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This ASCO 2016 oral abstract presentation took place on Sunday June 5, 9:45am–12:45pm, during the ‘Hematologic Malignancies-Lymphoma and Chronic Lymphocytic Leukemia’ session. This session was chaired by Pr Gilles Salles, Head of the Hematology Department in South Lyon hospitals, Lyon, France.
The presentation of this abstract (#7502) was given by Dr James L Rubenstein, Professor of Medicine at the University of California, San Francisco.
Currently, for relapsed CNS lymphoma, there is a lack of effective biological agents. Lenalidomide (CC-5013) has been shown to have activity in Activated B-Cell Like-DLBCL and so a phase I study (NCT01542918) investigating lenalidomide plus rituximab for the treatment of R/R CNS and Intraocular Lymphoma was initiated.
The primary outcome measure was to establish the maximal tolerated dose of lenalidomide (10, 20, or 30mg) in patients, who were followed for the duration of the treatment (an expected average of 4 months). Secondary endpoints were to determine: Cerebrospinal Fluid (CSF) penetration of lenalidomide; feasibility of intraventricular plus intravenous rituximab; and Time to Progression (TTP) of maintenance lenalidomide in an independent cohort of relapsed CNS NHL patients.
Inclusion criteria included age ≥18 years, CD20+ lymphoma on previous analysis, and an absolute neutrophil count of >1,500 (growth factors permitted).
It was found that maintenance with lenalidomide at modest doses was feasible and resulted in improved PFS in patients with R/R CNS lymphoma; it may delay or even completely remove the need for whole brain radiotherapy. Moreover, lenalidomide demonstrated the potential to be combined with focal irradiation, either radiosurgery or involved field radiation. This study presents some of the first emerging evidence in support of using lenalidomide as maintenance therapy; it significantly improved TTP after salvage in relapsed CNS DLBCL and delayed whole brain radiotherapy. Additionally, minimal sife effects were observed with lenalidomide (one non-invasive Basal Cell Carcinoma reported). However, further prospective clinical trials are required to confirm the efficacy and safety of immunomodulatory imide drugs for this patient population.
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Interpretation of R2-CHOP in large cell lymphoma
Interpretation of R2-CHOP in large cell lymphoma
Interpretation of R2-CHOP in large cell lymphoma
Interpretation of R2-CHOP in large cell lymphoma
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