Key clinical point: Ibrutinib showed efficacy in a real-world cohort of patients with previously untreated high-risk chronic lymphocytic leukemia (CLL) carrying 17p- or TP53 mutations (TP53 aberrations).

Major finding: At 24 months, the median overall survival was not reached; the estimated treatment persistence and survival rates were 63.4% (95% CI 60.0%-67.0%) and 82.6% (95% CI 79.9%-85.4%), respectively. The median time to treatment discontinuation was 37.4 months (95% CI 34.8-42.2 months). Disease progression or death were the reasons for discontinuation in 45.8% of patients.

Study details: This real-world registry study analyzed the data of 747 patients with CLL and TP53 aberrations treated with first-line ibrutinib.

Disclosures: This study was funded by the University of Ferrara, Italy, and others. Some authors, including the lead author, declared receiving research support, travel grants, or honoraria for speakers’ bureau or advisory board participation from various sources.

Source: Rigolin GM et al. Outcomes in patients with chronic lymphocytic leukemia and TP53 aberration who received first-line ibrutinib: A nationwide registry study from the Italian Medicines Agency. Blood Cancer J. 2023;13:99 (Jun 28). Doi: 10.1038/s41408-023-00865-z

Key clinical point: Ibrutinib showed efficacy in a real-world cohort of patients with previously untreated high-risk chronic lymphocytic leukemia (CLL) carrying 17p- or TP53 mutations (TP53 aberrations).

Major finding: At 24 months, the median overall survival was not reached; the estimated treatment persistence and survival rates were 63.4% (95% CI 60.0%-67.0%) and 82.6% (95% CI 79.9%-85.4%), respectively. The median time to treatment discontinuation was 37.4 months (95% CI 34.8-42.2 months). Disease progression or death were the reasons for discontinuation in 45.8% of patients.

Study details: This real-world registry study analyzed the data of 747 patients with CLL and TP53 aberrations treated with first-line ibrutinib.

Disclosures: This study was funded by the University of Ferrara, Italy, and others. Some authors, including the lead author, declared receiving research support, travel grants, or honoraria for speakers’ bureau or advisory board participation from various sources.

Source: Rigolin GM et al. Outcomes in patients with chronic lymphocytic leukemia and TP53 aberration who received first-line ibrutinib: A nationwide registry study from the Italian Medicines Agency. Blood Cancer J. 2023;13:99 (Jun 28). Doi: 10.1038/s41408-023-00865-z

Key clinical point: Ibrutinib showed efficacy in a real-world cohort of patients with previously untreated high-risk chronic lymphocytic leukemia (CLL) carrying 17p- or TP53 mutations (TP53 aberrations).

Major finding: At 24 months, the median overall survival was not reached; the estimated treatment persistence and survival rates were 63.4% (95% CI 60.0%-67.0%) and 82.6% (95% CI 79.9%-85.4%), respectively. The median time to treatment discontinuation was 37.4 months (95% CI 34.8-42.2 months). Disease progression or death were the reasons for discontinuation in 45.8% of patients.

Study details: This real-world registry study analyzed the data of 747 patients with CLL and TP53 aberrations treated with first-line ibrutinib.

Disclosures: This study was funded by the University of Ferrara, Italy, and others. Some authors, including the lead author, declared receiving research support, travel grants, or honoraria for speakers’ bureau or advisory board participation from various sources.

Source: Rigolin GM et al. Outcomes in patients with chronic lymphocytic leukemia and TP53 aberration who received first-line ibrutinib: A nationwide registry study from the Italian Medicines Agency. Blood Cancer J. 2023;13:99 (Jun 28). Doi: 10.1038/s41408-023-00865-z

Key clinical point: Front-line chemo-free combination therapy with rituximab and lenalidomide was moderately active in elderly frail patients with diffuse large B-cell lymphoma (DLBCL) who were ineligible for conventional cytotoxic therapy.

Major finding: The overall response rate was 50.8% (95% CI 38.1%-63.4%), with 27.7% of patients achieving a complete response. After a 24-month median follow-up, the median progression-free survival was 14.0 months (95% CI 6.8-not reached) and the 2-year duration of response rate was 64.6% (95% CI 42.1%-80.1%). The grade ≥3 extra-hematological toxicity event rate was 52.3%.

Study details: Findings are from the prospective phase 2 FIL_ReRi trial including 65 frail patients aged ≥70 years with untreated DLBCL who received ≤6 cycles of lenalidomide+rituximab; patients with partial or complete response at cycle 6 received lenalidomide for 12 cycles or until progression or unacceptable toxicity.

