Konference: 2015 51th ASCO Annual Meeting - účast ČR
Kategorie: Maligní lymfomy a leukémie
Téma: Lymphoma and Plasma Cell Disorders
Číslo abstraktu: TPS8603
Autoři: Prof. M.D. John P. Leonard; M.D. John G. Gribben, DSC, FMedSci; Prof. MUDr. Marek Trněný, CSc.; M.D. Phillip Scheinberg; MD Kensei Tobinai, Ph.D.; MD Nathan Hale Fowler; Nurgul Kilavuz; Pierre Fustier; MD Barbara Amoroso, Ph.D.
Background: The immunomodulatory drug, lenalidomide (Revlimid), has both anti-inflammatory and antiangiogenic properties. In preclinical studies, the immunological function of tumor-infiltrating lymphocytes is reduced in patients with follicular lymphoma (FL); lenalidomide can restore this response (Ramsay, Blood, 2009). In a phase 2 trial of frontline lenalidomide + rituximab (R2), the overall response rate (ORR) reached 90% (Fowler, Lancet Oncol, 2014) in iNHL patients; in a second study, patients with FL achieved 93% ORR (Martin, ICML, 2013). After treatment with R2 in phase 2 investigations, patients with R/R iNHL achieved clinical responses: ORRs of 73% (36% complete response [CR]) in R/R FL (Leonard, ASCO 2012 oral presentation), and 80% (55% CR) in marginal zone lymphoma (MZL; Raderer, EHA 2014 oral presentation) patients. Based on the results of these preclinical and phase 2 studies, further investigation of R2 in iNHL is warranted.Methods: This multicenter, double-blind, phase 3, randomized study (AUGMENT) is designed to evaluate the efficacy and safety of R2 versus placebo + rituximab (P+R) in patients with R/R iNHL. Eligibility criteria for patients include: grade 1, 2, or 3a FL or MZL; previous treatment with systemic therapy; considered refractory to or relapsed after last treatment; rituximab-sensitivity if prior rituximab therapy was administered; presentation of ≥ 1 measurable lesion; and adequate function in bone marrow, liver, and kidneys. An estimated 350 patients will be randomized 1:1 to either experimental or control groups. Patients enrolled in the R2 experimental study arm will receive lenalidomide (20 mg/day; days 1 to 21 up to 12 cycles) + rituximab (375 mg/m2; days 1, 8, 15, 22 of cycle 1 and day 1 of cycles 2 to 5) in 28-day cycles. Patients in the control study arm will receive P+R (375 mg/m2) following the same schedule. Progression-free survival is the primary endpoint, and key secondary endpoints will include rate of durable CR, overall survival, ORR, safety, and time to next anti-lymphoma treatment. Patients are currently being enrolled for this trial (NCT01938001). Clinical trial information: NCT01938001
Datum přednesení příspěvku: 31. 5. 2015