGH) respond to treatment, and some progress early after initial response. To investigate this, we examined 44 whole-genome and whole-exome sequencing data samples from 34 patients with t(11;14) MM treated with venetoclax. The presence of mutations in the RAS pathway was strongly associated with shortened progression-free survival (PFS) and was validated in an independent cohort of 21 patients with MM. The presence of 1q gain was also associated with shorter PFS in patients without RAS mutations. In 10 patients with paired prevenetoclax and postvenetoclax treatment samples, postvenetoclax progression was recurrently driven by the selection of genomic events in the BCL2/MCL1 and RAS pathways and of high-risk features (eg, loss of TP53 and CDKN2C). Overall, our study shows that comprehensive genomic profiling can identify most mechanisms underlying resistance to BCL2 inhibition in t(11;14)(CCND1;IGH) MM.
Real world efficacy and safety of elranatamab, a BCMA bispecific antibody for patients with relapsed and refractory multiple myeloma: An international myeloma working group immunotherapy database analysis
Popat, Rakesh , Morjaria, Oliver, Tan, Carlyn , Bal, Susan , Nagarajan, Chandramouli, Htut, Myo, Dave, Mrugakshi, Cowan, Andrew J. , Mian, Hira , Mian, Hira , Popat, Rakesh , Usmani, Saad Z. , Visram, Alissa , Costa, Luciano J. , Hájek, Roman , Mihalyova, Jana , Martinez-Lopez, Joaquin , Sáez, Adolfo , Dimopoulos, Meletios Α. , Kastritis, Efstathios , Nagarajan, Chandramouli , Chung, Shimin Jasmine , Htut, Myo , Chng, Wee Joo , Tso, Allison , Martin, Thomas G. , Huang, Chiung‐Yu , Einsele, Hermann , Lin, Yi

Blood | December 5, 2025 | Volume: 146 | Issue: Supplement 1 | Pages: 4588-4588

10.1182/blood-2025-4588 Get It

Abstract Introduction: Elranatamab (Elra) is a bispecific antibody (BsAb) targeting BCMA that is approved for patients with triple class exposed relapsed refractory myeloma (RRMM) on the basis of the MagnetisMM-3 phase 2 trial. For BCMA naïve patients, an overall response rate (ORR) of 61.0% and median progression free survival (PFS) of 17.2m was observed with a median overall survival (OS) of 24.6m. However, efficacy and safety information in the real world is lacking. Methods: This was an international retrospective study of patients with RRMM treated with Elra monotherapy outside of clinical trials. Data was collected through the International Myeloma Foundation Immunotherapy Database from 7 countries (UK, USA, Canada, Greece, Spain, Czech Republic and Singapore). High-risk cytogenetic abnormalities (HRCA) were defined as 1q+, t(4;14), t(14;16), t(14;20), and/or del(17p). Response was assessed using IMWG consensus criteria. Patient characteristics were summarized by frequency (percentage) or median (range). PFS, OS were evaluated using the Kaplan-Meier method and reported with 95% confidence intervals. Results: 79 patients were included. Median age was 67 years (range: 41-95y) with 20% ≥75 years. Racial distribution was: 75% White, 16% Black/African American, 8% Asian/Pacific. 55% were ECOG performance status (PS) 1-2. Patients received a median of 5 prior lines (range 1-11), and 35% were BCMA exposed (9% CAR-T, 5% ADC, 7% BsAb, 8% BsAb plus CAR-T, 4% ADC plus BsAb). Of those with available data, 45% had HRCA,13% had extramedullary disease (EMD) and 32% had penta-drug refractory RRMM. Overall, 48% would not have been eligible for the MagnetisMM-3 trial. Median follow-up was 6.3m (range 0.5-35.0). ORR was 53% (PR 11%, VGPR 33%, CR 8%, sCR 1%) and 67% for BCMA naïve patients. Responses were significantly lower for BCMA exposed patients (ORR 31%) but did not differ by age (51% <75yrs vs 60% ≥75yrs). On univariate analysis, prior BCMA exposure, platelets <50, presence of HRCA and penta-refractoriness were significantly associated with a lower response rate. PFS for the whole cohort at 6 and 12m was 64% (95%CI, 54-77%) and 52% (40-67%); for BCMA naïve patients, it was 77% (65-90%) and 67% (54-84%), respectively. Within the whole cohort, PFS was shorter for: BCMA exposed (median 4.0m vs not reached (NR)), platelets <50 (2.0 vs 21.7m), HRCA (7.2m vs NR), penta-refractory (4.3m vs NR). PFS did not differ significantly by EMD, PS, age, or creatinine clearance. OS for the whole cohort at 6 and12m was 74% (64-85%) and 58% (45-74%); for BCMA-naïve patients, it was 80% (43-85%) and 70% (57-87%), respectively. Within the whole cohort, OS was shorter for: BCMA exposed (median 10.3m vs NR), platelets <50 (4.3m vs NR), HRCA (10.7m vs NR) and penta-refractory (10.3m vs NR). Univariate regression analysis demonstrated that prior BCMA exposure, platelets <50 and penta-refractoriness were significantly associated with a worse PFS and OS, and HRCA predicted poorer survival CRS was observed in 41% of patients (grade(G)1: 35%, G2: 5%, ≥G3: 0%) with most occurring with the first step up dose (SUD): SUD1: 29%, SUD2: 15%, full dose: 4%. Tocilizumab was used in 20% and steroids in 3%. ICANS was observed in 4 cases (5%): G1: 2, G2: 1, G4: 1. Treatment was with steroids (n=3) and tocilizumab (n=2). G3-4 thrombocytopenia was observed in 19% and 14% required platelet transfusions. G3-4 neutropenia occurred in 25% with overall 31% requiring GCSF. Infections were reported in 33 (42%) patients with median time to infection of 41 days. A total of 94 infection episodes were observed over 581 personal months. There were 2 infection-related deaths reported (1 had IVIG, 1 did not). 64% had hypogammaglobulinemia (IgG < 400mg/dl) and IVIG was given in 65% of patients. Conclusions: In this first international real world analysis, Elranatamab achieved a response rate of 67% and a 12m PFS of 67% in BCMA naïve patients, similar to the MagnetisMM-3 trial despite almost half not meeting trial eligibility. However, prior BCMA exposure, platelets <50, high risk cytogenetics and penta refractory status were predictors of poorer outcomes. Acknowledgements: The International Myeloma Foundation, International Myeloma Working Group (IMWG)
Short survival with BCMA and GPRC5D dual antigen exposed relapsed myeloma- an international myeloma working group immunotherapy database analysis
Martin, Thomas , Dave, Mrugakshi, Asoori, Sireesha, Htut, Myo, Corraes, Andre De Menezes Silva , Kapoor, Prashant , Pan, Chris Lau Wai, Tan, Carlyn , Mian, Hira , Bal, Susan , Cowan, Andrew J. , Nagarajan, Chandramouli, Krishnan, Amrita , Popat, Rakesh , Mian, Hira , Janakiram, Murali , Huang, Chiung‐Yu , Htut, Myo , Pan, Chris Lau Wai, Usmani, Saad Z. , Hájek, Roman , Kastritis, Efstathios , Martínez‐López, Joaquín , Nagarajan, Chandramouli , Chng, Wee Joo , Tso, Allison , Einsele, Hermann , Popat, Rakesh , Lin, Yi , Pan, Darren

