Meta-analysis shows geriatric nutritional risk index to be a strong predictor of survival in DLBCL

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Key clinical point: A low (below cutoff) geriatric nutritional risk index (GNRI) score is significantly associated with worse prognosis in patients with diffuse large B-cell lymphoma (DLBCL).

Major finding: A low GNRI score was significantly associated with worse overall survival (pooled hazard ratio [pHR] 1.78; P < .01) and progression-free survival (pHR 2.31; P < .01).

Study details: This meta-analysis included seven retrospective cohort studies that provided a cutoff value for GNRI (between 92 and 104.24) and involved 2448 patients with DLBCL for whom a calculated GNRI score was available.

Disclosures: This study was supported by Key R&D Projects, Jiangxi. The authors declared no conflicts of interest.

Source: Yan C et al. Prognostic value of geriatric nutritional risk index in patients with diffuse large B-cell lymphoma: A meta-analysis. Clin Transl Oncol. 2023 (Jul 12). doi: 10.1007/s12094-023-03271-w

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Key clinical point: A low (below cutoff) geriatric nutritional risk index (GNRI) score is significantly associated with worse prognosis in patients with diffuse large B-cell lymphoma (DLBCL).

Major finding: A low GNRI score was significantly associated with worse overall survival (pooled hazard ratio [pHR] 1.78; P < .01) and progression-free survival (pHR 2.31; P < .01).

Study details: This meta-analysis included seven retrospective cohort studies that provided a cutoff value for GNRI (between 92 and 104.24) and involved 2448 patients with DLBCL for whom a calculated GNRI score was available.

Disclosures: This study was supported by Key R&D Projects, Jiangxi. The authors declared no conflicts of interest.

Source: Yan C et al. Prognostic value of geriatric nutritional risk index in patients with diffuse large B-cell lymphoma: A meta-analysis. Clin Transl Oncol. 2023 (Jul 12). doi: 10.1007/s12094-023-03271-w

Key clinical point: A low (below cutoff) geriatric nutritional risk index (GNRI) score is significantly associated with worse prognosis in patients with diffuse large B-cell lymphoma (DLBCL).

Major finding: A low GNRI score was significantly associated with worse overall survival (pooled hazard ratio [pHR] 1.78; P < .01) and progression-free survival (pHR 2.31; P < .01).

Study details: This meta-analysis included seven retrospective cohort studies that provided a cutoff value for GNRI (between 92 and 104.24) and involved 2448 patients with DLBCL for whom a calculated GNRI score was available.

Disclosures: This study was supported by Key R&D Projects, Jiangxi. The authors declared no conflicts of interest.

Source: Yan C et al. Prognostic value of geriatric nutritional risk index in patients with diffuse large B-cell lymphoma: A meta-analysis. Clin Transl Oncol. 2023 (Jul 12). doi: 10.1007/s12094-023-03271-w

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Pre-treatment serum IL-6 and IL-10 levels predict prognosis and treatment response in newly diagnosed DLBCL

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Key clinical point: Serum levels of IL-6 and IL-10 at diagnosis may serve as predictors of treatment response and prognosis in patients with newly diagnosed diffuse large B-cell lymphoma (DLBCL).

Major finding: Patients with partial or no rresponse vs complete response to treatment had significantly higher serum IL-6 (P = .009) and IL-10 (P < .001) levels. High serum IL-6 (≥ 4.5 pg/mL) and IL-10 (≥ 5.0 pg/mL) levels were independent prognostic factors for relapse (adjusted hazard ratio [aHR] 2.524; P = .003, and aHR 1.835; P = .007, respectively) and survival (aHR 2.012; P = .031, and aHR 5.312; P = .017, respectively).

Study details: This single-center retrospective study included 77 patients with newly diagnosed DLBCL and 77 matched control individuals without DLBCL.

Disclosures: This study did not receive any funding. The authors declared no conflicts of interest.

Source: Bao C et al. Cytokine profiles in patients with newly diagnosed diffuse large B-cell lymphoma: IL-6 and IL-10 levels are associated with adverse clinical features and poor outcomes. Cytokine. 2023;169:156289 (Jul 13). doi: 10.1016/j.cyto.2023.156289

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Key clinical point: Serum levels of IL-6 and IL-10 at diagnosis may serve as predictors of treatment response and prognosis in patients with newly diagnosed diffuse large B-cell lymphoma (DLBCL).

Major finding: Patients with partial or no rresponse vs complete response to treatment had significantly higher serum IL-6 (P = .009) and IL-10 (P < .001) levels. High serum IL-6 (≥ 4.5 pg/mL) and IL-10 (≥ 5.0 pg/mL) levels were independent prognostic factors for relapse (adjusted hazard ratio [aHR] 2.524; P = .003, and aHR 1.835; P = .007, respectively) and survival (aHR 2.012; P = .031, and aHR 5.312; P = .017, respectively).

Study details: This single-center retrospective study included 77 patients with newly diagnosed DLBCL and 77 matched control individuals without DLBCL.

