Day 3 of the ASH Annual Meeting & Exposition kicked off with a continuation of the Diversity, Health, and Equity track, focusing on changing the tide from paternalistic patterns and exclusion of marginalized populations to inclusion of clinical trial design and a “deliberateness” of engaging minority communities from the very start. This important effort to reevaluate the status quo is part of the hematology community’s commitment to ensuring equity and addressing disparities.
Research highlights from day 3 included:
- Chronic myeloid leukemia (CML) treatment: In comparing responses and outcomes of patients with newly diagnosed chronic phase CML treated with low-dose dasatinib vs. standard-dose dasatinib, similar efficacy with less intolerance was observed, potentially providing a new option for patients.
- Acute myeloid leukemia (AML) treatment: Updated results for more than one year of additional followup from the phase 3 QUAZAR AML-001 trial showed the median overall survival was unchanged in both treatment arms of oral azacitidine and placebo. However, at later time points, the tail of the overall survival curves showed wider separation, implying a sustained, long-term overall survival benefit.
- Treatment for older patients with IDH1 R132-mutated AML: In the BEAT AML MASTER trial, ivosidenib in combination with azacitidine in newly diagnosed older patients with IDH1 R132-mutated AML demonstrated high complete response rates, no (early) deaths within 60 days, and a one-year overall survival of 100%. This combination was well tolerated.
- Treatment for relapsed/refractory immune thrombocytopenia (ITP): A global phase I/II study of rilzabrutinib, including adult patients from eight different countries, demonstrated good tolerability and a durable, clinically significant platelet response across subgroups of patients with heavily pretreated ITP. Magnitude and durability of clinical benefit will be further studied in the phase 3 LUNA3 trial.
- Treatment of primary immune thrombocytopenia (ITP): A prospective multicenter interventional study was conducted to determine the effect of thrombopoietin receptor agonist (TPO-RA) exposure. Sustained off-treatment remission after TPO-RA discontinuation was observed in patients with chronic ITP who initially achieve a stable complete response. When relapse occurred it was typically observed within the first weeks after discontinuation.
- COVID-19: Dr. Lisa Hicks discussed the impact of advanced age on COVID-19 outcomes, as well as treatment patterns from the ASH Research Collaborative COVID-19 Malignant Registry. The following factors were associated with an increased risk for death: 60+ years of age, male, estimated pre-COVID-19 prognosis of less than six months, and ICU deferral. Increased risk for severe COVID-19 infection requiring hospitalization was associated with: 60+ years of age, male, estimated pre-COVID-19 prognosis of less than six months, presence of a major comorbidity, having active blood cancer, and cancer treatment in the previous year.