Lessons From ASH 2010: A Focus on NHL

Restricted access
At the 52nd Annual Meeting and Exposition of ASH in December, some 881 abstracts included information on Hodgkin lymphoma (HL) or non-Hodgkin lymphoma (NHL), with at least 363 on chronic lymphocytic leukemia (CLL). This brief summary discusses some of the important findings that will begin to impact practice.Follicular LymphomaOverall survival (OS) for patients with follicular lymphoma (FL) has improved since the introduction of rituximab. Data have shown that for patients who need treatment, rituximab added to chemotherapy improves overall response (OR) and complete response (CR) rates, progression-free survival (PFS), and OS.1–4In an update of the Primary RItuximab and MAintenance (PRIMA) trial, Salles et al.5 enrolled patients with untreated, high tumor-burden FL. Patients were treated with 1 of 3 regimens (R-CHOP, R-CVP, or R-FCM) at the discretion of the treating physician. Patients with a partial response or CR were randomized to observation or maintenance with rituximab, 375 mg/m2, once every 8 weeks for 2 years. At a median of 42 months after registration, the 36-month PFS was 75% in the maintenance arm versus 58% in the observation arm, which met the primary end point of a 45% improvement in median PFS. The only safety issue was a slight increase in risk of infection in the maintenance group.In a subanalysis of the PRIMA study, Trotman et al.6 examined the role of FDG-PET imaging to predict outcome in FL. At diagnosis, 99% (119/120) of PET scans were positive, demonstrating their utility for initial diagnosis. Among 124 patients who underwent...

Andrew D. Zelenetz, MD, PhD, is Chief of the Lymphoma Service, Division of Hematology/Oncology, Memorial Sloan-Kettering Cancer Center. His research focuses on improving clinical outcomes in lymphoma and on the molecular mechanisms of non-Hodgkin lymphoma.Dr. Zelenetz received his BA and PhD from Harvard University and his MD from Harvard Medical School. His internship and residency were completed at Stanford University Medical Center.Dr. Zelenetz is a member of ASH, ASCO, and the American College of Physicians. He participates in various committees: he is Vice Chairperson of the Cancer and Leukemia Group B Lymphoma Core Committee, Chair of the NCCN Non-Hodgkin's Lymphoma Panel, Board Member of the Leukemia and Lymphoma Society, and a member of the Lymphoma Research Foundation Scientific Advisory Board. He has been the recipient of the Memorial Sloan-Kettering Fellowship Teaching Excellence Award multiple times.Throughout his career, his research has been published in such journals as Blood, The Journal of Clinical Oncology, and Clinical Cancer Research.
  • 1.

    FisherRILeBlancMPressOW. New treatment options have changed the survival of patients with follicular lymphoma. J Clin Oncol2005;23:84478452.

    • Search Google Scholar
    • Export Citation
  • 2.

    HiddemannWKnebaMDreylingM. Frontline therapy with rituximab added to the combination of cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP) significantly improves the outcome for patients with advanced-stage follicular lymphoma compared with therapy with CHOP alone: results of a prospective randomized study of the German Low-Grade Lymphoma Study Group. Blood2005;106:37253732.

    • Search Google Scholar
    • Export Citation
  • 3.

    LiuQFayadLCabanillasF. Improvement of overall and failure-free survival in stage IV follicular lymphoma: 25 years of treatment experience at The University of Texas M.D. Anderson Cancer Center. J Clin Oncol2006;24:15821589.

    • Search Google Scholar
    • Export Citation
  • 4.

    MarcusRImrieKSolal-CelignyP. Phase III study of R-CVP compared with cyclophosphamide, vincristine, and prednisone alone in patients with previously untreated advanced follicular lymphoma. J Clin Oncol2008;26:45794586.

    • Search Google Scholar
    • Export Citation
  • 5.

    SallesGACatalanoJFeugierP. Updated results of the PRIMA study confirms the benefit of 2-years rituximab maintenance in follicular lymphoma patients responding to iImmunochemotherapy [abstract]. Blood2010;116:Abstract 1788.

    • Search Google Scholar
    • Export Citation
  • 6.

    TrotmanJFournierMLamyT. Result of FDG PET-CT imaging after immunochemotherapy induction is a powerful and independent prognostic indicator of outcome for patients with follicular lymphoma: an analysis from the PRIMA study [abstract]. Blood2010;116:Abstract 855.

    • Search Google Scholar
    • Export Citation
  • 7.

    HagenbeekARadfordJVan HoofA. 90Y-Ibritumomab tiuxetan (Zevalin) consolidation of first remission In advanced-stage follicular non-Hodgkin's lymphoma: updated results after a median follow-up of 66.2 months from the international, randomized, phase III First-Line Indolent Trial (FIT) in 414 patients [abstract]. Blood2010;116:Abstract 594.

    • Search Google Scholar
    • Export Citation
  • 8.

    ArdeshnaKMQianWSmithP. An Intergroup randomised trial of rituximab versus a watch and wait strategy in patients with stage II, III, IV, asymptomatic, non-bulky follicular lymphoma (grades 1, 2 and 3a). A preliminary analysis [abstract]. Blood2010;116:Abstract 6.

    • Search Google Scholar
    • Export Citation
  • 9.

    KedmiMHedvatCVMaraguliaJZelenetzAD. Low proliferation index may be associated with longer time to first therapy in low grade follicular lymphoma [abstract]. Blood2010;116:Abstract 4149.

    • Search Google Scholar
    • Export Citation
  • 10.