Disclosures: This study did not receive any funding. The authors declared no conflicts of interest.

Source: Bao C et al. Cytokine profiles in patients with newly diagnosed diffuse large B-cell lymphoma: IL-6 and IL-10 levels are associated with adverse clinical features and poor outcomes. Cytokine. 2023;169:156289 (Jul 13). doi: 10.1016/j.cyto.2023.156289

Key clinical point: Serum levels of IL-6 and IL-10 at diagnosis may serve as predictors of treatment response and prognosis in patients with newly diagnosed diffuse large B-cell lymphoma (DLBCL).

Major finding: Patients with partial or no rresponse vs complete response to treatment had significantly higher serum IL-6 (P = .009) and IL-10 (P < .001) levels. High serum IL-6 (≥ 4.5 pg/mL) and IL-10 (≥ 5.0 pg/mL) levels were independent prognostic factors for relapse (adjusted hazard ratio [aHR] 2.524; P = .003, and aHR 1.835; P = .007, respectively) and survival (aHR 2.012; P = .031, and aHR 5.312; P = .017, respectively).

Study details: This single-center retrospective study included 77 patients with newly diagnosed DLBCL and 77 matched control individuals without DLBCL.

Disclosures: This study did not receive any funding. The authors declared no conflicts of interest.

Source: Bao C et al. Cytokine profiles in patients with newly diagnosed diffuse large B-cell lymphoma: IL-6 and IL-10 levels are associated with adverse clinical features and poor outcomes. Cytokine. 2023;169:156289 (Jul 13). doi: 10.1016/j.cyto.2023.156289

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Bendamustine plus rituximab improves survival over rituximab plus CVP or CHOP in indolent B-cell lymphoma

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Key clinical point: Compared with rituximab plus cyclophosphamide, vincristine, and prednisone (R-CVP) or cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP), bendamustine plus rituximab (BR) improved survival but led to increased hospital admissions for infections in patients with indolent B-cell lymphoma (BCL).

Major finding: Patients receiving BR vs R-CVP or R-CHOP had a significantly higher 5-year overall survival (80% vs 75%; adjusted hazard ratio 0.79; P < .01) but increased hospital admissions for infections during the first 9 months (21.9% vs 17.3%) and 36 months (41.2% vs 33.6%)  (both P < .01).

Study details: This retrospective real-world cohort study propensity-score matched patients with indolent BCL (mostly follicular lymphoma with other subtypes being marginal zone, lymphoplasmacytic, and small lymphocytic lymphoma, and hairy cell leukemia) who received BR (n = 2032) and those who received R-CVP or R-CHOP (n = 2032).

Disclosures: This study was funded by the Ontario Ministry of Health and the Ministry of Long-Term Care, Canada. The authors declared no conflicts of interest.

Source: Suleman A et al. Outcomes of patients with indolent lymphoma treated with bendamustine plus rituximab compared to rituximab plus CVP or CHOP chemoimmunotherapy in Ontario. Br J Haematol. 2023 (Jul 20). doi: 10.1111/bjh.18972

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Key clinical point: Compared with rituximab plus cyclophosphamide, vincristine, and prednisone (R-CVP) or cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP), bendamustine plus rituximab (BR) improved survival but led to increased hospital admissions for infections in patients with indolent B-cell lymphoma (BCL).

Major finding: Patients receiving BR vs R-CVP or R-CHOP had a significantly higher 5-year overall survival (80% vs 75%; adjusted hazard ratio 0.79; P < .01) but increased hospital admissions for infections during the first 9 months (21.9% vs 17.3%) and 36 months (41.2% vs 33.6%)  (both P < .01).

Study details: This retrospective real-world cohort study propensity-score matched patients with indolent BCL (mostly follicular lymphoma with other subtypes being marginal zone, lymphoplasmacytic, and small lymphocytic lymphoma, and hairy cell leukemia) who received BR (n = 2032) and those who received R-CVP or R-CHOP (n = 2032).

Disclosures: This study was funded by the Ontario Ministry of Health and the Ministry of Long-Term Care, Canada. The authors declared no conflicts of interest.

Source: Suleman A et al. Outcomes of patients with indolent lymphoma treated with bendamustine plus rituximab compared to rituximab plus CVP or CHOP chemoimmunotherapy in Ontario. Br J Haematol. 2023 (Jul 20). doi: 10.1111/bjh.18972

Key clinical point: Compared with rituximab plus cyclophosphamide, vincristine, and prednisone (R-CVP) or cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP), bendamustine plus rituximab (BR) improved survival but led to increased hospital admissions for infections in patients with indolent B-cell lymphoma (BCL).

Major finding: Patients receiving BR vs R-CVP or R-CHOP had a significantly higher 5-year overall survival (80% vs 75%; adjusted hazard ratio 0.79; P < .01) but increased hospital admissions for infections during the first 9 months (21.9% vs 17.3%) and 36 months (41.2% vs 33.6%)  (both P < .01).

