Yttrium-90 Ibritumomab Tiuxetan Followed by Rituximab Maintenance as Treatment for Patients with Diffuse Large B-Cell Lymphoma Are Not Candidates for Autologous Stem Cell Transplant

Arnason, Jon; Luptakova, Katarina; Rosenblatt, Jacalyn; Tzachanis, Dimitrios; Avigan, David; Zwicker, Jeffrey I.; Levine, James D.; Kim, Michelle; Parker, Jefferson; Grant, Barbara; Joyce, Robin

doi:10.1159/000368291

Cited by 9 publications

(4 citation statements)

References 18 publications

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“…19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 Thirty-three studies aimed to investigate the association between platelet counts and bleeding but could not be included, as no bleeding events occurred during the study period. 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 81 82 83 84 85 86 87 88 89 90 91 92 93 Thus, 52 studies were included for quality assessment and data extraction. 2 …”

Section: Resultsmentioning

confidence: 99%

The Role of Platelets in Cancer-Related Bleeding Risk: A Systematic Review

Larsen

Højbjerg

Hvas

2019

Semin Thromb Hemost

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Cancer patients face an elevated risk of bleeding, and here platelets play a pivotal role. The association between platelet count and bleeding, as well as safe thresholds for prophylactic platelet transfusion, is described mainly in hematological malignancies, and knowledge is sparse for patients with solid tumors. Platelet function tests may further improve bleeding risk assessment in cancer patients. This study provides a systematic review of the available literature on associations between platelet count and/or function and bleeding in adult cancer patients. The review was performed according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) statement. PubMed, Embase, and Web of Science were searched up to August 2019. The National Heart, Lung, and Blood Institute's tools were used for quality assessment. In total, 52 studies investigated associations between bleeding and platelet count (n = 40) or function (n = 12) in patients with hematological malignancy (n = 31), solid tumors (n = 11), or both (n = 10). The majority of included studies rated good (n = 23) or fair (n = 25). The association between platelet count and bleeding was most pronounced at platelet counts ≤ 10 × 109/L but was less evident for solid tumors. Overall, reduced platelet function was significantly associated with bleeding risk. Thus, the available evidence supports current guidelines for prophylactic platelet transfusions at platelet count ≤ 10 × 109/L in hematological cancer patients, whereas more evidence is needed in patients with solid tumors. Platelet function analysis may be valuable in assisting bleeding risk assessment in cancer patients but is sparsely investigated so far.

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Section: Resultsmentioning

confidence: 99%

The Role of Platelets in Cancer-Related Bleeding Risk: A Systematic Review

Larsen

Højbjerg

Hvas

2019

Semin Thromb Hemost

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“…Treatments in the ASCT-ineligible studies were grouped as follows: (1) CAR T-cell therapy [ 5 , 32 ], including axicabtagene ciloleucel [ 8 ], lisocabtagene maraleucel [ 10 ], and tisagenlecleucel [ 9 ]; (2) chemotherapy, including R-Gemox (gemcitabine and oxaliplatin) [ 33 , 34 ], R-B (bendamustine) [ 14 , 35 – 38 ], pixantrone [ 39 ], one of the various chemotherapies [ 39 ] (one of vinorelbine, oxaliplatin, ifosfamide, etoposide, mitoxantrone, gemcitabine, or rituximab), R-ifosfamide+etoposide [ 40 ], R-pixantrone [ 41 ], R-gemcitabine [ 41 ], R-PECC (prednisolone, etoposide, chlorambucil, and lomustine) [ 42 ], decitabine plus DHAP [ 43 ], ibrutinib plus lenalidomide plus R-EPOCH (etoposide, prednisolone, vincristine, cyclophosphamide, and doxorubicin) [ 44 ], pixantrone plus obinutuzumab [ 45 ], and lenalidomide plus R-GDP [ 46 ]; (3) ibrutinib-based therapy, including ibrutinib plus durvalumab [ 47 ], ibrutinib plus nivolumab [ 48 ], and ibrutinib monotherapy [ 49 ]; (4) lenalidomide-based therapy, including R-lenalidomide [ 50 ], lenalidomide monotherapy [ 34 ], obinutuzumab plus lenalidomide [ 51 ], and temsirolimus plus lenalidomide [ 52 ]; (5) loncastuximab tesirine [ 17 ]; (6) polatuzumab plus bendamustine and rituximab [ 14 , 53 , 54 ] and R-polatuzumab [ 55 ]; (7) selinexor [ 15 ]; (8) tafasitamab, including tafasitamab monotherapy [ 56 ] and tafasitamab plus lenalidomide [ 16 ]; (9) others, including ibritumomab [ 57 , 58 ], temsirolimus [ 59 ], ofatumumab [ 60 ], R-everolimus [ …”

Section: Methodsmentioning

confidence: 99%

Efficacy of Salvage Treatments in Relapsed or Refractory Diffuse Large B-Cell Lymphoma Including Chimeric Antigen Receptor T-Cell Therapy: A Systematic Review and Meta-Analysis

Kim¹,

Cho²,

Yoon³

et al. 2023

Cancer Res Treat

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Purpose We intend to evaluate the efficacy of salvage treatments for relapsed or refractory diffuse large B-cell lymphoma (R/R DLBCL) through meta-analysis.Materials and Methods R/R DLBCL trials were divided into two groups based on eligibility for autologous stem-cell transplantation (ASCT), and meta-analysis of each group was performed. Random effects models were used to estimate the 1-year progression-free survival (PFS) rate, and chimeric antigen receptor (CAR) T-cell therapy was used as reference treatment.Results Twenty-six ASCT-eligible cohorts from 17 studies comprising 2,924 patients and 59 ASCT-ineligible cohorts from 53 studies comprising 3,617 patients were included in the pooled analysis. In the ASCT-eligible group, the pooled 1-year PFS rate was 0.40 (95% confidence interval [CI], 0.15 to 0.65) for the CAR T-cell group and 0.34 (95% CI, 0.30 to 0.37) for the group with chemotherapy followed by ASCT intention. The two treatments were not significantly different in meta-regression analysis. In the ASCT-ineligible group, the pooled 1-year PFS was 0.40 (95% CI, 0.35 to 0.46) for CAR T-cell, and the highest primary outcome was 0.47 (95% CI, 0.37 to 0.57) for the tafasitamab group. CAR T-cell therapy showed significantly better outcomes than chemotherapy and therapies based on ibrutinib, lenalidomide, and selinexor. However, loncastuximab, polatuzumab plus bendamustine and rituximab, and the tafasitamab group showed no different efficacy than CAR T-cell therapy after adjusting for median number of previous lines of treatment.Conclusion Although several regimens were crudely grouped for classification, CAR T-cell therapy did not outperform chemotherapy followed by ASCT in the second-line setting or several recently developed agents in the ASCT-ineligible setting.

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“…Currently, there are two approved RTX agents for use in B-cell lymphoma: 131 I-tositumomab (Bexxar Ò , GlaxoSmithKline) and 90 Y-ibritumomab tiuxetan (ZevalinÒ, Spectrum) [140]. Several clinical Phase III trials have shown the utility of those agents in treatment of B-cell NHLs [9, [141][142][143]. Unfortunately, 131 I-tositumomab has recently been discontinued by the GlaxoSmithKline (NYSE: GSK) because of low profits.…”

Section: Other Anti-cd20 Moabsmentioning

confidence: 99%