After summarizing the papers for everyone last week, I originally intended for that first post to be the last 😩. However, with the encouragement of my mentors, I have decided to publish another one. This time, we have selected 5 articles with significant "clinical decision-making impact," covering topics ranging from chemotherapy-free targeted therapy head-to-head trials in CLL, the shift of immunotherapy to the frontline for follicular lymphoma and Hodgkin lymphoma, to guidelines for the use of PTCy in HLA-matched transplants.
I hope this brings some practical new perspectives and inspiration to your evening reflection time, or to your upcoming clinical rounds and Journal Club!
[Chronic Lymphocytic Leukemia (CLL)]1. Pirtobrutinib Versus Ibrutinib in Treatment-Naïve and Relapsed/Refractory Chronic Lymphocytic Leukemia/Small Lymphocytic Lymphoma (Pirtobrutinib versus Ibrutinib for treatment-naïve and relapsed/refractory CLL/SLL)
Published in Journal：Journal of Clinical Oncology (JCO)
Key Takeaway: This is a head-to-head comparison between a non-covalent BTK inhibitor and ibrutinib. Not only is the objective response rate (ORR) non-inferior, but early progression-free survival (PFS) also favors pirtobrutinib. Furthermore, it reduces cardiovascular adverse events, which is of significant clinical importance for elderly patients with CLL/SLL and comorbidities when considering first-line treatment options.
Article link: https://doi.org/10.1200/JCO-25-024772. Fixed-duration VenO vs FCR/BR in fit patients with untreated CLL: primary analysis of the phase 3 CRISTALLO trial (Fixed-duration Venetoclax plus Obinutuzumab versus FCR/BR for treatment-naïve CLL patients: primary analysis of the phase 3 CRISTALLO trial)
Journal Published: Blood Key Summary: Using "undetectable measurable residual disease (uMRD)" as the primary endpoint, this trial demonstrated that a 12-month fixed-duration VenO regimen provides deeper molecular-level remission for young, fit, newly diagnosed CLL patients compared to intensive chemotherapy, while simultaneously advancing time-limited targeted therapy and avoiding the long-term bone marrow toxicity associated with FCR. Paper link：https://doi.org/10.1182/blood.2025030630 [Lymphoma]3. Epcoritamab, lenalidomide, and rituximab versus lenalidomide and rituximab for relapsed or refractory follicular lymphoma (EPCORE FL-1): a global, open-label, randomised, phase 3 trial (Epcoritamab combined with lenalidomide and rituximab versus the R2 regimen alone for the treatment of relapsed or refractory follicular lymphoma)
Journal of Publication: The Lancet Key Highlights: The Phase 3 EPCORE FL-1 trial confirms that adding the subcutaneous bispecific antibody Epcoritamab to the R2 (lenalidomide + rituximab) regimen significantly reduces the risk of disease progression or death by 79% in patients with relapsed/refractory follicular lymphoma. This sets a new benchmark for chemo-free outpatient treatment. Article link：https://doi.org/10.1016/S0140-6736(25)02360-8 [Hematopoietic Stem Cell Transplantation (HSCT)]4. PD-1–based combinations before autologous transplant are associated with improved outcomes in classical Hodgkin lymphoma (PD-1 inhibitor-based combination therapy prior to autologous stem cell transplantation significantly improves outcomes for patients with classical Hodgkin lymphoma)
Published in Journal：Blood Key Summary: A large-scale real-world retrospective analysis of nearly 1,300 patients has established that the use of PD-1 inhibitor-based salvage therapy prior to autologous stem cell transplantation in patients with relapsed/refractory classical Hodgkin lymphoma (cHL) yields significantly superior long-term progression-free survival compared to conventional chemotherapy or brentuximab vedotin (BV), supporting the shift of immunotherapy to an earlier line of treatment. Paper link：https://doi.org/10.1182/blood.20250301515. Posttransplant cyclophosphamide in HLA-matched peripheral blood transplantation: what's next? (Application and Future Prospects of PTCy in HLA-Matched Stem Cell Transplantation)
Published in Journal：Blood Key Takeaway: Although this article leans toward a practical perspective, it is highly useful for transplant teams. Post-transplant cyclophosphamide (PTCy) is no longer just a tool exclusive to haploidentical hematopoietic stem cell transplantation (haplo-HSCT); it is increasingly becoming a core topic in discussions regarding HLA-matched peripheral blood stem cell transplantation. Article link：https://doi.org/10.1182/blood.2025030416
Editor's Note: The research in this issue clearly demonstrates a strong trend in hematologic oncology treatment toward "precision targeted therapy" and "immune microenvironment remodeling." In particular, the deep remission achieved in frontline chemotherapy-free treatment for CLL, as well as the application of PTCy beyond the scope of haploidentical transplantation, are highly insightful for clinical practice!