First-line response-adapted treatment with the combination of bendamustine and rituximab in patients with mucosa-associated lymphoid tissue lymphoma (MALT2008-01): a multicentre, single-arm, phase 2 trial

Salar, Antonio; Domingo‐Domenech, Eva; Panizo, Carlos; Nicolás, Concepción; Bargay, Joan; Muntañola, Ana; Canales, Miguel; Bello, J.; Sancho, Juan‐Manuel; Tomás, José Francisco; Rodrí­guez, Marí­a José; Peñalver, Francisco Javier; Grande, Carlos; Sánchez-Blanco, José Javier; Palomera, Luis; Arranz, Reyes; Conde, Eulogio; Garcı́a, M.; Garcı́a, Juan F.; Caballero, Dolores; Montalbán, Carlos

doi:10.1016/s2352-3026(14)00021-0

Cited by 83 publications

(91 citation statements)

References 29 publications

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“…With the implementation of rituximab into the treatment plan of nearly all B‐cell malignancies, this monoclonal antibody was also studied in MALT lymphoma. Although it is a strong partner for combination with some substances like bendamustine, its benefit might be questionable for other regimens, including cladribine or chlorambucil . Single‐agent rituximab has been tested in several small studies, including 3 prospective trials for localized/disseminated and gastric/extragastric lymphoma, respectively; but, with CRRs from 15% to 45% and overall response rates from 65% to 75%, this treatment appears to be inferior to chemo‐containing regimens .…”

Section: Treatmentmentioning

confidence: 99%

“…Since then, several mostly small, uncontrolled trials using various agents and combinations in MALT lymphoma have been published, although few randomized data currently exist. The interested reader is referred to Table 4 102,[116][117][118][119][120][121][122][123][124][125][126] and to a recently published paper on the details of systemic therapies. 127 Two randomized trials exist, including the International Extranodal Lymphoma Study Group (IELSG)-19 study on chlorambucil versus rituximab plus chlorambucil 117 and a randomized study on wait and see versus chlorambucil in patients with gastric MALT lymphoma after HP eradication.…”

Section: Chemoimmunotherapiesmentioning

confidence: 99%

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Clinicopathologic characteristics and treatment of marginal zone lymphoma of mucosa‐associated lymphoid tissue (MALT lymphoma)

Raderer¹,

Kiesewetter

Ferreri³

2015

CA A Cancer J Clinicians

212

240

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Extranodal marginal zone lymphoma of the mucosa-associated lymphoid tissue (MALT lymphoma) accounts for 7% to 8% of newly diagnosed lymphomas. Because of its association with infectious causes, such as Helicobacter pylori (HP) or Chlamydophila psittaci (CP), and autoimmune diseases, it has become the paradigm of an antigen-driven malignancy. MALT lymphoma usually displays an indolent course, and watch-and-wait strategies are justified initially in a certain percentage of patients. In patients with gastric MALT lymphoma or ocular adnexal MALT lymphoma, antibiotic therapy against HP or CP, respectively, is the first-line management of choice, resulting in lymphoma response rates from 75% to 80% after HP eradication and from 33% to 65% after antibiotic therapy for CP. In patients who have localized disease that is refractory to antibiotics, radiation is widely applied in various centers with excellent local control, whereas systemic therapies are increasingly being applied, at least in Europe, because of the potentially systemic nature of the disease. Therefore, the objective of this review is to briefly summarize the clinicopathologic characteristics of this distinct type of lymphoma along with current data on management strategies.

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Section: Treatmentmentioning

confidence: 99%

Section: Chemoimmunotherapiesmentioning

confidence: 99%

Clinicopathologic characteristics and treatment of marginal zone lymphoma of mucosa‐associated lymphoid tissue (MALT lymphoma)

Raderer¹,

Kiesewetter

Ferreri³

2015

CA A Cancer J Clinicians

212

240

View full text Add to dashboard Cite

show abstract

“…94 95,96 Moreover, the activities of drugs such as rituximab, everolimus, bortezomib, lenalidomide, and clarithromycin, among others, in MZLs have been addressed in European trials. Importantly, studies of the association between infectious agents and MZL resulted in the development of safe, costbenefit, and effective therapeutic strategies, 93 as exemplified by the efficacy of antiviral therapy for hepatitis C virus-related MZL.…”

