Adding Revlimid to R-CHOP May Improve Outomes of Selected Patients with NHL

The results of a recently completed study reported in the Journal of Clinical Oncology indicate that the addition of Revlimid® (lenalidomide) to R-CHOP the standard treatment for non hodgkin lymphoma (NHL) can overcome the negative prognostic effect of the non–germinal B-cell phenotype in diffuse large B-cell lymphoma which is associated with significantly worse outcomes with R-CHOP therapy compared with the germinal B-cell subtype.

Diffuse large B-cell lymphoma (DLBCL) is the most common form of non-Hodgkin lymphoma, which is a cancer that begins in the cells of the immune system. The most widely used treatment for DLBCL is R-CHOP, which is a mixture of rituximab and several chemotherapy drugs (cyclophosphamide, doxorubicin, vincristine, and prednisone).

In this clinical study, 60 adults with untreated stage II to IV CD20-positive diffuse large B-cell lymphoma were treated with oral Revlimid in addition to standard-dose R-CHOP every 21 days for six cycles. All patients also received Neulasta® to reduce the risk of infection and ensure the chemotherapy could be delivered on time. The investigators designated this treatment new regimen as R2CHOP.

Among 60 evaluable patients receiving R2CHOP, 98% responded to treatment and 80% had complete disappearance of their cancer.   59% survived without evidence of cancer 2 years from treatment and 78% survived overall.

Diffuse large B-cell lymphomas were further classified as germinal B-cell vs non–germinal B-cell in the R2CHOP patients and compared to 87 patients with diffuse large B-cell lymphoma from a historical control group who were treated with conventional R-CHOP.

Both progression-free survival and overall appeared to be improved in non–germinal B-cell subtype treated with R2CHOP compared to the historical controls.

The investigators concluded that R2CHOP demonstrated promising efficacy in the treatment of diffuse large B-cell lymphoma and that the addition of Revlimid appears to appears to improve the outcome of the non–germinal B-cell phenotype.

Reference: 2014 ASCO Annual Meeting Abstract No: 8520


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