In a nutshell
This study reported the long-term effectiveness and safety outcomes of treatment with idelalisib (Zydelig) after a longer follow-up of patients with indolent (painless) non-Hodgkin lymphoma. The data showed that idelalisib treatment improved the overall survival of these patients in the long-term.
Non-Hodgkin lymphoma (NHL) is a cancer that starts in white blood cells called lymphocytes, which are part of the body’s immune system. Indolent non-Hodgkin lymphoma (iNHL) is a type of NHL that grows and spreads slowly and usually has very few symptoms.
Common iNHLs include follicular lymphomas (FL), marginal-zone lymphoma (MZL), lymphoplasmacytic lymphoma (LPL/Waldenström macroglobulinemia or WM), and small lymphocytic lymphoma (SLL). A high number of patients with NHL experience relapse (worsening of the disease) or refractory (not responsive to the treatment) disease. Treatment of iNHL usually involves immunotherapy with rituximab (Rituxan) or combination therapy with chemotherapy. Rituximab is an immune protein that works by helping the body’s immune system attack cancer cells.
Idelalisib (Zydelig) has been approved to treat iNHL patients with disease refractory to rituximab. Idelalisib is a type of targeted therapy that kills B-cells (white blood cells) that are involved in FL. Idelalisib has shown good anticancer response in patients with iNHL unresponsive to previous treatments in the short-term. However, longer-term outcomes of idelalisib in these patients remain under investigation.
Methods & findings
This study involved 125 patients with B-cell iNHL refractory to rituximab and other standard therapies. All patients received 150 mg of idelalisib twice a day until their disease progressed or they could no longer tolerate the treatment. The average follow-up time was 6.7 years.
The overall response rate (ORR; partial or complete disappearance of the cancer) for the whole population was 57.6%. ORR was 55.6% for patients with FL, 80% for those with LPL/WM, and 46.7% for MZL.
The average survival without cancer progression was 11 months for patients with FL, 22.2 months for patients with LPL/WM, and 6.6 months for patients with MZL. The average overall survival time was 48.6 months for all patients.
No additional side effects were reported with longer follow-up.
The bottom line
This study concluded that idelalisib treatment leads to long term benefits and no new safety issues in patients with relapsed/refractory iNHL.
The fine print
This study received funding from Gilead Sciences, the manufacturer of idelalisib.
Published By :
Leukemia & lymphoma
Dec 10, 2020
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