Mantle Cell, Follicular, and Other Indolent B-Cell Lymphoma—Clinical Studies: Novel Therapy and Prognostic Markers in Follicular Lymphoma

Monday, December 5, 2016: 4:30 PM-6:00 PM
Moderators:
Frederick Lansigan, MD, Dartmouth-Hitchcock Medical Center and John Kuruvilla, MD, Princess Margaret Cancer Centre
 
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Eva Kimby, MD, professor1, Stephanie Rondeau, MSc2*, Anna Vanazzi, MD3*, Bjorn Ostenstad, MD, PhD4*, Ulrich J.M. Mey, MD5, Daniel Rauch, MD6*, Björn E Wahlin, MD, PhD1, Felicitas Hitz, MD7*, Micaela Hernberg, MD8*, Ann-Sofie Johansson, MD9*, Peter de Nully Brown, MD, PhD10*, Hans Hagberg, MD, PhD11*, Andres J.M. Ferreri, MD, professor12, Andreas Lohri, MD, professor13, Urban Novak, MD14*, Thilo Zander, MD15*, Hanne Bersvendsen, MD16*, Mario Bergetzi, MD17*, Walter Mingrone, MD18*, Fatime Krasniqi, MD, PhD19*, Stefan Dirnhofer, MD, professor20*, Hanne Hawle, MD2*, Simona Berardi, PhD2*, Michele Ghielmini, MD, professor21 and Emanuele Zucca21

1Karolinska University Hospital, Stockholm, Sweden
2SAKK Coordinating Center, Bern, Switzerland
3European Institute of Oncology, Milano, Italy
4Oslo University Hospital, Oslo, Norway
5Kantonshospital Graubuenden, Chur, Switzerland
6Spital Thun Simmenthal, Thun, Switzerland
7Kantonsspital St.Gallen, St.Gallen, Switzerland
8Helsinki University Central Hospital, Helsingki, Finland
9Norrlands Universitetssjukhus, Umeå, Sweden
10Rigshospitalet, Copenhagen, Denmark
11Oncology, Uppsala university hospital, Uppsala, Sweden
12San Raffaele Hospital, Milano, Italy
13Dept. of Oncology/Hematology, Medical University Clinic, Liestal, Switzerland
14Universitatsspital Bern, Bern, Switzerland
15Luzerner Kantonsspital, Luzern, Switzerland
16Universitetssykehuseti Nord-Norge, Tromsoe, Norway
17Kantonsspital Aarau, Switzerland, Aarau, Switzerland
18Kantonsspital Olten, Olten, Switzerland
19University Hospital Basel, Basel, Switzerland
20University Institute of Pathology, Basel, Switzerland
21Oncology Institute of Southern Switzerland, Bellinzona, Switzerland

Conclusions: The SAKK 35/10 randomized trial confirmed that lenalidomide plus rituximab is an active and feasible initial treatment for FL pts in need of therapy. Addition of lenalidomide significantly increased the CR/CRu rate at week 23 (primary endpoint) and was maintained throughout 30 months. Although the trial was not powered to detect survival differences (secondary endpoints), a significantly better TTNT and a trend towards prolonged PFS and CR duration was seen in the combination arm. The excellent overall survival in both arms suggests that chemotherapy-free strategies should be further explored.
 
 
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Elise A. Chong, Jakub Svoboda, Sunita Dwivedy Nasta, David L. Porter, et al. 

CONCLUSIONS: These results suggest that a single treatment with CTL019 cells with no subsequent therapy has efficacy in FL and can improve time to next treatment compared with prior therapy in patients with poor prognosis, relapsed or refractory FL.

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Anne Ségolène Cottereau, Annibale Versari, Loïc Chartier, Jehan Dupuis, et al.

Conclusions:  SUVmax and β2 microglobulin are readily available parameters at staging. A low SUVmax observed on a baseline PET or an elevated β2 microglobulin is predictive of progression in patients with high tumor burden follicular lymphoma having received R-chemotherapy. The risk of progressive disease increases when patients have both these risk factors, and such patients deserve special consideration in treatment planning and follow-up.

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Christopher Flowers, Fang-Shu Ou, Qian Shi, Eva Hoster, et al.

Conclusions: FL pts > 70 yrs treated on trials have similar early disease outcomes to younger patients.  There is no disease-specific outcome difference between age groups.  Age alone should not disqualify patients from standard treatments or RCTs.

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Andrew J Davies, Biljana Mihaljevic, Santiago Mercadal, Georgi Mihaylovet al. 

Conclusions: Overall, there were no new clinically relevant safety signals observed with RSC and the safety profile was comparable to that of RIV. Response rates as well as PFS and OS data for rituximab SC were comparable to rituximab IV and indicate that the anti-lymphoma activity of rituximab is not impaired when given subcutaneously. The availability of RSC administration over approximately 6 minutes has positive implications for patient and healthcare professional convenience, as well as healthcare resource savings, without compromising efficacy or safety. 

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Sean I. Tracy, Matthew J Maurer, Thomas E. Witzig, Matthew T. Drake, et al.

Conclusions:  We confirm previous findings that vitamin D insufficiency is associated with adverse long-term prognosis among patients with FL treated with IC, and extend these findings to patients who are initially observed or treated with other therapies.  For the first time, we observed an association of vitamin D insufficiency with early clinical failure, suggesting a potentially modifiable factor to address in this subset of patients with poor outcomes.  Whether treating VDI improves outcomes in FL warrants assessment.