Lenalidomide plus R-CHOP21 in newly diagnosed diffuse large B-cell lymphoma (DLBCL): long-term follow-up results from a combined analysis from two phase 2 trials

A. Castellino, A. Chiappella, B. R. LaPlant, L. D. Pederson, G. Gaidano, W. R. Macon, G. Inghirami, C. B. Reeder, A. Tucci, Rebecca King, A. Congiu, James M Foran, V. Pavone, Candido E Rivera, M. Spina, Stephen Maxted Ansell, F. Cavallo, A. L. Molinari, Giovannino Ciccone, Thomas Matthew HabermannThomas Elmer Witzig, U. Vitolo, Grzegorz S Nowakowski

Research output: Contribution to journalArticle

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Abstract

Lenalidomide-RCHOP (R2-CHOP21) has been shown to be safe and effective in patients with untreated diffuse large B-cell lymphoma (DLBCL). The aim of this analysis is to report long-term outcome and toxicities in newly diagnosed DLBCL patients who received R2-CHOP21 in two independent phase 2 trials, conducted by Mayo Clinic (MC) and Fondazione Italiana Linfomi (FIL). All patients received R-CHOP21 plus lenalidomide. Long-term progression-free survival (PFS), time to progression (TTP), overall survival (OS) and late toxicities and second tumors were analyzed. Hundred and twelve patients (63 MC, 49 FIL) were included. Median age was 69 years, 88% were stage III–IV. At a median follow-up of 5.1 years, 5y-PFS was 63.5%, 5y-TTP 70.1% and 5y-OS 75.4%; according to cell of origin (COO): 5y-PFS 52.8% vs 64.5%, 5y-TTP 61.6% vs 69.6% and 5y-OS 68.6% vs 74.1% in germinal center (GCB) vs non-GCB respectively. Four patients experienced grade 4–5 late toxicities. Grade ≤ 3 toxicities were infections (N = 4), thrombosis (N = 1) and neuropathy (N = 3). Seven seconds tumors were observed. Long-term follow-up demonstrates that R2-CHOP21 efficacy was maintained with high rates of PFS, TTP, and OS. Lenalidomide appears to mitigate the negative prognosis of non-GCB phenotype. Incidence of therapy-related secondary malignancies and late toxicities were low.

Original languageEnglish (US)
Article number108
JournalBlood Cancer Journal
Volume8
Issue number11
DOIs
StatePublished - Nov 1 2018

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Lymphoma, Large B-Cell, Diffuse
Disease-Free Survival
Survival
Neoplasms
Germinal Center
Thrombosis
lenalidomide
Phenotype
Incidence
Infection

ASJC Scopus subject areas

  • Hematology
  • Oncology

Cite this

Lenalidomide plus R-CHOP21 in newly diagnosed diffuse large B-cell lymphoma (DLBCL) : long-term follow-up results from a combined analysis from two phase 2 trials. / Castellino, A.; Chiappella, A.; LaPlant, B. R.; Pederson, L. D.; Gaidano, G.; Macon, W. R.; Inghirami, G.; Reeder, C. B.; Tucci, A.; King, Rebecca; Congiu, A.; Foran, James M; Pavone, V.; Rivera, Candido E; Spina, M.; Ansell, Stephen Maxted; Cavallo, F.; Molinari, A. L.; Ciccone, Giovannino; Habermann, Thomas Matthew; Witzig, Thomas Elmer; Vitolo, U.; Nowakowski, Grzegorz S.

In: Blood Cancer Journal, Vol. 8, No. 11, 108, 01.11.2018.

