ASCO 2019 — Lenalidomide-rituximab yields high response rate in relapsed/refractory FL, MZL


  • David Reilly
  • Oncology Conference reports
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Takeaway

  • Lenalidomide-rituximab achieved an overall response rate (ORR) of 73% and a complete response rate of 45% in patients with relapsed/refractory follicular lymphoma (FL) and marginal zone lymphoma (MZL), including patients with rituximab-refractory/double-refractory disease and early relapse status.

Why this matters

  • Earlier data from the MAGNIFY study served as the basis for the recent approval of the regimen by the FDA.

Study design

  • Interim analysis of the phase 3b MAGNIFY study of 12 induction cycles of lenalidomide-rituximab (R2), followed by 1:1 randomization in patients with stable disease or better to continued R2 vs rituximab maintenance.
  • Patients had received a median of 2 prior systemic treatments.
  • Funding: Celgene Corporation.

Key results

  • 80% of patients have grade 1-3a FL; 20% have MZL.
  • Lenalidomide-rituximab induction yielded 73% ORR; rate of complete response/complete response unconfirmed (CR/CRu), 45%.
    • Rituximab-refractory disease: 63% ORR; 40% CR/CRu.
    • Double-refractory disease: 51% ORR; 27% CR/CRu.
    • Patients with early relapse: 69% ORR; 50% CR/CRu.
  • Median PFS, 36 months.
  • Most common grade 3-4 adverse events included neutropenia (34%), thrombocytopenia (6%), and leukopenia (5%).

Limitations

  • Open-label design.

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