Publications by authors named "Edward Libby"
Article Synopsis
- The phase 3 ASPEN trial compared the effectiveness of two BTK inhibitors, zanubrutinib and ibrutinib, in treating Waldenström macroglobulinemia, analyzing genetic mutations' impact on treatment response.
- The study found that patients with mutations in CXCR4 and TP53 had poorer responses and survival rates but those treated with zanubrutinib generally showed better outcomes than those given ibrutinib.
- Overall, the research indicated that zanubrutinib offers improved clinical outcomes for patients with specific mutations compared to ibrutinib, highlighting the importance of genetic testing in treatment decision-making.
Article Synopsis
- Belantamab mafodotin (belamaf) is a new treatment for patients with relapsed/refractory multiple myeloma (RRMM), targeting myeloma cells and enhancing immune response.
- The DREAMM-2 trial tested belamaf in heavily pretreated patients, revealing an overall response rate (ORR) of 32% to 35%, with median progression-free survival (PFS) of 2.8 to 3.9 months and overall survival (OS) of 14 to 15.3 months.
- The treatment demonstrated a manageable safety profile, with common side effects including keratopathy and thrombocytopenia, while also maintaining or
Article Synopsis
- The phase III ASPEN study showed that zanubrutinib is as effective as ibrutinib but has better safety for treating patients with Waldenström macroglobulinemia (WM).
- In a long-term follow-up, zanubrutinib demonstrated higher rates of very good partial response and complete response compared to ibrutinib in both cohorts of WM patients.
- Adverse events like diarrhea, muscle spasms, and hypertension were more common with ibrutinib, while zanubrutinib had a lower risk of treatment-related discontinuation.
Article Synopsis
- A study was conducted to assess the safety and determine the optimal dose of BCMA CAR T cells combined with the γ-secretase inhibitor crenigacestat for patients with relapsed or refractory multiple myeloma.
- 19 participants were enrolled, with 18 actually receiving the treatment; the study tracked them for a median of 36 months to evaluate outcomes and adverse effects.
- Early results indicate promising safety and tolerability of the combination therapy, leading to potential advancements in treatment strategies for multiple myeloma.
Article Synopsis
- AL amyloidosis is a serious disease caused by the buildup of misfolded immune proteins, and birtamimab is an experimental antibody aimed at treating it by targeting toxic protein aggregates.
- The VITAL clinical trial tested birtamimab in 260 newly diagnosed patients compared to a placebo, focusing on survival and hospitalization rates, but was halted early due to lack of significant overall benefits.
- However, a post hoc analysis showed promising survival improvements for a subset of high-risk patients (Mayo stage IV), leading to further investigation in a new trial (AFFIRM-AL).
Article Synopsis
- * The study involved 33 patients, revealing an overall response rate of 52% during the trial, with a median response duration of 25.8 months, highlighting the drug's effectiveness.
- * Ixazomib was well tolerated with manageable side effects, and all patients developed antibodies in response to a SARS-CoV-2 vaccine, indicating it maintains immune function while treating iNHL.
Objective: Although recurrence rates after radiotherapy for solitary plasmacytoma (SP) are well established, little is known about how SP responds radiographically, as most historical patients were treated in the 2D era. We evaluated the response to radiotherapy among SP patients staged and treated with 3D techniques, including proton therapy, which has not yet been previously reported.
Methods And Materials: Between 2007 and 2021, 15 SP patients (4 extramedullary, 11 bone) staged with 3D imaging and bone marrow evaluation were consecutively treated with definitive radiotherapy.
Six-Year Results From RELEVANCE: Lenalidomide Plus Rituximab (R) Versus Rituximab-Chemotherapy Followed by Rituximab Maintenance in Untreated Advanced Follicular Lymphoma.
