New combination treatments promising for blood cancers

One trial involved 33 adults and children with relapsed or refractory advanced acute myeloid leukemia with mutations of the KMT2A or NUP98 genes.

Nearly half of the patients achieved either a complete remission or a complete remission in bone marrow with a partial recovery of blood cell counts after treatment with a combination of Revuforj from Syndax Pharmaceuticals, AbbVie’s Venclexta and Inqovi from Astex Pharmaceuticals, which is a combination of the chemotherapy decitabine and cedazuridine. The treatment led to an 82% overall response rate.

Revuforj, known chemically as revumenib, is the first so-called menin inhibitor to win U.S. approval. By blocking the interaction between menin and other proteins, revumenib turns leukemia cells back into normal blood cells.

“This is a major step forward for treating acute leukemias with these genetic rearrangements,” study leader Dr. Ghayas Issa said in a statement.

In a separate trial involving 56 patients with acute myeloid leukemia, myelodysplastic syndromes and myeloproliferative neoplasms, the combination of Servier’s Tibsovo, Venclexta and Bristol Myers Squibb’s Onureg achieved an overall response rate of 94% and a complete remission rate of 93%, researchers said.

The three-year overall survival rate was 70.5%, and patients who went on to receive a stem cell transplant had a three-year overall survival rate of 94.7%.

“This triplet regimen is safe, well tolerated and provided impressive response rates for those enrolled in the trial,” said Dr. Jennifer Marvin-Peek, who presented the study at the ASH meeting. “The results we are seeing really position this triplet regimen as a potential standard-of-care option.”

In another trial of patients with previously untreated chronic lymphocytic leukemia, a triplet regimen of Eli Lilly’s Jaypirca, Gazyva from Roche, and Venclexta achieved high rates of undetectable measurable residual disease.

After 13 cycles, the undetectable MRD rate was 98% in bone marrow and 100% in blood among 41 evaluable patients. With more sensitive tests, MRD rates were 80% and 85% in bone marrow and blood, respectively.

“We were extremely impressed by the results of this frontline triplet regimen for our patients, as we observed some of the highest depths of remission we have ever seen in patients with CLL,” study leader Dr. Nitin Jain said in a statement.

“Today, we have several patients who are no longer on the therapy and are monitored by regular blood MRD testing.”

All three researchers cited are from the MD Anderson Cancer Center in Houston.

New imaging technique could improve ovarian cancer treatment

An MRI-based imaging technique that distinguishes between two different subtypes of ovarian tumors in test tube experiments with cancer cells may eventually help doctors customize patients’ treatments, researchers say.

The technique, called hyperpolarised carbon-13 imaging, would predict how well patients’ tumors will respond to treatment and also let doctors see whether treatments are working within 48 hours, according to a report published in Oncogene.

Different forms of ovarian cancer respond differently to drugs. With current tests, patients typically wait for weeks or months to find out whether their cancer is responding to treatment. The rapid feedback provided by this new technique would help oncologists adjust patients’ treatments within days, the researchers said.

Ovarian cancer patients often have multiple tumors, and it is not possible to biopsy all of them, the researchers noted. MRI, which is non-invasive, would allow for analysis of all of the tumors.

When they compared the hyperpolarised imaging technique with results from positron emission tomography scans, they found that the PET scans did not detect the metabolic differences between different tumor subtypes and so could not identify the type of tumor.

“One of the questions cancer patients ask most often is whether their treatment is working. If oncologists can speed their patients onto the best treatment, then it’s clearly of benefit,” study leader Kevin Brindle in the University of Cambridge said in a statement.

His team is hoping to test the technique in ovarian cancer patients within the next few years.

Brindle has also been studying ways to use hyperpolarised carbon-13 imaging to investigate breast, prostate and brain tumors.