Long‐term efficacy in patients with relapsed/refractory diffuse large B‐cell lymphoma achieving a complete response with pixantrone

Abstract

Introduction:The prognosis of diffuse large B-cell lymphoma (DLBCL) patients with refractory or multiply relapsed (R/R) disease is disappointing. Pixantrone is currently approved as third or fourth line regimen, with encouraging results, even if long-term follow-up data are limited. Methods:In this post-hoc analysis of our observational study, we retrospectively investigated disease outcome and clinical characteristics of 16 R/R DLBCL patients who achieved a complete response with pixantrone.Results: Pixantrone was administered as third or fourth line in 12/16 (75%) and 4/16 (25%) cases. After a median follow-up of 24 months, 14/16 patients (87.5%) were alive (causes of death were progressive disease and secondary acute myeloid leukemia, one case each). Median progression-free survival was 23.8 months, median duration of response was 17.8 months and median overall survival (OS) was not reached (2-years OS was 84%). A significant proportion of patients achieved a long-lasting response >12 months (7/16 cases). Response to prior therapy did not influence longterm remission after pixantrone. Conclusion:In this real-life experience, pixantrone demonstrated long-term efficacy in a cohort of R/R DLBCL cases who had previously received at least two prior regimens; many of whom had characteristics associated with poor prognosis.complete response, diffuse large B-cell lymphoma, long-term efficacy, pixantrone Novelty statementsTo our knowledge it is the first, Italian, long-term post-hoc analysis about the possibility to achieve a durable complete response (CR) with pixantrone in its approved indication. Our real-life study confirms data obtained by clinical trials in a hard-to-treat population of relapsed/refractory (R/R) DLBCL. The clinical relevance is represented by the achievement of a durable CR in a significant proportion of R/R DLBCL patients with manageable adverse events. Furthermore, we suggest the possibility to use pixantrone as a bridging therapy to transplant or CAR-T cells.