Blood | December 4, 2025 | Volume: 146 | Issue: Supplement 1 | Pages: 4598-4598

10.1182/blood-2025-4598 Get It

Abstract Background: BCMA- and GPRC5D-targeting immunotherapies including CART cell therapy and Bispecific antibodies are currently approved for the treatment of multiple myeloma. However, clinical outcomes after dual antigenic exposure remain undefined. Herein we report the first report of BCMA-GPRC5D dual targeted multiple myeloma (DEMM). Methods: We conducted a retrospective multi-center study of RRMM patients treated with both BCMA- and GPRC5D-targeted treatments (TT) (CAR T, bispecific antibodies, ADCs) between November 1, 2022, and July 1, 2025. Outcomes included PFS1 (post-dual exposure), and overall survival (OS). Kaplan-Meier estimates and event-free probabilities were calculated. Results: One hundred and fifty patients who underwent TCE treatments were included and 49 patients met the criteria for inclusion. Median age was 65 years, 22.4% had creatinine clearance <=30 and ECOG 2 or greater was present in 22.2%; 57% had high-risk cytogenetics (IMWG 2016), and 60.5% were penta-refractory. Patients received a median of 6 prior lines of therapy (LOT) before 1st TCE and 9 prior LOT before DEMM. 65.3% received 1 TCE, 30.6% received 2 TCE and 4.1% received 3 TCE before DEMM. Similarly, 67.3% received 1 BCMA, 24.5% received 2 BCMA TT and 4.1% received 3 BCMA TT before DEMM. Prior TT included- BCMA CART (57.1%), BCMA Bispecific (57.1%), BCMA ADC (18.4%), other TCE (10.2%). The last dual exposure was GPRC5D Bispecific in 91.8%, BCMA Bispecific in 6.1% and BCMA CART in 2%. The median followup post relapse was 3.4 months (range 0.0-16 mos). The median PFS during the last dual exposure TT was 3.98 months (95% CI: 2.96–6.70). 32.7% did not receive any subsequent LOT and died due to progressive disease. 67.3% of patients had progressive MM and received next LOT. Median PFS1 was 1.77 months (95% CI: 1.28–6.21) with 3-, 6-, and 12-month event-free probabilities of 44%%, 19% and 0% respectively. Median OS was 5.7 months (95% CI: 2.53-12.16) for DEMM from the time of refractoriness to dual antigenic targets. Conclusions: Patients dual-exposed to BCMA- and GPRC5D-directed therapies have a poor prognosis, 32.7% had not received further treatment and in those who received treatment the PFS1 was less than 2 months and an OS of 5.7 months from progression. This reflects an area of high unmet need for the patients that are dual-exposed to BCMA- and GPRC5D-directed therapies. Further data on the cohort will be updated at the meeting. Acknowledgements include, the International Myeloma Foundation, IMWG.
Acalabrutinib Plus Bendamustine-Rituximab in Untreated Mantle Cell Lymphoma
