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Bal S, Weaver A, Cornell RF, Costa LJ. Challenges and opportunities in the assessment of measurable residual disease in multiple myeloma. Br J Haematol 2019; 186:807-819. [PMID: 31364160 DOI: 10.1111/bjh.16130] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Treatment response assessment in multiple myeloma (MM) relies on the detection of paraprotein in serum and/or urine, bone marrow morphology and immunohistochemistry. With remarkable advances in therapy, particularly in the newly diagnosed setting, achievement of complete remission became frequent, creating the need to identify smaller amounts of residual disease and understand their prognostic and therapeutic implications. Measurable residual disease (MRD) can be assessed primarily by flow cytometry and next generation sequencing and state-of-the-art assays have sensitivity approaching 1 in 106 cells. This review discusses the existing challenges in utilizing MRD to inform management of MM and highlights open research questions and opportunities as MRD is more routinely incorporated into clinical practice for patients with MM.
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Affiliation(s)
- Susan Bal
- Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Allison Weaver
- Division of Hematology and Oncology, Vanderbilt University, Nashville, TN, USA
| | - Robert F Cornell
- Division of Hematology and Oncology, Vanderbilt University, Nashville, TN, USA
| | - Luciano J Costa
- Division of Hematology and Oncology, University of Alabama at Birmingham, Birmingham, AL, USA
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53
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Bachy E, Seymour JF, Feugier P, Offner F, López-Guillermo A, Belada D, Xerri L, Catalano JV, Brice P, Lemonnier F, Martin A, Casasnovas O, Pedersen LM, Dorvaux V, Simpson D, Leppa S, Gabarre J, da Silva MG, Glaisner S, Ysebaert L, Vekhoff A, Intragumtornchai T, Le Gouill S, Lister A, Estell JA, Milone G, Sonet A, Farhi J, Zeuner H, Tilly H, Salles G. Sustained Progression-Free Survival Benefit of Rituximab Maintenance in Patients With Follicular Lymphoma: Long-Term Results of the PRIMA Study. J Clin Oncol 2019; 37:2815-2824. [PMID: 31339826 PMCID: PMC6823890 DOI: 10.1200/jco.19.01073] [Citation(s) in RCA: 162] [Impact Index Per Article: 32.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
PURPOSE The PRIMA study (ClinicalTrials.gov identifier: NCT00140582) established that 2 years of rituximab maintenance after first-line immunochemotherapy significantly improved progression-free survival (PFS) in patients with follicular lymphoma compared with observation. Here, we report the final PFS and overall survival (OS) results from the PRIMA study after 9 years of follow-up and provide a final overview of safety. METHODS Patients (> 18 years of age) with previously untreated high-tumor-burden follicular lymphoma were nonrandomly assigned to receive one of three immunochemotherapy induction regimens. Responding patients were randomly assigned (stratified by induction regimen, response to induction treatment, treatment center, and geographic region) 1:1 to receive 2 years of rituximab maintenance (375 mg/m2, once every 8 weeks), starting 8 weeks after the last induction treatment, or observation (no additional treatment). All patients in the extended follow-up provided their written informed consent (data cutoff: December 31, 2016). RESULTS In total, 1,018 patients completed induction treatment and were randomly assigned to rituximab maintenance (n = 505) or observation (n = 513). Consent for the extended follow-up was provided by 607 patients (59.6%) of 1,018 (rituximab maintenance, n = 309; observation, n = 298). After data cutoff, median PFS was 10.5 years in the rituximab maintenance arm compared with 4.1 years in the observation arm (hazard ratio, 0.61; 95% CI, 0.52 to 0.73; P < .001). No OS difference was seen in patients randomly assigned to rituximab maintenance or observation (hazard ratio, 1.04; 95% CI, 0.77 to 1.40; P = .7948); 10-year OS estimates were approximately 80% in both study arms. No new safety signals were observed. CONCLUSION Rituximab maintenance after induction immunochemotherapy provides a significant long-term PFS, but not OS, benefit over observation.
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Affiliation(s)
- Emmanuel Bachy
- Hospices Civils de Lyon, Université Claude Bernard Lyon 1, Institut National de la Santé et de la Recherche Médicale (INSERM) 1052, Pierre-Bénite, France
| | - John F Seymour
- Royal Melbourne Hospital and University of Melbourne, Melbourne, Victoria, Australia
| | - Pierre Feugier
- Centre Hospitalier Régional Universitaire de Nancy, Université de Lorraine, INSERM 1256, Nancy, France
| | | | | | - David Belada
- Charles University, Hradec Králové, Czech Republic
| | - Luc Xerri
- Institut Paoli-Calmettes, Aix-Marseille Université, Marseille, France
| | - John V Catalano
- Frankston Hospital and Monash University, Frankston, Victoria, Australia
| | - Pauline Brice
- Hôpital Saint-Louis, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - François Lemonnier
- Hôpitaux Universitaires Henri Mondor, Université Paris-Est Créteil, INSERM U955, Créteil, France
| | - Alejandro Martin
- Hospital Universitario de Salamanca-Institute for Biomedical Research of Salamanca, Centro de Investigación Biomédica en Red de Cáncer, Salamanca, Spain
| | - Olivier Casasnovas
- Department of Haematology and INSERM 1231, University Hospital F. Mitterrand, Dijon, France
| | | | - Véronique Dorvaux
- Hôpital de Mercy Centre Hospitalier Régional Metz-Thionville, Metz, France
| | | | - Sirpa Leppa
- Helsinki University Hospital, University of Helsinki, Helsinki, Finland
| | | | | | | | - Loic Ysebaert
- Institut Universitaire du Cancer de Toulouse-Oncopole, Toulouse, France
| | - Anne Vekhoff
- Saint Antoine Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
| | | | - Steven Le Gouill
- Centre Hospitalier Universitaire de Nantes, Centre de Recherche en Cancérologie et Immunologie Nantes Angers, INSERM, Université de Nantes, Nantes, France
| | - Andrew Lister
- Queen Mary University of London, London, United Kingdom
| | - Jane A Estell
- Concord Hospital, Concord, University of Sydney, New South Wales, Australia
| | | | | | - Jonathan Farhi
- Centre Hospitalier Universitaire d'Angers, Angers, France
| | | | | | - Gilles Salles
- Hospices Civils de Lyon, Université Claude Bernard Lyon 1, Institut National de la Santé et de la Recherche Médicale (INSERM) 1052, Pierre-Bénite, France
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García-Álvarez M, Alonso-Álvarez S, Prieto-Conde I, Jiménez C, Sarasquete ME, Chillón MC, Medina A, Balanzategui A, Maldonado R, Antón A, Puig N, Rodríguez M, Blanco O, Tamayo P, González-Calle V, Martín A, García-Sanz R, González M, Caballero MD, Alcoceba M. Immunoglobulin gene rearrangement IGHV3-48 is a predictive marker of histological transformation into aggressive lymphoma in follicular lymphomas. Blood Cancer J 2019; 9:52. [PMID: 31209206 PMCID: PMC6579759 DOI: 10.1038/s41408-019-0213-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2018] [Revised: 01/23/2019] [Accepted: 04/03/2019] [Indexed: 12/03/2022] Open
Abstract
Follicular lymphoma (FL) is a heterogeneous disease whose pathogenesis remains partially unknown. Around 20% of FL patients experience early progression or treatment-refractory disease and 2–3% of patients per year experience histological transformation (HT) into a more aggressive lymphoma (tFL). Here, we evaluate the immunoglobulin heavy chain variable (IGHV) gene usage and mutational status in 187 FL cases to assess its impact on clinical outcome and histological transformation. The IGHV gene repertoire was remarkably biased in FL. The IGHV4-34 (14%), IGHV3-23 (14%), IGHV3-48 (10%), IGHV3-30 (9%) and IGHV3-21 (7%) genes accounted for more than half of the whole cohort. IGHV3-48 was overrepresented in cases of tFL (19%) compared with non-transformed FL at 5 years (5%, P = 0.05). Patients with the IGHV3-48 gene were significantly more likely to have had HT after 10 years than those who used other genes (71% vs. 25%, P < 0.05), irrespective of the therapy they received. Moreover, IGHV3-30 was also overrepresented in cases of FL (9%) and tFL (13%) compared with diffuse large B-cell lymphoma in which it was nearly absent. In conclusion, our results indicate a role for antigen selection in the development of FL, while the use of IGHV3-48 could help predict histological transformation.
