Salvatore Iachino, Hematology Resident/Fellow of Hematology and Steam Cell Transplantation Unit at Università Campus Bio-Medico di Roma, shared a post on LinkedIn:
“Just returned from PostASH2026 in Turin — three days of immersive seminars highlighting the most important breakthroughs from ASH 2025 and offering a valuable space for growth and exchange within the international hematology community.
We are witnessing a profound paradigm shift: moving away from conventional chemo-immunotherapy toward chemo-free strategies powered by bispecific antibodies (T-cell engagers), small molecules, ADCs, and cellular therapies. Hematology is increasingly a precision medicine discipline:
- Dynamic Algorithms: Treatment decisions are now driven by PET imaging, MRD (Minimal Residual Disease), molecular biology, and patient fitness (fit vs. frail).
- Safety First: Growing focus on novel toxicities (immune-mediated, neurological, and infectious) requiring structured monitoring protocols.
- Sustainability: Real-world access and economic viability will be a major challenge for healthcare systems globally, balancing innovation with equitable care.
Below are the key highlights from the Lymphoma sessions:
Mantle Cell Lymphoma | BTK inhibitors (BTKi) are redefining frontline therapy:
- TRIANGLE: Adding Ibrutinib to induction/maintenance is now a key element for young, fit patients (the role of ASCT in this setting remains debated).
- SYMPATICO: Ibrutinib + Venetoclax in R/R MCL: high response rates and MRD depth with an all-oral regimen.
- ECHO: Acalabrutinib + BR becomes the new standard for patients >64 years ineligible for transplant.
- Chemo-free Triplets: ZVO and AVR regimens show >90% response rates. The future lies in MRD-guided, fixed-duration treatment.
- High Risk: GLPG5101 CAR-T (early-memory enriched) shows a vein-to-vein time of ~7 days and <5% drop-out rate.
DLBCL & PMBL
- DLBCL: The STARGLO study (Glofitamab + GemOx) and CD20xCD3 TCEs in early 2L are challenging current standards.
- CAR-T: Focus on real-world data comparing Liso-cel vs. Axi-cel (DESCART) and bispecific CD19+CD20 CAR-Ts to overcome antigen escape.
- PMBL: Anti-PD-1 ± Brentuximab Vedotin in R/R PMBL confirms extraordinary efficacy (2-year OS: 75.5%).
Follicular Lymphoma
- Emerging Standards: Epcoritamab + R2 (EPCORE FL-1) in 2L and promising bispecific-based combinations in 1L (ROSEWOOD, CELESTIMO).
- CAR-T: Long-term data confirm curative potential in 3L+ (~50% 5-year PFS). Critical Note: Bendamustine <12 months pre-apheresis may negatively impact outcomes.
Hodgkin, CLL & T-Cell
- Hodgkin: SWOG1826 (Nivo-AVD) superior to BV-AVD. PET-driven strategies (BrECADD) for de-escalation in PET2-negative patients.
- CLL & WM: Management is increasingly MRD-driven. In Waldenström, focus on Pirtobrutinib (non-covalent BTKi).
- T-Cell: Innovation continues with Golidocitinib and new triplets (PD1 + Len + Aza) in PTCL.
Coming next: Multiple Myeloma, Acute Leukemias
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