ASCO 2026: Breakthrough Blood‑Cancer Readouts Spotlight Long‑Term BTK Control, Myelofibrosis Survival Signal and Promising Radiopharmaceutical Results

The 2026 American Society of Clinical Oncology (ASCO) meeting closed with major readouts across haematological malignancies, from frontline chronic lymphocytic leukaemia (CLL) to rarer disorders such as myelofibrosis and Waldenström macroglobulinemia (WM). Investigators presented long‑term data and late‑stage trials that could influence treatment algorithms and spur confirmatory studies.

CLL/SLL — SEQUOIA Delivers Robust Long‑Term PFS With Brukinsa

BeiGene reported extended follow‑up from the Phase III SEQUOIA study (NCT03336333) comparing the BTK inhibitor Brukinsa (zanubrutinib) with bendamustine plus rituximab (BR) as frontline therapy for CLL/small lymphocytic lymphoma (SLL). After 78 months of follow‑up, progression‑free survival (PFS) was 71.8% for patients on Brukinsa versus 31% in the BR arm. The benefit was even more pronounced in patients with mutations affecting B‑cell antibody production, where PFS at 78 months was 81.8% with Brukinsa compared with 45.1% with BR.

Time to next treatment also favoured Brukinsa, and its safety profile remained consistent with prior studies. BeiGene also presented a real‑world analysis suggesting Brukinsa may lower risks of death, progression to subsequent lines of therapy, or treatment discontinuation versus other BTK inhibitors such as Imbruvica (ibrutinib) and Calquence (acalabrutinib), with similar effects across age subgroups.

Myelofibrosis — SENTRY Shows Spleen Reduction And An Early OS Signal

Karyopharm disclosed topline results from the Phase III SENTRY trial (NCT04562389) evaluating selinexor (Xpovio) plus ruxolitinib (Jakafi) versus ruxolitinib alone in JAK inhibitor–naïve symptomatic myelofibrosis. The combination met a co‑primary endpoint: 50% of patients receiving the combination achieved ≥35% spleen volume reduction versus 28% with ruxolitinib monotherapy. An early overall survival (OS) signal favoured the combination (p=0.0222), which Karyopharm will continue to monitor as follow‑up matures.

However, the trial did not meet its key second primary endpoint for symptom response at week 24 (10.86‑point improvement with the combination vs 9.89 with ruxolitinib alone), and discontinuation rates were modestly higher with the combination (14.5% vs 8.6%). Investigators stressed the need for mature data to confirm the early survival finding and to balance efficacy with tolerability.

Waldenström Macroglobulinemia — Iopofosine Shows High Response Rate

Cellectar Biosciences said it will pursue accelerated U.S. approval for the radiopharmaceutical phospholipid–drug conjugate iopofosine I‑131 after a positive Phase IIb result in relapsed/refractory Waldenström macroglobulinemia (CLOVER WaM, NCT02952508). In 24 patients who had received more than two prior therapies and were treated with iopofosine after a BTK inhibitor, the overall response rate (ORR) was 87.5%, with 79.2% achieving a partial response or better. The median duration of response was 16 months and 20% of patients had a duration ≥30 months. The regimen was generally tolerable; the only treatment‑related grade ≥3 adverse event reported was cytopenia. A confirmatory Phase III study is planned to start in Q4 2026.

AL Amyloidosis — Mixed Results But New Biology‑Driven Approaches Emerge

AstraZeneca reported that its anti‑fibril antibody anselamimab did not meet the global Phase III CARES primary endpoint, though it showed statistically significant benefit in adults with advanced kappa AL amyloidosis when added to standard of care in frontline treatment. Regeneron presented early Phase I/II (LINKER AL‑2, NCT06292780) data for the BCMA‑CD3 bispecific linvoseltamab: among 20 patients with relapsed/refractory disease there were no dose‑limiting toxicities or ICANS, and haematalogic objective response rates were encouraging (100% at 80 mg; 92.3% at 240 mg). One patient experienced ventricular fibrillation and died; investigators judged the event unrelated to study treatment.

Currently, Johnson & Johnson’s Darzalex Faspro (daratumumab and hyaluronidase‑fihj) remains the only therapy specifically approved for AL amyloidosis, highlighting an urgent need for new, biology‑based treatments in this field.

What This Means

ASCO 2026 delivered several important signals: durable disease control with next‑generation BTK inhibition in frontline CLL/SLL, a potentially practice‑changing but still‑immature survival signal for a myelofibrosis combination, promising radiopharmaceutical activity in WM with plans for Phase III confirmation, and renewed momentum toward biology‑driven therapies for AL amyloidosis. Each of these readouts will require additional confirmatory data or longer follow‑up before practice changes are fully adopted.