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Affiliation(s)
- María García-Álvarez
- Department of Hematology, University Hospital of Salamanca (HUS/IBSAL), Salamanca, Spain
| | - Sara Alonso-Álvarez
- Department of Hematology, Central University Hospital of Asturias (HUCA), Oviedo, Spain
| | - Isabel Prieto-Conde
- Department of Hematology, University Hospital of Salamanca (HUS/IBSAL), Salamanca, Spain
| | - Cristina Jiménez
- Department of Hematology, University Hospital of Salamanca (HUS/IBSAL), Salamanca, Spain
| | - M Eugenia Sarasquete
- Department of Hematology, University Hospital of Salamanca (HUS/IBSAL), Salamanca, Spain.,Biomedical Research Networking Centre - Oncology (CIBERONC), Madrid, Spain
| | - M Carmen Chillón
- Department of Hematology, University Hospital of Salamanca (HUS/IBSAL), Salamanca, Spain.,Biomedical Research Networking Centre - Oncology (CIBERONC), Madrid, Spain
| | - Alejandro Medina
- Department of Hematology, University Hospital of Salamanca (HUS/IBSAL), Salamanca, Spain
| | - Ana Balanzategui
- Department of Hematology, University Hospital of Salamanca (HUS/IBSAL), Salamanca, Spain
| | - Rebeca Maldonado
- Department of Hematology, University Hospital of Salamanca (HUS/IBSAL), Salamanca, Spain
| | - Alicia Antón
- Department of Hematology, University Hospital of Salamanca (HUS/IBSAL), Salamanca, Spain
| | - Noemí Puig
- Department of Hematology, University Hospital of Salamanca (HUS/IBSAL), Salamanca, Spain.,Biomedical Research Networking Centre - Oncology (CIBERONC), Madrid, Spain
| | - Marta Rodríguez
- Department of Pathology, University Hospital of Salamanca (HUS/IBSAL), Salamanca, Spain
| | - Oscar Blanco
- Department of Pathology, University Hospital of Salamanca (HUS/IBSAL), Salamanca, Spain
| | - Pilar Tamayo
- Department of Nuclear Medicine, University Hospital of Salamanca (HUS/IBSAL), Salamanca, Spain
| | | | - Alejandro Martín
- Department of Hematology, University Hospital of Salamanca (HUS/IBSAL), Salamanca, Spain.,Biomedical Research Networking Centre - Oncology (CIBERONC), Madrid, Spain
| | - Ramón García-Sanz
- Department of Hematology, University Hospital of Salamanca (HUS/IBSAL), Salamanca, Spain. .,Biomedical Research Networking Centre - Oncology (CIBERONC), Madrid, Spain. .,Cancer Research Centre - IBMCC (USAL-CSIC), Salamanca, Spain.
| | - Marcos González
- Department of Hematology, University Hospital of Salamanca (HUS/IBSAL), Salamanca, Spain.,Biomedical Research Networking Centre - Oncology (CIBERONC), Madrid, Spain.,Cancer Research Centre - IBMCC (USAL-CSIC), Salamanca, Spain
| | - M Dolores Caballero
- Department of Hematology, University Hospital of Salamanca (HUS/IBSAL), Salamanca, Spain.,Biomedical Research Networking Centre - Oncology (CIBERONC), Madrid, Spain
| | - Miguel Alcoceba
- Department of Hematology, University Hospital of Salamanca (HUS/IBSAL), Salamanca, Spain.,Biomedical Research Networking Centre - Oncology (CIBERONC), Madrid, Spain
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Boughan KM, Caimi PF. Follicular Lymphoma: Diagnostic and Prognostic Considerations in Initial Treatment Approach. Curr Oncol Rep 2019; 21:63. [DOI: 10.1007/s11912-019-0808-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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Short regimen of rituximab plus lenalidomide in follicular lymphoma patients in need of first-line therapy. Blood 2019; 134:353-362. [PMID: 31101627 DOI: 10.1182/blood-2018-10-879643] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2018] [Accepted: 04/03/2019] [Indexed: 11/20/2022] Open
Abstract
The SAKK 35/10 phase 2 trial, developed by the Swiss Group for Clinical Cancer Research and the Nordic Lymphoma Group, compared the activity of rituximab vs rituximab plus lenalidomide in untreated follicular lymphoma patients in need of systemic therapy. Patients were randomized to rituximab (375 mg/m2 IV on day 1 of weeks 1-4 and repeated during weeks 12-15 in responding patients) or rituximab (same schedule) in combination with lenalidomide (15 mg orally daily for 18 weeks). Primary end point was complete response (CR)/unconfirmed CR (CRu) rate at 6 months. In total, 77 patients were allocated to rituximab monotherapy and 77 to the combination (47% poor-risk Follicular Lymphoma International Prognostic Index score in each arm). A significantly higher CR/CRu rate at 6 months was documented in the combination arm by the investigators (36%; 95% confidence interval [CI], 26%-48% vs 25%; 95% CI, 16%-36%) and confirmed by an independent response review of computed tomography scans only (61%; 95% CI, 49%-72% vs 36%; 95% CI, 26%-48%). After a median follow-up of 4 years, significantly higher 30-month CR/CRu rates and longer progression-free survival (PFS) and time to next treatment (TTNT) were observed for the combination. Overall survival (OS) rates were similar in both arms (≥90%). Toxicity grade ≥3 was more common in the combination arm (56% vs 22% of patients), mainly represented by neutropenia (23% vs 7%). Addition of lenalidomide to rituximab significantly improved CR/CRu rates, PFS, and TTNT, with expected higher, but manageable toxicity. The excellent OS in both arms suggests that chemotherapy-free strategies should be further explored. This trial was registered at www.clinicaltrials.gov as #NCT01307605.
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Opat S, Dickinson M, Cheah CY, Tam C, Boulos J, Thorburn AN, Trotman J. Management of patients with follicular lymphoma treated first line with obinutuzumab. Asia Pac J Clin Oncol 2019; 15 Suppl 3:3-11. [PMID: 31058467 DOI: 10.1111/ajco.13153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Recently, obinutuzumab was included in the Australian Pharmaceutical Benefits Scheme for use in first line, advanced or bulky stage 2, follicular lymphoma, providing more immunochemotherapy treatment options available than ever before. Rituximab with chemotherapy has been the standard of care since reimbursement in the late 1990s; however, obinutuzumab-based regimens have shown superior progression-free survival in comparison to rituximab-based options, albeit at an increased risk of grade ≥3 adverse events. As median overall survival approaches 20 years or more, the long-term effects and sequencing of any strategy should be considered. Here we discuss the considerations for selection of front-line therapy, based on evidence and local Australian clinician experience, in the management of first line follicular lymphoma.
