Long‐lasting efficacy and safety of lenalidomide maintenance in patients with relapsed diffuse large B‐cell lymphoma who are not eligible for or failed autologous transplantation

Ferreri, Andrés J.M.; Sassone, Marianna; Angelillo, Piera; Zaja, Francesco; Re, Alessandro; Rocco, Alice Di; Spina, Michele; Fabbri, Alberto; Stelitano, Caterina; Frezzato, Maurizio; Volpetti, Stefano; Zambello, Renato; Rusconi, Chiara; Lorenzo, Daniela De; Scarano, Eloise; Arcari, Annalisa; Bertoldero, Giovanni; Nonis, Alessandro; Calimeri, Teresa; Perrone, Salvatore; Cecchetti, Caterina; Tarantino, Vittoria; Steffanoni, Sara; Foppoli, Marco; Ciceri, Fabio; Ponzoni, Maurilio

doi:10.1002/hon.2742

Cited by 7 publications

(4 citation statements)

References 23 publications

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“…Wang M et al [ 41 ] reported common grades 3–4 hematological adverse events (≥ 10 events), including neutropenia (53%), lymphopenia (40%), thrombocytopenia (33%), leukopenia (27%) and anemia (18%). Ferreri et al [ 42 ] found lenalidomide was well tolerated, especially in this elderly population, with the exception of neutropenia, grade-4 toxicities occurred in < 1% of courses. Our study summarized grade ≥ 3 hematological toxicity events.…”

Section: Discussionmentioning

confidence: 99%

Efficacy and safety of lenalidomide in diffuse large B-cell lymphoma: a meta-analysis of randomized controlled trials

Liu

Chen

et al. 2022

Clin Exp Med

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As an immunomodulatory agent with antitumor activity, lenalidomide has been evaluated for its value in diffuse large B-cell lymphoma (DLBCL). We performed a meta-analysis to gain a better understanding of the efficacy and safety of lenalidomide in DLBCL. PubMed, Cochrane Library, and Embase were searched up to March 2022 for potential studies. The pooled hazard ratio (HR) and relative risk (RR) with 95% confidence interval (CI) were estimated by the fixed/random effects model. Overall, 6 randomized controlled trials including 1938 patients were included. The complete response rate (CRR) of the group containing lenalidomide was 47.7% (95%CI 28.5–67.2%), which was higher than the 37.8% (95%CI 16.7–61.5%) of the control group without lenalidomide (RR = 1.11, 95%CI 1.03–1.20, P = 0.008). The overall estimation of survival showed a benefit for progression-free survival (PFS) (HR = 0.77, 95%CI 0.66–0.90, P = 0.001) but not overall survival (OS) or event-free survival (EFS). The lenalidomide group had a significant incidence of grade ≥ 3 hematological adverse events (AEs) involving neutropenia (RR = 1.56, 95%CI 1.15–2.11, P = 0.004) and febrile neutropenia (RR = 1.81, 95%CI 1.31–2.49, P < 0.001), with the incidence of neutropenia (48.3%, 95%CI 37.5–59.1%) being highest. In conclusion, addition of lenalidomide results in a higher CRR and better PFS but a higher incidence of grade ≥ 3 hematological AEs involving neutropenia and febrile neutropenia.

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Section: Discussionmentioning

confidence: 99%

Efficacy and safety of lenalidomide in diffuse large B-cell lymphoma: a meta-analysis of randomized controlled trials

Liu

Chen

et al. 2022

Clin Exp Med

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“…Our initial screening led to the identification of 1237 potentially eligible studies (1231 from PubMed, EMBASE, and Cochrane Library, and 6 from other sources). We ultimately excluded 1226 of these studies based on the inclusion and exclusion criteria, and included 11 publications from 10 studies from that were published from 2008 to 2020 (Figure 1 and Table 1) (7,8,(14)(15)(16)(17)(18)(19)(20)(21)(22). Five of these studies were prospective one-arm studies (7,8,15,16,20,21), four were retrospective analyses (14,17,18,22), and one was a randomized controlled trial (19).…”

Section: Basic Characteristics Of Studiesmentioning

confidence: 99%

“…We ultimately excluded 1226 of these studies based on the inclusion and exclusion criteria, and included 11 publications from 10 studies from that were published from 2008 to 2020 (Figure 1 and Table 1) (7,8,(14)(15)(16)(17)(18)(19)(20)(21)(22). Five of these studies were prospective one-arm studies (7,8,15,16,20,21), four were retrospective analyses (14,17,18,22), and one was a randomized controlled trial (19). The sample size ranged from 15 to 153 patients, and the median patient age ranged from 51 to 79 years old.…”

Section: Basic Characteristics Of Studiesmentioning

confidence: 99%

Efficacy and Safety of Lenalidomide Monotherapy for Relapsed/Refractory Diffuse Large B Cell Lymphoma: Systematic Review and Meta-Analysis

Zhou

Guo

et al. 2021

Front. Oncol.

