Lenalidomide in Pretreated Patients with Diffuse Large B-Cell Lymphoma: An Italian Observational Multicenter Retrospective Study in Daily Clinical Practice

Alessandro Broccoli, Beatrice Casadei, Annalisa Chiappella, Carlo Visco, Monica Tani, Nicola Cascavilla, Annarita Conconi, Monica Balzarotti, Maria Christina Cox, Dario Marino, Maria Cecilia Goldaniga, Roberto Marasca, Cristina Tecchio, Caterina Patti, Gerardo Musuraca, Liliana Devizzi, Federico Monaco, Alessandra Romano, Angelo Fama, Michelle ZancanellaRossella Paolini, Luigi Rigacci, Claudia Castellino, Francesco Gaudio, Lisa Argnani, Pier Luigi Zinzani

Research output: Contribution to journalArticle

Abstract

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.

Original languageEnglish
JournalOncologist
DOIs
Publication statusPublished - Jan 1 2019

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Lymphoma, Large B-Cell, Diffuse
Multicenter Studies
Retrospective Studies
Non-Hodgkin's Lymphoma
Therapeutics
Disease-Free Survival
lenalidomide
Hematology
Life Expectancy
Pharmaceutical Preparations
Italy
Observational Studies

Keywords

  • Diffuse large B-cell lymphoma
  • Lenalidomide
  • Real life
  • Refractory
  • Relapsed

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

Cite this

Lenalidomide in Pretreated Patients with Diffuse Large B-Cell Lymphoma : An Italian Observational Multicenter Retrospective Study in Daily Clinical Practice. / 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.

In: Oncologist, 01.01.2019.

Research output: Contribution to journalArticle

Broccoli, A, Casadei, B, Chiappella, A, Visco, C, Tani, M, Cascavilla, N, Conconi, A, Balzarotti, M, Cox, MC, Marino, D, Goldaniga, MC, Marasca, R, Tecchio, C, Patti, C, Musuraca, G, Devizzi, L, Monaco, F, Romano, A, Fama, A, Zancanella, M, Paolini, R, Rigacci, L, Castellino, C, Gaudio, F, Argnani, L & Zinzani, PL 2019, 'Lenalidomide in Pretreated Patients with Diffuse Large B-Cell Lymphoma: An Italian Observational Multicenter Retrospective Study in Daily Clinical Practice', Oncologist. https://doi.org/10.1634/theoncologist.2018-0603
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. / Lenalidomide in Pretreated Patients with Diffuse Large B-Cell Lymphoma : An Italian Observational Multicenter Retrospective Study in Daily Clinical Practice. In: Oncologist. 2019.
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abstract = "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.",
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TY - JOUR

T1 - Lenalidomide in Pretreated Patients with Diffuse Large B-Cell Lymphoma

T2 - An Italian Observational Multicenter Retrospective Study in Daily Clinical Practice

AU - Broccoli, Alessandro

AU - Casadei, Beatrice

AU - Chiappella, Annalisa

AU - Visco, Carlo

AU - Tani, Monica

AU - Cascavilla, Nicola

AU - Conconi, Annarita

AU - Balzarotti, Monica

AU - Cox, Maria Christina

AU - Marino, Dario

AU - Goldaniga, Maria Cecilia

AU - Marasca, Roberto

AU - Tecchio, Cristina

AU - Patti, Caterina

AU - Musuraca, Gerardo

AU - Devizzi, Liliana

AU - Monaco, Federico

AU - Romano, Alessandra

AU - Fama, Angelo

AU - Zancanella, Michelle

AU - Paolini, Rossella

AU - Rigacci, Luigi

AU - Castellino, Claudia

AU - Gaudio, Francesco

AU - Argnani, Lisa

AU - Zinzani, Pier Luigi

PY - 2019/1/1

Y1 - 2019/1/1

N2 - 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.

AB - 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.

KW - Diffuse large B-cell lymphoma

KW - Lenalidomide

KW - Real life

KW - Refractory

KW - Relapsed

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