Franck Morschhauser Loretta Nastoupil Pierre Feugier Jean-Marc Schiano de Colella Hervé Tilly Edward N Libby
J Clin Oncol
October 2022
Article Synopsis
- The RELEVANCE trial compared the effectiveness of lenalidomide plus rituximab (R) to rituximab plus chemotherapy (R-chemo) in patients with untreated advanced-stage follicular lymphoma (FL) over a follow-up period of 6 years.
- Both treatment groups showed similar 6-year progression-free survival (PFS) rates of about 60% and overall survival rates of 89%, indicating that R is as effective as R-chemo.
- The study also found no significant safety concerns, suggesting that R is a viable chemo-free option for treating previously untreated patients with FL.
Article Synopsis
- A phase 3 trial analyzed the impact of adding autologous stem-cell transplantation (ASCT) to a treatment regimen involving lenalidomide, bortezomib, and dexamethasone (known as RVD) in patients with newly diagnosed multiple myeloma.
- Results showed that the group receiving RVD plus ASCT had a median progression-free survival of 67.5 months, compared to 46.2 months for those receiving just RVD, indicating a significantly lower risk of disease progression or death with ASCT.
- Although progression-free survival improved with ASCT, there was no overall survival advantage, with 5-year survival rates being comparable between the two
In the phase 3 ANDROMEDA trial, patients treated with daratumumab, bortezomib, cyclophosphamide, and dexamethasone (D-VCd) had significantly higher rates of organ and hematologic response compared with patients who received VCd alone. Here, we present patient-reported outcomes (PROs) from the ANDROMEDA trial. PROs were assessed through cycle 6 using three standardized questionnaires.
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- * Common symptoms at diagnosis include anemia (73% of patients), bone disease (79%), and kidney injury (19%), with specific tests required for accurate diagnosis.
- * First-line treatment typically involves a combination of a proteasome inhibitor, an immunomodulatory agent, and dexamethasone, significantly improving survival rates when followed by stem cell transplantation and maintenance therapy.
Article Synopsis
- This study investigates the safety and effectiveness of a treatment regimen called dose-dense BV-ICE (brentuximab vedotin combined with ifosfamide, carboplatin, and etoposide) for patients with relapsed or refractory classical Hodgkin lymphoma.
- The research involved a phase 1/2 clinical trial at Seattle Cancer Care Alliance, focusing on adult patients who had not responded to previous treatments and had measurable disease.
- Key goals included determining the maximum safe dosage of the drugs and aiming for a complete response rate of 78% after two treatment cycles.
Article Synopsis
- Multiple myeloma (MM) is a complex cancer with varied responses to treatment, and there's a need for better biomarkers to predict how patients will respond to therapies.
- A clinical trial tested 170 compounds using high-throughput screening (HTS) on samples from patients with relapsed or refractory MM, aiming to guide personalized treatment decisions and analyze gene expression and mutation profiles.
- The results showed that HTS results were quickly available (within 5 days), led to actionable insights for all patients, and 92% of those who received therapy based on the assay achieved stable disease or better, highlighting the potential of this approach in future treatments.
Article Synopsis
- Systemic immunoglobulin light-chain (AL) amyloidosis involves amyloid fibrils from abnormal plasma cells, with daratumumab showing potential to enhance treatment outcomes.
- In a study with 388 patients, those receiving daratumumab alongside standard therapy had significantly higher complete hematologic response rates (53.3% vs. 18.1%) and benefits in organ function.
- Adverse effects were noted, with common severe events including lymphopenia and pneumonia, but overall, daratumumab improved survival metrics and organ responses without drastically increasing mortality from the disease.
Since the introduction of lenalidomide into induction therapy for multiple myeloma (MM), there have been conflicting reports about its impact on autologous peripheral blood stem cell (PBSC) mobilization. We evaluated the impact of previous lenalidomide exposure in a large cohort of patients with MM undergoing mobilization and collection at a tertiary stem cell transplantation center. We hypothesized that collection of PBSCs is feasible even with a prolonged duration of previous lenalidomide therapy.