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Affiliation(s)
- Stephen Opat
- School of Clinical Sciences, Monash Health, Monash University, Clayton, Melbourne, VIC, Australia
| | - Michael Dickinson
- Clinical Haematology, Peter MacCallum Cancer Centre and Royal Melbourne Hospital, Melbourne, VIC, Australia
| | - Chan Yoon Cheah
- Department of Haematology, Sir Charles Gairdner Hospital, Nedlands, WA, Australia
| | - Constantine Tam
- Clinical Haematology, Peter MacCallum Cancer Centre and Royal Melbourne Hospital, Melbourne, VIC, Australia.,Department of Haematology, St Vincent's Hospital, Melbourne, VIC, Australia
| | - Joy Boulos
- Roche Products Pty Ltd, Sydney, NSW, Australia
| | | | - Judith Trotman
- Haematology Department, Concord Hospital, University of Sydney, Concord, NSW, Australia
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Bruna R, Benedetti F, Boccomini C, Patti C, Barbui AM, Pulsoni A, Musso M, Liberati AM, Gini G, Castellino C, Rossini F, Ciceri F, Rota-Scalabrini D, Stelitano C, Di Raimondo F, Tucci A, Devizzi L, Zoli V, Zallio F, Narni F, Dondi A, Parvis G, Semenzato G, Lanza F, Perrone T, Angrilli F, Billio A, Gueli A, Mantoan B, Rambaldi A, Gianni AM, Corradini P, Passera R, Ladetto M, Tarella C. Prolonged survival in the absence of disease-recurrence in advanced-stage follicular lymphoma following chemo-immunotherapy: 13-year update of the prospective, multicenter randomized GITMO-IIL trial. Haematologica 2019; 104:2241-2248. [PMID: 31666344 PMCID: PMC6821615 DOI: 10.3324/haematol.2018.209932] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2018] [Accepted: 04/10/2019] [Indexed: 01/31/2023] Open
Abstract
A prospective trial conducted in the period 2000-2005 showed no survival advantage for high-dose chemotherapy with rituximab and autograft (R-HDS) versus conventional chemotherapy with rituximab (CHOP-R) as first-line therapy in 134 high-risk follicular lymphoma patients aged <60 years. The study has been updated at the 13-year median follow up. As of February 2017, 88 (66%) patients were alive, with overall survival of 66.4% at 13 years, without a significant difference between R-HDS (64.5%) and CHOP-R (68.5%). To date, 46 patients have died, mainly because of disease progression (47.8% of all deaths), secondary malignancies (3 solid tumor, 9 myelodysplasia/acute leukemia; 26.1% of all deaths), and other toxicities (21.7% of all deaths). Complete remission was documented in 98 (73.1%) patients and associated with overall survival, with 13-year estimates of 77.0% and 36.8% for complete remission versus no-complete remission, respectively. Molecular remission was documented in 39 (65%) out of 60 evaluable patients and associated with improved survival. In multivariate analysis, complete remission achievement had the strongest effect on survival (P<0.001), along with younger age (P=0.002) and female sex (P=0.013). Overall, 50 patients (37.3%) survived with no disease recurrence (18 CHOP-R, 32 R-HDS). This follow up is the longest reported on follicular lymphoma treated upfront with rituximab-chemotherapy and demonstrates an unprecedented improvement in survival compared to the pre-rituximab era, regardless of the use of intensified or conventional treatment. Complete remission was the most important factor for prolonged survival and a high proportion of patients had prolonged survival in their first remission, raising the issue of curability in follicular lymphoma. (Registered at clinicaltrials.gov identifier: 00435955)
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Affiliation(s)
- Riccardo Bruna
- Onco-Hematology Division, IEO, European Institute of Oncology IRCCS, Milano
| | | | | | - Caterina Patti
- Hematology Division, Azienda Villa Sofia-Cervello, Palermo
| | | | - Alessandro Pulsoni
- Department of Cellular Biotechnologies and Hematology, La Sapienza University, Roma
| | | | | | | | | | | | | | | | | | | | | | - Liliana Devizzi
- University Division of Hematology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano
| | | | - Francesco Zallio
- SC Ematologia AO SS Antonio e Biagio e Cesare Arrigo, Alessandria
| | | | | | - Guido Parvis
- Division of Internal Medicine, S. Luigi Hospital, Orbassano
| | | | | | | | | | | | - Angela Gueli
- Onco-Hematology Division, IEO, European Institute of Oncology IRCCS, Milano
| | - Barbara Mantoan
- Hematology University Division, Città della Salute Hospital, Torino
| | - Alessandro Rambaldi
- Hematology Division, Papa Giovanni XXIII Hospital, Bergamo.,Department of Oncology and Onco-Hematology, University of Milan, Milano
| | | | - Paolo Corradini
- University Division of Hematology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano.,Department of Oncology and Onco-Hematology, University of Milan, Milano
| | - Roberto Passera
- Nuclear Medicine Division, Città della Salute Hospital, Torino
| | - Marco Ladetto
- SC Ematologia AO SS Antonio e Biagio e Cesare Arrigo, Alessandria
| | - Corrado Tarella
- Onco-Hematology Division, IEO, European Institute of Oncology IRCCS, Milano .,Department of Health Sciences, University of Milan, Milano, Italy
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Lockmer S, Østenstad B, Hagberg H, Holte H, Wahlin BE, Wader KF, Smedby KE, Brown P, Kimby E. Reply to M. Sorigue et al. J Clin Oncol 2019; 37:759-760. [PMID: 30735430 DOI: 10.1200/jco.18.02362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Sandra Lockmer
- Sandra Lockmer, MD, Karolinska Institutet, Stockholm, Sweden Karolinska University Hospital, Stockholm, Sweden; Bjørn Østenstad, MD, PhD, Oslo University Hospital, Oslo, Norway; Hans Hagberg, MD, PhD, Academic Hospital, Uppsala, Sweden; Harald Holte, MD, PhD, Oslo University Hospital, Oslo, Norway; Björn Engelbrekt Wahlin, MD, PhD, Karolinska Institutet, Stockholm, Sweden Karolinska University Hospital, Stockholm, Sweden; Karin Fahl Wader, MD, PhD, St Olavs Hospital, Trondheim, Norway; Karin Ekström Smedby, MD, PhD, Karolinska Institutet, Stockholm, Sweden Karolinska University Hospital, Stockholm, Sweden; Peter Brown, MD, PhD, Rigshospitalet, Copenhagen, Denmark; and Eva Kimby, MD, PhD, Karolinska Institutet, Stockholm, Sweden
| | - Bjørn Østenstad
- Sandra Lockmer, MD, Karolinska Institutet, Stockholm, Sweden Karolinska University Hospital, Stockholm, Sweden; Bjørn Østenstad, MD, PhD, Oslo University Hospital, Oslo, Norway; Hans Hagberg, MD, PhD, Academic Hospital, Uppsala, Sweden; Harald Holte, MD, PhD, Oslo University Hospital, Oslo, Norway; Björn Engelbrekt Wahlin, MD, PhD, Karolinska Institutet, Stockholm, Sweden Karolinska University Hospital, Stockholm, Sweden; Karin Fahl Wader, MD, PhD, St Olavs Hospital, Trondheim, Norway; Karin Ekström Smedby, MD, PhD, Karolinska Institutet, Stockholm, Sweden Karolinska University Hospital, Stockholm, Sweden; Peter Brown, MD, PhD, Rigshospitalet, Copenhagen, Denmark; and Eva Kimby, MD, PhD, Karolinska Institutet, Stockholm, Sweden
| | - Hans Hagberg