Study details: This retrospective real-world cohort study propensity-score matched patients with indolent BCL (mostly follicular lymphoma with other subtypes being marginal zone, lymphoplasmacytic, and small lymphocytic lymphoma, and hairy cell leukemia) who received BR (n = 2032) and those who received R-CVP or R-CHOP (n = 2032).

Disclosures: This study was funded by the Ontario Ministry of Health and the Ministry of Long-Term Care, Canada. The authors declared no conflicts of interest.

Source: Suleman A et al. Outcomes of patients with indolent lymphoma treated with bendamustine plus rituximab compared to rituximab plus CVP or CHOP chemoimmunotherapy in Ontario. Br J Haematol. 2023 (Jul 20). doi: 10.1111/bjh.18972

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Lenalidomide plus R-ESHAP a feasible salvage regimen in relapsed or refractory DLBCL

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Key clinical point: Lenalidomide combined with rituximab + etoposide, cytarabine, cisplatinum, and methylprednisolone (LR-ESHAP) shows promising efficacy and manageable toxicity and is a feasible salvage regimen before autologous stem-cell transplantation in patients with relapsed or refractory diffuse large B-cell lymphoma (DLBCL).

Major finding: The overall and complete response rates were 67% (95% CI 52%-81%) and 35% (95% CI 21%-50%), respectively. At a 41-month median follow-up, the median progression-free, overall, and event-free survival were 16 months (95% CI 4-28), 22 months (95% CI not estimable), and 7 months (95% CI 0-20), respectively. The most common grade ≥3 adverse events were thrombocytopenia (70%) and neutropenia (67%).

Study details: This phase 2 study included 46 adult patients with DLBCL who had relapsed after or were refractory to first-line therapy and received three cycles of LR-ESHAP.

Disclosures: This study was supported by the GELTAMO group (Spain) and Celgene Corporation. Some authors declared receiving consulting fees, research funding, travel support, or honoraria for lectures, presentations, or participation in speakers' bureaus or educational events from various sources, including Celgene. Fourteen authors declared no conflicts of interest.

Source: Martín García-Sancho A et al. Lenalidomide in combination with R-ESHAP in patients with relapsed or refractory diffuse large B-cell lymphoma: A phase 2 study from GELTAMO. Br J Haematol. 2023 (Jul 23). doi: 10.1111/bjh.18989

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Key clinical point: Lenalidomide combined with rituximab + etoposide, cytarabine, cisplatinum, and methylprednisolone (LR-ESHAP) shows promising efficacy and manageable toxicity and is a feasible salvage regimen before autologous stem-cell transplantation in patients with relapsed or refractory diffuse large B-cell lymphoma (DLBCL).

Major finding: The overall and complete response rates were 67% (95% CI 52%-81%) and 35% (95% CI 21%-50%), respectively. At a 41-month median follow-up, the median progression-free, overall, and event-free survival were 16 months (95% CI 4-28), 22 months (95% CI not estimable), and 7 months (95% CI 0-20), respectively. The most common grade ≥3 adverse events were thrombocytopenia (70%) and neutropenia (67%).

Study details: This phase 2 study included 46 adult patients with DLBCL who had relapsed after or were refractory to first-line therapy and received three cycles of LR-ESHAP.

Disclosures: This study was supported by the GELTAMO group (Spain) and Celgene Corporation. Some authors declared receiving consulting fees, research funding, travel support, or honoraria for lectures, presentations, or participation in speakers' bureaus or educational events from various sources, including Celgene. Fourteen authors declared no conflicts of interest.

Source: Martín García-Sancho A et al. Lenalidomide in combination with R-ESHAP in patients with relapsed or refractory diffuse large B-cell lymphoma: A phase 2 study from GELTAMO. Br J Haematol. 2023 (Jul 23). doi: 10.1111/bjh.18989

Key clinical point: Lenalidomide combined with rituximab + etoposide, cytarabine, cisplatinum, and methylprednisolone (LR-ESHAP) shows promising efficacy and manageable toxicity and is a feasible salvage regimen before autologous stem-cell transplantation in patients with relapsed or refractory diffuse large B-cell lymphoma (DLBCL).

Major finding: The overall and complete response rates were 67% (95% CI 52%-81%) and 35% (95% CI 21%-50%), respectively. At a 41-month median follow-up, the median progression-free, overall, and event-free survival were 16 months (95% CI 4-28), 22 months (95% CI not estimable), and 7 months (95% CI 0-20), respectively. The most common grade ≥3 adverse events were thrombocytopenia (70%) and neutropenia (67%).

Study details: This phase 2 study included 46 adult patients with DLBCL who had relapsed after or were refractory to first-line therapy and received three cycles of LR-ESHAP.

Disclosures: This study was supported by the GELTAMO group (Spain) and Celgene Corporation. Some authors declared receiving consulting fees, research funding, travel support, or honoraria for lectures, presentations, or participation in speakers' bureaus or educational events from various sources, including Celgene. Fourteen authors declared no conflicts of interest.

