Consensus treatment recommendations from the tenth International Workshop for Waldenström Macroglobulinaemia
Castillo, Jorge J; Advani, Ranjana H; Branagan, Andrew R; Buske, Christian; Dimopoulos, Meletios A; D'Sa, Shirley; Kersten, Marie José; Leblond, Veronique; Minnema, Monique C; Owen, Roger G; Palomba, M Lia; Talaulikar, Dipti; Tedeschi, Alessandra; Trotman, Judith; Varettoni, Marzia; Vos, Josephine M; Treon, Steven P; Kastritis, Efstathios
(2020) Lancet haematology, volume 7, issue 11, pp. e827 - e837
(Article)
Abstract
Waldenström macroglobulinaemia is an indolent B-cell lymphoma with clearly defined criteria for diagnosis, initiation of therapy, and response, which was established by consensus panels at previous International Workshops for Waldenström Macroglobulinaemia (IWWM). The treatment options for Waldenström macroglobulinaemia continued to be researched after the publication of the eighth IWWM consensus
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recommendations in 2016, and at the tenth IWWM in New York, USA (October, 2018) an international consensus panel was formed to update treatment recommendations. Participants were selected as members of the consensus panel based on their expertise on Waldenström macroglobulinaemia. The initial live discussion took place during the tenth IWWM meeting and two separate teleconferences were held in June, 2019, and January, 2020, to refine recommendations. No external or financial support was received for the elaboration of these recommendations. According to these updated consensus recommendations, alkylating drugs (bendamustine, cyclophosphamide) and proteasome inhibitors (bortezomib, carfilzomib, ixazomib), both in combination with rituximab, as well as BTK inhibitors (ibrutinib), alone or in combination with rituximab, are preferred first-line therapy options for symptomatic patients with Waldenström macroglobulinaemia. In previously treated patients with Waldenström macroglobulinaemia who had an initial durable response, reuse of a previous regimen or another primary therapy regimen are acceptable options. Novel BTK inhibitors (acalabrutinib, zanubrutinib, tirabrutinib) and the BCL2 antagonist venetoclax appear safe and active, and represent emerging options for the treatment of Waldenström macroglobulinaemia. The choice of therapy should be guided by the patient's clinical profile, genomic features, and drug availability.
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Keywords: Hematology, Review, Journal Article
ISSN: 2352-3026
Publisher: Lancet Publishing Group
Note: Funding Information: JJC has received honoraria or research funding from AbbVie, Beigene, Janssen, Kymera, Pharmacyclics, and TG Therapeutics. RHA has received honoraria or research funding from Genentech, Agensys, AstraZeneca, Autolus, Bayer, Bristol Myers Squibb (BMS), Celgene, Cell Medica, Forty Seven, Gilead, Infinity, Janssen, Kyowa Hakko Kirin, Kura, Merck, Millennium, Pharmacyclics, Regeneron, Roche, Seattle Genetics, and Takeda. ARB received honoraria from Pharmacyclics. CB has received research funding from Roche, Janssen, Bayer, and MSD. MAD received honoraria from participation in advisory boards from Amgen, Takeda, Celgene, Janssen, and BMS. SD'S has received honoraria and grant funding from Janssen, grant funding from BeiGene, honoraria from Novartis, and is an advisory board member for Sanofi. EK has received research honoraria or research funding from Amgen, Genesis Pharma, Janssen, Takeda, and Pfizer. MJK has received honoraria or research funding from Novartis, Kite (Gilead), Celgene, Roche, BMS, Merck, Amgen, Janssen, and Miltenyi Biotech. VL has received honoraria from AbbVie, Beigene, Roche, Gilead, Janssen, Amgen, and AstraZeneca. MCM has received honoraria or research funding from Celgene (BMS), Janssen, Servier and, Kite (Gilead). RGO has received research funding from AztraZeneca. MLP has received honoraria or research funding from Janssen and Pharmacyclics. AT has received honoraria from AbbVie, Janssen, Sunesis, and AstraZeneca. DT has received honoraria or research funding from Amgen, Janssen, Novartis, Roche, and Takeda. JT has received research funding from Pharmacyclics, Janssen, Roche, Celgene, and Beigene. SPT has received honoraria or research funding from Pharmacyclics and BMS. MV has received honoraria from Janssen and Roche. JMV declares no competing interests. Publisher Copyright: © 2020 Elsevier Ltd Copyright: Copyright 2021 Elsevier B.V., All rights reserved.
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