- Sandra Lockmer, MD, Karolinska Institutet, Stockholm, Sweden Karolinska University Hospital, Stockholm, Sweden; Bjørn Østenstad, MD, PhD, Oslo University Hospital, Oslo, Norway; Hans Hagberg, MD, PhD, Academic Hospital, Uppsala, Sweden; Harald Holte, MD, PhD, Oslo University Hospital, Oslo, Norway; Björn Engelbrekt Wahlin, MD, PhD, Karolinska Institutet, Stockholm, Sweden Karolinska University Hospital, Stockholm, Sweden; Karin Fahl Wader, MD, PhD, St Olavs Hospital, Trondheim, Norway; Karin Ekström Smedby, MD, PhD, Karolinska Institutet, Stockholm, Sweden Karolinska University Hospital, Stockholm, Sweden; Peter Brown, MD, PhD, Rigshospitalet, Copenhagen, Denmark; and Eva Kimby, MD, PhD, Karolinska Institutet, Stockholm, Sweden
| | - Harald Holte
- Sandra Lockmer, MD, Karolinska Institutet, Stockholm, Sweden Karolinska University Hospital, Stockholm, Sweden; Bjørn Østenstad, MD, PhD, Oslo University Hospital, Oslo, Norway; Hans Hagberg, MD, PhD, Academic Hospital, Uppsala, Sweden; Harald Holte, MD, PhD, Oslo University Hospital, Oslo, Norway; Björn Engelbrekt Wahlin, MD, PhD, Karolinska Institutet, Stockholm, Sweden Karolinska University Hospital, Stockholm, Sweden; Karin Fahl Wader, MD, PhD, St Olavs Hospital, Trondheim, Norway; Karin Ekström Smedby, MD, PhD, Karolinska Institutet, Stockholm, Sweden Karolinska University Hospital, Stockholm, Sweden; Peter Brown, MD, PhD, Rigshospitalet, Copenhagen, Denmark; and Eva Kimby, MD, PhD, Karolinska Institutet, Stockholm, Sweden
| | - Björn Engelbrekt Wahlin
- Sandra Lockmer, MD, Karolinska Institutet, Stockholm, Sweden Karolinska University Hospital, Stockholm, Sweden; Bjørn Østenstad, MD, PhD, Oslo University Hospital, Oslo, Norway; Hans Hagberg, MD, PhD, Academic Hospital, Uppsala, Sweden; Harald Holte, MD, PhD, Oslo University Hospital, Oslo, Norway; Björn Engelbrekt Wahlin, MD, PhD, Karolinska Institutet, Stockholm, Sweden Karolinska University Hospital, Stockholm, Sweden; Karin Fahl Wader, MD, PhD, St Olavs Hospital, Trondheim, Norway; Karin Ekström Smedby, MD, PhD, Karolinska Institutet, Stockholm, Sweden Karolinska University Hospital, Stockholm, Sweden; Peter Brown, MD, PhD, Rigshospitalet, Copenhagen, Denmark; and Eva Kimby, MD, PhD, Karolinska Institutet, Stockholm, Sweden
| | - Karin Fahl Wader
- Sandra Lockmer, MD, Karolinska Institutet, Stockholm, Sweden Karolinska University Hospital, Stockholm, Sweden; Bjørn Østenstad, MD, PhD, Oslo University Hospital, Oslo, Norway; Hans Hagberg, MD, PhD, Academic Hospital, Uppsala, Sweden; Harald Holte, MD, PhD, Oslo University Hospital, Oslo, Norway; Björn Engelbrekt Wahlin, MD, PhD, Karolinska Institutet, Stockholm, Sweden Karolinska University Hospital, Stockholm, Sweden; Karin Fahl Wader, MD, PhD, St Olavs Hospital, Trondheim, Norway; Karin Ekström Smedby, MD, PhD, Karolinska Institutet, Stockholm, Sweden Karolinska University Hospital, Stockholm, Sweden; Peter Brown, MD, PhD, Rigshospitalet, Copenhagen, Denmark; and Eva Kimby, MD, PhD, Karolinska Institutet, Stockholm, Sweden
| | - Karin Ekström Smedby
- Sandra Lockmer, MD, Karolinska Institutet, Stockholm, Sweden Karolinska University Hospital, Stockholm, Sweden; Bjørn Østenstad, MD, PhD, Oslo University Hospital, Oslo, Norway; Hans Hagberg, MD, PhD, Academic Hospital, Uppsala, Sweden; Harald Holte, MD, PhD, Oslo University Hospital, Oslo, Norway; Björn Engelbrekt Wahlin, MD, PhD, Karolinska Institutet, Stockholm, Sweden Karolinska University Hospital, Stockholm, Sweden; Karin Fahl Wader, MD, PhD, St Olavs Hospital, Trondheim, Norway; Karin Ekström Smedby, MD, PhD, Karolinska Institutet, Stockholm, Sweden Karolinska University Hospital, Stockholm, Sweden; Peter Brown, MD, PhD, Rigshospitalet, Copenhagen, Denmark; and Eva Kimby, MD, PhD, Karolinska Institutet, Stockholm, Sweden
| | - Peter Brown
- Sandra Lockmer, MD, Karolinska Institutet, Stockholm, Sweden Karolinska University Hospital, Stockholm, Sweden; Bjørn Østenstad, MD, PhD, Oslo University Hospital, Oslo, Norway; Hans Hagberg, MD, PhD, Academic Hospital, Uppsala, Sweden; Harald Holte, MD, PhD, Oslo University Hospital, Oslo, Norway; Björn Engelbrekt Wahlin, MD, PhD, Karolinska Institutet, Stockholm, Sweden Karolinska University Hospital, Stockholm, Sweden; Karin Fahl Wader, MD, PhD, St Olavs Hospital, Trondheim, Norway; Karin Ekström Smedby, MD, PhD, Karolinska Institutet, Stockholm, Sweden Karolinska University Hospital, Stockholm, Sweden; Peter Brown, MD, PhD, Rigshospitalet, Copenhagen, Denmark; and Eva Kimby, MD, PhD, Karolinska Institutet, Stockholm, Sweden
| | - Eva Kimby
- Sandra Lockmer, MD, Karolinska Institutet, Stockholm, Sweden Karolinska University Hospital, Stockholm, Sweden; Bjørn Østenstad, MD, PhD, Oslo University Hospital, Oslo, Norway; Hans Hagberg, MD, PhD, Academic Hospital, Uppsala, Sweden; Harald Holte, MD, PhD, Oslo University Hospital, Oslo, Norway; Björn Engelbrekt Wahlin, MD, PhD, Karolinska Institutet, Stockholm, Sweden Karolinska University Hospital, Stockholm, Sweden; Karin Fahl Wader, MD, PhD, St Olavs Hospital, Trondheim, Norway; Karin Ekström Smedby, MD, PhD, Karolinska Institutet, Stockholm, Sweden Karolinska University Hospital, Stockholm, Sweden; Peter Brown, MD, PhD, Rigshospitalet, Copenhagen, Denmark; and Eva Kimby, MD, PhD, Karolinska Institutet, Stockholm, Sweden
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Magnano L, Alonso-Alvarez S, Alcoceba M, Rivas-Delgado A, Muntañola A, Nadeu F, Setoain X, Rodríguez S, Andrade-Campos M, Espinosa-Lara N, Rodríguez G, Sancho JM, Moreno M, Mercadal S, Carro I, Salar A, Garcia-Pallarols F, Arranz R, Cannata J, Terol MJ, Teruel AI, Jiménez-Ubieto A, Rodriguez A, González de Villambrosía S, Bello JL, López L, Novelli S, de Cabo E, Infante ME, Pardal E, Monsalvo S, González M, Martín A, Caballero MD, López-Guillermo A. Life expectancy of follicular lymphoma patients in complete response at 30 months is similar to that of the Spanish general population. Br J Haematol 2019; 185:480-491. [PMID: 30793290 DOI: 10.1111/bjh.15805] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2018] [Accepted: 12/21/2018] [Indexed: 12/29/2022]
Abstract
The use of immunochemotherapy has improved the outcome of follicular lymphoma (FL). Recently, complete response at 30 months (CR30) has been suggested as a surrogate for progression-free survival. This study aimed to analyse the life expectancy of FL patients according to their status at 30 months from the start of treatment in comparison with the sex and age-matched Spanish general population (relative survival; RS). The training series comprised 263 patients consecutively diagnosed with FL in a 10-year period who needed therapy and were treated with rituximab-containing regimens. An independent cohort of 693 FL patients from the Grupo Español de Linfomas y Trasplante Autólogo de Médula Ósea (GELTAMO) group was used for validation. In the training cohort, 188 patients were in CR30, with a 10-year overall survival (OS) of 53% and 87% for non-CR30 and CR30 patients, respectively. Ten-year RS was 73% and 100%, showing no decrease in life expectancy for CR30 patients. Multivariate analysis indicated that the FL International Prognostic Index was the most important variable predicting OS in the CR30 group. The impact of CR30 status on RS was validated in the independent GELTAMO series. In conclusion, FL patients treated with immunochemotherapy who were in CR at 30 months showed similar survival to a sex- and age-matched Spanish general population.