Research output: Contribution to journalArticle

Castellino, A, Chiappella, A, LaPlant, BR, Pederson, LD, Gaidano, G, Macon, WR, Inghirami, G, Reeder, CB, Tucci, A, King, R, Congiu, A, Foran, JM, Pavone, V, Rivera, CE, Spina, M, Ansell, SM, Cavallo, F, Molinari, AL, Ciccone, G, Habermann, TM, Witzig, TE, Vitolo, U & Nowakowski, GS 2018, 'Lenalidomide plus R-CHOP21 in newly diagnosed diffuse large B-cell lymphoma (DLBCL): long-term follow-up results from a combined analysis from two phase 2 trials', Blood Cancer Journal, vol. 8, no. 11, 108. https://doi.org/10.1038/s41408-018-0145-9
Castellino, A. ; Chiappella, A. ; LaPlant, B. R. ; Pederson, L. D. ; Gaidano, G. ; Macon, W. R. ; Inghirami, G. ; Reeder, C. B. ; Tucci, A. ; King, Rebecca ; Congiu, A. ; Foran, James M ; Pavone, V. ; Rivera, Candido E ; Spina, M. ; Ansell, Stephen Maxted ; Cavallo, F. ; Molinari, A. L. ; Ciccone, Giovannino ; Habermann, Thomas Matthew ; Witzig, Thomas Elmer ; Vitolo, U. ; Nowakowski, Grzegorz S. / Lenalidomide plus R-CHOP21 in newly diagnosed diffuse large B-cell lymphoma (DLBCL) : long-term follow-up results from a combined analysis from two phase 2 trials. In: Blood Cancer Journal. 2018 ; Vol. 8, No. 11.
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abstract = "Lenalidomide-RCHOP (R2-CHOP21) has been shown to be safe and effective in patients with untreated diffuse large B-cell lymphoma (DLBCL). The aim of this analysis is to report long-term outcome and toxicities in newly diagnosed DLBCL patients who received R2-CHOP21 in two independent phase 2 trials, conducted by Mayo Clinic (MC) and Fondazione Italiana Linfomi (FIL). All patients received R-CHOP21 plus lenalidomide. Long-term progression-free survival (PFS), time to progression (TTP), overall survival (OS) and late toxicities and second tumors were analyzed. Hundred and twelve patients (63 MC, 49 FIL) were included. Median age was 69 years, 88{\%} were stage III–IV. At a median follow-up of 5.1 years, 5y-PFS was 63.5{\%}, 5y-TTP 70.1{\%} and 5y-OS 75.4{\%}; according to cell of origin (COO): 5y-PFS 52.8{\%} vs 64.5{\%}, 5y-TTP 61.6{\%} vs 69.6{\%} and 5y-OS 68.6{\%} vs 74.1{\%} in germinal center (GCB) vs non-GCB respectively. Four patients experienced grade 4–5 late toxicities. Grade ≤ 3 toxicities were infections (N = 4), thrombosis (N = 1) and neuropathy (N = 3). Seven seconds tumors were observed. Long-term follow-up demonstrates that R2-CHOP21 efficacy was maintained with high rates of PFS, TTP, and OS. Lenalidomide appears to mitigate the negative prognosis of non-GCB phenotype. Incidence of therapy-related secondary malignancies and late toxicities were low.",
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T2 - long-term follow-up results from a combined analysis from two phase 2 trials

AU - Castellino, A.

AU - Chiappella, A.

AU - LaPlant, B. R.

AU - Pederson, L. D.

AU - Gaidano, G.

AU - Macon, W. R.

AU - Inghirami, G.

AU - Reeder, C. B.

AU - Tucci, A.

AU - King, Rebecca

AU - Congiu, A.

AU - Foran, James M

AU - Pavone, V.

AU - Rivera, Candido E

AU - Spina, M.

AU - Ansell, Stephen Maxted

AU - Cavallo, F.

AU - Molinari, A. L.

AU - Ciccone, Giovannino

AU - Habermann, Thomas Matthew

AU - Witzig, Thomas Elmer

AU - Vitolo, U.

AU - Nowakowski, Grzegorz S

PY - 2018/11/1

Y1 - 2018/11/1

N2 - Lenalidomide-RCHOP (R2-CHOP21) has been shown to be safe and effective in patients with untreated diffuse large B-cell lymphoma (DLBCL). The aim of this analysis is to report long-term outcome and toxicities in newly diagnosed DLBCL patients who received R2-CHOP21 in two independent phase 2 trials, conducted by Mayo Clinic (MC) and Fondazione Italiana Linfomi (FIL). All patients received R-CHOP21 plus lenalidomide. Long-term progression-free survival (PFS), time to progression (TTP), overall survival (OS) and late toxicities and second tumors were analyzed. Hundred and twelve patients (63 MC, 49 FIL) were included. Median age was 69 years, 88% were stage III–IV. At a median follow-up of 5.1 years, 5y-PFS was 63.5%, 5y-TTP 70.1% and 5y-OS 75.4%; according to cell of origin (COO): 5y-PFS 52.8% vs 64.5%, 5y-TTP 61.6% vs 69.6% and 5y-OS 68.6% vs 74.1% in germinal center (GCB) vs non-GCB respectively. Four patients experienced grade 4–5 late toxicities. Grade ≤ 3 toxicities were infections (N = 4), thrombosis (N = 1) and neuropathy (N = 3). Seven seconds tumors were observed. Long-term follow-up demonstrates that R2-CHOP21 efficacy was maintained with high rates of PFS, TTP, and OS. Lenalidomide appears to mitigate the negative prognosis of non-GCB phenotype. Incidence of therapy-related secondary malignancies and late toxicities were low.

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