Wang, Michael , Song, Yuqin, Jurczak, Wojciech, Kahl, Brad S. , Chu, Michael P., Kryachok, Iryna, Fogliatto, Laura, Cheah, Chan Y. , Morawska, Marta , Li, Yufu, Patti, Caterina , Forsyth, Cecily , Lesley, Robin, Ramadan, Safaa, Rule, Simon, Dreyling, Martin , investigators, for the ECHO, Cazap, Nicolás, Foncuberta, María Cecilia, Garate, Gonzalo, Gustavo, Jarchum, Pavlovsky, Miguel Arturo , Riveros, Dardo, Baker, Ross, Butler, Jason, Cannell, Paul , Cheah, Chan, Forsyth, Cecily, Giri, Pratyush, Johnston, Amanda, Lee, Denise , Lee, Hui‐Peng, Mapp, Sally, Roncolato, Fernando , Thant, Aung , Walker, Patricia, Doo, Nicole Wong, Demuynck, Hilde, Offner, Fritz , Hende, Vanessa Van, Vergote, Vibeke, Wu, Ka Lung , Chiattone, Carlos, Azevedo, Sergio de, Fogliatto, Laura, Fonseca, Ana, Hamerschlak, Nelson, Lazaretti, Nicolas, Rocha, Vanderson, Salvino, Marco, Santucci, Rodrigo, Schaan, Mariza, Scheliga, Adriana, Vieira, Garles Miller, Berinstein, Neil, Boutin, Mélina , Chu, Michael, Keating, Mary‐Margaret, Schattner, Ariah, Restrepo, Diego Villa, Cen, Xinan, Du, Xin, Feng, Ru, Gao, Sujun, Huang, Haiwen, Ji, Jie, Jin, Jie, Ke, Xiaoyan, Li, Dengju, Li, Fei, Li, Jianyong, Li, Junmin, Li, Yan, Li, Yufu, Li, Zhenyu, Lin, Li'e, Liu, Tingbo, Lv, Fangfang , Shuang, Yuerong, Sun, Lan, Sun, Xiuhua, Wang, Zhao, Wu, Huijing, Xi, Yaming, Xia, Ruixiang, Xue, Hongwei, Yang, Haiyan, Yi, Shuhua, Zhang, Cheng, Zhang, Huilai, Zhang, Mingzhi, Zhang, Qingyuan, Zhao, Xielan, Zhou, Hui, Hajek, Roman, Jindra, Pavel , Mayer, Jiri, Novak, Jan, Abraham, Julie, Bijou, Fontanet, Bouabdallah, Kamal , Cymbalista, Florence, Guilbert, Sophie, Laribi, Kamel, Rodon, Philippe, Decker, Thomas, Dreger, Peter, Dreyling, Martin, Hess, Georg, Lenz, Georg, Stilgenbauer, Stephan, Tummes, Dirk, Anargyrou, Konstantinos , Dimopoulos, Meletios-Athanassios, Kapsali, Eleni, Kyriakou, Despoina, Panayiotidis, Panayiotis, Pappa, Vasiliki , Stavroyianni, Niki, Cheng, Hoi Ching, Kwong, Yok-Lam, Lee, Harold, Ng, Ting Ying, Wong, Raymond, Borbényi, Zita , Illés, Árpád, Lázár, Zsolt, Nagy, Ágnes , Nagy, Zsolt, Schneider, Tamas, Avivi, Irit, Gurion, Ronit, Horowitz, Netanel, Ronson, Aaron, Arcaini, Luca, Boccomini, Carola, Ghia, Paolo, Luminari, Stefano, Plenteda, Caterina, Santoro, Armando, Zilioli, Vittorio Ruggero, Zinzani, Pier Luigi, Choi, Ilseung , Ennishi, Daisuke , Ichikawa, Satoshi, Ishikawa, Takayuki, Izutsu, Koji, Kato, Koji, Maruyama, Dai, Nagai, Hirokazu, Ota, Shuichi, Saito, Toko, Sakai, Rika, Suzuki, Ritsuro, Uoshima, Nobuhiko , Yano, Takahiro, Yoshida, Isao, Eom, Ki-Seong, Kim, Jin Seok, Kim, Seok Jin, Lee, Jung-Hee, Mun, Yeung Chul, Yoon, Sung Soo , Arreguin, Elsa Veronica Avila, Andrade, Adriana Dominguez, Almaguer, David Gómez, Vera, Maria Silvia Rivas, Anaya, Luis Solís, Berkahn, Leanne, Pemberton, Lucy, Simpson, David, Beltrán, Brady, Quintana, Shirely, Revilla, Jose Carlos, Vargas, Ernesto, Grosicki, Sebastian , Hałka, Janusz , Jedrzejczak, Wieslaw, Knopińska-Posłuszny, Wanda, Krzanowski, Jacek, Lech-Maranda, Ewa, Robak, Tadeusz, Rzepecki, Piotr , Wróbel, Tomasz, Borsaru, Gabriela, Ciuleanu, Tudor Eliade, Danaı̈la, Catalin, Lazaroiu, Mihaela, Alexeeva, Julia, Chistyakov, Valeriy, Manikhas, Georgy, Mikhailova, Natalia, Proydakov, Andrey, Volodicheva, Elena , Voloshin, Sergey, Bastos, Mariana, Cordoba, Raul, Codina, José , Gonzalez, Eva Maria, Marin, Ana, Panizo, Carlos, Rodriguez, Guillermo, Salar, Antonio, Sancho, Juan-Manuel, Velo, Jose A, Chiu, Chang-Fang, Hsiao, Liang-Tsai, Kuo, Ching-Yuan, Lin, Tung-Liang, Lysa, Tamila, Maslyak, Zvenyslava, Nogaieva, Larysa, Polenkov, Sergey, Usenko, Ganna, Agajanian, Richie, Anz, Bertrand, Chaudhry, Arvind, Chiu, Alden , Cultrera, Jennifer, D’Olimpio, James, Dunleavy, Kieron, Fanning, Suzanne, Flinn, Ian, Gabrail, Nashat, Gallinson, David, Goldenberg, Alec, Graf, Solomon, Grover, N., Hess, Brian, Hoffman, Marc, Isufi, Iris, Kahl, Brad, Kambhampati, Suman , Kirkel, Dean, Diaz, Guillermo Lazo, Levy, Moshe, Liu, Delong, Mead, Monica , Paludo, Jonas, Patel, Anjan, Peles, Shachar, Persky, Daniel, Portell, Craig, Rosenthal, Allison, Sano, Dahlia , Smith, Sonali , Smith, Stephen, Spurgeon, Stephen, Tache, Jason, Tsai, Michaela, Veltri, Lauren, Wang, Michael, Yimer, Habte, Bach, Quoc Khanh, Đỗ, Huyền Nga, Luu, Hung Vu, Khoa, Trọng, Phạm, Như Hiệp, Panizo, Carlos , Kriachok, Iryna , Kahl, Brad S , Paludo, Jonas , Cheah, Chan Yoon , Morawska, Marta , Sancho, Juan-Manuel , Forsyth, Cecily , Dreyling, Martin , Belada, David , Song, Yuqin , Paludo, Jonas , Fogliatto, Laura , Zhang, Jingyang , Lesley, Robin, Ramadan, Safaa Mahmoud , Garate, Gonzalo, Riveros, Dardo Alberto, Cannell, Paul , Cochrane, Tara , Giri, Pratyush, Mapp, Sally , Doo, Nicole Wong , Demuynck, H, Hende, Vanessa Van, Vergote, Vibeke K. J. , CHIATTONE, CARLOS SÉRGIO , Farias, João Samuel de Holanda , Fonseca, Ana Rita Da , Rocha, Vanderson , Oliveira, José Salvador Rodrigues de , Scheinberg, Phillip , Scheliga, Adriana , Vieira, Garles Miller Matias , Berinstein, Neil Lorne , Shuang, Yuerong , Hájek, Roman , Mayer, Jiřı́ , Bijou, Fontanet , Cymbalista, Florence, Delwail, Vincent , Genet, Philippe , Dreger, Peter , Heß, Georg , Lenz, Georg , Stilgenbauer, Stephan , Kapsali, Eleni , Katodritou, Eirini , Kyriakou, Despoina S, Panayiotidis, Panayiotis G. , Symeonidis, Argiris , Schneider, Tamas J., Avivi, Irit, Gurion, Ronit , Horowitz, Netanel A. , Arcaini, Luca , Boccomini, Carola , Luminari, Stefano , Santoro, Armando, Zilioli, Vittorio Ruggero , Zinzani, Pier Luigi , Fukushima, Kentaro , Izutsu, Koji , Maruyama, Dai , Tatetsu, Hiro , Kim, Sang‐A , Oh, Sung Yong , Arreguin, Elsa Ávila, Gómez‐Almaguer, David , Issa, Samar , Revilla, Jose C., Vargas, Ernesto, Lech-Maranda, Ewa, Robak, Tadeusz , Borsaru, Gabriela, Ciuleanu, Tudor–Eliade , Danaila, Catalin-Doru , Alexeeva, Julia, Briones, Javier , Salar, Antonio , Yuste, Victor Jimenez, Chen, Chien‐Yuan , Kuo, Ching‐Yuan, Anz, Bertrand, Cultrera, Jennifer L. , D’Olimpio, James, Dunleavy, Kieron , Gabrail, Nashat , Gallinson, David, Goldenberg, Alec S., Goy, Andre Henri , Graf, Solomon A. , Hess, Brian, Kirkel, Dean, Portell, Craig A. , Rosenthal, Allison , Stevens, Don, Veltri, Lauren Westfall , Yimer, Habte, Tran, Thanh Tung

