Lenalidomide in Relapsed or Refractory Diffuse Large B-Cell Lymphoma: Is It a Valid Treatment Option?. (5th July 2016)

• Record Type: Journal Article
• Authors: Mondello, Patrizia; Steiner, Normann; Willenbacher, Wolfgang; Ferrero, Simone; Ghione, Paola; Marabese, Alessandra; Pitini, Vincenzo; Cuzzocrea, Salvatore; Mian, Michael
• Is Part Of: Oncologist. Volume 21:Number 9(2016)
• Page Start: 1107
• Page End: 1112
• Publication Date: 2016-07-05
• Subjects: Diffuse large B-cell lymphoma -- Lenalidomide -- Immunomodulatory drug -- Relapsed/refractory lymphoma; Oncology -- Periodicals; Tumors -- Periodicals; Cancérologie -- Périodiques; Tumeurs -- Périodiques; Oncology; Tumors; Neoplasms; Electronic journals; Periodicals; Periodicals; 616.994
• DOI: 10.1634/theoncologist.2016-0103
• Languages: English
• ISSNs: 1083-7159

Abstract

Abstract : Background: Despite the advent of new treatment strategies, many patients with diffuse large B-cell lymphoma (DLBCL) relapse or die of the disease. Prospective clinical trials have demonstrated that lenalidomide is an effective and safe treatment option, especially for non-germinal center B-cell (non-GCB) DLBCL. However, routine clinical data are lacking, which is why we provide the results of the so-far largest relapsed/refractory (R/R) DLBCL real-life analysis. Methods: We retrospectively assessed 123 R/R DLBCL patients who received either 15 or 25 mg/day of lenalidomide from January 2006 to January 2015. Results: During a median follow-up period of 4.5 years, complete remission was achieved in 32% and a partial remission in 33% non-GCB patients compared with 0% and 3% in the GCB group ( p < .001 and .001, respectively), with median response durations of 15 and 5 months, respectively ( p < .001). Lenalidomide at 25 mg was superior to 15 mg in terms of response (complete remission 21% and partial remission 23% vs. 0% and 8%; p = .007 and .05) and median response duration (10 vs. 4 months; p = .03). Toxicity was limited and reversible. Median progression-free survival differed between non-GCB and GCB patients (37 vs. 30 months; p < .001) and between the two dosages (24 vs. 34 months; p = .002). However, overall survival was similar between the subgroups (38–42 months). Conclusion: We provide evidence that lenalidomide is a valid treatment option for R/R DLBCL, with limited and reversible toxicity, and is more efficient in non-GCB DLBCL and at higher doses. Abstract : In 123 patients with relapsed/refractory diffuse large B-cell lymphoma who received either 15 or 25 mg/day of lenalidomide, complete remission was achieved in 32% and a partial remission in 33% non-germinal center B-cell (non-GCB) patients compared with 0% and 3% in the GCB group. Lenalidomide at 25 mg was superior to 15 mg in terms of response and median response duration. Toxicity was limited and reversible.