Ibrutinib Monotherapy in Relapsed or Refractory, Transformed Diffuse Large B-cell Lymphoma
| Autor: | Elizabeth F. Krakow, Ryan C. Lynch, Sandra Kanan, Karolyn Morris, Lorinda Soma, Stephen D. Smith, Ryan D. Cassaday, Thomas R. Chauncey, Solomon A. Graf, Sanaz Behnia, Jenna M. Voutsinas, Heather Rasmussen, Qian Vicky Wu, Ajay K. Gopal |
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| Rok vydání: | 2021 |
| Předmět: |
Male
0301 basic medicine Cancer Research medicine.medical_specialty Kaplan-Meier Estimate Gastroenterology Article 03 medical and health sciences chemistry.chemical_compound 0302 clinical medicine Piperidines Refractory Recurrence Internal medicine medicine Clinical endpoint Humans Adverse effect Protein Kinase Inhibitors business.industry Adenine Disease Management Histology Hematology Prognosis medicine.disease Confidence interval Lymphoma Treatment Outcome 030104 developmental biology Oncology chemistry Drug Resistance Neoplasm 030220 oncology & carcinogenesis Ibrutinib Retreatment Disease Progression Female Lymphoma Large B-Cell Diffuse business Diffuse large B-cell lymphoma |
| Zdroj: | Clin Lymphoma Myeloma Leuk |
| ISSN: | 2152-2650 |
| DOI: | 10.1016/j.clml.2020.11.023 |
| Popis: | Background Histologic transformation to diffuse large B-cell lymphoma (tDLBCL) occurs in a significant proportion of indolent lymphomas. However, few studies of novel agents inform its management, particularly when relapsed after or refractory (R/R) to prior treatment. Patients and Methods We prospectively evaluated ibrutinib monotherapy in pathologically documented patients with R/R tDLBCL in a single-arm study. The primary endpoint was overall response rate. Results Twenty patients who had received a median of 4 (range, 2-9) prior lines of therapy overall (median, 2.5; range, 1-9 for tDLBCL) were treated. The overall response rate was 35%, including complete responses in 15%. The median progression-free survival and overall survival were 4.1 months (95% confidence interval, 2.4-6.2 months) and 22.4 months (95% confidence interval, 7.5 months to not reached), respectively. Disease control > 2 months was seen in 75% and > 1 year in 15%. Response was associated with either low tumor bulk or low metabolic tumor volume (P = .05) but not with antecedent lymphoma histology (P = 1.0). Treatment-related adverse events were consistent with prior studies of ibrutinib. Conclusions Ibrutinib showed low toxicity and meaningful efficacy in R/R tDLBCL, including short-term disease control in most cases. Results demonstrate the potential utility of ibrutinib in this challenging clinical setting, including as a potential bridge to more definitive treatments. |
| Databáze: | OpenAIRE |
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