Journal of Clinical Oncology | May 1, 2025 | Volume: 43 | Issue: 20 | Pages: 2276-2284

10.1200/jco-25-00690 | PMID 40311141 Get It

PURPOSE The combination of the Bruton tyrosine kinase inhibitor ibrutinib with bendamustine-rituximab for first-line treatment of mantle cell lymphoma (MCL) prolonged progression-free survival (PFS), but without improvement in overall survival (OS), likely because of toxicity. Acalabrutinib was shown to be efficacious and less toxic than ibrutinib in a head-to-head trial in chronic lymphocytic leukemia and therefore might lead to better outcomes in MCL. METHODS Patients 65 years and older with previously untreated MCL received acalabrutinib (100 mg twice daily) or placebo (until disease progression or unacceptable toxicity), plus six cycles of bendamustine (90 mg/m 2 once daily; days 1 and 2) and rituximab (375 mg/m 2 as a single dose; day 1) followed by rituximab maintenance in responding patients for 2 years. Crossover to acalabrutinib at disease progression was permitted. The primary end point was PFS per the independent review committee; overall response rate and OS were secondary end points. RESULTS In total, 598 patients were randomly assigned, with 299 in each arm. At a median follow-up of 49.8 months using the reverse Kaplan-Meier method, the median PFS was 66.4 months in the acalabrutinib arm and 49.6 months in the placebo arm (hazard ratio [HR], 0.73 [95% CI, 0.57 to 0.94]; P = .0160). Benefit was seen across all subgroups, including those with high-risk features. Overall response/complete response rates were 91.0%/66.6% and 88.0%/53.5% in the acalabrutinib and placebo arms, respectively. OS was not significantly different (HR, 0.86 [95% CI, 0.65 to 1.13]; P = .27). Grade 3 or greater adverse events were reported in 88.9% and 88.2% in the acalabrutinib and placebo arms, respectively. CONCLUSION The combination of acalabrutinib with bendamustine-rituximab significantly improved PFS. Clinical benefit of acalabrutinib with bendamustine-rituximab was achieved with manageable toxicity.
Delayed Neurotoxicity after CAR-T in Multiple Myeloma: Results from a Global IMWG Registry
Kumar, Anupama, Hashmi, Hamza , Corraes, Andre De Menezes Silva , Htut, Myo, Scheller, Lukas , Kadel, Sofie‐Katrin , Hájek, Roman , Martínez‐López, Joaquín , Biran, Noa , Abrahamsen, Ingerid Weum , Chen, Szu-Ying, Ng, Melissa , Harrison, Simon J, Costello, Caitlin , Matos, Isadora, Gupta, Sasha , Lin, Yi, Hajek, Roman , Martinez-Lopez, Joaquin , Abrahamsen, Ingerid Weum , Atallah‐Yunes, Suheil Albert , Rajeeve, Sridevi , Abdelhak, Ahmed , Htut, Myo , Rodríguez‐Otero, Paula , Parrondo, Ricardo D , Chhabra, Saurabh , Kortüm, K. Martin , Einsele, Hermann , Donk, Niels W.C.J. van de , Mihalyova, Jana , Larrea, Carlos Fernández de , Chen, Szu‐Ying , Patiño-Escobar, Bonell , Harrison, Simon J , Matos, Isadora, Crusoé, Edvan de Queiroz , Costa, Luciano J. , Wiita, Arun P. , Martin, Thomas G. , Chari, Ajai

