Evaluating lenalidomide plus everolimus for relapsed or refractory lymphoma

This study investigated the effectiveness and safety of lenalidomide (Revlimid) plus everolimus (Afinitor) in pretreated patients with relapsed (recurrent) or refractory (does not respond to treatment) lymphoma. This study concluded that this combination was well-tolerated and showed promising effectiveness in these patients.

Typical first-line (primary) therapy for non-Hodgkin’s lymphoma (NHL) involves chemotherapy with rituximab (Rituxan). However, many patients relapse or develop refractory disease. New treatment options are needed for these patients, especially those who do not respond to multiple chemotherapy regimens.

Lenalidomide and everolimus have been used as monotherapies for patients with relapsed or refractory lymphoma. Lenalidomide is an immunomodulatory drug. This type of treatment boosts the body’s immune system to help it attack cancer cells. Everolimus is a targeted therapy. This type of treatment blocks cancer cell growth. The effectiveness and safety of lenalidomide combined with everolimus in relapsed or refractory lymphoma remain under investigation.

This study involved 55 pretreated patients with relapsed or refractory lymphoma. 81.8% of patients had NHL, with the most common subtype being diffuse large B-cell lymphoma (51.1%). 78.2% of patients had failed 3 or more previous lines of therapy. Patients received lenalidomide plus everolimus for 21 days. Patients were followed-up for an average of 19.8 months.

Overall, 27% of patients responded to treatment. 7.27% of patients achieved a complete response (disappearance of all signs of cancer). At follow-up, 38% of patients had stable disease (tumor is neither growing nor shrinking). 

The average progression-free survival (time from treatment until tumor grows or spreads) was 5.3 months. The average overall survival (time from treatment until death from any cause) was 20.3 months. 

The most commonly reported severe to life-threatening side effects were low white blood cell count (56%), low platelet count (cells involved in blood clotting; 33%), and low red blood cell count (13%). 18% of patients also reported infections. 12.7% of patients stopped treatment early due to side effects.

This study concluded that the combination of lenalidomide and everolimus was well-tolerated and showed promising effectiveness in patients with relapsed or refractory lymphoma.

This was a Phase 1/2 study with a small patient population. Further studies are needed to determine the role of lenalidomide plus everolimus in the treatment of relapsed lymphoma. This study received funding support from Celgene and Novartis, the manufacturers of lenalidomide and everolimus.