Disclosures: This study was sponsored by Fondazione Italiana Linfomi (FIL), Alessandria, Italy. Some authors declared participating on data safety monitoring or advisory boards of, serving in leadership roles in, or receiving consulting fees or speaker honoraria from various sources, including FIL.

Source: Gini G et al. Lenalidomide plus rituximab for the initial treatment of elderly frail patients with DLBCL: The FIL_ReRi phase 2 study. Blood. 2023 (Jul 7). Doi: 10.1182/blood.2022019173

Key clinical point: Front-line chemo-free combination therapy with rituximab and lenalidomide was moderately active in elderly frail patients with diffuse large B-cell lymphoma (DLBCL) who were ineligible for conventional cytotoxic therapy.

Major finding: The overall response rate was 50.8% (95% CI 38.1%-63.4%), with 27.7% of patients achieving a complete response. After a 24-month median follow-up, the median progression-free survival was 14.0 months (95% CI 6.8-not reached) and the 2-year duration of response rate was 64.6% (95% CI 42.1%-80.1%). The grade ≥3 extra-hematological toxicity event rate was 52.3%.

Study details: Findings are from the prospective phase 2 FIL_ReRi trial including 65 frail patients aged ≥70 years with untreated DLBCL who received ≤6 cycles of lenalidomide+rituximab; patients with partial or complete response at cycle 6 received lenalidomide for 12 cycles or until progression or unacceptable toxicity.

Disclosures: This study was sponsored by Fondazione Italiana Linfomi (FIL), Alessandria, Italy. Some authors declared participating on data safety monitoring or advisory boards of, serving in leadership roles in, or receiving consulting fees or speaker honoraria from various sources, including FIL.

Source: Gini G et al. Lenalidomide plus rituximab for the initial treatment of elderly frail patients with DLBCL: The FIL_ReRi phase 2 study. Blood. 2023 (Jul 7). Doi: 10.1182/blood.2022019173

Key clinical point: Front-line chemo-free combination therapy with rituximab and lenalidomide was moderately active in elderly frail patients with diffuse large B-cell lymphoma (DLBCL) who were ineligible for conventional cytotoxic therapy.

Major finding: The overall response rate was 50.8% (95% CI 38.1%-63.4%), with 27.7% of patients achieving a complete response. After a 24-month median follow-up, the median progression-free survival was 14.0 months (95% CI 6.8-not reached) and the 2-year duration of response rate was 64.6% (95% CI 42.1%-80.1%). The grade ≥3 extra-hematological toxicity event rate was 52.3%.

Study details: Findings are from the prospective phase 2 FIL_ReRi trial including 65 frail patients aged ≥70 years with untreated DLBCL who received ≤6 cycles of lenalidomide+rituximab; patients with partial or complete response at cycle 6 received lenalidomide for 12 cycles or until progression or unacceptable toxicity.

Disclosures: This study was sponsored by Fondazione Italiana Linfomi (FIL), Alessandria, Italy. Some authors declared participating on data safety monitoring or advisory boards of, serving in leadership roles in, or receiving consulting fees or speaker honoraria from various sources, including FIL.

Source: Gini G et al. Lenalidomide plus rituximab for the initial treatment of elderly frail patients with DLBCL: The FIL_ReRi phase 2 study. Blood. 2023 (Jul 7). Doi: 10.1182/blood.2022019173

Key clinical point: Nivolumab+brentuximab vedotin (BV) showed long-term efficacy and safety in patients with treatment-resistant relapsed or refractory (R/R) primary mediastinal large B-cell lymphoma (PMBL).

Major finding: After a median follow-up of 39.6 months, the objective response rate was 73.3% (95% CI 54.1%-87.7%), with 40.0% and 33.3% of patients achieving complete and partial responses, respectively. The median duration of response or overall survival was not reached, and the median progression-free survival was 26.0 (95% CI 2.6-not reached) months. No new safety signals were reported.

Study details: This 3-year follow-up study of phase 1/2 CheckMate 436 trial included 30 patients age ≥15 years with R/R PMBL previously treated with high-dose chemotherapy+autologous hematopoietic cell transplantation or ≥2 prior multiagent chemotherapies who received 240 mg nivolumab and 1.8 mg/kg BV once every 3 weeks.

Disclosures: This study was supported by Bristol Myers Squibb (BMS) and Seagen. Some authors declared serving as advisory board members and receiving consulting fees, honoraria, or research grants from BMS, Seagen, and others. Three authors declared being employees of or holding stocks in BMS or Seagen.