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Affiliation(s)
- Laura Magnano
- Haematology Department, Hospital Clínic de Barcelona, Barcelona, Spain.,CIBERONC, Madrid, Spain
| | - Sara Alonso-Alvarez
- Haematology Department, Hospital Universitario de Salamanca and IBSAL, Salamanca, Spain
| | - Miguel Alcoceba
- CIBERONC, Madrid, Spain.,Haematology Department, Hospital Universitario de Salamanca and IBSAL, Salamanca, Spain
| | - Alfredo Rivas-Delgado
- Haematology Department, Hospital Clínic de Barcelona, Barcelona, Spain.,CIBERONC, Madrid, Spain
| | - Anna Muntañola
- Haematology Department, Hospital Universitario Mutua de Terrassa, Terrassa, Spain
| | - Ferran Nadeu
- Lymphoid Neoplasms Program, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Xavier Setoain
- Nuclear Medicine Department, Hospital Clinic de Barcelona, Barcelona, Centro de Investigación Biomédica en Red en Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN)2, Barcelona, Spain
| | - Sonia Rodríguez
- Nuclear Medicine Department, Hospital Clinic de Barcelona, Barcelona, Centro de Investigación Biomédica en Red en Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN)2, Barcelona, Spain
| | | | | | | | - Juan Manuel Sancho
- Haematology Department, Hospital GermansTrias i Pujol (ICO-IJC), Badalona, Spain
| | - Miriam Moreno
- Haematology Department, Hospital GermansTrias i Pujol (ICO-IJC), Badalona, Spain
| | - Santiago Mercadal
- Haematology Department, Hospital Duran i Reynals (ICO), Hospitalet, Spain
| | - Itziar Carro
- Haematology Department, Hospital Duran i Reynals (ICO), Hospitalet, Spain
| | - Antonio Salar
- Haematology Department, Hospital del Mar, Barcelona, Spain
| | | | - Reyes Arranz
- Haematology Department, Hospital de la Princesa, Madrid, Spain
| | - Jimena Cannata
- Haematology Department, Hospital de la Princesa, Madrid, Spain
| | - María J Terol
- Haematology Department, Hospital Clínico de Valencia, Valencia, Spain
| | - Ana I Teruel
- Haematology Department, Hospital Clínico de Valencia, Valencia, Spain
| | | | | | | | - José L Bello
- Haematology Department, Hospital de Nuestra Señora de la Esperanza, Santiago de Compostela, Spain
| | - Lourdes López
- Haematology Department, Hospital MD Anderson, Madrid, Spain
| | | | - Erik de Cabo
- Haematology Department, Hospital del Bierzo, Ponferrada, Spain
| | - María E Infante
- Haematology Department, Hospital Infanta Leonor, Madrid, Spain
| | - Emilia Pardal
- Haematology Department, Hospital Virgen del Puerto, Plasencia, Spain
| | - Silvia Monsalvo
- Haematology Department, Hospital Fundación Jiménez Díaz, Madrid, Spain
| | - Marcos González
- CIBERONC, Madrid, Spain.,Haematology Department, Hospital Universitario de Salamanca and IBSAL, Salamanca, Spain
| | - Alejandro Martín
- CIBERONC, Madrid, Spain.,Haematology Department, Hospital Universitario de Salamanca and IBSAL, Salamanca, Spain
| | - M Dolores Caballero
- Haematology Department, Hospital Clínic de Barcelona, Barcelona, Spain.,CIBERONC, Madrid, Spain
| | - Armando López-Guillermo
- Haematology Department, Hospital Clínic de Barcelona, Barcelona, Spain.,CIBERONC, Madrid, Spain
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Çağlayan Ç, Terawaki H, Ayer T, Goldstein JS, Rai A, Chen Q, Flowers C. Assessing the Effectiveness of Treatment Sequences for Older Patients With High-risk Follicular Lymphoma With a Multistate Model. CLINICAL LYMPHOMA MYELOMA & LEUKEMIA 2019; 19:300-309.e5. [PMID: 30686772 DOI: 10.1016/j.clml.2018.12.019] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/22/2018] [Revised: 12/01/2018] [Accepted: 12/26/2018] [Indexed: 02/04/2023]
Abstract
BACKGROUND Disease progression within < 2 years of initial chemoimmunotherapy and patient age > 60 years have been associated with poor overall survival (OS) in follicular lymphoma (FL). No standard treatment exists for these high-risk patients, and the effectiveness of sequential therapies remains unclear. PATIENTS AND METHODS We studied the course of FL with first-, second-, and third-line treatment. Using large population-based data, we identified 5234 patients with FL diagnosed in 2000 to 2009. Of these patients, 71% had received second-line therapy < 2 years, and 29% had received no therapy after first-line therapy, with a median OS of < 3 years. Treatment included rituximab, R-CVP (rituximab, cyclophosphamide, vincristine), R-CHOP (rituximab, cyclophosphamide, hydroxydaunorubicin, vincristine), R-Other (other rituximab-containing), and other regimens. The Aalen-Johansen estimator and Cox proportional hazards models were used to quantify the outcomes and assess the effects of the clinical and sociodemographic factors. RESULTS R-CHOP demonstrated the most favorable 5-year OS among first- (71%), second- (55%), and third-line (61%) therapies. First-line R-CHOP improved OS (hazard ratio [HR], 0.57; 95% confidence interval [CI], 0.50-0.64) and reduced the mortality risks after first-line (HR, 0.60; 95% CI, 0.47-0.77), second-line (HR, 0.40; 95% CI, 0.29-0.53), and third-line (HR, 0.63; 95% CI, 0.53-0.76) treatments. B-symptoms, being married, and histologic grade 1/2 were associated with the use of earlier second-line therapy. Early progression from second- to third-line therapy was associated with poor OS. The repeated use of R-CHOP or R-CVP as first- and second-line treatment yielded high 2-year mortality rates (R-CHOP + R-CHOP, 17.3%; R-CVP + R-CVP, 21.1%). CONCLUSION Our multistate approach assessed the effect of sequential therapy on the immediate and subsequent treatment-line outcomes. We found that R-CHOP in any line improved OS for patients with high-risk FL.
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Affiliation(s)
- Çağlar Çağlayan
- H. Milton Stewart School of Industrial and Systems Engineering, Georgia Institute of Technology, Atlanta, GA.
