Single-agent lenalidomide is active in patients with relapsed or refractory aggressive non-Hodgkin lymphoma who received prior stem cell transplantation

Br J Haematol. 2013 Sep;162(5):639-47. doi: 10.1111/bjh.12449. Epub 2013 Jul 9.

Abstract

Patients with aggressive non-Hodgkin lymphoma (NHL) who relapse after autologous stem cell transplantation (ASCT) have a poor prognosis. Additional therapy is often poorly tolerated, and new treatment modalities are needed. This efficacy and safety study was a retrospective analysis of two phase II trials (NHL-002 and NHL-003) that studied single-agent lenalidomide in patients with relapsed/refractory aggressive NHL with prior (n = 87) compared with no prior ASCT (n = 179). The overall response rate in the ASCT group was 39% [14% complete response (CR)], including 29% in patients with diffuse large B-cell lymphoma, 63% in mantle cell lymphoma, and 60% in transformed lymphoma. The timing of transplant relative to receiving lenalidomide had no effect on outcomes. Median progression-free survival for the ASCT group was 3·7 months (16·9 months for patients in CR; 7·3 months for partial responders) at a median 12·5-month follow-up. Median response duration was 7·9 months. Regardless of prior ASCT, lenalidomide monotherapy was efficacious in heavily pretreated patients with aggressive, relapsed/refractory NHL, with a safety profile that was consistent with prior studies of single-agent lenalidomide.

Trial registration: ClinicalTrials.gov NCT00765245 NCT00799513 NCT00907348 NCT01021423 NCT01035463.

Keywords: autologous stem cell transplantation; lenalidomide; non-Hodgkin lymphoma.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Angiogenesis Inhibitors / adverse effects
  • Angiogenesis Inhibitors / therapeutic use*
  • Combined Modality Therapy
  • Disease Progression
  • Drug Evaluation / methods
  • Female
  • Hematopoietic Stem Cell Transplantation / methods*
  • Humans
  • Lenalidomide
  • Lymphoma, Non-Hodgkin / drug therapy*
  • Lymphoma, Non-Hodgkin / therapy
  • Male
  • Middle Aged
  • Recurrence
  • Retrospective Studies
  • Thalidomide / adverse effects
  • Thalidomide / analogs & derivatives*
  • Thalidomide / therapeutic use
  • Treatment Outcome
  • Young Adult

Substances

  • Angiogenesis Inhibitors
  • Thalidomide
  • Lenalidomide

Associated data

  • ClinicalTrials.gov/NCT00765245
  • ClinicalTrials.gov/NCT00799513
  • ClinicalTrials.gov/NCT00907348
  • ClinicalTrials.gov/NCT01021423
  • ClinicalTrials.gov/NCT01035463