Source: Zinzani PL et al. Nivolumab combined with brentuximab vedotin for R/R primary mediastinal large B-cell lymphoma: A 3-year follow-up. Blood Adv. 2023 (Jun 23). Doi: 10.1182/bloodadvances.2023010254

Key clinical point: Nivolumab+brentuximab vedotin (BV) showed long-term efficacy and safety in patients with treatment-resistant relapsed or refractory (R/R) primary mediastinal large B-cell lymphoma (PMBL).

Major finding: After a median follow-up of 39.6 months, the objective response rate was 73.3% (95% CI 54.1%-87.7%), with 40.0% and 33.3% of patients achieving complete and partial responses, respectively. The median duration of response or overall survival was not reached, and the median progression-free survival was 26.0 (95% CI 2.6-not reached) months. No new safety signals were reported.

Study details: This 3-year follow-up study of phase 1/2 CheckMate 436 trial included 30 patients age ≥15 years with R/R PMBL previously treated with high-dose chemotherapy+autologous hematopoietic cell transplantation or ≥2 prior multiagent chemotherapies who received 240 mg nivolumab and 1.8 mg/kg BV once every 3 weeks.

Disclosures: This study was supported by Bristol Myers Squibb (BMS) and Seagen. Some authors declared serving as advisory board members and receiving consulting fees, honoraria, or research grants from BMS, Seagen, and others. Three authors declared being employees of or holding stocks in BMS or Seagen.

Source: Zinzani PL et al. Nivolumab combined with brentuximab vedotin for R/R primary mediastinal large B-cell lymphoma: A 3-year follow-up. Blood Adv. 2023 (Jun 23). Doi: 10.1182/bloodadvances.2023010254

Key clinical point: Nivolumab+brentuximab vedotin (BV) showed long-term efficacy and safety in patients with treatment-resistant relapsed or refractory (R/R) primary mediastinal large B-cell lymphoma (PMBL).

Major finding: After a median follow-up of 39.6 months, the objective response rate was 73.3% (95% CI 54.1%-87.7%), with 40.0% and 33.3% of patients achieving complete and partial responses, respectively. The median duration of response or overall survival was not reached, and the median progression-free survival was 26.0 (95% CI 2.6-not reached) months. No new safety signals were reported.

Study details: This 3-year follow-up study of phase 1/2 CheckMate 436 trial included 30 patients age ≥15 years with R/R PMBL previously treated with high-dose chemotherapy+autologous hematopoietic cell transplantation or ≥2 prior multiagent chemotherapies who received 240 mg nivolumab and 1.8 mg/kg BV once every 3 weeks.

Disclosures: This study was supported by Bristol Myers Squibb (BMS) and Seagen. Some authors declared serving as advisory board members and receiving consulting fees, honoraria, or research grants from BMS, Seagen, and others. Three authors declared being employees of or holding stocks in BMS or Seagen.

Source: Zinzani PL et al. Nivolumab combined with brentuximab vedotin for R/R primary mediastinal large B-cell lymphoma: A 3-year follow-up. Blood Adv. 2023 (Jun 23). Doi: 10.1182/bloodadvances.2023010254

Key clinical point: BCL6 positivity is associated with worse survival outcomes and a higher Ki67 index and shows a positive correlation with CD10 positivity in patients with mantle cell lymphoma (MCL).

Major finding: A positive vs negative expression of BCL6 was associated with a significantly shorter median overall survival (14 vs 43 months; P =.01) and was significantly correlated with CD10 positivity (odds ratio 5.11; P =.0000286) and a higher Ki67 index (P =.0094).

Study details: The data come from a systematic review and meta-analysis of 10 studies that involved 102 patients with MCL and reported BCL6- and CD10-positive or -negative MCL and Ki67% in BCL6-positive or -negative MCL.

Disclosures: This study received no external funding. The authors declared no conflicts of interest.

Source: Castillo DR et al. Unveiling the prognostic significance of BCL6+/CD10+ mantle cell lymphoma: Meta-analysis of individual patients and systematic review. Int J Mol Sci. 2023;24(12):10207 (Jun 16). Doi: 10.3390/ijms241210207

Key clinical point: BCL6 positivity is associated with worse survival outcomes and a higher Ki67 index and shows a positive correlation with CD10 positivity in patients with mantle cell lymphoma (MCL).

Major finding: A positive vs negative expression of BCL6 was associated with a significantly shorter median overall survival (14 vs 43 months; P =.01) and was significantly correlated with CD10 positivity (odds ratio 5.11; P =.0000286) and a higher Ki67 index (P =.0094).

Study details: The data come from a systematic review and meta-analysis of 10 studies that involved 102 patients with MCL and reported BCL6- and CD10-positive or -negative MCL and Ki67% in BCL6-positive or -negative MCL.

Disclosures: This study received no external funding. The authors declared no conflicts of interest.