Blood | December 6, 2024 | Volume: 144 | Issue: Supplement 1 | Pages: 4758-4758

10.1182/blood-2024-201783 Get It

Background Emerging evidence has demonstrated rare subacute to late neurological toxicities (NTs) after BCMA CAR T-cell therapy (CAR-T) in multiple myeloma (MM). These adverse events can be categorized as: 1) Parkinsonism (PD), 2) cranial nerve (CN) palsies, and 3) peripheral neuropathies/Guillan Barré syndrome (GBS). These toxicities can cause significant morbidity, but given their relative rarity in clinical trials, there is limited data regarding evaluation and treatment. To our knowledge, this is the largest and only global registry of delayed NTs after BCMA CAR-T. Methods We retrospectively established a registry of NTs via the Immune Therapy Working Committee of the International Myeloma Working Group (IMWG). We gathered data pertaining to demographics, MM characteristics, MM response, NT signs/symptoms, diagnostic workup, and treatment. Result A total of 52 patients with delayed neurotoxicity were included from 14 institutions and 6 countries; 92% received ciltacel, 4% idecel, and 4% investigational CAR-T. Median age at CAR-T infusion was 65 years; 69% were male and 88% were Caucasian. Median bone marrow plasma cell (PC) burden was 15% prior to CAR-T (range 0-95%). Patients received a median of 4 prior lines of therapy (LOT), with 67% progressing on last LOT. Seventeen percent had pre-existing neurological diagnoses (including stroke, epilepsy, migraines). We identified sixteen cases of PD (94% with movement disorder, 69% with cognitive impairment, 75% with personality changes), occurring at a median of 26 days (range: 15-87) after CAR-T. Ninety four percent had CRS (grade (G)1 50%, G2 38%, G3 6%, G4 0%), while 19% had ICANS (G1 13%, G2 6%, G3-G4 0%). Median peak absolute lymphocyte count (ALC) was 9.5 x 109/L, peak C-reactive protein (CRP) 60.9 mg/L, and peak ferritin 1893.5 ug/L within the first 30 days. Concurrently, 3 upper respiratory infections (URIs) and 2 low-level HHV7 in the cerebrospinal fluid (CSF) were detected. A median of 73% of T-cells in the CSF were CAR-T, based on a flow cytometry assay. Ten patients received steroids (median 19 days after symptoms, 70% partial response, 20% no response, 10% unknown), 2 received intrathecal (IT) methotrexate-based therapy (median 32 days after symptoms, 1 with no response, 1 unknown), 5 received intravenous (IV) cyclophosphamide (median 31 days after symptoms, 40% full response, 20% partial response, 40% no response), 4 received high-dose IVIG ≥1g/kg for one or more dose (50% partial response, 50% no response), and 6 received dopamine agonists. There were 37 CN palsies (76% CN7, 15% CN6, 7% CN5, 2% CN3), occurring at a median of 37.5 days (range: 7-482) after CAR-T. Eighty one percent had CRS (G1 68%, G2 14%, G3-G4 0%); 11% had G1 ICANS (G2-G4 0%). Median peak ALC was 4.1 x 109/L, CRP 25.4 mg/L, and ferritin 543 ug/L within the first 30 days. We identified 2 concurrent URIs, 4 CMV viremia (50% with viral load >1500 IU/mL), 1 HHV6 viremia, and 1 HSV in the CSF. Thirty-two (86%) received steroids for a median duration of 12 days, 50% with full response, 3% with no response, and 47% with partial response (of which 43% had later full recovery without further intervention). One received IT methotrexate and another received IV cyclophosphamide without response. Thirteen (41%) received IVIG, of which 38% was high-dose IVIG. Four patients with CN palsies developed peripheral neuropathy/GBS. Eight patients (15%) in this cohort were not heavily pre-treated (≤1 prior LOT); 7 developed CN palsies (6 after ciltacel, 1 after investigational CAR-T) and 1 PD (after idecel). These patients had median <5% PC; none had extramedullary disease. Median ALC was 4.14 x 109/L, CRP 33 mg/L, and ferritin 448.5 ug/L within the first 30 days. Conclusions Delayed NT requires prompt recognition, evaluation for alternative causes, and treatment. In our cohort, the majority of patients were male and Caucasian, suggesting that sex and race may impact the likelihood of developing NT. Individuals with PDs had greater inflammatory response (CRS, ALC, CRP, ferritin) compared to those with CN palsies. CN palsies responded to steroids and/or IVIG, whereas PD had at best partial response to steroids, prompting additional therapy. These toxicities notably did occur in less heavily pre-treated patients, perhaps driven by immune fitness and greater circulating T-cells rather than MM burden. At the time of the annual meeting, data will be updated with additional NTs from less heavily pre-treated patients.
Particle Thompson Sampling with Static Particles
Zhou, Zeyu , Hajek, Bruce

2023 57th Annual Conference on Information Sciences and Systems (CISS) | April 10, 2023 | Volume: No volume available | Issue: No issue available | Pages: 1-6

10.1109/ciss56502.2023.10089653 Get It

Improving Particle Thompson Sampling through Regenerative Particles
Zhou, Zeyu , Hajek, Bruce

2023 57th Annual Conference on Information Sciences and Systems (CISS) | April 10, 2023 | Volume: No volume available | Issue: No issue available | Pages: 1-4

10.1109/ciss56502.2023.10089647 Get It

Efficacy and Safety of the Panobinostat-Bortezomib-Dexamethasone Combination in Relapsed or Relapsed/Refractory Multiple Myeloma: Results from the Randomized Panorama 3 Study
Laubach, Jacob P. , Mariz, Mário, Shelekhova, Tatiana , Abdo, André , Jacobasch, Lutz , Hájek, Roman , Sureda, Anna , Beksaç, Meral , Gonçalves, Iara, Creixenti, Joan Bladé, Spencer, Andrew , Maison‐Blanche, Pierre, Richardson, Paul G. , Hajek, Roman , Beksac, Meral , Schjesvold, Fredrik , Dimopoulos, Meletios Α. , Lech‐Marańda, Ewa , Špıčka, Ivan , Hungria, Vânia , Polprasert, Chantana , Illés, Árpád , Wróbel, Tomasz , Rajkumar, S. Vincent , Chari, Ajai , Lonial, Sagar , Moreau, Philippe , Richardson, Paul Gerard Guy , Miguel, Jesús F. San