Source: Martín García-Sancho A et al. Lenalidomide in combination with R-ESHAP in patients with relapsed or refractory diffuse large B-cell lymphoma: A phase 2 study from GELTAMO. Br J Haematol. 2023 (Jul 23). doi: 10.1111/bjh.18989

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Idelalisib a favorable treatment option for pretreated relapsed or refractory CLL in the absence of alternatives

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Key clinical point: Idelalisib demonstrated long-term efficacy in heavily pretreated patients with relapsed or refractory chronic lymphocytic leukemia (CLL), and despite having a relatively higher toxicity profile than other targeted therapeutics, can be used in such patients in the absence of alternative therapies.

Major finding: The overall response rate was 65%, with 1 patient achieving complete remission. At a median follow-up of 33.6 months, the median progression-free survival was 16.4 months (95% CI 10.4-26.3), whereas the median overall survival was not reached. Grade ≥ 3 adverse events occurred in 10 patients. The most common serious adverse event was grade ≥ 3 infection (65%).

Study details: This real-world observational retrospective study included 37 patients with CLL (for up to 2.5 years after idelalisib approval in 2014) who had relapsed after or were refractory to ≥ 1 prior lines of therapy and received idelalisib with or without concomitant rituximab.

Disclosures: This study was supported by grants from AFA Insurance (Australia), the Swedish Cancer Society, and others. Three authors declared receiving research grants or honoraria from various sources. The other authors did not have any conflicts of interest to disclose.

Source: Mattsson A et al. Idelalisib (PI3Kδ inhibitor) therapy for patients with relapsed/refractory chronic lymphocytic leukemia: A Swedish nation-wide real-world report on consecutively identified patients. Eur J Haematol. 2023 (Jul 27). doi: 10.1111/ejh.14065

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Key clinical point: Idelalisib demonstrated long-term efficacy in heavily pretreated patients with relapsed or refractory chronic lymphocytic leukemia (CLL), and despite having a relatively higher toxicity profile than other targeted therapeutics, can be used in such patients in the absence of alternative therapies.

Major finding: The overall response rate was 65%, with 1 patient achieving complete remission. At a median follow-up of 33.6 months, the median progression-free survival was 16.4 months (95% CI 10.4-26.3), whereas the median overall survival was not reached. Grade ≥ 3 adverse events occurred in 10 patients. The most common serious adverse event was grade ≥ 3 infection (65%).

Study details: This real-world observational retrospective study included 37 patients with CLL (for up to 2.5 years after idelalisib approval in 2014) who had relapsed after or were refractory to ≥ 1 prior lines of therapy and received idelalisib with or without concomitant rituximab.

Disclosures: This study was supported by grants from AFA Insurance (Australia), the Swedish Cancer Society, and others. Three authors declared receiving research grants or honoraria from various sources. The other authors did not have any conflicts of interest to disclose.

Source: Mattsson A et al. Idelalisib (PI3Kδ inhibitor) therapy for patients with relapsed/refractory chronic lymphocytic leukemia: A Swedish nation-wide real-world report on consecutively identified patients. Eur J Haematol. 2023 (Jul 27). doi: 10.1111/ejh.14065

Key clinical point: Idelalisib demonstrated long-term efficacy in heavily pretreated patients with relapsed or refractory chronic lymphocytic leukemia (CLL), and despite having a relatively higher toxicity profile than other targeted therapeutics, can be used in such patients in the absence of alternative therapies.

Major finding: The overall response rate was 65%, with 1 patient achieving complete remission. At a median follow-up of 33.6 months, the median progression-free survival was 16.4 months (95% CI 10.4-26.3), whereas the median overall survival was not reached. Grade ≥ 3 adverse events occurred in 10 patients. The most common serious adverse event was grade ≥ 3 infection (65%).

Study details: This real-world observational retrospective study included 37 patients with CLL (for up to 2.5 years after idelalisib approval in 2014) who had relapsed after or were refractory to ≥ 1 prior lines of therapy and received idelalisib with or without concomitant rituximab.

Disclosures: This study was supported by grants from AFA Insurance (Australia), the Swedish Cancer Society, and others. Three authors declared receiving research grants or honoraria from various sources. The other authors did not have any conflicts of interest to disclose.

Source: Mattsson A et al. Idelalisib (PI3Kδ inhibitor) therapy for patients with relapsed/refractory chronic lymphocytic leukemia: A Swedish nation-wide real-world report on consecutively identified patients. Eur J Haematol. 2023 (Jul 27). doi: 10.1111/ejh.14065

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Zanubrutinib and obinutuzumab combo shows promise for relapsed or refractory FL

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Key clinical point: Compared with obinutuzumab alone, obinutuzumab combined with zanubrutinib significantly improved outcomes in patients with relapsed or refractory follicular lymphoma (FL) without causing safety concerns.

Major finding: At a median follow-up of 20.2 months, patients receiving zanubrutinib + obinutuzumab vs single-agent obinutuzumab had a significantly higher overall response rate (69% vs 46%; P = .001) and longer median progression-free survival (28.0 vs 10.4 months; hazard ratio 0.50; P < .001). The safety profile of zanubrutinib + obinutuzumab was consistent with the known safety profile of the individual drugs.

