Long-term follow-up of lenalidomide in relapsed/refractory mantle cell lymphoma: subset analysis of the NHL-003 study

P L Zinzani, J M Vose, M S Czuczman, C B Reeder, C Haioun, J Polikoff, H Tilly, L Zhang, K Prandi, J Li, T E Witzig, P L Zinzani, J M Vose, M S Czuczman, C B Reeder, C Haioun, J Polikoff, H Tilly, L Zhang, K Prandi, J Li, T E Witzig

Abstract

Background: Mantle cell lymphoma (MCL) is an uncommon type of non-Hodgkin lymphoma with poor overall prognosis, requiring the development of new therapies. Lenalidomide is an immunomodulatory agent demonstrating antitumor and antiproliferative effects in MCL. We report results from a long-term subset analysis of 57 patients with relapsed/refractory MCL from the NHL-003 phase II multicenter study of single-agent lenalidomide in patients with aggressive lymphoma

Design: Lenalidomide was administered orally 25 mg daily on days 1-21 every 28 days until progressive disease (PD) or intolerability. The primary end point was overall response rate (ORR).

Results: Fifty-seven patients with relapsed/refractory, advanced-stage MCL had a median of three prior therapies. The ORR was 35% [complete response (CR)/CR unconfirmed (CRu) 12%], with a median duration of response (DOR) of 16.3 months (not yet reached in patients with CR/CRu) by blinded independent central review. The median time to first response was 1.9 months. Median progression-free survival was 8.8 months, and overall survival had not yet been reached. The most common grade 3/4 adverse events (AEs) were neutropenia (46%), thrombocytopenia (30%), and anemia (13%).

Conclusions: These results show the activity of lenalidomide in heavily pretreated, relapsed/refractory MCL. Responders had a durable response with manageable side-effects. Clinical trial number posted on www.clinicaltrials.gov NCT00413036.

Keywords: lenalidomide; mantle cell lymphoma; non-Hodgkin lymphoma.

Figures

Figure 1.
Figure 1.
Median duration of response (DOR) of single-agent lenalidomide for responders with relapsed/refractory MCL (central review).

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