    CoiffierBOsmanovEHongX. A phase 3 trial comparing bortezomib plus rituximab with rituximab alone in patients with relapsed, rituximab-naive or -sensitive, follicular lymphoma [abstract]. Blood2010;116:Abstract 857.

    • Search Google Scholar
    • Export Citation
  • 11.

    HermineOHosterEWalewskiJ. 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) is superior to 6 courses CHOP plus rituximab followed by myeloablative radiochemotherapy and ASCT in mantle cell lymphoma: results of the MCL Younger Trial of the European Mantle Cell Lymphoma Network (MCL net) [abstract]. Blood2010;116:Abstract 110.

    • Search Google Scholar
    • Export Citation
  • 12.

    MoskowitzCHamlinPAJrMaraguliaJ. Sequential dose-dense RCHOP followed by ICE consolidation (MSKCC protocol 01-142) without radiotherapy for patients with primary mediastinal large B cell lymphoma [abstract]. Blood2010;116:Abstract 420.

    • Search Google Scholar
    • Export Citation
  • 13.

    GordonLIHongFFisherRI. A randomized phase III trial of ABVD Vs. Stanford V +/- radiation therapy in locally extensive and advanced stage hodgkin's lymphoma: an Intergroup study coordinated by the Eastern Cooperatve Oncology Group (E2496) [abstract]. Blood2010;116:Abstract 415.

    • Search Google Scholar
    • Export Citation
  • 14.

    AdvaniRHongFFisherRI. Randomized phase III trial comparing ABVD + radiotherapy and the Stanford V regimen in patients with stage I/II bulky mediastinal Hodgkin lymphoma: a subset analysis of the US Intergroup trial E2496 [abstract]. Blood2010;116:Abstract 416.

    • Search Google Scholar
    • Export Citation
  • 15.

    BollBGorgenHFuchsM. Feasibility and efficacy of ABVD in elderly Hodgkin lymphoma patients: analysis of two randomized prospective multicenter trials of the German Hodgkin Study Group (HD10 and HD11) [abstract]. Blood2010;116:Abstract 418.

    • Search Google Scholar
    • Export Citation
  • 16.

    ChenRGopalAKSmithSE. Results of a pivotal phase 2 study of brentuximab vedotin (SGN-35) in patients with relapsed or refractory Hodgkin lymphoma [abstract]. Blood2010;116:Abstract 283.

    • Search Google Scholar
    • Export Citation
  • 17.

    SibonDFournierMBriereJ. Prognostic factors and long term outcome of 138 adults with systemic anaplastic large-cell lymphoma: a retrospective study by the Groupe d'Etude Des Lymphomes De l'Adulte (GELA) [abstract]. Blood2010;116:Abstract 322.

    • Search Google Scholar
    • Export Citation
  • 18.

    ShustovARAdvaniRBriceP. Complete remissions with brentuximab vedotin (SGN-35) in patients with relapsed or refractory systemic anaplastic large cell lymphoma [abstract]. Blood2010;116:Abstract 961.

    • Search Google Scholar
    • Export Citation
  • 19.

    CoiffierBProBPrinceHM. Final results from a pivotal, multicenter, international, open-label, phase 2 study of romidepsin in progressive or relapsed peripheral t-cell lymphoma (PTCL) following prior systemic therapy [abstract]. Blood2010;116:Abstract 114.

    • Search Google Scholar
    • Export Citation
  • 20.

    FowlerNSharmanJPSmithSM. The Btk inhibitor, PCI-32765, induces durable responses with minimal toxicity in patients with relapsed/refractory B-cell malignancies: results from a phase I study [abstract]. Blood2010;116:Abstract 964.

    • Search Google Scholar
    • Export Citation
  • 21.

    BurgerJAO'BrienSFowlerN. The Bruton's tyrosine kinase inhibitor, PCI-32765, is well tolerated and demonstrates promising clinical activity in chronic lymphocytic leukemia (CLL) and small lymphocytic lymphoma (SLL): an update on ongoing phase 1 studies [abstract]. Blood2010;116:Abstract 57.

    • Search Google Scholar
    • Export Citation
  • 22.

    PonaderSBuggyJO'BrienS. Bruton's tyrosine kinase inhibitor PCI-32765 abrogates BCR- and nurselike cell-derived activation of CLL cells in vitro and in vivo [abstract]. Blood2010;116:Abstract 45.

    • Search Google Scholar
    • Export Citation
  • 23.

    FurmanRRByrdJCBrownJR. CAL-101, an isoform-selective inhibitor of phosphatidylinositol 3-kinase P110{delta}, demonstrates clinical activity and pharmacodynamic effects in patients with relapsed or refractory chronic lymphocytic leukemia [abstract]. Blood2010;116:Abstract 55.

    • Search Google Scholar
    • Export Citation
  • 24.

    KahlBByrdJCFlinnIW. Clinical safety and activity in a phase 1 study of CAL-101, an isoform-selective inhibitor of phosphatidylinositol 3-kinase P110{delta}, in patients with relapsed or refractory non-Hodgkin lymphoma [abstract]. Blood2010;116:Abstract 1777.

    • Search Google Scholar
    • Export Citation
  • 25.

    FlinnIWSchreederMTWagner-JohnstonN. A phase 1 study of CAL-101, an isoform-selective inhibitor of phosphatidylinositol 3-kinase P110{delta}, in combination with rituximab and/or bendamustine in patients with relapsed or refractory B-cell malignancies [abstract]. Blood2010;116:Abstract 2832.

    • Search Google Scholar
    • Export Citation
All Time Past Year Past 30 Days
Abstract Views 0 0 0
Full Text Views 255 252 5
PDF Downloads 9 9 1
EPUB Downloads 0 0 0