Study details: Findings are from the phase 2 ROSEWOOD study including 217 patients with FL who were refractory to or had relapsed after ≥ 2 prior systemic treatments, including an anti-CD20 antibody and alkylating agent, and were randomly assigned to receive zanubrutinib + obinutuzumab (n = 145) or Obinutuzumab alone (n = 72).

Disclosures: This study was sponsored by BeiGene. No information on conflicts of interest was provided.

Source: Zinzani PL et al. ROSEWOOD: A phase II randomized study of zanubrutinib plus obinutuzumab versus obinutuzumab monotherapy in patients with relapsed or refractory follicular lymphoma. J Clin Oncol. 2023 (Jul 28). doi: 10.1200/JCO.23.00775

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Key clinical point: Compared with obinutuzumab alone, obinutuzumab combined with zanubrutinib significantly improved outcomes in patients with relapsed or refractory follicular lymphoma (FL) without causing safety concerns.

Major finding: At a median follow-up of 20.2 months, patients receiving zanubrutinib + obinutuzumab vs single-agent obinutuzumab had a significantly higher overall response rate (69% vs 46%; P = .001) and longer median progression-free survival (28.0 vs 10.4 months; hazard ratio 0.50; P < .001). The safety profile of zanubrutinib + obinutuzumab was consistent with the known safety profile of the individual drugs.

Study details: Findings are from the phase 2 ROSEWOOD study including 217 patients with FL who were refractory to or had relapsed after ≥ 2 prior systemic treatments, including an anti-CD20 antibody and alkylating agent, and were randomly assigned to receive zanubrutinib + obinutuzumab (n = 145) or Obinutuzumab alone (n = 72).

Disclosures: This study was sponsored by BeiGene. No information on conflicts of interest was provided.

Source: Zinzani PL et al. ROSEWOOD: A phase II randomized study of zanubrutinib plus obinutuzumab versus obinutuzumab monotherapy in patients with relapsed or refractory follicular lymphoma. J Clin Oncol. 2023 (Jul 28). doi: 10.1200/JCO.23.00775

Key clinical point: Compared with obinutuzumab alone, obinutuzumab combined with zanubrutinib significantly improved outcomes in patients with relapsed or refractory follicular lymphoma (FL) without causing safety concerns.

Major finding: At a median follow-up of 20.2 months, patients receiving zanubrutinib + obinutuzumab vs single-agent obinutuzumab had a significantly higher overall response rate (69% vs 46%; P = .001) and longer median progression-free survival (28.0 vs 10.4 months; hazard ratio 0.50; P < .001). The safety profile of zanubrutinib + obinutuzumab was consistent with the known safety profile of the individual drugs.

Study details: Findings are from the phase 2 ROSEWOOD study including 217 patients with FL who were refractory to or had relapsed after ≥ 2 prior systemic treatments, including an anti-CD20 antibody and alkylating agent, and were randomly assigned to receive zanubrutinib + obinutuzumab (n = 145) or Obinutuzumab alone (n = 72).

Disclosures: This study was sponsored by BeiGene. No information on conflicts of interest was provided.

Source: Zinzani PL et al. ROSEWOOD: A phase II randomized study of zanubrutinib plus obinutuzumab versus obinutuzumab monotherapy in patients with relapsed or refractory follicular lymphoma. J Clin Oncol. 2023 (Jul 28). doi: 10.1200/JCO.23.00775

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Rituximab plus chemotherapy vs chemotherapy alone improves survival in untreated advanced-stage MCL

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Key clinical point: The addition of rituximab (R) to standard cyclophosphamide, doxorubicine, vincristine, and prednisone (CHOP) first-line therapy significantly prolongs failure-free survival (FFS), overall survival (OS), and the duration of response (DOR) in patients with previously untreated, advanced-stage mantle cell lymphoma (MCL).

Major finding: At a median follow-up of 13.4 years, the R-CHOP vs CHOP group had significantly longer median FFS (2.07 vs 1.36 years; adjusted hazard ratio [aHR] 0.62; P < .0001), OS (5.81 vs 4.84 years; aHR 0.78; P = .039), and DOR (2.08 vs 1.48 years; aHR 0.67; P = .0012). No clinically meaningful differences in late toxicities were observed between the groups.

Study details: This long-term pooled trials analysis of two prospective randomized trials included 385 adult patients with untreated advanced-stage MCL who were randomly assigned to receive CHOP (n = 201) or R-CHOP (n = 184).

Disclosures: This study did not receive any specific funding. Some authors declared serving as advisors, consultants, or board members for or receiving research funding, travel support, or honoraria from various sources.

