Treatment patterns and outcomes in relapsed/refractory follicular lymphoma: results from the international SCHOLAR-5 study

Abstract

The SCHOLAR-5 study examines treatment patterns and outcomes of real-world follicular lymphoma (FL) patients on 3rd line of treatment (LoT) or higher, for whom existing data are limited. SCHOLAR-5 is a retrospective cohort study using data from adults (≥ 18 years) with grade 1-3a FL, initiating ≥3rd LoT after June 2014 at major lymphoma centers in the United States (US) and Europe. Objective response rate (ORR), complete response (CR), progression free survival (PFS) and overall survival (OS) were analyzed by LoT. Time-to-event outcomes were assessed using Kaplan-Meier methods. Of 128 patients, 87 initiated 3rd LoT, 63 initiated 4th LoT, and 47 initiated 5th LoT. At 1st eligible LoT, 31% progressed within 24-months of 1st LoT anti-CD20 combination therapy, 28% had prior autologous stem-cell transplantation, and 31% were refractory to the previous LoT. The most common regimen in each LoT was chemoimmunotherapy; however, experimental drugs were increasingly used at later LoTs. In the US, anti-CD20 monotherapy was more common at ≥3rd LoT compared to Europe, where stem cell transplants were more common. ORR at 3rd LoT was 68% (CR 44%), but decreased after each LoT to 37% (CR 22%) in ≥5 LoT. Median OS and PFS at 3rd LoT were 68 and 11 months, respectively, and reduced to 43 and 4 months at ≥5 LoT. Treatments were heterogenous at each LoT in both the US and Europe. Few FL patients achieved complete response in later LoT, and duration of response and survival diminished with each subsequent line.

Management and clinical outcomes of follicular lymphoma across continuous lines of treatments: a retrospective analysis in China

“…The ORR in our study at the third line was 48.6%, which was lower than that of SCHOLAR-5 (68.3%) and LEO-CReWE (69.5%) and was relatively similar to a Japanese cohort (53.7%) and a meta-analysis (58.5%) ( 21 – 23 , 25 ). However, it is important to note that there were variations in population, time spans, and inclusion and exclusion criteria among these studies.…”

“…PI3K inhibitors, lenalidomide, and CAR T-cell therapy were administrated in both our study and the LEO-CReWE study at the third line and subsequent lines. Since the SCHOLAR-5 study was designed in part to create an external control group for the ZUMA-5 trial, which examined the clinical effectiveness of axicabtagene ciloleucel, CAR T-cell therapies were not covered in the SCHOLAR-5 study ( 21 ). The variations in treatment patterns among cohorts can be attributed to geographical and population characteristics.…”

Can bispecific antibodies change the paradigm and goals of therapy for patients with relapsed non-Hodgkin lymphomas?

“…Медиана выживаемости без прогрессирования от начала 3-й линии составляет 11 мес и ухудшается до 4 мес к 5-й линии (рис. 2) [13]. Эти сведения используются в качестве группы контроля для международных исследовательских проектов.…”

“…2. Выживаемость без прогрессирования в зависимости от линии терапии при ФЛ в исследовании SCHOLAR-5 (кривые Каплана-Мейера) [13]. Fig.…”

“…2. Progression-free survival by line of therapy in follicular lymphoma in the SCHOLAR-5 study (Kaplan-Meier curves) [13].…”