inMIND trial: Tafasitamab plus lenalidomide and rituximab for R/R FL

During the 66th American Society of Hematology (ASH) Meeting and Exposition, the Lymphoma Hub was pleased to speak to Stefano Luminari, University of Modena and Reggio Emilia, Modena, IT. We asked about the latest updates from the inMIND trial of tafasitamab plus lenalidomide and rituximab (Tafa-Len-R) for relapsed/refractory (R/R) follicular lymphoma (FL).

In this interview, Luminari shares the efficacy and safety outcomes from the phase III inMIND (NCT04680052) trial of Tafa-Len-R vs placebo (Pbo)-Len-R in patients with R/R FL. Luminari covers key outcomes, highlighting promising efficacy and safety data. He concludes that the data are encouraging, and this combination could be a viable treatment option for patients with R/R FL in the second-line setting.

During the interview, Luminari shared the following key points¹:

• The inMIND trial is a multicenter, Pbo-controlled, randomized, phase III study evaluating the efficacy and safety of Tafa-Len-R in patients with R/R FL. This trial is the first to validate the approach of combining two antibodies (anti-CD19 with anti-CD20) for R/R FL.
• Overall, 548 patients (Tafa-Len-R, n = 273; Pbo-Len-R, n = 275) aged ≥18 years with R/R FL or marginal zone lymphoma were included.
• The median age of patients was 64 years, and the median number of prior lines of systemic therapy was 1; 45% had ≥2 prior lines; 32% had disease progression within 24 months (POD24), and 43% were refractory to a prior anti-CD20 monoclonal antibody.
• The inMIND trial met its primary endpoint of prolonging PFS in patients with R/R FL.
  • The median PFS was significantly improved in the Tafa-Len-R vs Pbo-Len-R arm (22.4 months vs 13.9 months, respectively; p < 0.0001).
  • The PFS benefits were observed in all prespecified subgroups, including patients receiving multiple prior lines of therapy, with POD24, and refractory to prior anti-CD20 monoclonal antibody.
• The overall response rate was higher in the Tafa-Len-R vs Pbo-Len-R arm (83.5% vs 72.4%; p = 0.0014).
• The duration of response was improved in the Tafa-Len-R vs Pbo-Len-R arm (21.2 months vs 13.6 months, p < 0.0001).
• The median time to next treatment was not reached vs 28.8 months in the Tafa-Len-R vs Pbo-Len-R arm, respectively (p < 0.0001).
• Similar rates of treatment-emergent adverse events were observed in both groups (99%). The common Grade 3 or 4 adverse events reported in the Tafa-Len-R vs Pbo-Len-R arms were neutropenia (40% vs 38%), pneumonia (8% vs 5%), thrombocytopenia (6% vs 7%), decreased neutrophils (6% vs 7%), COVID-19 (6% vs 2%), and COVID-19 pneumonia (5% vs 1%). The higher COVID-19 consequences are attributed to the fact that the study enrolled patients during one of the peaks of the COVID-19 pandemic.

In summary, the phase III inMIND trial demonstrated that adding Tafa to Len and R significantly improved survival outcomes with manageable safety in patients with R/R FL. With its demonstrated efficacy and favorable safety profile, the Tafa-Len-R regimen is an excellent option for treating rituximab-refractory FL and is practical for use in both community and academic settings. This combination offers a promising new standard of care for R/R FL.

This educational resource is independently supported by Incyte. All content is developed by SES in collaboration with an expert steering committee; funders are allowed no influence on the content of this resource.