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An expert panel hosted by
Customizing first-line BTK inhibitors for CLL
with Gilles Salles, Paolo Ghia, and Francesc Bosch
Wednesday, October 23, 2024
18:30-19:30 BST
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On 9 May 2019, Ian Flinn from the Sarah Cannon Research Institute, Nashville, TN, USA, and colleagues, published diffuse large B-cell lymphoma (DLBCL) phase II clinical trial results (NCT01626352) in The Oncologist.1 This trial investigated the efficacy of bendamustine and ofatumumab in elderly patients with newly-diagnosed DLBCL, who were not good candidates for standard chemotherapy regimens.
The current standard of care for DLBCL is R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone) chemotherapy. Nevertheless, old age has been associated with worse outcomes following R-CHOP in patients with DLBCL2. Bendamustine in combination with rituximab has shown a more tolerable safety profile in elderly patients than R-CHOP3. The anti-CD20 antibody ofatumumab, is also well-tolerated in this population and mediates B-cell lysis.4 Therefore, this trial sought to examine whether bendamustine plus ofatumumab could be an effective and well tolerated regimen for naïve and elderly DLBCL patients.
The primary endpoint of this single-arm trial was complete response (CR) rate. Secondary endpoints included, overall response rate (ORR), progression-free survival (PFS), overall survival (OS), and safety.
ORR, n (%) |
19 (90.5%) |
---|---|
Complete response (CR) |
7 (33.3%) |
Partial response (PR) |
12 (57.1%) |
Stable disease (SD) |
1 (4.8%) |
Progressive disease (PD) |
1 (4.8%) |
Not evaluable |
0 |
Median PFS (90% CI) |
8.6 months (4.6−10.6) |
Median OS (90% CI) |
12.0 months (5.9−30.8) |
Median time-to-progression (TTP; 90% CI) |
10.5 months (4.5−not reached) |
The results of this small phase II trial showed that the combination of ofatumumab and bendamustine was well tolerated and led to modest response rates in elderly, newly-diagnosed patients with DLBCL. The degree of efficacy may appear modest when compared to standard of care, but maybe of benefit to those intolerant to R-CHOP.
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