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IntroductionSeveral maintenance therapies are available for treatment of patients with relapsed/refractory (R/R) diffuse large B cell lymphoma (DLBCL). The objective of this review was to assess the efficacy and safety of lenalidomide monotherapy in these patients.MethodsMEDLINE, EMBASE, and the Cochrane Library databases were searched for publications up to April 7, 2021. Original studies that had information on lenalidomide monotherapy for DLBCL patients with R/R status were included. Meta-analyses of response rates, adverse events (AEs), overall survival (OS), and progression-free survival (PFS) were performed. The pooled event rates were calculated using a double arcsine transformation to stabilize the variances of the original proportions. Subgroup analysis was used to compare patients with different germinal center B-cell-like (GCB) phenotypes.ResultsWe included 11 publications that examined DLBCL patients with R/R status. These studies were published from 2008 to 2020. The cumulative objective response rate (ORR) for lenalidomide monotherapy was 0.33 (95% CI: 0.26, 0.40), and the ORR was better in patients with the non-GCB phenotype (0.50; 95% CI: 0.26, 0.74) than the GCB phenotype (0.06; 95% CI: 0.03, 0.11). The major serious treatment-related AEs were neutropenia, thrombocytopenia, respiratory disorders, anemia, and diarrhea. The median PFS ranged from 2.6 to 34 months and the median OS ranged from 7.8 to 37 months.ConclusionThis study provides evidence that lenalidomide monotherapy was active and tolerable in DLBCL patients with R/R status. Patients in the non-GCB subgroup had better responsiveness.

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“…Lenalidomide is a well-known drug that blocks the BCR-NF-κB pathway by targeting the E3 ubiquitin ligase component cereblon, with antineoplastic consequences [170]. The efficacy of lenalidomide maintenance has yielded positive results in DLBCL patients after salvage or frontline therapy [171]. DLBCL demonstrated a substantial activity in patients with R/R, especially in the non-GBC and ABC-DLBCL subtypes.…”

Section: Nf-κb Inhibitionmentioning

confidence: 99%

Diffuse Large B-Cell Lymphoma: Recognition of Markers for Targeted Therapy

Tomás‐Roca

Rodríguez

Alonso‐Alonso

et al. 2021

Hemato

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Diffuse large B-cell lymphomas (DLBCL)s, the most common type of Non-Hodgkin’s Lymphoma, constitute a heterogeneous group of disorders including different disease sites, strikingly diverse molecular features and a profound variability in the clinical behavior. Molecular studies and clinical trials have partially revealed the underlying causes for this variability and have made possible the recognition of some molecular variants susceptible of specific therapeutic approaches. The main histogenetic groups include the germinal center, activated B cells, thymic B cells and terminally differentiated B cells, a basic scheme where the large majority of DLBCL cases can be ascribed. The nodal/extranodal origin, specific mutational changes and microenvironment peculiarities provide additional layers of complexity. Here, we summarize the status of the knowledge and make some specific proposals for addressing the future development of targeted therapy for DLBC cases.

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Long‐lasting efficacy and safety of lenalidomide maintenance in patients with relapsed diffuse large B‐cell lymphoma who are not eligible for or failed autologous transplantation

Cited by 7 publications

References 23 publications

Efficacy and safety of lenalidomide in diffuse large B-cell lymphoma: a meta-analysis of randomized controlled trials

Efficacy and safety of lenalidomide in diffuse large B-cell lymphoma: a meta-analysis of randomized controlled trials

Efficacy and Safety of Lenalidomide Monotherapy for Relapsed/Refractory Diffuse Large B Cell Lymphoma: Systematic Review and Meta-Analysis

Diffuse Large B-Cell Lymphoma: Recognition of Markers for Targeted Therapy

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