Blood | February 8, 2021 | Volume: 136 | Issue: Supplement 1 | Pages: 4-6

10.1182/blood-2020-140697 Get It

Background Panobinostat (Pano), a pan-histone deacetylase inhibitor, is approved for the treatment of relapsed or relapsed/refractory multiple myeloma (RRMM) in combination with bortezomib and dexamethasone (FVd) in patients who have received ≥2 prior lines of therapy, including bortezomib and an immunomodulatory agent (IMiD). The pivotal phase 3 PANORAMA 1 trial, which used intravenous (i.v.) bortezomib, demonstrated significant progression-free survival benefit with FVd compared with placebo-Vd; however, adverse events (AEs) were also more frequent (San-Miguel J. et al., Lancet Oncol. 2014). The randomized phase 2 PANORAMA 3 study was conducted to optimize FVd by comparing three regimens with varying dose and schedule of Pano and by incorporating subcutaneous (s.c.) bortezomib. Methods PANORAMA 3 (NCT02654990) was a randomized, open-label, international, multicenter phase 2 study conducted in compliance with the Declaration of Helsinki. Eligible patients were ≥18 years old with 1‒4 prior lines of therapy, including an IMiD. Patients refractory to bortezomib were excluded. Patients were randomized 1:1:1 to Pano 20 mg three times weekly (TIW; the currently approved dosing regimen; Days 1, 3, 5, 8, 10, 12), Pano 20 mg twice weekly (BIW; Days 1, 4, 8, 11), or Pano 10 mg TIW (Days 1, 3, 5, 8, 10, 12), all administered in 21-day cycles. Randomization was stratified by number of prior treatment lines (1 vs 2 vs 3 or 4) and by age at screening (≤75 vs >75 years). For Cycles 1-4, all patients ≤75 years old received s.c. bortezomib 1.3 mg/m2 BIW (Days 1, 4, 8, 11) and oral dexamethasone 20 mg (Days 1, 2, 4, 5, 8, 9, 11, 12). Patients aged ≤75 years from Cycle 5 onwards, and patients >75 years for all cycles, received bortezomib 1.3 mg/m2 weekly (Days 1 and 8) and dexamethasone 20 mg on Days 1, 2, 8, and 9. Patients were treated until progressive disease or death, or until discontinuation due to toxicity or withdrawal of consent. The primary endpoint was overall response rate (ORR; IMWG 2011 criteria) after up to 8 treatment cycles by Independent Review Committee assessment. Secondary endpoints included best response, time to response (TTR), duration of response (DOR) and safety. Results In total, 248 patients were randomized (Pano: 20 mg TIW, N=82; 20 mg BIW, N=83; 10 mg TIW, N=83) and 241 patients received treatment (Pano: 20 mg TIW, N=79; 20 mg BIW, N=82; 10 mg TIW, N=80). Mean (SD) age was 65 (9) years; 55% of patients were male. Overall, patients had a median (range) time since diagnosis of 49 months (7‒242) and a median (range) of 2 (1-4) prior lines of therapy; 17% and 2% of patients were refractory to lenalidomide and pomalidomide, respectively. In total, 68% of patients had relapsed and 32% had relapsed/refractory disease. High-risk molecular findings were present in 15% of patients, with either del(17p) or t (4;14) at screening by fluorescence in situ hybridization. For the Pano 20 mg TIW, 20 mg BIW, and 10 mg TIW arms, respectively, median (range) number of treatment cycles completed was 9 (1; 50), 8 (1; 40) and 7 (1; 39); ORR (95% CI) after up to 8 treatment cycles was 62% (51; 73), 65% (54; 75), and 51% (39; 62); median TTR was 1, 2, and 3 months, with a median (95% CI) DOR of 22 (14, not estimable), 12 (9, 21), and 11 (6, 14.5) months. Best responses are presented in Table 1. In the Pano 20 mg TIW, 20 mg BIW, and 10 mg TIW arms, respectively, treatment-related AEs Grade ≥3 were reported in 78%, 72%, and 54% of patients; serious AEs were reported in 54%, 48%, and 44% of patients; and discontinuations due to AEs occurred in 29.5%, 28%, and 15% of patients, respectively. Most common treatment-emergent AEs (≥20% patients) are presented in Table 2. Grade ≥3 diarrhea occurred in 11.5%, 10%, and 5% of patients, respectively. There were 14 (6%) on-treatment deaths during the study (20 mg TIW, n=5; 20 mg BIW, n=3; 10 mg TIW, n=6), with none causally related to therapy and with 12 of 14 directly attributable to progressive disease. Conclusion In patients with RRMM, the 20 mg TIW and 20 mg BIW dosing regimens provided favorable outcomes, with most durable and deepest responses observed in the 20 mg TIW arm. The rate of AEs, including diarrhea, with Pano 20 mg TIW was lower than those observed with the same dosing regimen in PANORAMA 1, suggesting s.c. administration of bortezomib improves tolerability compared with i.v. administration. Moreover, all three regimens of FVd proved generally manageable; Pano 20 mg TIW had greatest efficacy, while 10mg TIW proved best tolerated. Disclosures Schjesvold: Celgene, Amgen, Janssen, Oncopeptides: Research Funding; Amgen, Celgene, Janssen, MSD, Novartis, Oncopeptides, Sanofi, Takeda: Consultancy; Amgen, Celgene, Janssen, MSD, Novartis, Oncopeptides, Sanofi, SkyliteDX, Takeda: Honoraria. Dimopoulos:Celgene: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees, Other: Personal