Lenalidomide in combination with R-CHOP produces high response rates and progression-free survival in new, untreated diffuse large B-cell lymphoma transformed from follicular lymphoma: results from the Phase 2 MC078E study

Sanjal H. Desai, Betsy LaPlant, William R. Macon, Rebecca L. King, Yucai Wang, David J. Inwards, Ivana Micallef, Patrick B. Johnston, Luis F. Porrata, Stephen M. Ansell, Thomas M. Habermann, Thomas E. Witzig, Grzegorz S. Nowakowski

Research output: Contribution to journalArticlepeer-review

Abstract

Diffuse large B-cell lymphoma (DLBCL), either concurrent with or transformed from follicular lymphoma (FL) is often excluded from clinical trials. Lenalidomide has response rates of 45% in relapsed transformed DLBCL. Herein we present an analysis of MC078E, a phase II clinical trial testing lenalidomide plus R-CHOP (R2CHOP) for patients with untreated transformed/concurrent DLBCL (NCT00670358). Adult patients with transformed or concurrent DLBCL were included. Patients received six cycles of rituximab, cyclophosphamide, doxorubicin, vincristine, prednisone (R-CHOP) with lenalidomide 25 mg days 1–10 of each cycle. The primary outcome was progression-free survival (PFS) at 24 months. Secondary outcomes were response rates, event-free survival (EFS), and overall survival (OS). Thirty-nine patients were accrued from August 5, 2013 to July 28, 2020 and 33 were eligible by central pathology review. The median age was 64 (24–80) years, 18 (54%) were male, 25 (76%) were concurrent and 8 (24%) were transformed DLBCL. The PFS, EFS, and OS rates at 24 months were 84.4% (CI95: 67.2–94.7%), 84.5% (CI95: 72.9–98%), and 97.0% (CI95: 91.3–100%), respectively. R2CHOP is effective in concurrent and transformed DLBCL. The study supports the inclusion of anthracycline-naive transformed and concurrent DLBCL in future clinical trials of novel immunomodulatory analogues.

Original languageEnglish (US)
Article number160
JournalBlood cancer journal
Volume11
Issue number9
DOIs
StatePublished - Sep 2021
Externally publishedYes

Bibliographical note

Funding Information:
Yucai Wang: research funding from Incyte, Innocare, Novartis, Genentech and member of the advisory board of Eli Lilly; Stephen M. Ansell: research funding from Bristol Myer Squibb (BMS), Seattle Genetics, Takeda, Al Therapeutics, Regeneron, Affimed, Trillium, ADC therapeutics; Thomas E. Witzig: consultancy in Celgene, MorphoSys, Abbvie, Incyte, Spectrum, and research funding: Celgene, Acerta, Karyopharm Therapeutics, Immune Design; Grzegorz S. Nowakowski: consultancy in Celgene/BMS, MorphoSys, Ryvu, Kite, Kymera, Curis, Seattle Genetics and research funding from Celgene/BMS, MorphoSys, Nanostring; Rebecca L. King: research funding from BMS/Celgene. The remaining authors declare no competing interests.

Publisher Copyright:
© 2021, The Author(s).

PubMed: MeSH publication types

  • Clinical Trial, Phase II
  • Journal Article

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