Topline Presentation Points 

Refining diagnostic testing and risk stratification

ASH Abstract 6. Profiling of Circulating Tumor DNA for Noninvasive Disease Detection, Risk Stratification, MRD Monitoring in Patients with CNS Lymphoma
Jurik Andreas Mutter et al.

  • Primary central nervous system lymphoma (PCNSL) – predominantly older individuals, presenting diagnostic and therapeutic challenges
    • Often requires invasive procedures for diagnosis, for which not all may not be suited, or which may not be feasible
  • ctDNA emerging as a powerful biomarker in lymphoma, with potential applications in diagnostics (“liquid biopsy”), risk stratification, clinical outcome prediction, among others
    • Ultrasensitive detection of ctDNA may have important applications in the diagnosis of PCNSL, avoiding the need for more invasive procedures
Improving outcomes in front-line therapy
DLBCL

ASH LBA 1. The POLARIX Study: Polatuzumab Vedotin with Rituximab, Cyclophosphamide, Doxorubicin, and Prednisone (pola-R-CHP) Versus Rituximab, Cyclophosphamide, Doxorubicin, Vincristine and Prednisone (R-CHOP) Therapy in Patients with Previously Untreated Diffuse Large B-Cell Lymphoma
Hervé Tilly et al.

  • R-CHOP represents SOC for DLBCL
  • Roughly 40% of patients not cured with front-line therapy
  • POLARIX addresses the question of whether 1st-line polatuzumab vedotin improves outcomes
    • Pola-R-CHP demonstrated a 27% relative risk reduction in disease progression, relapse or death
    • Requires longer follow-up to evaluate impact on OS

Additional Presenter Perspective: Cost-efficacy analyses will be important for determining the overall relevance of this approach within the Canadian landscape

Hodgkin Lymphoma

ASH Abstract 231. Frontline Treatment with Single Agent Pembrolizumab (PEM) Followed By AVD Chemotherapy for Classic Hodgkin Lymphoma: Updated Results and Correlative Analysis
Pamela Allen, MD et al.

  • PD-1 inhibitors established in rel/ref disease
  • Pembrolizumab + AVD is a highly effective first-line strategy
    • Even low-level PD-L1 and PD-L2 expressors likely to benefit
    • Toxicity profile likely highly favourable compared with conventional standards
    • Larger Phase II (KEYNOTE-C11) and Phase III (SWOG S1826) trials ongoing, evaluating role of checkpoint inhibitors in 1st line treatment

Additional Presenter Perspective: Question remains if this may supplant current standard of care

Novel strategies for salvage therapy in r/r NHL

ASH Abstract 127. Mosunetuzumab Monotherapy is an Effective and Well-Tolerated Treatment Option for Patients with Relapsed/Refractory (R/R) Follicular Lymphoma (FL) Who Have Received > 2 Prior Lines of Therapy: Pivotal Results from a Phase I/II Study
L. Elizabeth Buddle et al.

  • Mosunetuzumab is a fully humanized IgG1, bispecific for CD20 and CD3
    • Bridges T-cell with tumour cells, allowing initiation of an immune effector response
  • Phase I/Ib dose escalation study in r/r FL revealed ORR of 68% (CR 50%), with promising DOR and PFS
    • High risk patients equally likely to respond
    • Responses appear sustained beyond 12 months for most
    • Step-up dosing appears to mitigate against severe CRS, facilitating out-patient treatment
    • Relatively low toxicity in heavily pre-treated patients is appealing

Additional Presenter Perspective: Likely to become a new therapeutic option for r/r FL