Source: Fischer L et al on behalf of the German Lymphoma Alliance (GLA) and the German Low-Grade Lymphoma Study Group (GLSG). The addition of rituximab to chemotherapy improves overall survival in mantle cell lymphoma-A pooled trials analysis. Ann Hematol. 2023 (Aug 8). doi: 10.1007/s00277-023-05385-1

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Key clinical point: The addition of rituximab (R) to standard cyclophosphamide, doxorubicine, vincristine, and prednisone (CHOP) first-line therapy significantly prolongs failure-free survival (FFS), overall survival (OS), and the duration of response (DOR) in patients with previously untreated, advanced-stage mantle cell lymphoma (MCL).

Major finding: At a median follow-up of 13.4 years, the R-CHOP vs CHOP group had significantly longer median FFS (2.07 vs 1.36 years; adjusted hazard ratio [aHR] 0.62; P < .0001), OS (5.81 vs 4.84 years; aHR 0.78; P = .039), and DOR (2.08 vs 1.48 years; aHR 0.67; P = .0012). No clinically meaningful differences in late toxicities were observed between the groups.

Study details: This long-term pooled trials analysis of two prospective randomized trials included 385 adult patients with untreated advanced-stage MCL who were randomly assigned to receive CHOP (n = 201) or R-CHOP (n = 184).

Disclosures: This study did not receive any specific funding. Some authors declared serving as advisors, consultants, or board members for or receiving research funding, travel support, or honoraria from various sources.

Source: Fischer L et al on behalf of the German Lymphoma Alliance (GLA) and the German Low-Grade Lymphoma Study Group (GLSG). The addition of rituximab to chemotherapy improves overall survival in mantle cell lymphoma-A pooled trials analysis. Ann Hematol. 2023 (Aug 8). doi: 10.1007/s00277-023-05385-1

Key clinical point: The addition of rituximab (R) to standard cyclophosphamide, doxorubicine, vincristine, and prednisone (CHOP) first-line therapy significantly prolongs failure-free survival (FFS), overall survival (OS), and the duration of response (DOR) in patients with previously untreated, advanced-stage mantle cell lymphoma (MCL).

Major finding: At a median follow-up of 13.4 years, the R-CHOP vs CHOP group had significantly longer median FFS (2.07 vs 1.36 years; adjusted hazard ratio [aHR] 0.62; P < .0001), OS (5.81 vs 4.84 years; aHR 0.78; P = .039), and DOR (2.08 vs 1.48 years; aHR 0.67; P = .0012). No clinically meaningful differences in late toxicities were observed between the groups.

Study details: This long-term pooled trials analysis of two prospective randomized trials included 385 adult patients with untreated advanced-stage MCL who were randomly assigned to receive CHOP (n = 201) or R-CHOP (n = 184).

Disclosures: This study did not receive any specific funding. Some authors declared serving as advisors, consultants, or board members for or receiving research funding, travel support, or honoraria from various sources.

Source: Fischer L et al on behalf of the German Lymphoma Alliance (GLA) and the German Low-Grade Lymphoma Study Group (GLSG). The addition of rituximab to chemotherapy improves overall survival in mantle cell lymphoma-A pooled trials analysis. Ann Hematol. 2023 (Aug 8). doi: 10.1007/s00277-023-05385-1

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AlloSCT leads to long-term remissions in TP53-mutated MCL

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Key clinical point: Allogeneic stem cell transplantation (alloSCT) results in long-term disease control in patients with mantle cell lymphoma (MCL), including those with TP53-mutated disease, and should be considered for earlier use in these high-risk patients who are unresponsive to conventional chemoimmunotherapy.

Major finding: The estimated overall survival rates were 56% (95% CI 36%-72%) at 10 years for the overall cohort and 59% (95% CI 21%-75%) at 4 years for patients with TP53-mutated disease at median follow-ups of 10.8 and 4.2 years, respectively. No relapses were observed in the TP53-mutated subset beyond 6 months after transplantation.

Study details: This retrospective study included 36 patients who underwent alloSCT for MCL, including 13 patients with TP53-mutated disease.

Disclosures: This study did not receive any funding. Some authors declared serving as advisory board members for or receiving honoraria, research funding, or speaker fees from various sources.

Source: Lew TE et al. Allogeneic stem cell transplantation achieves long-term remissions in mantle cell lymphoma, including in TP53-mutated disease. Leuk Lymphoma. 2023 (Aug 2). doi: 10.1080/10428194.2023.2241095

 

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Key clinical point: Allogeneic stem cell transplantation (alloSCT) results in long-term disease control in patients with mantle cell lymphoma (MCL), including those with TP53-mutated disease, and should be considered for earlier use in these high-risk patients who are unresponsive to conventional chemoimmunotherapy.

Major finding: The estimated overall survival rates were 56% (95% CI 36%-72%) at 10 years for the overall cohort and 59% (95% CI 21%-75%) at 4 years for patients with TP53-mutated disease at median follow-ups of 10.8 and 4.2 years, respectively. No relapses were observed in the TP53-mutated subset beyond 6 months after transplantation.

Study details: This retrospective study included 36 patients who underwent alloSCT for MCL, including 13 patients with TP53-mutated disease.

