In a nutshell
This study looked at the safety and effectiveness of lenalidomide (Revlimid) to treat patients with relapsed diffuse large B-cell lymphoma. The authors concluded that lenalidomide is safe and effective for treating patients with relapsed diffuse large B-cell lymphoma, especially in patients with non-germinal center B-cell (GCB) like lymphoma.
Some background
Diffuse large B-cell lymphoma (DLBCL) is the most common type of non-Hodgkin lymphoma. It has three different sub-types based on what type of cell the cancer comes from: germinal center B-cell (GCB) type, activated B-cell (ABC) type, and unclassified. (ABC and unclassified are both non-GCB types.)
Patients with the ABC subtype generally have poor outcomes when treated with traditional therapies. Lenalidomide is a relatively new treatment that may be more effective at treating DLBCL patients, especially those with the ABC subtype. More research is needed to determine the effectiveness and safety of lenalidomide treatment in patients with DLBCL.
Methods & findings
111 patients participated in the study. 54 patients were treated with lenalidomide. These patients received 25 mg/day of lenalidomide for 21 days of a 28-day cycle. 57 were treated based on the physician’s judgment (investigator’s choice; IC). These patients either received gemcitabine, rituximab, etoposide, or oxaliplatin. All patients had relapsed or difficult to treat DLBCL.
54 patients had a non-GCB subtype. 48 patients had the GCB subtype. 9 patients could not be typed.
Patients treated with lenalidomide had a better overall response rate (percentage of patients whose cancer is reduced or eliminated) compared to the IC group. For patients with non-GCB subtype, the complete response rate for lenalidomide patients (28.6%) was higher than the complete response rate in the IC group (11.5%). For patients with the GCB subtype, the complete response rate for lenalidomide patients (26.1%) was also higher than the complete response rate in the IC group (12%).
The average overall survival time (time from treatment to death from any cause) for non-GCB patients treated with lenalidomide was 32.3 weeks compared to 20.4 weeks in the IC group. The average overall survival time for GCB patients treated with lenalidomide was 30 weeks compared to 24.9 weeks in the IC group.
The negative side effects associated with treatment were similar in the lenalidomide group and the IC group. All patients experienced at least one side effect. 43 patients in both groups experienced a grade 3 or higher adverse event.
The bottom line
The authors concluded that lenalidomide is a safe and effective treatment option for patients with relapsed diffuse large B-cell lymphoma, especially those with non-GCB subtypes.
Published By :
Clinical Cancer Research
Date :
Aug 01, 2017
