Real-world experience of tafasitamab and lenalidomide for the treatment of R/R DLBCL

The Lymphoma Hub was pleased to speak to Grzegorz S. Nowakowski, Mayo Clinic, Rochester, US. Nowakowski discussed real-world experience of using tafasitamab and lenalidomide for the treatment of relapsed/refractory (R/R) diffuse large B-cell lymphoma (DLBCL).

Key points

L-MIND

The combination of tafasitamab, an anti-CD19 antibody, and lenalidomide is approved by the U.S. Food and Drug Administration (FDA) as a second-line treatment for patients with R/R DLBCL.¹ This approval was based on results from the open-label, multicenter, single-arm, phase II L-MIND trial (NCT02399085), which included patients with R/R DLBCL who were not eligible for high-dose chemotherapy and autologous hematopoietic stem cell transplantation (auto-HSCT).² The overall response rate (ORR) was 60%, with a complete response (CR) of 43%.² Long-term follow-up analysis confirmed that responses were durable, and patients who received one prior line of therapy showed higher response rates and longer progression-free survival (PFS).³

RE-MIND

The retrospective, multicenter, observational RE-MIND study (NCT04150328) assessed tafasitamab plus lenalidomide vs lenalidomide monotherapy using a propensity-matched historical control for the L-MIND trial.⁴ Tafasitamab plus lenalidomide was associated with higher response rates, and better PFS and overall survival (OS) vs lenalidomide alone.⁴

RE-MIND2

The subsequent retrospective, multicenter, observational RE-MIND2 study (NCT04697160) compared outcomes of patients treated with tafasitamab plus lenalidomide in the L-MIND trial with a propensity-matched cohort of patients treated with frequently used chemotherapy regimens for patients with R/R DLBCL.⁵ Results showed that tafasitamab plus lenalidomide compared favorably to systemic pooled chemotherapy.⁵

Additional real-world studies

A real-world retrospective study showed that patients who did not meet the eligibility criteria for the L-MIND trial, and who had more high-risk disease features and comorbidities compared with the trial population, had poorer outcomes following treatment with tafasitamab plus lenalidomide than the L-MIND population.⁶ However, further retrospective, multicenter, real-world analyses have confirmed the efficacy and safety of tafasitamab plus lenalidomide in patients who met the eligibility criteria for the L-MIND trial.⁷

realMIND

The ongoing, multicenter, observational, prospective and retrospective realMIND study (NCT04981795) will prospectively assess the safety and efficacy of tafasitamab plus lenalidomide in real-world patients with R/R DLBCL in the US.⁸

Conclusion

Nowakowski concluded by highlighting that tafasitamab plus lenalidomide represents a major breakthrough in the treatment of patients with R/R DLBCL, with real-world evidence confirming the efficacy of this combination that was observed in the L-MIND trial, and which compares favorably to salvage chemotherapy regimens. Finally, he highlighted that studies are now evaluating tafasitamab plus lenalidomide with rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) vs R-CHOP alone in the first-line setting.

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