A phase 2 multicenter study of lenalidomide in relapsed or refractory classical Hodgkin lymphoma

Fehniger, Todd A.; Larson, Sarah; Trinkaus, Kathryn; Siegel, Marilyn J.; Cashen, Amanda F.; Blum, Kristie A.; Fenske, Timothy S.; Hurd, David D.; Goy, André; Schneider, Stephanie; Keppel, Catherine R.; Wagner‐Johnston, Nina D.; Carson, Kenneth R.; Bartlett, Nancy L.

doi:10.1182/blood-2011-07-362475

Cited by 186 publications

(139 citation statements)

References 27 publications

(31 reference statements)

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“…44 Of the 36 evaluable patients, responses were: CR ¼ 1, PR ¼ 6 and stable disease ¼ 5, resulting in an objective response of 19% and a cytostatic ORR of 33%. 44 This and other studies suggest that lenalidomide is active in heavily pretreated HL. 39,[45][46][47] ALLOGENEIC HCT Use of myeloablative preparative regimens for allo-HCT resulted in prohibitive non-relapse mortality (NRM), discouraging its widespread application as salvage treatment especially in the setting of prior auto-HCT failure.…”

Section: Monoclonal Antibodiesmentioning

confidence: 99%

“…A multicenter phase 2 study evaluated the efficacy of lenalidomide, in 38 patients with relapsed/refractory HL (87% had prior auto-HCT). 44 Lenalidomide was administered until disease progression or if unacceptable toxicity occurred. 44 Of the 36 evaluable patients, responses were: CR ¼ 1, PR ¼ 6 and stable disease ¼ 5, resulting in an objective response of 19% and a cytostatic ORR of 33%.…”

Section: Monoclonal Antibodiesmentioning

confidence: 99%

“…44 Lenalidomide was administered until disease progression or if unacceptable toxicity occurred. 44 Of the 36 evaluable patients, responses were: CR ¼ 1, PR ¼ 6 and stable disease ¼ 5, resulting in an objective response of 19% and a cytostatic ORR of 33%. 44 This and other studies suggest that lenalidomide is active in heavily pretreated HL.…”

Section: Monoclonal Antibodiesmentioning

confidence: 99%

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Managing Hodgkin lymphoma relapsing after autologous hematopoietic cell transplantation: a not-so-good cancer after all!

Kharfan‐Dabaja

Hamadani

Sibai

et al. 2014

Bone Marrow Transplant

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Hodgkin lymphoma (HL) relapsing after an autologous hematopoietic cell transplant (HCT) poses a therapeutic challenge. In this setting, salvage chemotherapy (for example, gemcitabine-based, ifosfamide-containing and others) or immunotherapy (for example, brentuximab vedotin) is essential as a bridging-cytoreduction strategy to an allogeneic HCT. Myeloablative allogeneic hematopoietic cell transplantation in relapsed HL is associated with high rates of non-relapse mortality. In carefully selected patients with chemosensitive disease, allografting following lower-intensity conditioning regimens can provide durable disease control rates of about 25-35%. Promising early results with haploidentical and umbilical cord transplantation are noteworthy and are expanding this procedure to patients for whom HLA-matched related or unrelated donors are not available. Unfortunately, a significant number of HL patients relapsing after an autologous HCT are not candidates for allografting because of the presence of resistant disease, donor unavailability or comorbidities. Brentuximab vedotin is approved for HL relapsing after a prior autograft. Rituximab and bendamustine are also active in this setting, albeit with short durations of remission. Histone deacetylase inhibitors (for example, panobinostat, mocetinostat), mTOR inhibitors (for example, everolimus) and immunomodulatory agents (lenalidomide) have shown activity in phase II trials, but currently are not approved for this indication. Second autologous HCT are rarely performed but this approach should not be considered standard practice at this time. The need for effective agents for post autograft failures of HL largely remains unmet. Continuous efforts to ensure early referral of such patients for allogeneic HCT or investigational therapies are the key to improving outcomes of this not-so-good lymphoma.

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Section: Monoclonal Antibodiesmentioning

confidence: 99%

Section: Monoclonal Antibodiesmentioning

confidence: 99%

Section: Monoclonal Antibodiesmentioning

confidence: 99%

See 1 more Smart Citation

Managing Hodgkin lymphoma relapsing after autologous hematopoietic cell transplantation: a not-so-good cancer after all!

Kharfan‐Dabaja

Hamadani

Sibai

et al. 2014

Bone Marrow Transplant

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“…Other novel drugs that were recently shown to be active in HL include the immunomodulatory drug lenalidomide, the mTOR inhibitor everolimus and HDAC inhibitor panobinostat [46][47][48][49]. However, all of them appear to be either less effective or more toxic or both when compared with brentuximab vedotin.…”

Section: Novel Drugsmentioning

confidence: 99%

Advances in the treatment of Hodgkin lymphoma

Eichenauer

Engert

2012

Int J Hematol

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In the past decades, Hodgkin lymphoma (HL) has turned from an incurable disease to one with the most favorable prognosis among adult malignancies. This is due to the introduction of effective multi-agent chemotherapy and the optimization of radiation techniques. At present, 80-90 % of patients achieve long-term remission when receiving appropriate first-line treatment. Even in case of relapse, up to 50 % can be successfully salvaged with highdose chemotherapy and autologous stem cell transplantation. Thus, current studies do not necessarily aim at increasing treatment efficacy but rather focus on a possible reduction of acute and late toxicity by decreasing treatment intensity if possible. One promising strategy to spare therapy in good-risk patients is early response-adapted treatment stratification according to the result of interim positron emission tomography. The evaluation of novel drugs and the optimization of treatment for elderly HL patients and those with nodular lymphocyte-predominant HL are further aspects that are currently being addressed in ongoing trials. This review will give an overview on more recent clinical trials and discuss possible future strategies for the treatment of HL.

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“…Previously, ReedSternberg cells were shown to be dependent on their microenvironment such that their culture is very difficult once removed from their "home" (11). Lenalidomide has several effects on the tumour microenvironment and its growth: antiangiogenic effects, immunomodulation via alterations in cytokine production, activation of T-cells, augmentation of NK cell activity and direct anti-tumour activity by cell cycle arrest and the induction of apoptosis (12). Recently, two trials used Lenalidomide as a single agent to treat patients with refractory or relapsed Hodgkin disease, with interesting results.…”

mentioning

confidence: 99%

ESHAP chemotherapy regimen associated to lenalidomide induces complete isotopic remission in Hodgkin’s lymphoma relapsing after autologous stem cell transplantation

et al. 2010

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A phase 2 multicenter study of lenalidomide in relapsed or refractory classical Hodgkin lymphoma

Cited by 186 publications

References 27 publications

Managing Hodgkin lymphoma relapsing after autologous hematopoietic cell transplantation: a not-so-good cancer after all!

Managing Hodgkin lymphoma relapsing after autologous hematopoietic cell transplantation: a not-so-good cancer after all!

Advances in the treatment of Hodgkin lymphoma

ESHAP chemotherapy regimen associated to lenalidomide induces complete isotopic remission in Hodgkin’s lymphoma relapsing after autologous stem cell transplantation

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