All content on this site is intended for healthcare professionals only. By acknowledging this message and accessing the information on this website you are confirming that you are a Healthcare Professional. If you are a patient or carer, please visit the Lymphoma Coalition.

The Lymphoma Hub uses cookies on this website. They help us give you the best online experience. By continuing to use our website without changing your cookie settings, you agree to our use of cookies in accordance with our updated Cookie Policy

The Lymphoma Hub website uses a third-party service provided by Google that dynamically translates web content. Translations are machine generated, so may not be an exact or complete translation, and the Lymphoma Hub cannot guarantee the accuracy of translated content. The Lymphoma Hub and its employees will not be liable for any direct, indirect, or consequential damages (even if foreseeable) resulting from use of the Google Translate feature. For further support with Google Translate, visit Google Translate Help.

Steering CommitteeAbout UsNewsletterContact
You're logged in! Click here any time to manage your account or log out.
You're logged in! Click here any time to manage your account or log out.

ASH 2018 | Results from the HOVON 130 trial: Lenalidomide and R-CHOP for B-cell lymphoma with MYC rearrangements

Dec 18, 2018

Bookmark this article

On Monday 3 December 2018, Oral Session 626 took place at the 60th American Society of Hematology (ASH) Annual Meeting, San Diego, CA. During that session, results from the phase II HOVON 130 trial (Abstract #786) were presented by Martine Chamuleau from the University Medical Center, Amsterdam, NL.

In this prospective phase II trial (HOVON 130) the combination of lenalidomide and R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone), was assessed for efficacy and safety in patients with large B-cell lymphoma (except Burkitt lymphoma) with MYC rearrangements. R-CHOP alone leads to poor response rates and outcomes in these patients. The primary endpoint of the study was end of treatment complete metabolic response rate (CMR), as detected by positron emission tomography and computed tomography (PET/CT). The secondary endpoint of the trial was the predictive value of PET/CT for patient outcomes.

Study design

  • N = 82 eligible newly-diagnosed patients with proven MYC rearrangement by fluorescence in situ hybridization (FISH), Ann Arbor stage II-IV, aged ≥ 18 and single, double or triple MYC rearrangement
  • Patients with Burkitt lymphoma, transformed lymphoma or central nervous system localization were excluded
  • Median age (range) = 63 (28−82) years
  • Dosing: R2-CHOP regimen every 3 weeks:
    • Six cycles R-CHOP:
      • Rituximab: 750 mg/m2 intravenously (i.v) on Day 1
      • Cyclophosphamide: 750 mg/m2v on Day 1
      • Doxorubicin: 50 mg/m2v on Day 1
      • Vincristine: 1.4 mg/m2v (maximum 2 mg) on Day 1
      • Prednisone: 100 mg orally on Day 1-5
    • Six cycles lenalidomide (15 mg) orally on Day 1−14 followed by two rituximab administrations
  • All patients received intrathecal methotrexate prophylaxis
  • PET/CT scans were performed at baseline, after 3 treatment cycles (interim) and at the end of treatment (EOT)


  • Interim PET/CT:
    • Revealed that 70% of patients (n = 57) achieved CMR, 28% (n = 23) reached a partial metabolic response and 2% (n = 2) progressed to disease (PD)
    • Revealed that overall 67% of patients (n = 55) achieved CMR
  • Interim PET/CT scans were not predictive of patient outcomes in this trial
  • Age, International Prognostic Index (IPI) or MYC rearrangement status were not significant prognostic factors for CMR
  • There was a tendency for higher risk of death for double and triple hit patients when compared to single hit (HR = 6.35; P = 0.07; 95% CI, 0.84−75)
  • Median follow-up = 15.9 months
  • One-year estimates:
    • Progression-free survival (PFS) = 66%
    • Overall survival (OS) = 85%


  • Adverse events (AEs) of Grade 2 were seen in 32%, of Grade 3 in 39% and of Grade 4 in 16% of patients
  • The most common Grade 3−4 AEs were:
    • Neutropenia: 18%
    • Infections: 14%
    • Gastrointestinal disorders: 14%
  • Serious AEs (n = 72) were observed in 37 patients, leading to 67 hospitalizations and one death due to PD
  • No treatment-related deaths occurred


  • R2CHOP and lenalidomide are well tolerated by newly-diagnosed B-cell lymphoma patients with MYC rearrangements
  • R2CHOP and lenalidomide led to promising CMR and survival rates and this combination treatment might be considered in the future as the new standard of care for MYC-positive B-cell lymphoma patients
  1. Chamuleau M. et al. Successful Treatment of MYC rearrangement Positive Large B Cell Lymphoma Patients with R-CHOP21 Plus Lenalidomide: Results of a Multicenter Phase II HOVON Trial. Oral Abstract #786: ASH 60th Annual Meeting and Exposition, December 2018, San Diego, CA.

Understanding your specialty helps us to deliver the most relevant and engaging content.

Please spare a moment to share yours.

Please select or type your specialty

  Thank you

Your opinion matters

Which treatment do you select for patients with follicular lymphoma after multiple relapses?
0 votes - 6 days left ...


Subscribe to get the best content related to lymphoma & CLL delivered to your inbox