Marginal zone lymphoma: long-term data for lenalidomide-rituximab

  • Becnel MR & al.
  • Br J Haematol
  • 28 Mar 2019

  • curated by David Reilly
  • Univadis Clinical Summaries
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Takeaway

  • Lenalidomide+rituximab (R2) demonstrated favorable response and survival outcomes with a manageable safety profile in long-term follow-up of patients with previously untreated marginal zone lymphoma (MZL).
  • Almost all patients remained alive.

Why this matters

  • No universal standard of care exists for patients with MZL.

Study design

  • Phase 2 study of lenalidomide+R2 in 27 patients with previously untreated MZL.
  • 75.1 (range, 16.2-100.2) months median follow-up.
  • 58 (range, 36-77) years median patient age.
  • 70% and 30% of patients had stage IV and III disease, respectively.
  • Funding: University of Texas MD Anderson Cancer Center, Celgene Corporation, MDACC.

Key results

  • Overall 93% overall response rate (ORR), including:
    • 88% in nodal MZL.
    • 80% in extranodal MZL/mucosa-associated lymphoid tissue (MALT) lymphoma.
    • 100% in splenic MZL.
  • Overall 70% rate of complete response (CR)/CR unconfirmed (Cru), including:
    • 56% in nodal MZL.
    • 73% in extranodal MZL/MALT lymphoma.
    • 100% in splenic MZL.
  • Overall 59.8 months (95% CI, 50.6-not reached) median PFS.
  • Overall 96% (95% CI, 89%-100%) 5-year OS.
  • PFS and OS rates were consistent across MZL subgroups.
  • Neutropenia (33%) and leukopenia (7%) were the only grade 3 hematological adverse events.

Limitations

  • Single-institution study.

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