Lenalidomide for the treatment of B-cell lymphoma

Garciaz, Sylvain; Coso, Diane; Colella, Jean-Marc Schiano de; Bouabdallah, Réda

doi:10.1080/13543784.2016.1208170

Cited by 21 publications

(24 citation statements)

References 88 publications

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“…Lenalidomide, as an immunomodulatory agent, is proved to have a variety of effects on the immune system and also alter tumor microenvironment by affecting the production and activity of cytokines involved in the maintenance of tumor growth and survival. Meanwhile, lenalidomide could exert direct tumor toxicities via binding to cereblon to inhibit downstream NF-κB signaling [ 33 ]. Combination of lenalidomide and R-CHOP21 (R2-CHOP) seemed to provide benefits in several phase 2 studies, especially for the non-GCB and high-risk subgroups [ 34 ].…”

Section: Immunotherapymentioning

confidence: 99%

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New agents and regimens for diffuse large B cell lymphoma

2020

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As a widely recognized standard regimen, R-CHOP (rituximab plus cyclophosphamide, doxorubicin, vincristine, and prednisone) is able to cure two-thirds patients with diffuse large B cell lymphoma (DLBCL), and the remaining patients suffer from refractory or relapsed disease due to resistance to R-CHOP and fare poorly. Unsatisfied outcomes for those relapsed/refractory patients prompted efforts to discover new treatment approaches for DLBCL, including chimeric antigen receptor T cells, bispecific T cell engagers, immunomodulatory drugs, immune checkpoint inhibitors, monoclonal antibodies, antibody–drug conjugates, molecular pathway inhibitors, and epigenetic-modifying drugs. Herein, up-to-date data about the most promising treatment approaches for DLBCL are recapitulated, and novel genetic classification systems are introduced to guide individualized treatment for DLBCL.

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Section: Immunotherapymentioning

confidence: 99%

“…Lenalidomide can also exert direct tumor toxicities via binding to cereblon to inhibit downstream NF-κB signaling [ 33 ]. As aforementioned, lenalidomide has been shown to provide benefits for r/r ABC-DLBCL [ 39 , 40 ], as well as elderly patients when used as maintenance therapy [ 35 ].…”

Section: Molecular Pathway Inhibitorsmentioning

confidence: 99%

New agents and regimens for diffuse large B cell lymphoma

2020

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“…Lenalidomide is an oral immunomodulatory drug with complex and pleiotropic immunologic and antiproliferative activities in B-cell lymphomas. 8 Lenalidomide demonstrated activity in xenograft models of ABC DLBCL by downregulating the BCR-NFKB pathway through inhibition of IRF4 and Cereblon. 9 In combination with R-CHOP (R2-CHOP), lenalidomide has acceptable levels of toxicity and may mitigate the negative prognosis of the non-GCB phenotype.…”

Section: Introductionmentioning

confidence: 99%

Subcutaneous Rituximab-MiniCHOP Compared With Subcutaneous Rituximab-MiniCHOP Plus Lenalidomide in Diffuse Large B-Cell Lymphoma for Patients Age 80 Years or Older

Obéric

Peyrade

Puyade

et al. 2021

JCO

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PURPOSE: The prognosis of elderly patients with diffuse large B-cell lymphoma (DLBCL) is worse than that of young patients. An attenuated dose of chemotherapy—cyclophosphamide, doxorubicin, vincristine, and prednisone plus rituximab (R-miniCHOP)—is a good compromise between efficacy and safety in very elderly patients. In combination with R-CHOP (R2-CHOP), lenalidomide has an acceptable level of toxicity and may mitigate the negative prognosis of the non–germinal center B-cell–like phenotype. The Lymphoma Study association conducted a multicentric, phase III, open-label, randomized trial to compare R-miniCHOP and R2-miniCHOP. PATIENTS AND METHODS: Patients of age 80 years or older with untreated DLBCL were randomly assigned into the R-miniCHOP21 group or the R2-miniCHOP21 group for six cycles and stratified according to CD10 expression and age. The first cycle of rituximab was delivered by IV on D1 after a prephase and then delivered subcutaneously on D1 of cycles 2-6. Lenalidomide was delivered at a dose of 10 mg once daily on D1-D14 of each cycle. The primary end point was overall survival (OS). RESULTS: A total of 249 patients with new DLBCL were randomly assigned (127 R-miniCHOP and 122 R2-miniCHOP). The median age was 83 years (range, 80-96), and 55% of the patients were classified as non-GCB. The delivered dose for each R-miniCHOP compound was similar in both arms. Over a median follow-up of 25.1 months, the intention-to-treat analysis revealed that R2-miniCHOP did not improve OS (2-year OS 66% in R-miniCHOP and 65.7% in R2-miniCHOP arm, P = .98) in the overall population or in the non-GCB population. Grade 3-4 adverse events occurred in 53% of patients with R-miniCHOP and in 81% of patients with R2-miniCHOP. CONCLUSION: The addition of lenalidomide to R-miniCHOP does not improve OS. Rituximab delivered subcutaneously was safe in this population.

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“…Furthermore, its efficacy has been demonstrated for B-cell lymphoma, particularly mantle cell lymphoma, follicular lymphoma and non-germinal centre diffuse large B-cell lymphoma. 16 After the administration of lenalidomide, serum protein electrophoresis detected the M protein; however, its level decreased and abnormal plasmacytoid cells disappeared from bone marrow. Lenalidomide was effective for not only gamma HCD, but also pulmonary hypertension.…”

Section: Discussionmentioning

confidence: 99%

Gamma heavy chain disease complicated by pulmonary hypertension, which was successfully treated with lenalidomide

Shibata

Fukunaga

2020

BMJ Case Rep

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Heavy chain disease (HCD) is a rare B-cell proliferative neoplasm that is characterised by the production of truncated monoclonal immunoglobulin heavy chains without light chains. Gamma HCD is a subgroup of HCD. A 67-year-old man was admitted to our hospital with dyspnoea and lower leg oedema. Based on the results of heart catheterisation, he was diagnosed with pulmonary hypertension. Laboratory tests revealed an elevated level of IgG, and serum immunoelectrophoresis showed that IgG was a monoclonal gamma heavy chain without light chains. Finally, he was diagnosed with gamma HCD complicated by pulmonary hypertension. Bortezomib and dexamethasone therapy was initiated, but became refractory within 8 months. Therefore, the treatment was switched to lenalidomide and dexamethasone therapy, and the disease has been stably controlled for more than 2 years. To the best of our knowledge, this is the first case of gamma HCD being successfully treated by lenalidomide and dexamethasone therapy.

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Lenalidomide for the treatment of B-cell lymphoma

Cited by 21 publications

References 88 publications

New agents and regimens for diffuse large B cell lymphoma

New agents and regimens for diffuse large B cell lymphoma

Subcutaneous Rituximab-MiniCHOP Compared With Subcutaneous Rituximab-MiniCHOP Plus Lenalidomide in Diffuse Large B-Cell Lymphoma for Patients Age 80 Years or Older

Gamma heavy chain disease complicated by pulmonary hypertension, which was successfully treated with lenalidomide

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