Source: Castillo DR et al. Unveiling the prognostic significance of BCL6+/CD10+ mantle cell lymphoma: Meta-analysis of individual patients and systematic review. Int J Mol Sci. 2023;24(12):10207 (Jun 16). Doi: 10.3390/ijms241210207

Key clinical point: BCL6 positivity is associated with worse survival outcomes and a higher Ki67 index and shows a positive correlation with CD10 positivity in patients with mantle cell lymphoma (MCL).

Major finding: A positive vs negative expression of BCL6 was associated with a significantly shorter median overall survival (14 vs 43 months; P =.01) and was significantly correlated with CD10 positivity (odds ratio 5.11; P =.0000286) and a higher Ki67 index (P =.0094).

Study details: The data come from a systematic review and meta-analysis of 10 studies that involved 102 patients with MCL and reported BCL6- and CD10-positive or -negative MCL and Ki67% in BCL6-positive or -negative MCL.

Disclosures: This study received no external funding. The authors declared no conflicts of interest.

Source: Castillo DR et al. Unveiling the prognostic significance of BCL6+/CD10+ mantle cell lymphoma: Meta-analysis of individual patients and systematic review. Int J Mol Sci. 2023;24(12):10207 (Jun 16). Doi: 10.3390/ijms241210207

Key clinical point: Among patients receiving the bendamustine-rituximab regimen for newly diagnosed mantle cell lymphoma (MCL), selected patients with high-risk disease may require CD19-directed autologous chimeric antigen receptor-T cell therapy within 6 months of bendamustine exposure.

Major finding: The cumulative incidences of the first and second MCL progression were 14% (95% CI 8%-20%) and 6% (95% CI 3%-11%), respectively, at 6 months from the last bendamustine dose. Ki67 ≥ 50% was a significant risk factor for the occurrence of the first MCL progression within 6 months of bendamustine exposure (adjusted sub-hazard ratio 3.38; P =.022).

Study details: Findings are from retrospective population-based study including 118 adult patients with newly diagnosed MCL who received bendamustine-rituximab induction therapy with or without high-dose cytarabine and autologous stem cell transplantation followed by maintenance rituximab therapy.

Disclosures: This study did not receive any funding. All authors declared receiving honoraria from various sources.

Source: Puckrin R et al. Estimating the impact of early bendamustine failure on feasibility of subsequent CAR-T cell therapy in mantle cell lymphoma. Leuk Lymphoma. 2023 (Jun 20). Doi: 10.1080/10428194.2023.2226278

Key clinical point: Among patients receiving the bendamustine-rituximab regimen for newly diagnosed mantle cell lymphoma (MCL), selected patients with high-risk disease may require CD19-directed autologous chimeric antigen receptor-T cell therapy within 6 months of bendamustine exposure.

Major finding: The cumulative incidences of the first and second MCL progression were 14% (95% CI 8%-20%) and 6% (95% CI 3%-11%), respectively, at 6 months from the last bendamustine dose. Ki67 ≥ 50% was a significant risk factor for the occurrence of the first MCL progression within 6 months of bendamustine exposure (adjusted sub-hazard ratio 3.38; P =.022).

Study details: Findings are from retrospective population-based study including 118 adult patients with newly diagnosed MCL who received bendamustine-rituximab induction therapy with or without high-dose cytarabine and autologous stem cell transplantation followed by maintenance rituximab therapy.

Disclosures: This study did not receive any funding. All authors declared receiving honoraria from various sources.

Source: Puckrin R et al. Estimating the impact of early bendamustine failure on feasibility of subsequent CAR-T cell therapy in mantle cell lymphoma. Leuk Lymphoma. 2023 (Jun 20). Doi: 10.1080/10428194.2023.2226278

Key clinical point: Among patients receiving the bendamustine-rituximab regimen for newly diagnosed mantle cell lymphoma (MCL), selected patients with high-risk disease may require CD19-directed autologous chimeric antigen receptor-T cell therapy within 6 months of bendamustine exposure.

Major finding: The cumulative incidences of the first and second MCL progression were 14% (95% CI 8%-20%) and 6% (95% CI 3%-11%), respectively, at 6 months from the last bendamustine dose. Ki67 ≥ 50% was a significant risk factor for the occurrence of the first MCL progression within 6 months of bendamustine exposure (adjusted sub-hazard ratio 3.38; P =.022).

Study details: Findings are from retrospective population-based study including 118 adult patients with newly diagnosed MCL who received bendamustine-rituximab induction therapy with or without high-dose cytarabine and autologous stem cell transplantation followed by maintenance rituximab therapy.

