Follicular lymphoma: m7-FLIPI not prognostic with chemo-free immunotherapy

  • Lockmer S & al.
  • Br J Haematol
  • 18 Aug 2019

  • curated by David Reilly
  • Univadis Clinical Summaries
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Takeaway

  • The m7-FLIPI (follicular lymphoma international prognostic index) prognostic model failed to stratify patients with follicular lymphoma (FL) into risk groups in terms of time to treatment failure (TTF) and OS after first-line chemo-free immunotherapy.

Why this matters

  • The m7-FLIPI stratifies patients with FL into risk categories regarding 5-year failure-free survival after first-line immunochemotherapy, but has not been tested after first-line chemo-free immunotherapy.

Study design

  • Study to test the m7-FLIPI in 95 patients with FL treated with rituximab monotherapy or rituximab+interferon-α 2a.
  • 81% had low- and 18% had high-risk m7-FLIPI scores.
  • Funding: Stockholm County Council; Centre for Innovative Medicine Karolinska Institutet; Swedish Cancer Society; Swedish Research Council; the NLG.

Key results

  • 76% of patients remained alive at a median follow-up of 10.6 (range, 0.6-18.3) years.
  • When comparing high- and low-risk m7-FLIPI groups:
    • No significant difference in TTF (HR, 0.98; 95% CI, 0.53-1.81; P=.94).
    • No significant difference in OS (HR, 01.00; 95% CI, 0.34-2.93; P=.99).
  • In univariate analysis:
    • EZH2 mutations were associated with longer TTF (HR, 0.55; 95% CI, 0.30-0.99; P=.05).
    • EP300 mutations were associated with shorter TTF (HR, 2.20; 95% CI, 1.17-4.13; P=.01).

Limitations

  • Retrospective data.