In a nutshell
This study evaluated the safety and effectiveness of ibrutinib (Imbruvica) plus nivolumab (Opdivo) for relapsed or unresponsive non-Hodgkin’s lymphoma (NHL). This study concluded that this treatment was well-tolerated and showed promising effectiveness in these patients.
Treatment remains challenging for high-risk patients with relapsed or refractory NHL. One of the goals of developing new treatments is to improve treatment response. This can help reduce the chances of disease relapse and progression (tumor growth or spread). One new treatment combination under investigation is ibrutinib plus nivolumab.
Ibrutinib is a targeted therapy. This type of treatment only targets cancer cells and blocks their growth. Nivolumab is a monoclonal antibody. This type of treatment helps the body’s immune system attack cancer cells. The safety and effectiveness of these agents together for relapsed or unresponsive NHL remain under investigation.
Methods & findings
This study involved 141 patients with relapsed or refractory NHL. Patients previously received an average of 3 prior lines of treatment. All patients received ibrutinib combined with nivolumab.
Overall, 33% of patients with follicular lymphoma (FL) and 36% of those with diffuse large B cell lymphoma (DLBCL) responded to treatment. 65% of patients with transformed lymphoma responded to treatment.
The average progression-free survival (time from treatment until tumor growth or spread) ranged from 2.6 months to 9.1 months. The average time the disease remained stable ranged from 13 months to 18.4 months.
Overall, diarrhea (33%), low white blood cell count (31%), and fatigue (26%) were the most common side effects. 58% of all patients experienced severe side effects. The most common ones were low white blood cell count (28%) and low red blood cell count (23%). Serious pneumonia (9%) and rash (10%) were also reported.
The bottom line
This study concluded that this treatment was well-tolerated and showed promising effectiveness for patients with relapsed or unresponsive NHL.
The fine print
The numbers of patients with each NHL subtype were small. Larger studies are needed to confirm these results.
This was a Phase 1/2 study. Further studies are needed to determine the role of ibrutinib combined with nivolumab for the treatment of relapsed or refractory NHL.
Published By :
The Lancet. Haematology
Jan 11, 2019
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