Recent Advances in the Treatment of Non-Hodgkin’s Lymphomas

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  • 1 Presented by Jeremy S. Abramson, MD, Clinical Director, Lymphoma Program, Massachusetts General Hospital Cancer Center, Boston, Massachusetts, and Andrew D. Zelenetz, MD, PhD, Vice Chair of Medical Informatics, Memorial Sloan-Kettering Cancer Center, New York, New York.
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Non-Hodgkin’s lymphomas (NHL) represent a diverse set of diseases, with different treatment pathways based on the stage and type of hematologic cancer. In their presentation at the NCCN 18th Annual Conference, Dr. Jeremy Abramson and Dr. Andrew D. Zelenetz discuss 3 specific B-cell NHLs: follicular lymphoma, mantle cell lymphoma, and chronic lymphocytic leukemia. They provided an overview of the treatment strategies for patients with these hematologic malignancies, and offered highlights from recent clinical trials supporting these recommendations.

Correspondence: Jeremy S. Abramson, MD, Massachusetts General Hospital Cancer Center, Yawkey Center for Outpatient Care, Mailstop: Yawkey 9A, 32 Fruit Street, Boston, MA 02114. E-mail: jabramson@partners.org

Dr. Abramson has revealed that he has served as a consultant for Seattle Genetics. Dr. Zelenetz has revealed that he receives clinical research support from Abbott Laboratories; Celgene Corporation; Cephalon, Inc.; Genentech, Inc.; GlaxoSmithKline; Millennium Pharmaceuticals, Inc.; Onyx Pharmaceuticals, Inc.; Allos Pharm; Calistoga, Pharmacyclics; Plexxikon; Roche; and Seattle Genetics and serves on an advisory board or as a consultant for Abbott Laboratories; Celgene Corporation; Cell Therapeutics, Inc.; Cephalon, Inc.; Genentech, Inc.; GlaxoSmithKline; Allos; Cancer Genetics; Gilead; Seattle Genetics; Roche Laboratories, Inc.; and sanofi-aventis U.S.

Andrew D. Zelenetz, MD, PhD, Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, Box 330, New York, NY 10065. E-mail: a-zelenetz@ski.mskcc.org

  • 1.

    Federico M, Luminari S, Dondi A. R-CVP versus R-CHOP versus R-FM as first-line therapy for advanced-stage follicular lymphoma: final results of FOLL05 trial from the FondazioneItalianaLinfomi (FIL). J ClinOncol 2013; in press.

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  • 2.

    Rummel MJ, Niederle N, Maschmeyer G. Bendamustine plus rituximab versus CHOP plus rituximab as first-line treatment for patients with indolent and mantle-cell lymphomas: an open-label, multicenter, randomized, phase 3 non-inferiority trial. Lancet 2013; in press.

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  • 3.

    Salles G, Seymour JF, Offner F. Rituximab maintenance for 2 years in patients with high tumour burden follicular lymphoma responding to rituximab plus chemotherapy (PRIMA): a phase 3, randomized controlled trial. Lancet 2011;377:4251.

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  • 4.

    Leonard J, Jung S-H, Johnson JL. CALGB 50401: a randomized trial of lenalidomide alone versus lenalidomide plus rituximab in patients with recurrent follicular lymphoma [abstract]. J ClinOncol 2012;30(Suppl): Abstract 8000.

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  • 5.

    Geisler CH, Kolstad A, Laurell A. Nordic MCL2 trial update: six-year follow-up after intensive immunochemotherapy for untreated mantle cell lymphoma followed by BEAM or BEAC + autologous stem-cell support: still very long survival but late relapses do occur. Br J Haematol 2012;158:815816.

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  • 6.

    Hermine O, Hoster E, Walewski J. Alternating courses of 3x CHOP and 3x DHAP plus rituximab followed by a high dose ARA-C containing myeloablative regimen and autologous stem cell transplantation (ASCT) increases overall survival when compared to 6 courses of CHOP plus rituximab followed by myeloablative radiochemotherapy and ASCT in mantle cell lymphoma: final analysis of the MCL Younger Trial of the European Mantle Cell Lymphoma Network (MCL net) [abstract]. Blood 2012;120: Abstract 151.

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  • 7.

    Kluin-Nelemans HC, Hoster E, Hermine O. Treatment of older patients with mantle-cell lymphoma. N Engl J Med 2012;367:520531.

  • 8.

    Rummel MJ, Niederle N, Maschmeyer G. Bendamustine plus rituximab (B-R) versus CHOP plus rituximab (CHOP-R) as first-line treatment in patients with indolent and mantle cell lymphomas (MCL): updated results from the StiL NHL1 study. Lancet 2013; in press.

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  • 9.

    Hallek M, Cheson BD, Catovsky D. Guidelines for the diagnosis and treatment of chronic lymphocytic leukemia: a report from the International Workshop on Chronic Lymphocytic Leukemia updating the National Cancer Institute-Working Group 1996 guidelines. Blood 2008;111:54465456.

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  • 10.

    Wierda WG, O‘Brien S, Wang X. Multivariable model for time to first treatment in patients with chronic lymphocytic leukemia. J ClinOncol 2011;29:40884095.

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  • 11.

    Miller MD, Paradis CF, Houck PR. Rating chronic medial illness burden in geropsychiatric practice and research: application of the Cumulative Illness Rating Scale. Psychiatry Res 1992;41:237248.

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  • 12.

    Hallek M, Fischer K, Fingerle-Rowson G. Addition of rituximab to fludarabine and cyclophosphamide in patients with chronic lymphocytic leukaemia: a randomized, open-label, phase 3 trial. Lancet 2010;376:11641174.

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  • 13.

    Byrd JC, Furman RR, Coutre S. The Bruton‘s tyrosine kinase (BTK) inhibitor ibrutinib (PCI-32765) promotes high response rate, durable remissions, and is tolerable in treatment naive (TN) and relapsed or refractory (RR) chronic lymphocytic leukemia (CLL) or small lymphocytic lymphoma (SLL) patients including patients with high-risk (HR) disease: new and updated results of 116 patients in a phase Ib/II study [abstract]. Blood 2012;120: Abstract 189.

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