| | | | - Turgay Ayer
- H. Milton Stewart School of Industrial and Systems Engineering, Georgia Institute of Technology, Atlanta, GA
| | | | - Ashish Rai
- American Cancer Society, Inc, Atlanta, GA
| | - Qiushi Chen
- Institute for Technology Assessment, Massachusetts General Hospital, Boston, MA
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Qu X, Li H, Braziel RM, Passerini V, Rimsza LM, Hsi ED, Leonard JP, Smith SM, Kridel R, Press O, Weigert O, LeBlanc M, Friedberg JW, Fang M. Genomic alterations important for the prognosis in patients with follicular lymphoma treated in SWOG study S0016. Blood 2019; 133:81-93. [PMID: 30446494 PMCID: PMC6318431 DOI: 10.1182/blood-2018-07-865428] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2018] [Accepted: 11/06/2018] [Indexed: 02/08/2023] Open
Abstract
Although recent advances in molecular genetics have enabled improved risk classification of follicular lymphoma (FL) using, for example, the m7-FLIPI score, the impact on treatment has been limited. We aimed to assess the prognostic significance of copy-number aberrations (CNAs) and copy-neutral loss of heterozygosity (cnLOH) identified by chromosome genomic-array testing (CGAT) at FL diagnosis using prospectively collected clinical trial specimens from 255 patients enrolled in the SWOG study S0016. The impact of genomic aberrations was assessed for early progression (progressed or died within 2 years after registration), progression-free survival (PFS), and overall survival (OS). We showed that increased genomic complexity (ie, the total number of aberration calls) was associated with poor outcome in FL. Certain chromosome arms were critical for clinical outcome. Prognostic CNAs/cnLOH were identified: whereas early progression was correlated with 2p gain (P = .007; odds ratio [OR] = 2.55 [1.29, 5.03]) and 2p cnLOH (P = .005; OR = 10.9 [2.08, 57.2]), 2p gain specifically encompassing VRK2 and FANCL predicted PFS (P = .01; hazard ratio = 1.80 [1.14, 2.68]) as well as OS (P = .005; 2.40 [1.30, 4.40]); CDKN2A/B (9p) deletion correlated with worse PFS (P = .004, 3.50 [1.51, 8.28]); whereas CREBBP (16p) (P < .001; 6.70 [2.52, 17.58]) and TP53 (17p) (P < .001; 3.90 [1.85, 8.31]) deletion predicted worse OS. An independent cohort from the m7-FLIPI study was explored, and the prognostic significance of aberration count, and TP53 and CDKN2A/B deletion were further validated. In conclusion, assessing genomic aberrations at FL diagnosis with CGAT improves risk stratification independent of known clinical parameters, and provides a framework for development of future rational targeted therapies.
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Affiliation(s)
- Xiaoyu Qu
- Fred Hutchinson Cancer Research Center, Seattle, WA
| | - Hongli Li
- SWOG Statistical Center, Seattle, WA
| | - Rita M Braziel
- Department of Pathology, Oregon Health & Science University, Portland, OR
| | - Verena Passerini
- Department of Medicine III, University Hospital, Ludwig Maximilians University Munich, Munich, Germany
- German Cancer Consortium, German Cancer Research Center, Heidelberg, Germany
| | | | | | - John P Leonard
- Weill Cornell Medicine/New York Presbyterian Hospital, New York, NY
| | - Sonali M Smith
- Department of Medicine, University of Chicago, Chicago, IL
| | - Robert Kridel
- Princess Margaret Cancer Centre, University Health Network (UHN), Toronto, ON, Canada; and
| | - Oliver Press
- Fred Hutchinson Cancer Research Center, Seattle, WA
| | - Oliver Weigert
- Department of Medicine III, University Hospital, Ludwig Maximilians University Munich, Munich, Germany
- German Cancer Consortium, German Cancer Research Center, Heidelberg, Germany
| | | | | | - Min Fang
- Fred Hutchinson Cancer Research Center, Seattle, WA
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63
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Roschewski M, Hill BT. One Size Does Not Fit All: Who Benefits From Maintenance After Frontline Therapy for Follicular Lymphoma? Am Soc Clin Oncol Educ Book 2019; 39:467-476. [PMID: 31099693 DOI: 10.1200/edbk_239065] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Follicular lymphoma (FL) is the second most common non-Hodgkin lymphoma and the most common indolent B-cell malignancy. The disease often presents in advanced stage and can often be observed before initiation of therapy. Although the incidence is only approximately 15,000 new cases per year, the prevalence is substantially higher owing to the favorable overall survival (OS) of most patients. The most impactful advance responsible for the improvement of OS in FL was the introduction of the anti-CD20 monoclonal antibody (mAb) rituximab over 20 years ago. Phase III trials demonstrate that rituximab improves the OS in FL when combined with chemotherapy. However, unlike aggressive B-cell lymphomas, advanced stage FL is generally incurable and often displays a pattern of progressively shorter remissions with subsequent lines of therapy. Hence, maintenance strategies have been developed to prolong remissions achieved with frontline therapy. The value of maintenance after frontline therapy has been most extensively studied with extended treatment of anti-CD20 mAb, but recent approaches include chemotherapy-free combinations and targeted therapies given for extended durations. Here, we review relevant data that provide rationale in support of maintenance therapy in FL as well as the risks and limitations of a "one-size-fits-all" approach. Importantly, we note the biologic and clinical heterogeneity across patients with FL that must be considered when making clinical decisions. Finally, we highlight ongoing research that explores response-adapted approaches based on the depth of response as defined by PET scans and assays for minimal residual disease (MRD) that aim to better personalize individual management strategies.
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64
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Leonard JP, Nastoupil LJ, Flowers CR. Where to start? Upfront therapy for follicular lymphoma in 2018. HEMATOLOGY. AMERICAN SOCIETY OF HEMATOLOGY. EDUCATION PROGRAM 2018; 2018:185-188. [PMID: 30504308 PMCID: PMC6246009 DOI: 10.1182/asheducation-2018.1.185] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
The initial approach to the management of follicular lymphoma (FL) is challenging for patients and physicians. Most FL patients present with minimal symptoms; given the lack of a survival benefit to early treatment in this population, a period of observation without therapy is often appropriate. Once there is disease progression beyond low-tumor-burden criteria or symptoms prompting intervention, patients may be considered for an array of potential treatment options. These range from single-agent rituximab (anti-CD20) to various forms of chemoimmunotherapy, including rituximab or the newer anti-CD20 monoclonal antibody obinutuzumab. Unfortunately, prognostic and other clinical factors are of limited value in guiding optimal selection of therapy. Once patients complete initial treatment and achieve a complete or a partial remission, the next decision relates to the pros and cons of maintenance anti-CD20 therapy. Maintenance antibody administration can improve progression-free, but not overall, survival; hence, patient preferences typically drive this decision. Monitoring after remission is achieved should generally be guided by symptoms, physical examination, and laboratory findings, with routine surveillance imaging discouraged in the absence of new clinical issues. Given the wide range of options available and the importance of optimizing quality of life in this chronic health condition, education and shared decision making are pillars in the upfront management of FL to help patients achieve the best possible outcomes.