fees, Speakers Bureau; Janssen: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees, Other: Personal fees, Research Funding, Speakers Bureau; Amgen: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees, Other: Personal fees, Research Funding, Speakers Bureau; Takeda: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees, Other: Personal fees, Research Funding, Speakers Bureau; BMS: Consultancy, Membership on an entity's Board of Directors or advisory committees, Other: Personal fees. Lech-Marańda:Roche, Amgen, Gilead: Speakers Bureau; Roche, Novartis, Takeda, Janssen-Cilag, Amgen, Gilead, AbbVie, Sanofi: Consultancy. Spicka:Celgene, Amgen, Janssen-Cilag, Takeda, Bristol-Myers Squibb, Novartis, Sanofi: Consultancy, Honoraria, Speakers Bureau. Hajek:Takeda: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees, Research Funding; Abbvie: Consultancy, Honoraria; PharmaMar: Consultancy, Honoraria; BMS: Consultancy, Honoraria, Research Funding; Celgene: Consultancy, Honoraria, Research Funding; Janssen: Consultancy, Honoraria, Research Funding; Amgen: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees, Research Funding; Novartis: Consultancy, Research Funding; Oncopeptides: Consultancy. Wróbel:Roche: Honoraria, Research Funding; Takeda, Celgene, Janssen, Amgen, AbbVie, Teva, Sandoz: Consultancy, Honoraria. Sureda Balari:Takeda: Consultancy, Honoraria, Speakers Bureau; Merck Sharpe and Dohme: Consultancy, Honoraria, Speakers Bureau; Sanofi: Consultancy, Honoraria; Novartis: Consultancy, Honoraria; Gilead/Kite: Consultancy, Honoraria; Janssen: Consultancy, Honoraria; Incyte: Consultancy; Celgene: Consultancy, Honoraria; BMS: Speakers Bureau; Roche: Honoraria; Celgene/Bristol-Myers Squibb: Consultancy, Honoraria. Beksac:Janssen&janssen: Membership on an entity's Board of Directors or advisory committees, Speakers Bureau; Amgen: Membership on an entity's Board of Directors or advisory committees, Speakers Bureau; Sanofi: Speakers Bureau; Takeda: Membership on an entity's Board of Directors or advisory committees, Speakers Bureau; Celgene: Membership on an entity's Board of Directors or advisory committees, Speakers Bureau; Deva: Membership on an entity's Board of Directors or advisory committees, Speakers Bureau. Goncalves:Janssen, Takeda, Amgen, Bayer, Novartis, Merck, Bayer, Celgene, GSK, BMS: Research Funding; Janssen: Consultancy, Speakers Bureau. Bladé Creixenti:Celgene: Honoraria; Amgen: Honoraria; Oncopeptides: Honoraria; Takeda: Honoraria; Janssen: Honoraria. Chari:Bristol Myers Squibb: Consultancy; Pharmacyclics: Research Funding; Novartis: Honoraria; Oncopeptides: Consultancy; Takeda: Consultancy, Research Funding; Antengene: Consultancy; Sanofi Genzyme: Consultancy; Seattle Genetics: Consultancy, Research Funding; Secura Bio: Consultancy; Adaptive Biotechnology: Honoraria; Array BioPharma: Honoraria; Karyopharm: Consultancy; Glaxo Smith Kline: Consultancy; Amgen: Consultancy, Research Funding; Celgene: Consultancy, Research Funding; Janssen: Consultancy, Research Funding; The Binding Site: Honoraria. Lonial:JUNO Therapeutics: Consultancy; Merck: Consultancy, Honoraria, Other: Personal fees; Abbvie: Consultancy; GSK: Consultancy, Honoraria, Other: Personal fees; BMS: Consultancy, Honoraria, Other: Personal fees, Research Funding; Janssen: Consultancy, Honoraria, Other: Personal fees, Research Funding; Novartis: Consultancy, Honoraria, Other: Personal fees; Takeda: Consultancy, Other: Personal fees, Research Funding; Amgen: Consultancy, Honoraria, Other: Personal fees; Onyx: Honoraria; Genentech: Consultancy; Karyopharm: Consultancy; Sanofi: Consultancy; TG Therapeutics: Membership on an entity's Board of Directors or advisory committees; Millennium: Consultancy, Honoraria. Spencer:Haemalogix: Consultancy, Honoraria, Other: Grant/Research Support; Secura Bio: Consultancy, Honoraria; Pharmamar: Other; Abbvie: Consultancy, Honoraria, Other: Grant/Research Support; Janssen: Consultancy, Honoraria, Other: Grant/Research Support, Speakers Bureau; Roche: Consultancy, Honoraria; Pfizer: Consultancy, Honoraria; TheraMyc: Consultancy, Honoraria; Amgen: Consultancy, Honoraria, Other: Grant/Research Support; BMS: Honoraria, Other: Grant/Research Support, Research Funding, Speakers Bureau; Sanofi: Consultancy, Honoraria; Servier: Consultancy, Other: Grant/Research Support; Takeda: Honoraria, Other, Speakers Bureau; Antegene: Consultancy, Honoraria. Maison-Blanche:Chiesi Pharmaceutical, Sanofi, Novartis: Honoraria. Moreau:Novartis: Honoraria; Sanofi: Consultancy, Honoraria; Celgene/Bristol-Myers Squibb: Consultancy, Honoraria; Janssen: Consultancy, Honoraria; Takeda: Honoraria; Abbvie: Consultancy, Honoraria; Amgen: Consultancy, Honoraria. Richardson:Celgene/BMS, Oncopeptides, Takeda, Karyopharm: Research Funding. San-Miguel:Amgen, BMS, Celgene, Janssen, MSD, Novartis, Takeda, Sanofi, Roche, Abbvie, GlaxoSmithKline and Karyopharm: Consultancy, Membership on an entity's Board of Directors or advisory committees.