T E Witzig1, J M Vose2, P L Zinzani3, C B Reeder4, R Buckstein5, J A Polikoff6, R Bouabdallah7, C Haioun8, H Tilly9, P Guo10, D Pietronigro10, A L Ervin-Haynes10, M S Czuczman11. 1. Department of Medicine, Division of Hematology, Mayo Clinic, Rochester. Electronic address: witzig@mayo.edu. 2. Section of Hematology/Oncology, University of Nebraska, Omaha, USA. 3. Institute of Hematology and Oncology Seragnoli, University of Bologna, Bologna, Italy. 4. Department of Medicine, Division of Hematology, Mayo Clinic, Scottsdale, USA. 5. Department of Hematology, Sunnybrook Odette Cancer Center, Toronto, Canada. 6. Department of Hematology/Oncology, Kaiser Permanente Medical Group, San Diego, USA. 7. Department of Hematology, Institut Paoli Calmettes, Marseilles. 8. Department of Hôpital Henri Mondor-AP-HP, Créteil. 9. Department of Centre Henri Becquerel, Rouen, France. 10. Department of Celgene Corporation, Summit. 11. Department of Medicine, Lymphoma/Myeloma Service, Roswell Park Cancer Institute, Buffalo, USA.
Abstract
BACKGROUND: Lenalidomide is an immunomodulatory agent with antitumor activity in B-cell malignancies. This phase II trial aimed to demonstrate the safety and efficacy of lenalidomide in patients with relapsed or refractory diffuse large B-cell lymphoma (DLBCL), mantle cell lymphoma (MCL), follicular grade 3 lymphoma (FL-III), or transformed lymphoma (TL). METHODS: Patients received oral lenalidomide 25 mg on days 1-21 every 28 days as tolerated or until progression. The primary end point was overall response rate (ORR). RESULTS: Two hundred and seventeen patients enrolled and received lenalidomide. The ORR was 35% (77/217), with 13% (29/217) complete remission (CR), 22% (48/217) partial remission, and 21% (45/217) with stable disease. The ORR for DLBCL was 28% (30/108), 42% (24/57) for MCL, 42% (8/19) for FL-III, and 45% (15/33) for TL. Median progression-free survival for all 217 patients was 3.7 months [95% confidence interval (CI) 2.7-5.1]. For 77 responders, the median response duration lasted 10.6 months (95% CI 7.0-NR). Median response duration was not reached in 29 patients who achieved a CR and in responding patients with FL-III or MCL. The most common adverse event was myelosuppression with grade 4 neutropenia and thrombocytopenia in 17% and 6%, respectively. CONCLUSION: Lenalidomide is well tolerated and produces durable responses in patients with relapsed or refractory aggressive non-Hodgkin's lymphoma.
BACKGROUND:Lenalidomide is an immunomodulatory agent with antitumor activity in B-cell malignancies. This phase II trial aimed to demonstrate the safety and efficacy of lenalidomide in patients with relapsed or refractory diffuse large B-cell lymphoma (DLBCL), mantle cell lymphoma (MCL), follicular grade 3 lymphoma (FL-III), or transformed lymphoma (TL). METHODS:Patients received oral lenalidomide 25 mg on days 1-21 every 28 days as tolerated or until progression. The primary end point was overall response rate (ORR). RESULTS: Two hundred and seventeen patients enrolled and received lenalidomide. The ORR was 35% (77/217), with 13% (29/217) complete remission (CR), 22% (48/217) partial remission, and 21% (45/217) with stable disease. The ORR for DLBCL was 28% (30/108), 42% (24/57) for MCL, 42% (8/19) for FL-III, and 45% (15/33) for TL. Median progression-free survival for all 217 patients was 3.7 months [95% confidence interval (CI) 2.7-5.1]. For 77 responders, the median response duration lasted 10.6 months (95% CI 7.0-NR). Median response duration was not reached in 29 patients who achieved a CR and in responding patients with FL-III or MCL. The most common adverse event was myelosuppression with grade 4 neutropenia and thrombocytopenia in 17% and 6%, respectively. CONCLUSION:Lenalidomide is well tolerated and produces durable responses in patients with relapsed or refractory aggressive non-Hodgkin's lymphoma.
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