Section: European Research Contributionsmentioning

confidence: 99%

The European Hematology Association Roadmap for European Hematology Research: a consensus document

et al. 2016

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T he European Hematology Association (EHA) Roadmap for European Hematology Research highlights major achievements in diagnosis and treatment of blood disorders and identifies the greatest unmet clinical and scientific needs in those areas to enable better funded, more focused European hematology research. Initiated by the EHA, around 300 experts contributed to the consensus document, which will help European policy makers, research funders, research organizations, researchers, and patient groups make better informed decisions on hematology research. It also aims to raise public awareness of the burden of blood disorders on European society, which purely in economic terms is estimated at €23 billion per year, a level of cost that is not matched in current European hematology research funding. In recent decades, hematology research has improved our fundamental understanding of the biology of blood disorders, and has improved diagnostics and treatments, sometimes in revolutionary ways. This progress highlights the potential of focused basic research programs such as this EHA Roadmap. The EHA Roadmap identifies nine 'sections' in hematology: normal hematopoiesis, malignant lymphoid and myeloid diseases, anemias and related diseases, platelet disorders, blood coagulation and hemostatic disorders, transfusion medicine, infections in hematology, and hematopoietic stem cell transplantation. These sections span 60 smaller groups of diseases or disorders. The EHA Roadmap identifies priorities and needs across the field of hematology, including those to develop targeted therapies based on genomic profiling and chemical biology, to eradicate minimal residual malignant disease, and to develop cellular immunotherapies, combination treatments, gene therapies, hematopoietic stem cell treatments, and treatments that are better tolerated by elderly patients.

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“…Extranodal marginal zone B‐cell lymphoma of the mucosa‐associated lymphoid tissue (MALT lymphoma) represents a distinct type of non‐Hodgkin lymphoma characterized by its ability to arise in mucosa‐associated lymphoid structures throughout the entire body . While for decades, the optimal approach for advanced or Helicobacter pylori (HP)‐eradication refractory patients was a matter of discussion, recent data on chemotherapy +/− rituximab (R) have shown favorable outcomes . However, due to the indolent clinical pattern of this disease in the majority of cases, it appears of interest to explore also chemotherapy‐free treatment regimens.…”

Section: Introductionmentioning

confidence: 99%

Immunohistochemical expression of cereblon and MUM1 as potential predictive markers of response to lenalidomide in extranodal marginal zone B‐cell lymphoma of the mucosa‐associated lymphoid tissue (MALT lymphoma)

Kiesewetter

Simonitsch‐Klupp

Kornauth

et al. 2017

Hematological Oncology

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Lenalidomide is an active agent for the treatment of MALT lymphoma. Recently, high expression levels of cereblon (CRBN) and MUM1 have been associated with better response rates in multiple myeloma treated with lenalidomide. However, there are no data on CRBN and MUM1 expression in MALT lymphoma. In the current study, we have systematically investigated a potential correlation of CRBN/MUM1 immunohistochemical expression and response to lenalidomide-based therapy in a series of 46 patients with MALT lymphoma treated at the Medical University Vienna 2009 to 2014. In total, 28% (13/46) of biopsy specimens derived from gastric tissues, while 72% (33/46) originated from extragastric MALT lymphoma. In terms of CRBN, 54% showed high expression (CRBN+, ≥50% positive cells); the remaining 46% were classified as low expression (CRBN-). In contrast to other reports, there was a non-significant trend towards worse response rates in CRBN+ (68% versus 86%, P = 0.161). Relapse rates (P = 0.592) and PFS (P = 0.306) did not differ between CRBN+/CRBN-, but all 3 patients progressing on lenalidomide were CRBN+ and both patients completely lacking CRBN expression responded to treatment. Concerning MUM1, 62% were MUM1-negative (MUM1-) and 38% positive (MUM1+). There was no difference in response to lenalidomide by MUM1-status (MUM1+ 71% versus MUM1- 79%, P = 0.546) and also relapse rates (P = 0.828) and PFS (P = 0.681) did not differ. Interestingly, a subgroup analysis of gastric lymphoma revealed a significantly better PFS for CRBN- and MUM1- patients, respectively (both P < 0.05). To conclude, there was no significant difference in response to lenalidomide between patients with low or high expression of CRBN/MUM1 in a general population of MALT lymphoma, and immunohistochemical CRBN/MUM1 assessment cannot be recommended in the clinical routine.

show abstract

First-line response-adapted treatment with the combination of bendamustine and rituximab in patients with mucosa-associated lymphoid tissue lymphoma (MALT2008-01): a multicentre, single-arm, phase 2 trial

Cited by 83 publications

References 29 publications

Clinicopathologic characteristics and treatment of marginal zone lymphoma of mucosa‐associated lymphoid tissue (MALT lymphoma)

Clinicopathologic characteristics and treatment of marginal zone lymphoma of mucosa‐associated lymphoid tissue (MALT lymphoma)

The European Hematology Association Roadmap for European Hematology Research: a consensus document

Immunohistochemical expression of cereblon and MUM1 as potential predictive markers of response to lenalidomide in extranodal marginal zone B‐cell lymphoma of the mucosa‐associated lymphoid tissue (MALT lymphoma)

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