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Adult Acute Lymphocytic Leukemia: Strategies for Selection of Consolidation Therapy

Presented by: Aaron C. Logan

Malignancies, Aaron C. Logan, MD, PhD, MPhil, Associate Professor of Clinical Medicine, UCSF Helen Diller Family Comprehensive Cancer Center, and member of the NCCN Guidelines Panel for ALL, discussed strategies for selection of consolidation therapy in adults

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Counterpoint: Intraperitoneal Chemotherapy: An Investigational Treatment in Ovarian Cancer

Robert F. Ozols

Intraperitoneal (IP) chemotherapy in ovarian cancer has been studied since 1978. Numerous phase II trials have been performed, which have shown that higher levels can be obtained in the peritoneal cavity compared with systemic circulation after administration of cytoxic agents in a large volume via a semi-permanent catheter. Three randomized trials have been performed in patients with ovarian cancer comparing different IP regimens to standard therapy with intravenous agents. The last two trials from the Gynecologic Oncology Group (GOG) and the Southwest Oncology Group (SWOG) compared two different IP regimens versus standard therapy with intravenous cisplatin plus paclitaxel. Although an improvement in progression-free survival was reported for the IP regimens, they have been associated with unacceptable toxicity, and no IP regimen can be considered standard therapy. Maintenance therapy with IP cisplatin also failed to improve survival in patients who obtained complete remission after intravenous chemotherapy. The GOG is considering another phase III trial of IP therapy that will compare a carboplatin-based regimen versus standard therapy with intravenous paclitaxel plus carboplatin. Unless such a trial shows an improvement in clinical outcome, intravenous carboplatin plus paclitaxel remains the standard of care and IP chemotherapy should not be used outside of a clinical trial.

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Acute Myeloid Leukemia

Margaret R. O'Donnell, Camille N. Abboud, Jessica Altman, Frederick R. Appelbaum, Daniel A. Arber, Eyal Attar, Uma Borate, Steven E. Coutre, Lloyd E. Damon, Salil Goorha, Jeffrey Lancet, Lori J. Maness, Guido Marcucci, Michael M. Millenson, Joseph O. Moore, Farhad Ravandi, Paul J. Shami, B. Douglas Smith, Richard M. Stone, Stephen A. Strickland, Martin S. Tallman, Eunice S. Wang, Maoko Naganuma, and Kristina M. Gregory

achieved. Many institutions also use HLA typing to select platelet donors for allogeneic HSCT. Principles of AML Treatment Treatment of acute leukemia has been divided into induction chemotherapy and postremission (or consolidation) therapy

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Who Benefits From Maintenance Therapy in Acute Promyelocytic Leukemia?

Edmond Marzbani and Elihu Estey

benefit and the possibility of combining ATO with ATRA to allow avoidance of chemotherapy, at least in patients with low-risk disease (WBC count < 10,000). 1 , 5 Consolidation therapy involves at least 2 further cycles of anthracycline

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Optimizing Therapy for Acute Myeloid Leukemia

Holbrook E. Kohrt and Steven E. Coutre

. 22. Wiernik PH Banks PL Case DC Jr . Cytarabine plus idarubicin or daunorubicin as induction and consolidation therapy for previously untreated adult patients with acute myeloid leukemia . Blood 1992 ; 79 : 313 – 319 . 23. Vogler WR

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Non-Hodgkin’s Lymphomas, Version 2.2014

Andrew D. Zelenetz, Leo I. Gordon, William G. Wierda, Jeremy S. Abramson, Ranjana H. Advani, C. Babis Andreadis, Nancy Bartlett, Naresh Bellam, John C. Byrd, Myron S. Czuczman, Luis E. Fayad, Richard I. Fisher, Martha J. Glenn, Nancy Lee Harris, Richard T. Hoppe, Steven M. Horwitz, Christopher R. Kelsey, Youn H. Kim, Susan Krivacic, Ann S. LaCasce, Auayporn Nademanee, Pierluigi Porcu, Oliver Press, Rachel Rabinovitch, Nishitha Reddy, Erin Reid, Lubomir Sokol, Lode J. Swinnen, Christina Tsien, Julie M. Vose, Joachim Yahalom, Nadeem Zafar, Mary Dwyer, and Hema Sundar

first-line chemotherapy. As of February 2014, 131 I-tositumumab has been discontinued and will no longer be available for the treatment of patients with FL. For patients receiving consolidation therapy, clinical follow-up with a complete physical

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Identification of a Novel Fusion Gene, IRF2BP2-RARA, in Acute Promyelocytic Leukemia

C. Cameron Yin, Nitin Jain, Meenakshi Mehrotra, Jianhua Zhagn, Alexei Protopopov, Zhuang Zuo, Naveen Pemmaraju, Courtney DiNardo, Cheryl Hirsch-Ginsberg, Sa A. Wang, L. Jeffrey Medeiros, Lynda Chin, Keyur P. Patel, Farhad Ravandi, Andrew Futreal, and Carlos E. Bueso-Ramos

remained slightly elevated at 3.57 mcg/mL at last checkup, 11 months post-diagnosis of APL. She achieved complete molecular remission 5 weeks later, and received 8 months of consolidation therapy with ATRA and arsenic trioxide. However, the patient

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Allogeneic Stem Cell Transplantation for Philadelphia Chromosome–Positive Acute Myeloid Leukemia

Vijaya Raj Bhatt, Mojtaba Akhtari, R. Gregory Bociek, Jennifer N. Sanmann, Ji Yuan, Bhavana J. Dave, Warren G. Sanger, Anne Kessinger, and James O. Armitage

mitotic cells prohibited conventional cytogenetic analysis. All of the patients received induction therapy with 7 days of cytarabine and 3 days of idarubicin along with imatinib, and consolidation therapy with high-dose cytarabine (± imatinib). The first

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Challenges in the Treatment of Newly Diagnosed and Recurrent Primary Central Nervous System Lymphoma

Matthias Holdhoff, Maciej M. Mrugala, Christian Grommes, Thomas J. Kaley, Lode J. Swinnen, Carlos Perez-Heydrich, and Lakshmi Nayak

Therapy in Newly Diagnosed PCNSL Multiple consolidation therapies are in use today, but similar to the induction regimens described earlier, no clear consensus exists on the optimal choice for consolidation. In addition, the question of the added value of

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Highlights of the NCCN Oncology Research Program

by the ORP. This feature highlights an NCCN study funded through the grant mechanism. Randomized Phase II Trial of Osimertinib With or Without Local Consolidation Therapy for Patients With EGFR-Mutant Metastatic Non–Small Cell Lung Cancer (NORTHSTAR