Mantle Cell, Follicular, and Other Indolent B-Cell Lymphoma—Clinical Studies: Antibodies, Immunomodulators, and BTK Inhibitors in Indolent NHL

445 AUGMENT: A Phase III Randomized Study of Lenalidomide Plus Rituximab (R2) Vs Rituximab/Placebo in Patients with Relapsed/Refractory Indolent Non-Hodgkin Lymphoma

John P. Leonard, et al.

The Abstract concludes: R2 demonstrated superior efficacy over rituximab monotherapy (plus placebo) as measured by the primary endpoint of progression-free survival as well as secondary endpoints of ORR, CR, DOR, and TTNLT in patients with R/R FL grade 1-3a and MZL. At this early analysis, fewer deaths have been observed in the R2 arm. Despite additional hematologic toxicity, greater efficacy of the R2 regimen (and fewer early progressions) allowed more patients to complete the planned therapy and delayed the need for subsequent treatment. R2 represents an important new treatment option in patients with previously treated FL/MZL, with meaningful advantages over single-agent rituximab.

 

446  A Phase II Lysa Study of Obinutuzumab Combined with Lenalidomide for Advanced Untretated Follicular B-Cell Lymphoma in Need of Systemic Therapy

Franck Morschhauser, et al.

The Abstract concludes: The immunomodulatory GALEN regimen is highly effective with no unexpected toxicity in advanced, untreated FL pts in need of systemic therapy and has the potential to challenge immunochemotherapy in this setting.

 

447  Safety and Efficacy of Ibrutinib in Combination with Rituximab and Lenalidomide in Previously Untreated Subjects with Follicular and Marginal Zone Lymphoma: An Open Label, Phase II Study

Loretta J. Nastoupil, et al.

The Abstract concludes: Ibrutinib in combination with rituximab and lenalidomide for untreated FL and MZL was associated with promising efficacy. The toxicity profile was manageable. Modification of lenalidomide dose did not significantly impact the incidence of grade 3 or higher rash. Biomarkers are underway to identify patients most likely to benefit from triplet therapy.

 

448  Chemotherapy-Free Combination of Obinutuzumab and Ibrutinib in First LINE Treatment of Follicular Lymphoma. the Alternative Study By the German Low Grade Lymphoma Study Group (GLSG)

Christian Schmidt, et al.

The Abstract concludes: The chemotherapy – free combination of ibrutinib and obinutuzumab showed high anti-lymyphoma activity with high overall response rates and a high proportion of MRD negativity at one year. While the combination of ibrutinib and obinutuzumab was associated with a low toxicity profile, the combination was inferior to the published results of conventional immunochemotherapies in terms of the primary efficacy endpoint (1-year-PFS).
Further evaluations might demonstrate whether subgroups exist which particularly benefit clinically from this low toxicity regime.

 

449  Avadomide (CC-122), a Novel Cereblon Modulating Agent, in Combination with Obinutuzumab (GA101) in Patients with Relapsed or Refractory B-Cell Non-Hodgkin Lymphoma

Jean-Marie Michot, et al.

The Abstract concludes: Avadomide given in combination with obinutuzumab was well-tolerated and demonstrated promising clinical activity, with encouraging response rates and mPFS observed in pts with R/R FL, irrespective of their disease risk status. Avadomide plus obinutuzumab may provide a new chemotherapy-free treatment option for pts with R/R FL failing standard therapies.

 

450  Results of the Primary Analysis of Complement A+B: A Phase III Study of Ofatumumab in Combination with Bendamustine Versus Bendamustine Alone in Patients with Indolent Non-Hodgkin's Lymphoma That Is Unresponsive Following Rituximab or Rituximab-Containing Regimen

Mathias J Rummel, et al.

The Abstract concludes:  No significant improvement in PFS was seen with OFA+Benda as compared with Benda alone for patients with RTX-refractory iNHL. The safety profile for OFA was consistent with prior experience. The difference in outcomes compared to those in the GADOLIN trial (Sehn, 2016) could be due to the differences in drug exposure as patients in the GADOLIN study received maintenance anti-CD 20 therapy for up to 2 years; in the patient population as approximately 80% had FL in GADOLIN versus 69% in COMPLEMENT A+B; and in the mechanism of action of type-1 versus type-2 monoclonal antibody.