Open AccessLenalidomide in Pretreated Patients with Diffuse Large B‐Cell Lymphoma: An Italian Observational Multicenter Retrospective Study in Daily Clinical Practice
Author(s) -
Broccoli Alessandro,
Casadei Beatrice,
Chiappella Annalisa,
Visco Carlo,
Tani Monica,
Cascavilla Nicola,
Conconi Annarita,
Balzarotti Monica,
Cox Maria Christina,
Marino Dario,
Goldaniga Maria Cecilia,
Marasca Roberto,
Tecchio Cristina,
Patti Caterina,
Musuraca Gerardo,
Devizzi Liliana,
Monaco Federico,
Romano Alessandra,
Fama Angelo,
Zancanella Michelle,
Paolini Rossella,
Rigacci Luigi,
Castellino Claudia,
Gaudio Francesco,
Argnani Lisa,
Zinzani Pier Luigi
Publication year - 2019
Publication title -
the oncologist
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.176
H-Index - 164
eISSN - 1549-490X
pISSN - 1083-7159
DOI - 10.1634/theoncologist.2018-0603
Subject(s) - medicine , lenalidomide , discontinuation , refractory (planetary science) , retrospective cohort study , thalidomide , observational study , diffuse large b cell lymphoma , lymphoma , surgery , multiple myeloma , physics , astrobiology
Background Diffuse large B‐cell lymphoma (DLBCL) is the most common non‐Hodgkin lymphoma subtype, and approximately 50% of the patients are >60 years of age. Patients with relapsed/refractory (rr) disease have a poor prognosis with currently available treatments. Lenalidomide is available in Italy for patients with rrDLBCL based on a local disposition of the Italian Drug Agency. Subjects, Materials, and Methods An observational retrospective study was conducted in 24 Italian hematology centers with the aim to improve information on effectiveness and safety of lenalidomide use for rrDLBCL in real practice. Results One hundred fifty‐three patients received lenalidomide for 21/28 days with a median of four cycles. At the end of therapy, there were 36 complete responses (23.5%) and 9 partial responses with an overall response rate (ORR) of 29.4%. In the elderly (>65 years) subset, the ORR was 33.6%. With a median follow‐up of 36 months, median overall survival was reached at 12 months and median disease‐free survival was not reached at 62 months. At the latest available follow‐up, 29 patients are still in response out of therapy. Median progression‐free survivals differ significantly according to age (2.5 months vs. 9.5 in the younger vs. elderly group, respectively) and to disease status at the latest previous therapy (15 months for relapsed patients vs. 3.5 for refractory subjects). Toxicities were manageable, even if 30 of them led to an early drug discontinuation. Conclusion Lenalidomide therapy for patients with rrDLBCL is effective and tolerable even in a real‐life context, especially for elderly patients. Implications for Practice Diffuse large B‐cell lymphoma (DLBCL) is the most common subtype of non‐Hodgkin lymphoma, and approximately 50% of the patients are >60 years of age. Patients with relapsed/refractory (rr) disease have a poor prognosis, reflected by the remarkably short life expectancy of 12 months with currently available treatments. The rrDLBCL therapeutic algorithm is not so well established because data in the everyday clinical practice are still poor. Lenalidomide for patients with rrDLBCL is effective and tolerable even in a real‐life context, especially for elderly patients.