Disclosures: This study did not receive any funding. Some authors declared serving as advisory board members for or receiving honoraria, research funding, or speaker fees from various sources.

Source: Lew TE et al. Allogeneic stem cell transplantation achieves long-term remissions in mantle cell lymphoma, including in TP53-mutated disease. Leuk Lymphoma. 2023 (Aug 2). doi: 10.1080/10428194.2023.2241095

 

Key clinical point: Allogeneic stem cell transplantation (alloSCT) results in long-term disease control in patients with mantle cell lymphoma (MCL), including those with TP53-mutated disease, and should be considered for earlier use in these high-risk patients who are unresponsive to conventional chemoimmunotherapy.

Major finding: The estimated overall survival rates were 56% (95% CI 36%-72%) at 10 years for the overall cohort and 59% (95% CI 21%-75%) at 4 years for patients with TP53-mutated disease at median follow-ups of 10.8 and 4.2 years, respectively. No relapses were observed in the TP53-mutated subset beyond 6 months after transplantation.

Study details: This retrospective study included 36 patients who underwent alloSCT for MCL, including 13 patients with TP53-mutated disease.

Disclosures: This study did not receive any funding. Some authors declared serving as advisory board members for or receiving honoraria, research funding, or speaker fees from various sources.

Source: Lew TE et al. Allogeneic stem cell transplantation achieves long-term remissions in mantle cell lymphoma, including in TP53-mutated disease. Leuk Lymphoma. 2023 (Aug 2). doi: 10.1080/10428194.2023.2241095

 

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Combination of MIPI, Ki-67, and p53 expression defines a high-risk group in MCL

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Key clinical point: The combination of the prognostic mantle cell lymphoma (MCL) International Prognostic Index (MIPI) with biological risk factors Ki-67 and p53 expression identifies a subset of patients with MCL having poor prognosis.

Major finding: Patients with high combined MIPI (MIPI-c) or p53 expression > 50% (high-risk disease) vs low, low-intermediate, or high-intermediate MIPI-c and p53 expression ≤ 50% (low-risk disease) had significantly shorter median failure-free survival (hazard ratio [HR] 2.97) and overall survival (HR 3.69) at median follow-ups of 9.6 and 9.4 years, respectively (both P < .0001). The results were confirmed in validation cohorts.

Study details: The training cohort included 684 patients with MCL from the MCL-Younger and MCL-Elderly trials with evaluable data for Ki-67 or p53; patients were classified as having high-risk or low-risk disease. The validation cohorts included 230 and 44 patients from the MCL0208 and Nordic-MCL4 trials, respectively.

Disclosures: This study did not receive any funding. Some authors declared serving on advisory boards or speakers’ bureaus of or receiving research funding, consultancy fees, or honoraria from various sources.

Source: Scheubeck G et al. Clinical outcome of mantle cell lymphoma patients with high-risk disease (high-risk MIPI-c or high p53 expression). Leukemia. 2023;37(9):1887-1894 (Jul 26). doi: 10.1038/s41375-023-01977-y

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Key clinical point: The combination of the prognostic mantle cell lymphoma (MCL) International Prognostic Index (MIPI) with biological risk factors Ki-67 and p53 expression identifies a subset of patients with MCL having poor prognosis.

Major finding: Patients with high combined MIPI (MIPI-c) or p53 expression > 50% (high-risk disease) vs low, low-intermediate, or high-intermediate MIPI-c and p53 expression ≤ 50% (low-risk disease) had significantly shorter median failure-free survival (hazard ratio [HR] 2.97) and overall survival (HR 3.69) at median follow-ups of 9.6 and 9.4 years, respectively (both P < .0001). The results were confirmed in validation cohorts.

Study details: The training cohort included 684 patients with MCL from the MCL-Younger and MCL-Elderly trials with evaluable data for Ki-67 or p53; patients were classified as having high-risk or low-risk disease. The validation cohorts included 230 and 44 patients from the MCL0208 and Nordic-MCL4 trials, respectively.

Disclosures: This study did not receive any funding. Some authors declared serving on advisory boards or speakers’ bureaus of or receiving research funding, consultancy fees, or honoraria from various sources.

Source: Scheubeck G et al. Clinical outcome of mantle cell lymphoma patients with high-risk disease (high-risk MIPI-c or high p53 expression). Leukemia. 2023;37(9):1887-1894 (Jul 26). doi: 10.1038/s41375-023-01977-y

Key clinical point: The combination of the prognostic mantle cell lymphoma (MCL) International Prognostic Index (MIPI) with biological risk factors Ki-67 and p53 expression identifies a subset of patients with MCL having poor prognosis.

Major finding: Patients with high combined MIPI (MIPI-c) or p53 expression > 50% (high-risk disease) vs low, low-intermediate, or high-intermediate MIPI-c and p53 expression ≤ 50% (low-risk disease) had significantly shorter median failure-free survival (hazard ratio [HR] 2.97) and overall survival (HR 3.69) at median follow-ups of 9.6 and 9.4 years, respectively (both P < .0001). The results were confirmed in validation cohorts.

