Lenalidomide plus rituximab produces durable responses in mantle cell lymphoma patients

November 12, 2015

TAMPA, Fla. (Nov. 12, 2015) - New research from Moffitt Cancer Center and its collaborators find that the drug combination rituximab plus lenalidomide was effective and produced long-term responses in patients with mantle cell lymphoma. The results from the multicenter phase 2 study were published in the Nov. 5 issue of The New England Journal of Medicine.

Mantle cell lymphoma is a rare form of B-cell non-Hodgkin lymphoma that has a median survival of only 4 to 5 years. The most common type of treatment is an aggressive form of chemotherapy with or without the addition of a drug called rituximab that targets a specific protein on B-cells called CD20. However, these intensive treatments are often associated with significant side effects and are less often used in older patients. Researchers and clinicians hope to improve initial therapies by using more targeted, biological-based regimens to reduce toxicity.

Lenalidomide is an oral drug with different anti-tumor activity, including expansion of immune cells and stimulation of tumor cell death. Lenalidomide is currently approved by the Food and Drug Administration to treat patients with mantle cell lymphoma whose disease has either relapsed or progressed following two prior therapies.

Moffitt researchers, along with collaborators at Weill Cornell Medical College, assessed the combination of lenalidomide plus rituximab in patients with mantle cell lymphoma who had not received prior treatment. The patients received the combination treatment for approximately a year followed by a period of low-dose treatment for up to three years to maintain an anti-tumor response.

A total of 38 patients were enrolled in the study from July 2011 through April 2014 at cancer centers throughout the United States.

The combination of lenalidomide and rituximab was very effective in previously untreated mantle cell lymphoma patients. Ninety-two percent of patients who could be evaluated had either a complete response or a partial response to therapy, with 64 percent of patients achieving a complete response.

The responses to treatment were also durable. Eighty-five percent of patients were alive two years after therapy without experiencing any disease progression.

The most common high-grade immune-associated toxicities during treatment included reduced levels of neutrophils in 50 percent of patients, reduced levels of platelets (13 percent) and anemia (11 percent). The most common non-immune related toxicities were rash in 29 percent of patients, tumor flare (11 percent), and fatigue and pneumonia (8 percent each).

These results are encouraging. "The lenalidomide plus rituximab regimen stands out because it is a low intensity therapy. Usually, standard treatment with this disease is intensive chemotherapy or aggressive stem cell transplants. We were able to avoid both of those," said Bijal D. Shah, M.D., assistant member of the Malignant Hematology Department at Moffitt.

Lenalidomide is also approved to treat patients with either multiple myeloma or myelodysplastic syndromes (MDS), and is currently being investigated in a number of other hematologic malignancies, including chronic lymphocytic leukemia. Moffitt researchers, led by Alan F. List, M.D., CEO of Moffitt Cancer Center, were instrumental in the clinical development and FDA approval of lenalidomide in MDS.
The clinical trial was funded in part by Celgene Corporation.

About Moffitt Cancer Center

Located in Tampa, Moffitt is one of only 45 National Cancer Institute-designated Comprehensive Cancer Centers, a distinction that recognizes Moffitt's excellence in research, its contributions to clinical trials, prevention and cancer control. Moffitt is the top-ranked cancer hospital in Florida and has been listed in U.S. News & World Report as one of the "Best Hospitals" for cancer care since 1999. With more than 4,600 team members, Moffitt has an economic impact in the state of $1.9 billion. For more information, visit MOFFITT.org, and follow the Moffitt momentum on Facebook, Twitter and YouTube.

H. Lee Moffitt Cancer Center & Research Institute

Related Neutrophils Articles from Brightsurf:

The unexpected repair function of neutrophils
Scientists at the Centro Nacional de Investigaciones Cardiovasculares (CNIC) have discovered that neutrophils, the most abundant cells of the innate immune system, have many more functions in the body than previously thought.

Cells sacrifice themselves to boost immune response to viruses
Whether flu or coronavirus, it can take several days for the body to ramp up an effective response to a viral infection.

LJI team gets first-ever look at a rare but vital stem cell in humans
Scientists at La Jolla Institute for Immunology (LJI) have tracked down the rare stem cells that generate neutrophils in human bone marrow.

COVID-19 - The virus and the vasculature
In severe cases of COVID-19, the infection can lead to obstruction of the blood vessels in the lung, heart and kidneys.

How rod-shaped particles might distract an out-of-control COVID immune response
A long-ignored white blood cell may be central to the immune system overreaction that is the most common cause of death for COVID-19 patients--and University of Michigan researchers found that rod-shaped particles can take them out of circulation.

A better model for neutrophil-related diseases
Neutrophils are critical immune cells for antimicrobial defense, but they can exacerbate a number of diseases, perhaps including COVID-19.

Tumor secreted ANGPTL2 facilitates recruitment of neutrophils to the lung to promote lung pre-metastatic niche formation and targeting ANGPTL2 signaling affects metastatic disease
The authors determined that tumor-derived ANGPTL2 stimulates lung epithelial cells, which is essential for primary tumor-induced neutrophil recruitment in lung and subsequent pre-metastatic niche formation.

Neutrophils are equipped with a 'disarmament' program that prevents the immune system going 'out of control'
The new finding, published in Nature Immunology, could have major implications for the understanding and treatment of disorders such as myocardial infarction, stroke, and acute inflammatory processes.

Scientists link common immune cell to failure of checkpoint inhibitors in lung cancer
For many lung cancer patients, the best treatment options involve checkpoint inhibitors, but the drugs only help a small subset of patients.

New technology promises improved treatment of inflammatory diseases
A study led by researchers at Washington State University has uncovered a potential new treatment approach for diseases associated with inflammation, including sepsis and stroke.

Read More: Neutrophils News and Neutrophils Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.