In a nutshell
This study investigated the safety and effectiveness of coltuximab ravtansine for relapsed or refractory (does not respond to treatment) diffuse large B-cell lymphoma. The authors concluded that coltuximab ravtansine monotherapy was reasonably effective and well-tolerated in these patients.
Some background
The most widely used treatment for diffuse large B-cell lymphoma (DLBCL) is R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, prednisone). However, patients who relapse after this treatment must undergo stem cell transplantation. There are fewer options for patients who cannot undergo or relapse after transplantation.
Coltuximab ravtansine is a new targeted therapy. This type of treatment attaches to a protein on the cancer cell, delivering a therapy that blocks cell growth. The safety and effectiveness of this treatment for patients with relapsed or refractory DLBCL remains under investigation.
Methods & findings
This study involved 61 patients with relapsed (46.7%) or refractory (52.4%) DLBCL. 75.4% of patients had stage 3 – 4 disease. 45.9% of patients had bulky disease (high tumor burden). 57.4% of patients received at least 2 chemotherapy regimens containing rituximab (Rituxan). Patients were followed up every 12 weeks. Only 41 patients were included in this analysis.
Overall, 43.9% of patients responded to treatment. These included complete disappearance of all signs of cancer (14.6%) or tumor shrinkage (29.3%).
82.9% of patients experienced disease progression. Average progression-free survival (time from treatment until disease progression) was 4.4 months. Average overall survival (time from treatment until death from any cause) was 9.2 months.
54% of all patients experienced at least one treatment-related side effect. 28% of patients needed treatment delay due to side effects.
The most common side effects included fatigue (30%), nausea (23%), and diarrhea (20%). Low red blood cell levels occured in 87%. 52% to 67% experienced low levels of different types of white blood cells. This was severe in 15% to 25%.
The bottom line
The authors concluded that coltuximab ravtansine monotherapy was reasonably effective and well-tolerated in rituximab-treated patients with relapsed or refractory DLBCL.
The fine print
This study received funding support from Sanofi, one of the manufacturers of coltuximab ravtansine. Also, 20 patients were excluded from this study’s analysis. The final patient population (41 patients) is quite small.
Published By :
Haematologica
Date :
May 10, 2018