Study details: The training cohort included 684 patients with MCL from the MCL-Younger and MCL-Elderly trials with evaluable data for Ki-67 or p53; patients were classified as having high-risk or low-risk disease. The validation cohorts included 230 and 44 patients from the MCL0208 and Nordic-MCL4 trials, respectively.

Disclosures: This study did not receive any funding. Some authors declared serving on advisory boards or speakers’ bureaus of or receiving research funding, consultancy fees, or honoraria from various sources.

Source: Scheubeck G et al. Clinical outcome of mantle cell lymphoma patients with high-risk disease (high-risk MIPI-c or high p53 expression). Leukemia. 2023;37(9):1887-1894 (Jul 26). doi: 10.1038/s41375-023-01977-y

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Final phase 2 results favor acalabrutinib therapy in relapsed or refractory MCL

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Key clinical point: Acalabrutinib demonstrates favorable long-term efficacy and safety in patients with relapsed or refractory mantle cell lymphoma (MCL), including those with poor prognostic factors.

Major finding: The overall and complete response rates were 81.5% (95% CI 73.5%-87.9%) and 47.6% (95% CI 38.5%-56.7%), respectively. After a 38.1-month median follow-up, median duration of response and progression-free survival were 28.6 (95% CI 17.5-39.1) and 22.0 (95% CI 16.6-33.3) months, respectively. No new safety signals were observed.

Study details: The data represent the final results of the phase 2 ACE-LY-004 study of 124 adult patients with MCL, including those with poor prognostic factors, such as blastoid or pleomorphic morphology and Ki-67 index of >30%, who relapsed after or were refractory to ≤ 5 previous therapies and received acalabrutinib twice daily.

Disclosures: This study was funded by AstraZeneca. Some authors declared serving as consultants, advisors, or speakers for and receiving research funds or travel or accommodation expenses from various sources, including AstraZeneca. Two authors declared being employees or equity holders of AstraZeneca.

Source: Le Gouill S et al. Final results and overall survival data from a phase II study of acalabrutinib monotherapy in patients with relapsed/refractory mantle cell lymphoma, including those with poor prognostic factors. Haematologica. 2023 (Jul 20). doi: 10.3324/haematol.2022.282469

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Key clinical point: Acalabrutinib demonstrates favorable long-term efficacy and safety in patients with relapsed or refractory mantle cell lymphoma (MCL), including those with poor prognostic factors.

Major finding: The overall and complete response rates were 81.5% (95% CI 73.5%-87.9%) and 47.6% (95% CI 38.5%-56.7%), respectively. After a 38.1-month median follow-up, median duration of response and progression-free survival were 28.6 (95% CI 17.5-39.1) and 22.0 (95% CI 16.6-33.3) months, respectively. No new safety signals were observed.

Study details: The data represent the final results of the phase 2 ACE-LY-004 study of 124 adult patients with MCL, including those with poor prognostic factors, such as blastoid or pleomorphic morphology and Ki-67 index of >30%, who relapsed after or were refractory to ≤ 5 previous therapies and received acalabrutinib twice daily.

Disclosures: This study was funded by AstraZeneca. Some authors declared serving as consultants, advisors, or speakers for and receiving research funds or travel or accommodation expenses from various sources, including AstraZeneca. Two authors declared being employees or equity holders of AstraZeneca.

Source: Le Gouill S et al. Final results and overall survival data from a phase II study of acalabrutinib monotherapy in patients with relapsed/refractory mantle cell lymphoma, including those with poor prognostic factors. Haematologica. 2023 (Jul 20). doi: 10.3324/haematol.2022.282469

Key clinical point: Acalabrutinib demonstrates favorable long-term efficacy and safety in patients with relapsed or refractory mantle cell lymphoma (MCL), including those with poor prognostic factors.

Major finding: The overall and complete response rates were 81.5% (95% CI 73.5%-87.9%) and 47.6% (95% CI 38.5%-56.7%), respectively. After a 38.1-month median follow-up, median duration of response and progression-free survival were 28.6 (95% CI 17.5-39.1) and 22.0 (95% CI 16.6-33.3) months, respectively. No new safety signals were observed.

Study details: The data represent the final results of the phase 2 ACE-LY-004 study of 124 adult patients with MCL, including those with poor prognostic factors, such as blastoid or pleomorphic morphology and Ki-67 index of >30%, who relapsed after or were refractory to ≤ 5 previous therapies and received acalabrutinib twice daily.

Disclosures: This study was funded by AstraZeneca. Some authors declared serving as consultants, advisors, or speakers for and receiving research funds or travel or accommodation expenses from various sources, including AstraZeneca. Two authors declared being employees or equity holders of AstraZeneca.

Source: Le Gouill S et al. Final results and overall survival data from a phase II study of acalabrutinib monotherapy in patients with relapsed/refractory mantle cell lymphoma, including those with poor prognostic factors. Haematologica. 2023 (Jul 20). doi: 10.3324/haematol.2022.282469

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