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Affiliation(s)
- John P. Leonard
- Meyer Cancer Center, Division of Hematology and Medical Oncology, Weill Cornell Medicine and New York Presbyterian Hospital, New York, NY
| | - Loretta J. Nastoupil
- Department of Lymphoma/Myeloma, The University of Texas MD Anderson Cancer Center, Houston, TX; and
| | - Christopher R. Flowers
- Department of Hematology and Oncology, Winship Cancer Institute, Emory University, Atlanta, GA
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65
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Montroni I, Ugolini G, Saur NM, Spinelli A, Rostoft S, Millan M, Wolthuis A, Daniels IR, Hompes R, Penna M, Fürst A, Papamichael D, Desai AM, Cascinu S, Gèrard JP, Myint AS, Lemmens VE, Berho M, Lawler M, De Liguori Carino N, Potenti F, Nanni O, Altini M, Beets G, Rutten H, Winchester D, Wexner SD, Audisio RA. Personalized management of elderly patients with rectal cancer: Expert recommendations of the European Society of Surgical Oncology, European Society of Coloproctology, International Society of Geriatric Oncology, and American College of Surgeons Commission on Cancer. Eur J Surg Oncol 2018; 44:1685-1702. [DOI: 10.1016/j.ejso.2018.08.003] [Citation(s) in RCA: 57] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2018] [Revised: 07/22/2018] [Accepted: 08/03/2018] [Indexed: 12/23/2022] Open
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66
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Dasari A, Grothey A, Kopetz S. Circulating Tumor DNA-Defined Minimal Residual Disease in Solid Tumors: Opportunities to Accelerate the Development of Adjuvant Therapies. J Clin Oncol 2018; 36:JCO2018789032. [PMID: 30376428 PMCID: PMC6286158 DOI: 10.1200/jco.2018.78.9032] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Affiliation(s)
- Arvind Dasari
- Arvind Dasari, The University of Texas MD Anderson Cancer Center, Houston, TX; Axel Grothey, The University of Tennessee West Cancer Center, Memphis, TN; and Scott Kopetz, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Axel Grothey
- Arvind Dasari, The University of Texas MD Anderson Cancer Center, Houston, TX; Axel Grothey, The University of Tennessee West Cancer Center, Memphis, TN; and Scott Kopetz, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Scott Kopetz
- Arvind Dasari, The University of Texas MD Anderson Cancer Center, Houston, TX; Axel Grothey, The University of Tennessee West Cancer Center, Memphis, TN; and Scott Kopetz, The University of Texas MD Anderson Cancer Center, Houston, TX
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67
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Trotman J, Barrington SF, Belada D, Meignan M, MacEwan R, Owen C, Ptáčník V, Rosta A, Fingerle-Rowson GR, Zhu J, Nielsen T, Sahin D, Hiddemann W, Marcus RE, Davies A. Prognostic value of end-of-induction PET response after first-line immunochemotherapy for follicular lymphoma (GALLIUM): secondary analysis of a randomised, phase 3 trial. Lancet Oncol 2018; 19:1530-1542. [PMID: 30309758 DOI: 10.1016/s1470-2045(18)30618-1] [Citation(s) in RCA: 82] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2018] [Revised: 08/08/2018] [Accepted: 08/09/2018] [Indexed: 01/23/2023]
Abstract
BACKGROUND Initial results from the ongoing GALLIUM trial have shown that patients with follicular lymphoma have a longer progression-free survival after first-line immunochemotherapy with obinutuzumab than with rituximab. The aim of this secondary analysis was to evaluate the prognostic value of PET-CT responses after first-line immunochemotherapy in the GALLIUM study. METHODS GALLIUM is an open-label, parallel-group randomised, phase 3 trial, which recruited previously untreated patients with CD20-positive follicular lymphoma (grades 1-3a; disease stage III/IV, or stage II with largest tumour diameter ≥7 cm) who were aged 18 years or older and met the criteria for needing treatment. Eligible patients were randomly assigned in a 1:1 ratio to receive intravenous administration of obinutuzumab (1000 mg on days 1, 8, and 15 of cycle 1, then day 1 of subsequent cycles) or rituximab (375 mg/m2 on day 1 of each cycle), in six 21-day cycles with cyclophosphamide, doxorubicin, vincristine, and prednisone (known as CHOP; oral administration) followed by two 21-day cycles of antibody alone, or eight 21-day cycles cyclophosphamide, vincristine, and prednisone (known as CVP; oral administration), or six 28-day cycles with bendamustine, followed by maintenance antibody every 2 months for up to 2 years. The primary endpoint of the trial, investigator-assessed progression-free survival, has been reported previously. This secondary analysis reports PET and CT-based responses at end-of-induction therapy and explains their relation with progression-free and overall survival outcomes in patients with available scans. As per protocol, during the trial, PET scans (mandatory in the first 170 patients enrolled at sites with available PET facilities, and optional thereafter), acquired at baseline and end of induction (PET population), were assessed prospectively by investigators and an independent review committee (IRC) applying International Harmonisation Project (IHP) 2007 response criteria, and retrospectively by the IRC only applying current Lugano 2014 response criteria. IRC members (but not study investigators) were masked to treatment and clinical outcome when assessing response. The landmark analyses excluded patients who died or progressed (contrast enhanced CT-based assessment of progressive disease, or started next anti-lymphoma treatment) before or at end of induction. GALLIUM is registered at ClinicalTrials.gov, number NCT01332968. FINDINGS 1202 patients were enrolled in GALLIUM between July 6, 2011, and Feb 4, 2014, of whom 595 were included in the PET population; 533 (IHP 2007; prospective analysis), and 508 (Lugano 2014; retrospective analysis) were analysed for progression-free survival (landmark analysis). At end of induction, 390 of 595 patients (65·5% [95% CI 61·6-69·4]) achieved PET complete response according to IHP 2007 criteria, and 450 (75·6% [95% CI 72·0-79·0]) obtained PET complete metabolic response according to Lugano 2014 criteria. With a median of 43·3 months of observation (IQR 36·2-51·8), 2·5-year progression-free survival from end of induction was 87·8% (95% CI 83·9-90·8) in PET complete responders and 72·0% (63·1-79·0) in non-complete responders according to IRC-assessed IHP 2007 criteria (hazard ratio [HR] 0·4, 95% CI 0·3-0·6, p<0·0001). According to Lugano 2014 criteria, 2·5-year progression-free survival in complete metabolic responders was 87·4% (95% CI 83·7-90·2) and in non-complete metabolic responders was 54·9% (40·5-67·3; HR 0·2, 95% CI 0·1-0·3, p<0·0001). INTERPRETATION Our results suggest that PET is a better imaging modality than contrast-enhanced CT for response assessment after first-line immunochemotherapy in patients with follicular lymphoma. PET assessment according to Lugano 2014 response criteria provides a platform for investigation of response-adapted therapeutic approaches. Additional supportive data are welcomed. FUNDING F Hoffmann-La Roche.
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Affiliation(s)
- Judith Trotman
- Haematology Department, Concord Repatriation General Hospital, University of Sydney, Sydney, NSW, Australia.
| | - Sally F Barrington
- King's College London and Guy's and St Thomas' PET Centre, School of Biomedical Engineering and Imaging Sciences, King's College London, King's Health Partners, London, UK
| | - David Belada
- 4th Department of Internal Medicine-Hematology, University Hospital Hradec Králové, Hradec Králové, Czech Republic; Faculty of Medicine in Hradec Králové, Hradec Králové, Czech Republic
| | - Michel Meignan
- LYSA Imaging, Hôpital Henri Mondor and Université Paris Est Créteil, Créteil, France
| | - Robert MacEwan
- University of Alberta, Cross Cancer Institute, Edmonton, AB, Canada
| | - Carolyn Owen
- Foothills Medical Centre and Tom Baker Cancer Centre, Calgary, AB, Canada
| | - Václav Ptáčník
- Institute of Nuclear Medicine, First Faculty of Medicine, Charles University, Prague, Czech Republic
| | - András Rosta
- Department of Medicine, National Institute of Oncology, Budapest, Hungary
| | | | - Jiawen Zhu
