Lenalidomide in Relapsed or Refractory Diffuse Large B-Cell Lymphoma: Is It a Valid Treatment Option?

Abstract

Background. Despite the advent of new treatment strategies, many patients with diffuse large B-cell lymphoma (DLBCL) relapse or die of the disease. Prospective clinical trials have demonstrated that lenalidomide is an effective and safe treatment option, especially for non-germinal center B-cell (non-GCB) DLBCL. However, routine clinical data are lacking, which is why we provide the results of the so-far largest relapsed/refractory (R/R) DLBCL real-life analysis. Methods. We retrospectively assessed 123 R/R DLBCL patients who received either 15 or 25 mg/day of lenalidomide from January 2006 to January 2015. Results. During a median follow-up period of 4.5 years, complete remission was achieved in 32% and a partial remission in 33% non-GCB patients compared with 0% and 3% in the

A Phase 2/3 Multicenter, Randomized, Open-Label Study to Compare the Efficacy and Safety of Lenalidomide Versus Investigator's Choice in Patients with Relapsed or Refractory Diffuse Large B-Cell Lymphoma

“…Median PFS was also longer with lenalidomide in the non-GCB population (37 vs. 30 months for GCB; P < 0.001; ref. 31). The proteasome inhibitor bortezomib in combination with DA-EPOCH (dose-adjusted etoposide, vincristine, doxorubicin, cyclophosphamide, and prednisone) showed significantly higher ORR (83% vs. 13%; P < 0.001) and median OS (10.8 vs. 3.4 months; P ¼ 0.003) in relapsed/refractory ABC versus GCB DLBCL subpopulations (N ¼ 49) (32).…”

A multi-institutional outcomes analysis of patients with relapsed or refractory DLBCL treated with ibrutinib

“…Several drugs, such as bortezomib, [10][11][12][13] lenalidomide, [14][15][16][17][18] and ibrutinib, 9,19 all known to affect NF-kB signaling implicated in ABC-DLBCL, are being incorporated into treatment strategies. The only study evaluating the efficacy of single-agent ibrutinib in the r/r setting classified 80 patients with GEP and found improved responses in ABC compared with GCB (ORR 37% vs 5%), but also demonstrated a number of responses in patients with unknown/unclassifiable DLBCL (ORR 22%) with relatively few complete remissions.…”

“…Clinical syndromes linked to autoimmune HIT include delayed-onset HIT (where HIT begins or worsens after stopping heparin), 15 persisting HIT (where thrombocytopenia continues for several weeks despite stopping heparin), 15,16 and spontaneous HIT syndrome (clinical/ serological picture of HIT without proximate heparin exposure). 17,18 We now report 4 multiple myeloma (MM) patients who developed HIT exclusively through exposure to UFH flushes (for apheresis catheter management) prior to autologous stem cell transplantation (aSCT), implicating autoimmune HIT antibodies. These patients were identified during a 44-month period (beginning May 2013) during which …”

Single-Agent Pixantrone as a Bridge to Autologous Stem Cell Transplantation in a Patient with Refractory Diffuse Large B-Cell Lymphoma

“…Several novel agents are undergoing evaluation, but few treatment options are available for this patient population after the failure of established second-line treatments (R-DHAP or R-ICE) [5]. Promising results have been reported with the use of lenalidomide [14] or lenalidomide plus rituximab [15]. In patients who are old and with comorbidities, who are not candidates for SCT, gemcitabine and oxaliplatin have shown efficacy with a good tolerability profile [16].…”