Disclosures: This study did not receive any funding. All authors declared receiving honoraria from various sources.

Source: Puckrin R et al. Estimating the impact of early bendamustine failure on feasibility of subsequent CAR-T cell therapy in mantle cell lymphoma. Leuk Lymphoma. 2023 (Jun 20). Doi: 10.1080/10428194.2023.2226278

Key clinical point: Time to progression of disease (POD), defined as the time between first-line rituximab‐based therapy initiation and disease progression before second-line Bruton tyrosine kinase inhibitor (BTKi) therapy initiation, is associated with survival outcomes in patients with relapsed or refractory mantle cell lymphoma (MCL) receiving second-line BTKi therapy.

Major finding: After initiating second-line BTKi therapy, patients with POD within vs after 24 months of first-line therapy had significantly shorter median progression‐free survival (0.45 vs 2.3 years; P < .001) and overall survival (0.9 vs 5.5 years; P < .001).

Study details: This multicenter retrospective observational study included 360 adult patients with relapsed or refractory MCL who initiated second-line BTKi therapy after first-line rituximab-based therapy.

Disclosures: No information on the source of funding was provided. Some authors declared serving as consultants or advisors and receiving research funding, speaker fees, or honoraria from various sources.

Source: Villa D et al. Time to progression of disease and outcomes with second-line BTK inhibitors in relapsed/refractory mantle cell lymphoma. Blood Adv. 2023 (Jun 12). Doi: 10.1182/bloodadvances.2023009804

Key clinical point: Time to progression of disease (POD), defined as the time between first-line rituximab‐based therapy initiation and disease progression before second-line Bruton tyrosine kinase inhibitor (BTKi) therapy initiation, is associated with survival outcomes in patients with relapsed or refractory mantle cell lymphoma (MCL) receiving second-line BTKi therapy.

Major finding: After initiating second-line BTKi therapy, patients with POD within vs after 24 months of first-line therapy had significantly shorter median progression‐free survival (0.45 vs 2.3 years; P < .001) and overall survival (0.9 vs 5.5 years; P < .001).

Study details: This multicenter retrospective observational study included 360 adult patients with relapsed or refractory MCL who initiated second-line BTKi therapy after first-line rituximab-based therapy.

Disclosures: No information on the source of funding was provided. Some authors declared serving as consultants or advisors and receiving research funding, speaker fees, or honoraria from various sources.

Source: Villa D et al. Time to progression of disease and outcomes with second-line BTK inhibitors in relapsed/refractory mantle cell lymphoma. Blood Adv. 2023 (Jun 12). Doi: 10.1182/bloodadvances.2023009804

Key clinical point: Time to progression of disease (POD), defined as the time between first-line rituximab‐based therapy initiation and disease progression before second-line Bruton tyrosine kinase inhibitor (BTKi) therapy initiation, is associated with survival outcomes in patients with relapsed or refractory mantle cell lymphoma (MCL) receiving second-line BTKi therapy.

Major finding: After initiating second-line BTKi therapy, patients with POD within vs after 24 months of first-line therapy had significantly shorter median progression‐free survival (0.45 vs 2.3 years; P < .001) and overall survival (0.9 vs 5.5 years; P < .001).

Study details: This multicenter retrospective observational study included 360 adult patients with relapsed or refractory MCL who initiated second-line BTKi therapy after first-line rituximab-based therapy.

Disclosures: No information on the source of funding was provided. Some authors declared serving as consultants or advisors and receiving research funding, speaker fees, or honoraria from various sources.

Source: Villa D et al. Time to progression of disease and outcomes with second-line BTK inhibitors in relapsed/refractory mantle cell lymphoma. Blood Adv. 2023 (Jun 12). Doi: 10.1182/bloodadvances.2023009804

Key clinical point: The noncovalent Bruton’s tyrosine kinase inhibitor (BTKi) pirtobrutinib was efficacious in patients with relapsed or refractory chronic lymphocytic leukemia (CLL) or small lymphocytic lymphoma (SLL) who had previously received BTKi therapy.

Major finding: An overall response was achieved by 73.3% (95% CI 67.3%-78.7%) of patients previously treated with BTKi therapy and by 82.2% (95% CI 76.8%-86.7%) of patients when partial response with lymphocytosis was included. At a 19.4-month median follow-up, the median progression-free survival was 19.6 (95% CI 16.9-22.1) months. Only 2.8% of patients discontinued pirtobrutinib permanently due to treatment-related adverse events.

Study details: Findings are from the phase 1-2 BRUIN trial including 317 patients with relapsed or refractory CLL or SLL who received pirtobrutinib, of which 247 had previously received ≥1 BTK inhibitor.

