Rituximab, lenalidomide and pembrolizumab in refractory primary cutaneous diffuse large B‐cell lymphoma, leg type

Raimondo, Cosimo Di; Abdulla, Farah; Zain, Jasmine; Querfeld, Christiane; Rosen, Steven T.

doi:10.1111/bjh.16211

Cited by 13 publications

(12 citation statements)

References 10 publications

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“…In refractory cases, rituximab can also be applied in combination with other systemic therapies. A patient with DLCBCL, LT, who relapsed after radiotherapy and R-CGOP (rituximab, cyclophosphamide, gemcitabine, vincristine, prednisone), was treated with a combination of rituximab, lenalidomide antiPD-1 antibody pembrolizumab (21). The patient developed a complete response, which was still ongoing at 7 months after the initiation of therapy.…”

Section: Systemic Therapies Monoclonal Antibodiesmentioning

confidence: 99%

Innovative Therapeutic Approaches in Primary Cutaneous B Cell Lymphoma

2020

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Background: Primary cutaneous B-cell lymphomas (pCBCL) include an infrequent group of non-Hodgkin lymphomas that are limited to skin sites at the time of diagnosis. They comprise roughly 20-25% of all cutaneous lymphomas and are subdivided into primary cutaneous marginal zone lymphoma (PCMZL), primary cutaneous follicle center lymphoma (PCFCL), and primary cutaneous diffuse large cell B cell lymphoma, leg type (PCDLCBCL, LT). The first two show a rather indolent course while PCDLCBCL, LT carries a worse prognosis. Intravascular large cell B-cell lymphoma is the most infrequent subtype, and its therapy is not covered in this review. Topical Therapy: For solitary, single-site PCMZL and PCFCL, several topical treatment options exist. They include, but are not limited to, excision, radiotherapy, and intralesional therapies, discussed in this review. However, in selected cases, even "watchful waiting" is reasonable. Systemic Therapy: Indolent types of pCBCL rarely require systemic treatment. However, in extended cases and more importantly DLCBCL, LT, systemic treatment is the first choice. Monoclonal anti-CD20-antibody rituximab is often used as monotherapy in PCMZL and PCFCL or combined with chemotherapy in PCDLBCL, LT. Newer options are monoclonal anti-CD40 antibody dacetuzumab, anti-PD-1 and anti-PD-L1 checkpoint inhibitors, and Bruton tyrosine kinase inhibitors. Conclusion: Indolent pCBCL are treated with a risk-adapted strategy using intralesional steroids, RT, and interferon-α as first-line treatments. Relapsing cases may profit from rituximab. In aggressive PCDLCBCL, LT, rituximab with polychemotherapy is recommended. Innovative therapies include intralesional oncolytic virotherapy, systemic monoclonal antibodies, and small molecules.

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Section: Systemic Therapies Monoclonal Antibodiesmentioning

confidence: 99%

Innovative Therapeutic Approaches in Primary Cutaneous B Cell Lymphoma

2020

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“…Di Raimondo et al. reported combining rituximab, lenalidomide, and pembrolizumab in the treatment of one patient with relapsed/refractory, PCDLBCL, LT which resulted in a complete response for seven months 16 . Al Dhafiri et al.…”

Section: Discussionmentioning

confidence: 99%

“…The significance of our study was to shed light on salvage ICI therapy used in relapsed/refractory, PCDLBCL, LT, but also to provide data on front-line treatments as well.The use of immune checkpoint inhibition and immune cell modulation in the treatment of PCDLBCL, LT, was, so far, limited to case reports. Di Raimondo et al reported combining rituximab, lenalidomide, and pembrolizumab in the treatment of one patient with relapsed/refractory, PCDLBCL, LT which resulted in a complete response for seven months 16. Al Dhafiri et al also provided a case report using lenalidomide-an immune modulatory drug that activates and increases the number of T cells and NK cells-in the treatment of relapsed/refractory, PCDLBCL, LT.…”

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confidence: 99%

Outcomes in primary cutaneous diffuse large B‐cell lymphoma, leg type

Kraft

Ansell

Villasboas

et al. 2021

Hematological Oncology

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Primary cutaneous diffuse large B-cell lymphoma, leg type (PCDLBCL, LT) is a rare, aggressive lymphoma characterized by skin involvement predominantly in the lower extremities. Immunochemotherapy with or without involved-site radiation therapy (ISRT) is considered standard front-line therapy. Over-expression of PD-L1/PD-L2 is seen in a high proportion of PCDLBCL, LT cases, but efficacy of immune checkpoint inhibitors (ICI) in relapsed/refractory, PCDLBCL, LT has not been thoroughly studied. We conducted a retrospective cohort study of patients diagnosed with

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“…CR was observed with the association of rituximab, lenalidomide and pembrolizumab. Introduction of the treatments was sequential (rituximab first, then lenalidomide and finally pembrolizumab) with the aim to enhance the efficacy of the checkpoint inhibitor [ 85 ].…”

Section: Aggressive Pcbclmentioning

confidence: 99%

Diagnosis and Treatment of Primary Cutaneous B-Cell Lymphomas: State of the Art and Perspectives

Dumont

Battistella

Ram‐Wolff

et al. 2020

Cancers

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Primary cutaneous B-cell lymphomas are rare entities that develop primarily in the skin. They constitute a heterogeneous group that represents around a quarter of primary cutaneous lymphomas. The 2018 update of the World Health Organization-European Organization for Research and Treatment of Cancer (WHO-EORTC) classification differentiates primary cutaneous marginal zone lymphoma and primary cutaneous follicle center lymphoma with an indolent course from primary cutaneous diffuse large B-cell lymphoma, leg type with an aggressive behavior. The broad spectrum of clinical presentations and the disease course marked by frequent relapses are diagnostic and therapeutic challenges. The classification of these diseases has been refined in recent years, which allows to better define their immunopathogenesis and specific management. In the present article, we review the main clinico-biological characteristics and the current therapeutic options of these three main subsets. Based on the recent therapeutic advances in nodal B-cell lymphomas, we focus on the development of novel treatment options applicable to primary cutaneous B-cell lymphomas, including targeted therapies, combination treatments and immunotherapeutic approaches, and cover basic, translational and clinical aspects aiming to improve the treatment of cutaneous B-cell lymphomas.

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Rituximab, lenalidomide and pembrolizumab in refractory primary cutaneous diffuse large B‐cell lymphoma, leg type

Cited by 13 publications

References 10 publications

Innovative Therapeutic Approaches in Primary Cutaneous B Cell Lymphoma

Innovative Therapeutic Approaches in Primary Cutaneous B Cell Lymphoma

Outcomes in primary cutaneous diffuse large B‐cell lymphoma, leg type

Diagnosis and Treatment of Primary Cutaneous B-Cell Lymphomas: State of the Art and Perspectives

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