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On Tuesday 4th June an oral abstract session took place at the 2019 American Society of Clinical Oncology (ASCO) Annual Meeting. During that session, Abstract 7508 was presented by Jason Westin, MD Anderson Cancer Center, Houston, TX, USA, on the Smart Start clinical trial.1
Patients with diffuse large B-cell lymphoma (DLBCL) of the non-germinal center (non-GCB) molecular subtype exhibit an inferior outcome following standard chemotherapy, with < 50% being cured by R-CHOP.2 This phase II study (NCT02636322) investigated the efficacy of rituximab, lenalidomide, and ibrutinib (RLI) combination prior to standard chemotherapy treatment, in patients with newly-diagnosed non-GCB DLBCL.
The primary objective of this open-label, single-arm, investigator-initiated trial was overall response rate (ORR) after two RLI cycles and complete response (CR) rate following two cycles RLI plus six cycles of RLI in combination with standard chemotherapy.
Baseline characteristic |
Total cohort (N = 60) |
---|---|
Median age (range) |
63.5 (29–83) |
Male patients |
50% |
International Prognostic index (IPI) score: Median 0–1 2 3–5 |
3 16.7% 31.7% 51.7% |
Disease stage III–IV |
65% |
Double expressor (Myc, Bcl2 positive by IHC) |
54% |
Double hit (Myc, Bcl6 positive by FISH) |
2.7% |
Ki-67: >80% >90% |
77% 49% |
|
RLI only |
RLI + 2 chemotherapy cycles |
End of treatment (cycles 1–8; |
---|---|---|---|
ORR |
86% |
100% |
100% |
CR |
36% |
73% |
96% |
Partial response (PR) |
50% |
27% |
4% |
Stable disease (SD) |
7% |
- |
- |
Progressive disease (PD) |
2% |
- |
- |
Missing response (MR) |
5% |
- |
- |
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