Disclosures: This study was supported by Loxo Oncology, a subsidiary of Eli Lilly. Some authors, including the lead author, declared serving as consultants or speakers for or receiving advisory board honoraria, travel support, or research funding from Loxo/Lilly. Seven authors declared being employees or stockholders of Loxo/Lilly.

Source: Mato AR et al. Pirtobrutinib after a covalent BTK inhibitor in chronic lymphocytic leukemia. N Engl J Med. 2023;389:33-44 (Jul 6). Doi: 10.1056/NEJMoa2300696

Key clinical point: The noncovalent Bruton’s tyrosine kinase inhibitor (BTKi) pirtobrutinib was efficacious in patients with relapsed or refractory chronic lymphocytic leukemia (CLL) or small lymphocytic lymphoma (SLL) who had previously received BTKi therapy.

Major finding: An overall response was achieved by 73.3% (95% CI 67.3%-78.7%) of patients previously treated with BTKi therapy and by 82.2% (95% CI 76.8%-86.7%) of patients when partial response with lymphocytosis was included. At a 19.4-month median follow-up, the median progression-free survival was 19.6 (95% CI 16.9-22.1) months. Only 2.8% of patients discontinued pirtobrutinib permanently due to treatment-related adverse events.

Study details: Findings are from the phase 1-2 BRUIN trial including 317 patients with relapsed or refractory CLL or SLL who received pirtobrutinib, of which 247 had previously received ≥1 BTK inhibitor.

Disclosures: This study was supported by Loxo Oncology, a subsidiary of Eli Lilly. Some authors, including the lead author, declared serving as consultants or speakers for or receiving advisory board honoraria, travel support, or research funding from Loxo/Lilly. Seven authors declared being employees or stockholders of Loxo/Lilly.

Source: Mato AR et al. Pirtobrutinib after a covalent BTK inhibitor in chronic lymphocytic leukemia. N Engl J Med. 2023;389:33-44 (Jul 6). Doi: 10.1056/NEJMoa2300696

Key clinical point: The noncovalent Bruton’s tyrosine kinase inhibitor (BTKi) pirtobrutinib was efficacious in patients with relapsed or refractory chronic lymphocytic leukemia (CLL) or small lymphocytic lymphoma (SLL) who had previously received BTKi therapy.

Major finding: An overall response was achieved by 73.3% (95% CI 67.3%-78.7%) of patients previously treated with BTKi therapy and by 82.2% (95% CI 76.8%-86.7%) of patients when partial response with lymphocytosis was included. At a 19.4-month median follow-up, the median progression-free survival was 19.6 (95% CI 16.9-22.1) months. Only 2.8% of patients discontinued pirtobrutinib permanently due to treatment-related adverse events.

Study details: Findings are from the phase 1-2 BRUIN trial including 317 patients with relapsed or refractory CLL or SLL who received pirtobrutinib, of which 247 had previously received ≥1 BTK inhibitor.

Disclosures: This study was supported by Loxo Oncology, a subsidiary of Eli Lilly. Some authors, including the lead author, declared serving as consultants or speakers for or receiving advisory board honoraria, travel support, or research funding from Loxo/Lilly. Seven authors declared being employees or stockholders of Loxo/Lilly.

Source: Mato AR et al. Pirtobrutinib after a covalent BTK inhibitor in chronic lymphocytic leukemia. N Engl J Med. 2023;389:33-44 (Jul 6). Doi: 10.1056/NEJMoa2300696

Key clinical point: Nearly one third of patients with treatment-refractory chronic migraine (CM) who did not respond to anti-calcitonin gene-related peptide (CGRP) receptor monoclonal antibodies (mAb) showed a meaningful response to anti-CGRP ligand mAb.

Major finding: Overall, 25.6% of patients achieved ≥30% reduction in monthly migraine days (MMD) after 3 months of initiating fremanezumab and were considered responders, with the mean MMD significantly reducing from 21.4 days at baseline to 15.0 days at 3 months (P = .007), 8.6 days at 6 months (P = .007), and 8.6 days at the last follow-up (P = .001). Treatment-related side effects were generally mild.

Study details: This long-term prospective real-world analysis included 39 patients with treatment-refractory CM who did not achieve a meaningful response to erenumab and switched to fremanezumab.

Disclosures: This study did not disclose the funding source. Some authors declared receiving research grants, funding for travel, personal fees as speakers or advisors, or honoraria for participation in advisory boards from various sources.