View Article and Find Full Text PDFEdward Libby, MD, and Josh Epworth, ARNP, interpreted data on current and novel treatments, discussed how to select initial therapy based on patient risk and in alignment with guidelines and best practices, and evaluated the use of minimal residual disease testing in patients with multiple myeloma.
View Article and Find Full Text PDFIntroduction: Daratumumab is a CD38-targeting monoclonal antibody that has demonstrated clinical benefit for multiple myeloma. Daratumumab inhibition of CD38, which is expressed on immune cell populations and cardiomyocytes, could potentially affect cardiac function. This QTc substudy of the phase 2 CENTAURUS study investigated the potential effect of intravenous daratumumab monotherapy on QTc prolongation and other electrocardiogram (ECG) parameters, including concentration-QTc effect modeling.
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- Daratumumab showed a 23% overall response rate in previously treated patients with Waldenström's macroglobulinemia (WM).* -
- Patients treated with daratumumab had a median progression-free survival (PFS) of 2 months.* -
- The two patients who had a partial response to the treatment had higher baseline levels of CD38 fluorescent intensity in their plasma cells.*
Article Synopsis
- Multiple myeloma (MM) is a type of cancer affecting plasma cells and leads to issues like bone damage and anemia, with limited global access to effective treatments.
- A study analyzed data from 2006-2015 on hematopoietic cell transplantation (HCT) for MM, revealing a 107% increase in autologous HCTs worldwide, particularly in high-income regions like Northern America and Europe.
- Despite the growth in autologous HCT utilization in wealthier areas, access remains critically low in regions like Africa and the East Mediterranean, highlighting the need for improved healthcare resources and support for MM patients in low to middle-income countries.
Article Synopsis
- Bruton tyrosine kinase (BTK) inhibition is an important treatment for Waldenström macroglobulinemia (WM), and the ASPEN study compared ibrutinib and zanubrutinib, two BTK inhibitors, in patients with the disease.
- In the study, while no patients achieved a complete response, a similar percentage of patients (28% with zanubrutinib vs. 19% with ibrutinib) reached a very good partial response, indicating both drugs are effective but showing no significant difference between them.
- Zanubrutinib showed a trend toward better response quality and lower rates of adverse effects, particularly cardiovascular issues, although some patients experienced higher rates of neutropenia compared to
Article Synopsis
- Bortezomib is being replaced with carfilzomib and lenalidomide in a treatment regimen (KRD-PACE) for multiple myeloma (MM) patients undergoing chemomobilization before stem cell transplantation.
- A retrospective study of 27 MM patients showed that the most common reason for using KRD-PACE was the presence of bone marrow plasma cells, and the overall response rate was found to be 43%.
- The KRD-PACE regimen effectively mobilized stem cells, cleared circulating plasma cells, and significantly reduced bone marrow plasma cell burden, while demonstrating a low incidence of cardiac issues despite using multiple potentially cardiotoxic agents.
Article Synopsis
- * The oncology specialists rapidly adapted their clinical practices to reduce COVID-19 risks for hematologic malignancy patients.
- * The recommendations made by the Seattle team are based on the latest clinical trial data and their expertise, aiming to provide safe and effective care amid changing circumstances.
Background: Belantamab mafodotin (GSK2857916), an immunoconjugate targeting B-cell maturation antigen, showed single-agent activity in the phase 1 DREAMM-1 study in heavily pre-treated patients with relapsed or refractory multiple myeloma. We further investigated the safety and activity of belantamab mafodotin in the DREAMM-2 study.
Methods: DREAMM-2 is an open-label, two-arm, phase 2 study done at 58 multiple myeloma specialty centres in eight countries.
Article Synopsis
- * Among 2397 MM patients analyzed from a database, the incidence of venous thromboembolism was 10% and arterial thromboembolism was 5%, with similar risk profiles for those treated with lenalidomide and thalidomide.
- * The research emphasizes the need for careful risk assessment and thromboprophylaxis, as less than 20% of patients in both treatment groups received anticoagulant prophylaxis despite