Efficacy of lenalidomide in high‐risk diffuse large B‐cell lymphoma

Rodgers, Thomas D.; Baran, Andrea; Reagan, Patrick M.; Casulo, Carla; Zent, Clive S.; Evans, Andrew; Burack, Richard; Williams, AnnaLynn M.; Friedberg, Jonathan W.; Barr, Paul M.

doi:10.1111/bjh.16302

Cited by 8 publications

(6 citation statements)

References 15 publications

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“…The phase II L-MIND study has shown durable remissions with lenalidomide and CD19 antibody in relapsed/refractory DLBCL [ 20 ]. A single-center retrospective study evaluating the real-world data of lenalidomide in relapsed/refractory DLBCL showed durable clinical activity regardless of the cell of origin [ 21 ]. In addition, Thieblemont et al investigated the role of lenalidomide maintenance in elderly patients with DLBCL and observed that there was PFS benefit with 24 months of maintenance compared to placebo [ 22 ].…”

Section: Discussionmentioning

confidence: 99%

Reduced-Intensity Anthracycline-Free Chemoimmunotherapy in Elderly Patients With Newly Diagnosed or Relapsed Diffuse Large B-Cell Lymphoma

Yohannan,

Rios

2023

J Hematol

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Diffuse large B-cell lymphoma (DLBCL) is the most common type of non-Hodgkin lymphoma (NHL); it has a cure rate of approximately 50% with standard anthracycline-based chemoimmunotherapy. However, the clinical outcomes of elderly unfit/frail DLBCL patients remain suboptimal due to poor tolerance of anthracycline-containing regimens. Herein, we report a series of seven elderly unfit patients with DLBCL who were treated with a reduced-intensity anthracycline-free chemoimmunotherapy (rituximab, cyclophosphamide, vincristine, and prednisone) regimen combined with lenalidomide (R 2 -COP). Five patients received R 2 -COP as first-line therapy, and two patients were treated for relapsed DLBCL. Four patients with newly diagnosed DLBCL and two with relapsed disease achieved complete remission. The R 2 -COP regimen was well tolerated. Interim positron emission tomography (PET) scans in four patients after two to three cycles showed a complete metabolic response. At a median follow-up of 24 months, six patients remain in complete remission. R 2 -COP is an effective anthracycline-free regimen with encouraging clinical activity in elderly DLBCL patients who are unfit for standard anthracycline-containing regimens.

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Section: Discussionmentioning

confidence: 99%

Reduced-Intensity Anthracycline-Free Chemoimmunotherapy in Elderly Patients With Newly Diagnosed or Relapsed Diffuse Large B-Cell Lymphoma

Yohannan,

Rios

2023

J Hematol

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“…PSMB2 is part of the proteasome complex, which is typically upregulated in many cancers. Unfortunately, inhibition of the proteasome with molecules such as bortezomib [ 47 ] and lenalidomide [ 48 ] in relapsed/refractory DLBCL has demonstrated modest responses. However, PSMB2 is not targeted by bortezomib and lenalidomide and may constitute a potential target.…”

Section: Discussionmentioning

confidence: 99%

Extracellular Vesicles in Diffuse Large B Cell Lymphoma: Characterization and Diagnostic Potential

Matthiesen

Gameiro

Henriques

et al. 2022

IJMS

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Diffuse large B cell lymphoma (DLBCL) is an aggressive B cell lymphoma characterized by a heterogeneous behavior and in need of more accurate biological characterization monitoring and prognostic tools. Extracellular vesicles are secreted by all cell types and are currently established to some extent as representatives of the cell of origin. The present study characterized and evaluated the diagnostic and prognostic potential of plasma extracellular vesicles (EVs) proteome in DLBCL by using state-of-the-art mass spectrometry. The EV proteome is strongly affected by DLBCL status, with multiple proteins uniquely identified in the plasma of DLBCL. A proof-of-concept classifier resulted in highly accurate classification with a sensitivity and specificity of 1 when tested on the holdout test data set. On the other hand, no proteins were identified to correlate with non-germinal center B-cell like (non-GCB) or GCB subtypes to a significant degree after correction for multiple testing. However, functional analysis suggested that antigen binding is regulated when comparing non-GCB and GCB. Survival analysis based on protein quantitative values and clinical parameters identified multiple EV proteins as significantly correlated to survival. In conclusion, the plasma extracellular vesicle proteome identifies DLBCL cancer patients from healthy donors and contains potential EV protein markers for prediction of survival.

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“…In a retrospective study of 62 patients with aggressive lymphomas treated with len-based regimens, Rodgers et al demonstrated that for patients with transformed follicular lymphoma, the ORR was 63%, with a median PFS of 24 months. This was significantly better then de-novo DLBCL, which has an ORR of 43.5% and median PFS of 4.6 months with len-based regimens [ 31 ]. This was also found in a subset analysis of the NHL-003 study of len monotherapy where 23 patients with transformed FL were found to have an ORR of 57% with a median PFS of 7.7 months [ 32 ].…”

Section: Discussionmentioning

confidence: 99%

Obinutuzumab, High-Dose Methylprednisolone (HDMP), and Lenalidomide for the Treatment of Patients with Richter’s Syndrome

Heyman

Choi

Kipps

2022

Cancers

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Background: For patients with Richter’s Syndrome (RS), a durable response is rarely achieved with standard therapies. Significant efforts have focused on the development of novel treatments with reduced toxicity. We describe our experience using the novel combination of obinutuzumab, high-dose methylprednisolone (HDMP) and lenalidomide (len) in patients with RS. Patients and Methods: Eligible patients included adults with biopsy-proven RS. Patients received obinutuzumab 1000 mg × 8 doses. All patients received HDMP 1000 mg/m2 on days 1–5 of cycles 1–4. Patients were administered len PO daily, starting at a dose of 5 mg. Starting on C2D1, the dose increased every 2 weeks in 5 mg increments to a maximum of 25 mg PO daily. Results: Seven patients were treated. The median dose of len was 10 mg and the median number of cycles of treatment completed was 2. The most common grade 3/4 adverse events were neutropenia (29%) and pulmonary embolism (29%). The overall response rate for the entire cohort was 43% (95% CI, 10–82%). All patients who achieved a response underwent consolidative autologous or allogeneic stem cell transplant and remain in remission to date. Conclusions: The combination of obinutuzumab, HDMP, and len is a well-tolerated, outpatient regimen that could serve as a bridge to transplantation, or as palliation for transplant-ineligible patients with RS.

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Efficacy of lenalidomide in high‐risk diffuse large B‐cell lymphoma

Cited by 8 publications

References 15 publications

Reduced-Intensity Anthracycline-Free Chemoimmunotherapy in Elderly Patients With Newly Diagnosed or Relapsed Diffuse Large B-Cell Lymphoma

Reduced-Intensity Anthracycline-Free Chemoimmunotherapy in Elderly Patients With Newly Diagnosed or Relapsed Diffuse Large B-Cell Lymphoma

Extracellular Vesicles in Diffuse Large B Cell Lymphoma: Characterization and Diagnostic Potential

Obinutuzumab, High-Dose Methylprednisolone (HDMP), and Lenalidomide for the Treatment of Patients with Richter’s Syndrome

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