Source: Lambru G et al. Long-term effect of switching from an anti-CGRP receptor to an anti-CGRP ligand antibody in treatment-refractory chronic migraine: A prospective real-world analysis. Neurotherapeutics. 2023 (Jul 10). Doi: 10.1007/s13311-023-01394-0

Key clinical point: Nearly one third of patients with treatment-refractory chronic migraine (CM) who did not respond to anti-calcitonin gene-related peptide (CGRP) receptor monoclonal antibodies (mAb) showed a meaningful response to anti-CGRP ligand mAb.

Major finding: Overall, 25.6% of patients achieved ≥30% reduction in monthly migraine days (MMD) after 3 months of initiating fremanezumab and were considered responders, with the mean MMD significantly reducing from 21.4 days at baseline to 15.0 days at 3 months (P = .007), 8.6 days at 6 months (P = .007), and 8.6 days at the last follow-up (P = .001). Treatment-related side effects were generally mild.

Study details: This long-term prospective real-world analysis included 39 patients with treatment-refractory CM who did not achieve a meaningful response to erenumab and switched to fremanezumab.

Disclosures: This study did not disclose the funding source. Some authors declared receiving research grants, funding for travel, personal fees as speakers or advisors, or honoraria for participation in advisory boards from various sources.

Source: Lambru G et al. Long-term effect of switching from an anti-CGRP receptor to an anti-CGRP ligand antibody in treatment-refractory chronic migraine: A prospective real-world analysis. Neurotherapeutics. 2023 (Jul 10). Doi: 10.1007/s13311-023-01394-0

Key clinical point: Nearly one third of patients with treatment-refractory chronic migraine (CM) who did not respond to anti-calcitonin gene-related peptide (CGRP) receptor monoclonal antibodies (mAb) showed a meaningful response to anti-CGRP ligand mAb.

Major finding: Overall, 25.6% of patients achieved ≥30% reduction in monthly migraine days (MMD) after 3 months of initiating fremanezumab and were considered responders, with the mean MMD significantly reducing from 21.4 days at baseline to 15.0 days at 3 months (P = .007), 8.6 days at 6 months (P = .007), and 8.6 days at the last follow-up (P = .001). Treatment-related side effects were generally mild.

Study details: This long-term prospective real-world analysis included 39 patients with treatment-refractory CM who did not achieve a meaningful response to erenumab and switched to fremanezumab.

Disclosures: This study did not disclose the funding source. Some authors declared receiving research grants, funding for travel, personal fees as speakers or advisors, or honoraria for participation in advisory boards from various sources.

Source: Lambru G et al. Long-term effect of switching from an anti-CGRP receptor to an anti-CGRP ligand antibody in treatment-refractory chronic migraine: A prospective real-world analysis. Neurotherapeutics. 2023 (Jul 10). Doi: 10.1007/s13311-023-01394-0

Key clinical point: Prophylactic treatment with monthly or quarterly fremanezumab demonstrated favorable efficacy and tolerability in a real-world cohort of patients with episodic migraine (EM) or chronic migraine (CM).

Major finding: After initiating fremanezumab, the monthly migraine days reduced by 6.1, 7.7, and 8.5 days at 1, 3, and 6 months, respectively, with similar reductions observed when categorized by EM or CM (all P < .001). At 6 months, ≥50%, ≥75%, and 100% response rates were achieved by 67.6%, 22.5%, and 5.4% of patients in the overall cohort, respectively, with 48.0% of patients with CM experiencing remission to EM after 1-month fremanezumab treatment. Overall, 9.5% of the patients experienced adverse reactions, which were mostly mild.

Study details: Findings are from a retrospective study that included 127 patients with migraine (EM n = 54; CM n = 73) who received monthly or quarterly fremanezumab doses over 6 months.

Disclosures: This study received no specific funding from any source. Four authors declared receiving lecture fees from various sources.

Source: Suzuki S et al. Real-world experience with monthly and quarterly dosing of fremanezumab for the treatment of patients with migraine in Japan. Front Neurol. 2023;14:1220285 (Jul 6). Doi: 10.3389/fneur.2023.1220285

Key clinical point: Prophylactic treatment with monthly or quarterly fremanezumab demonstrated favorable efficacy and tolerability in a real-world cohort of patients with episodic migraine (EM) or chronic migraine (CM).

Major finding: After initiating fremanezumab, the monthly migraine days reduced by 6.1, 7.7, and 8.5 days at 1, 3, and 6 months, respectively, with similar reductions observed when categorized by EM or CM (all P < .001). At 6 months, ≥50%, ≥75%, and 100% response rates were achieved by 67.6%, 22.5%, and 5.4% of patients in the overall cohort, respectively, with 48.0% of patients with CM experiencing remission to EM after 1-month fremanezumab treatment. Overall, 9.5% of the patients experienced adverse reactions, which were mostly mild.

