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An expert panel hosted by
Customizing first-line BTK inhibitors for CLL
with Gilles Salles, Paolo Ghia, and Francesc Bosch
Wednesday, October 23, 2024
18:30-19:30 BST
This independent educational activity is supported by Pharmacyclics LLC, an AbbVie Company and Janssen Biotech. All content is developed independently by the faculty. The funder is allowed no influence on the content of this activity.
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The phase II DELPHINUS trial (NCT03384654) assessed the safety and efficacy of daratumumab, an anti-CD38 monoclonal antibody, plus backbone chemotherapy in pediatric patients with B-cell ALL after ≥2 relapses (n = 7), and in pediatric and young adult patients with T-cell ALL (pediatric, n = 24; young adult, n = 5) and LL (n = 10) in first relapse.1 Results from this trial were published in Blood by Bhatla et al.1 |
Key learnings: |
CR rates after Cycle 2 in the pediatric T-cell ALL, young adult T-cell ALL, and T-cell LL cohorts were 50%, 60.0%, and 40%, respectively, with overall response rates of 83.3%, 80.0%, and 50.0%. No patients in the B-cell ALL cohort achieved a CR and the cohort was closed due to futility. |
In the pediatric T-cell ALL, young adult T-cell ALL, and T-cell LL cohorts, the observed 24-month EFS rates were 36.1%, 20.0%, and 20.0%, the observed 24-month OS rates were 41.3%, 25.0%, and 20.0%, and allo-HSCT rates were 75.0%, 60.0%, and 30.0%, respectively. |
The combination treatment was well tolerated, with no new safety concerns observed, aligning with known daratumumab safety profiles in adult patients with R/R multiple myeloma. |
Daratumumab combined with chemotherapy demonstrates potential in pediatric and young adult patients with R/R T-cell ALL and LL, showing encouraging response rates and serving as a bridge to allo-HSCT. Although daratumumab did not show efficacy in patients with B-cell ALL, the results support its role in R/R T-cell ALL/LL. |
Abbreviations: ALL, acute lymphoblastic leukemia; allo-HSCT, allogeneic hematopoietic stem cell transplant; CR, complete response; EFS, event-free survival; LL, lymphoblastic lymphoma; OS, overall survival; R/R, relapsed/refractory.
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