Lenalidomide in mantle cell lymphoma patients already treated with ibrutinib

This study examined the effectiveness of lenalidomide (Revlimid) in patients with mantle cell lymphoma (MCL) already treated with ibrutinib (Imbruvica). The authors concluded that lenalidomide was effective following ibrutinib.

There is no standard-of-care treatment for patients with relapsed or refractory (did not respond to treatment) MCL. Ibrutinib is one targeted treatment often used. Ibrutinib blocks certain proteins needed for cancer growth. Many patients may develop a resistance to this treatment, or may have to stop treatment due to side effects.

Lenalidomide is a treatment that can block new blood vessels from forming around that tumor. It may also stimulate the immune system to fight the cancer. It has been shown to be effective in relapsed/refractory MCL both on its own and in combination with rituximab (Rituxan). It is not clear whether it is effective in patients who have already been treated with ibrutinib.

This study examined the records of 58 MCL patients who had relapsed or had not responded to ibrutinib. Of these, 88% had tried at least three other treatments. Thirteen patients were treated with lenalidomide alone. Eleven patients were treated with lenalidomide and rituximab. Thirty-four patients were treated with lenalidomide and other treatments.

29% of patients responded to treatment. Eight patients achieved a complete response (no sign of active disease). The average length of response was 20 weeks. The rate of response was similar for patients who progressed after successful ibrutinib treatment (30%) and those who did not respond to ibrutinib (32%).

The most common side effect was fatigue (38%). Patients also experienced cough, dizziness, swelling, and nausea. 34% of patients experienced a serious side effect. These included fevers related to low white blood cells, low blood pressure, and blood clots.

This study concluded that lenalidomide was effective in patients already treated with ibrutinib.