Study details: Findings are from a retrospective study that included 127 patients with migraine (EM n = 54; CM n = 73) who received monthly or quarterly fremanezumab doses over 6 months.

Disclosures: This study received no specific funding from any source. Four authors declared receiving lecture fees from various sources.

Source: Suzuki S et al. Real-world experience with monthly and quarterly dosing of fremanezumab for the treatment of patients with migraine in Japan. Front Neurol. 2023;14:1220285 (Jul 6). Doi: 10.3389/fneur.2023.1220285

Key clinical point: Prophylactic treatment with monthly or quarterly fremanezumab demonstrated favorable efficacy and tolerability in a real-world cohort of patients with episodic migraine (EM) or chronic migraine (CM).

Major finding: After initiating fremanezumab, the monthly migraine days reduced by 6.1, 7.7, and 8.5 days at 1, 3, and 6 months, respectively, with similar reductions observed when categorized by EM or CM (all P < .001). At 6 months, ≥50%, ≥75%, and 100% response rates were achieved by 67.6%, 22.5%, and 5.4% of patients in the overall cohort, respectively, with 48.0% of patients with CM experiencing remission to EM after 1-month fremanezumab treatment. Overall, 9.5% of the patients experienced adverse reactions, which were mostly mild.

Study details: Findings are from a retrospective study that included 127 patients with migraine (EM n = 54; CM n = 73) who received monthly or quarterly fremanezumab doses over 6 months.

Disclosures: This study received no specific funding from any source. Four authors declared receiving lecture fees from various sources.

Source: Suzuki S et al. Real-world experience with monthly and quarterly dosing of fremanezumab for the treatment of patients with migraine in Japan. Front Neurol. 2023;14:1220285 (Jul 6). Doi: 10.3389/fneur.2023.1220285

Key clinical point: Higher intake of dietary caffeine was positively associated with a higher prevalence of severe headaches or migraines in US adults.

Major finding: Overall, the incidence of severe headaches or migraines increased by 5% with each 100 mg/day increase in dietary caffeine intake (odds ratio [OR] 1.05; P < .001), with the risk increasing by 42% with caffeine intake ≥ 400 mg/day vs ≥0 to <40 mg/day (OR 1.42; P < .001).

Study details: This cross-sectional study evaluated the association between dietary caffeine intake and severe headaches or migraines in 8993 U.S. adults age ≥ 20 years.

Disclosures: This study was funded by the Shandong Traditional Chinese Medicine Science and Technology Development Project, China. The authors declared no conflicts of interest.

Source: Zhang L et al. Association between dietary caffeine intake and severe headache or migraine in US adults. Sci Rep. 2023;13:10220 (Jun 23). Doi: 10.1038/s41598-023-36325-8

Key clinical point: Higher intake of dietary caffeine was positively associated with a higher prevalence of severe headaches or migraines in US adults.

Major finding: Overall, the incidence of severe headaches or migraines increased by 5% with each 100 mg/day increase in dietary caffeine intake (odds ratio [OR] 1.05; P < .001), with the risk increasing by 42% with caffeine intake ≥ 400 mg/day vs ≥0 to <40 mg/day (OR 1.42; P < .001).

Study details: This cross-sectional study evaluated the association between dietary caffeine intake and severe headaches or migraines in 8993 U.S. adults age ≥ 20 years.

Disclosures: This study was funded by the Shandong Traditional Chinese Medicine Science and Technology Development Project, China. The authors declared no conflicts of interest.

Source: Zhang L et al. Association between dietary caffeine intake and severe headache or migraine in US adults. Sci Rep. 2023;13:10220 (Jun 23). Doi: 10.1038/s41598-023-36325-8

Key clinical point: Higher intake of dietary caffeine was positively associated with a higher prevalence of severe headaches or migraines in US adults.

Major finding: Overall, the incidence of severe headaches or migraines increased by 5% with each 100 mg/day increase in dietary caffeine intake (odds ratio [OR] 1.05; P < .001), with the risk increasing by 42% with caffeine intake ≥ 400 mg/day vs ≥0 to <40 mg/day (OR 1.42; P < .001).

Study details: This cross-sectional study evaluated the association between dietary caffeine intake and severe headaches or migraines in 8993 U.S. adults age ≥ 20 years.

Disclosures: This study was funded by the Shandong Traditional Chinese Medicine Science and Technology Development Project, China. The authors declared no conflicts of interest.

Source: Zhang L et al. Association between dietary caffeine intake and severe headache or migraine in US adults. Sci Rep. 2023;13:10220 (Jun 23). Doi: 10.1038/s41598-023-36325-8