- Pharma Development Biometrics Biostatistics, F Hoffmann-La Roche, New York, NY, USA
| | - Tina Nielsen
- Pharma Development Clinical Oncology, F Hoffmann-La Roche, Basel, Switzerland
| | - Deniz Sahin
- Pharma Development Clinical Oncology, F Hoffmann-La Roche, Basel, Switzerland
| | - Wolfgang Hiddemann
- Department of Medicine III, LMU, University Hospital LMU, Munich, Germany
| | - Robert E Marcus
- Department of Haematology, Kings College Hospital, London, UK
| | - Andrew Davies
- Cancer Research UK Centre, University of Southampton, Southampton, UK
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Morschhauser F, Fowler NH, Feugier P, Bouabdallah R, Tilly H, Palomba ML, Fruchart C, Libby EN, Casasnovas RO, Flinn IW, Haioun C, Maisonneuve H, Ysebaert L, Bartlett NL, Bouabdallah K, Brice P, Ribrag V, Daguindau N, Le Gouill S, Pica GM, Martin Garcia-Sancho A, López-Guillermo A, Larouche JF, Ando K, Gomes da Silva M, André M, Zachée P, Sehn LH, Tobinai K, Cartron G, Liu D, Wang J, Xerri L, Salles GA. Rituximab plus Lenalidomide in Advanced Untreated Follicular Lymphoma. N Engl J Med 2018; 379:934-947. [PMID: 30184451 PMCID: PMC11003525 DOI: 10.1056/nejmoa1805104] [Citation(s) in RCA: 228] [Impact Index Per Article: 38.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
BACKGROUND Rituximab plus chemotherapy has been shown to be effective in patients with advanced-stage, previously untreated follicular lymphoma; nevertheless, most patients will have a relapse. Combination immunotherapy with lenalidomide and rituximab is an immunomodulatory regimen that has shown promising activity in patients with indolent B-cell non-Hodgkin's lymphoma. METHODS We conducted this multicenter, international, phase 3 superiority trial to evaluate rituximab plus lenalidomide, as compared with rituximab plus chemotherapy, in patients with previously untreated follicular lymphoma. Patients were randomly assigned to receive one of the two regimens, followed by maintenance monotherapy with rituximab. Treatment with rituximab plus lenalidomide consisted of 18 cycles of the two drugs, followed by rituximab maintenance therapy every 8 weeks for 12 cycles (six additional doses). Treatment with rituximab plus chemotherapy consisted of the investigator's choice of one of three rituximab-based regimens, followed by maintenance monotherapy with rituximab every 8 weeks for 12 cycles. The primary end points were complete response (confirmed or unconfirmed) at 120 weeks and progression-free survival. RESULTS A total of 1030 patients were randomly assigned to receive rituximab plus lenalidomide (513 patients) or rituximab plus chemotherapy (517 patients). The rate of confirmed or unconfirmed complete response at 120 weeks was similar in the two groups: 48% (95% confidence interval [CI], 44 to 53) in the rituximab-lenalidomide group and 53% (95% CI, 49 to 57) in the rituximab-chemotherapy group (P=0.13). The interim 3-year rate of progression-free survival was 77% (95% CI, 72 to 80) and 78% (95% CI, 74 to 82), respectively. A higher percentage of patients in the rituximab-chemotherapy group had grade 3 or 4 neutropenia (32% vs. 50%) and febrile neutropenia of any grade (2% vs. 7%), and a higher percentage of patients in the rituximab-lenalidomide group had grade 3 or 4 cutaneous reactions (7% vs. 1%). CONCLUSIONS Among patients with previously untreated follicular lymphoma, efficacy results were similar with rituximab plus lenalidomide and rituximab plus chemotherapy (with both regimens followed by rituximab maintenance therapy). The safety profile differed in the two groups. (Funded by Celgene; RELEVANCE ClinicalTrials.gov numbers, NCT01476787 and NCT01650701 , and EudraCT number, 2011-002792-42 .).
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Affiliation(s)
- Franck Morschhauser
- From Université Lille, Centre Hospitalier Universitaire (CHU), Groupe de Recherche sur les formes Injectables et les Technologies Associées, Lille (F.M.), CHU Régional de Nancy, Service d'Hématologie, Vandoeuvre lès Nancy (P.F.), Institut Paoli-Calmettes (R.B.) and Department of Pathology, Institut Paoli-Calmettes, Centre de Recherche en Cancerologie de Marseille, INSERM, Centre National de la Recherche Scientifique, Aix-Marseille Université (L.X.), Marseille, Centre Henri Becquerel, Unité 1245 and Département d'Hématologie, Université de Rouen, Rouen (H.T.), Institut d'Hématologie de Basse Normandie, Caen (C.F.), CHU Le Bocage Service d'Hématologie Clinique, Dijon (R.-O.C.), Hôpital Henri Mondor Unité Hémopathies Lymphoïdes, Créteil (C.H.), Centre Hospitalier Départemental Vendée Service d'Onco-Hématologie, La Roche sur Yon (H.M.), Institut Universitaire du Cancer de Toulouse Oncopole Service d'Hématologie, Toulouse (L.Y.), CHU Bordeaux, Service d'Hématologie, Bordeaux (K.B.), Hôpital Saint Louis Service d'Onco-Hématologie, Paris (P.B.), Gustave Roussy Cancer, Villejuif (V.R.), Centre Hospitalier Annecy Genevois Service, Annecy (N.D.), CHU de Nantes-Hôtel Dieu Service d'Hématologie Clinique, Centre de Recherche en Cancerologie et Immunologie, INSERM, Centre National de la Recherche Scientifique, Université de Nantes, Nantes (S.L.G.), Centre Hospitalier Métropole Savoie Service Hématologie, Chambery (G.M.P.), Department of Hematology, CHU Montpellier, University of Montpellier, Montpellier (G.C.), and Hospices Civils de Lyon, Centre Hospitalier Lyon-Sud, University of Lyon, Pierre-Benite (G.A.S.) - all in France; the Department of Lymphoma and Myeloma, University of Texas M.D. Anderson Cancer Center, Houston (N.H.F.); the Department of Medicine, Memorial Sloan Kettering Cancer Center, New York (M.L.P.); the Department of Medicine, Division of Medical Oncology, University of Washington, Seattle (E.N.L.); Sarah Cannon Research Institute-Tennessee Oncology, Nashville (I.W.F.); Washington University School of Medicine, Siteman Cancer Center, St. Louis (N.L.B.); the Department of Hematology, Hospital Universitario de Salamanca and Instituto de Investigación Biomédica de Salamanca, Centro de Investigación Biomédica en Red de Cáncer, Salamanca (A.M.G.-S.), and the Department of Hematology, Hospital Clinic de Barcelona, Barcelona (A.L.-G.) - both in Spain; CHU de Québec, Hôpital de l'Enfant-Jésus, Quebec (J.-F.L.), and British Columbia Cancer Centre for Lymphoid Cancer, University of British Columbia, Vancouver (L.H.S.) - both in Canada; the Department of Hematology and Oncology, Tokai University Hospital, Kanagawa, Japan (K.A.); Instituto Português de Oncologia Lisboa Francisco Gentil Departamento de Hematologia, Lisbon (M.G.S.); the Department of Hematology, CHU Université Catholique de Louvain Namur, Yvoir (M.A.), and the Department of Hematology, Ziekenhuis Netwerk Antwerpen Stuivenberg, Antwerp (P.Z.) - both in Belgium; the Department of Hematology, National Cancer Center Hospital, Tokyo, Japan (K.T.); and Celgene, Summit, NJ (D.L., J.W.)
| | - Nathan H Fowler
- From Université Lille, Centre Hospitalier Universitaire (CHU), Groupe de Recherche sur les formes Injectables et les Technologies Associées, Lille (F.M.), CHU Régional de Nancy, Service d'Hématologie, Vandoeuvre lès Nancy (P.F.), Institut Paoli-Calmettes (R.B.) and Department of Pathology, Institut Paoli-Calmettes, Centre de Recherche en Cancerologie de Marseille, INSERM, Centre National de la Recherche Scientifique, Aix-Marseille Université (L.X.), Marseille, Centre Henri Becquerel, Unité 1245 and Département d'Hématologie, Université de Rouen, Rouen (H.T.), Institut d'Hématologie de Basse Normandie, Caen (C.F.), CHU Le Bocage Service d'Hématologie Clinique, Dijon (R.-O.C.), Hôpital Henri Mondor Unité Hémopathies Lymphoïdes, Créteil (C.H.), Centre Hospitalier Départemental Vendée Service d'Onco-Hématologie, La Roche sur Yon (H.M.), Institut Universitaire du Cancer de Toulouse Oncopole Service d'Hématologie, Toulouse (L.Y.), CHU Bordeaux, Service d'Hématologie, Bordeaux (K.B.), Hôpital Saint Louis Service d'Onco-Hématologie, Paris (P.B.), Gustave Roussy Cancer, Villejuif (V.R.), Centre Hospitalier Annecy Genevois Service, Annecy (N.D.), CHU de Nantes-Hôtel Dieu Service d'Hématologie Clinique, Centre de Recherche en Cancerologie et Immunologie, INSERM, Centre National de la Recherche Scientifique, Université de Nantes, Nantes (S.L.G.), Centre Hospitalier Métropole Savoie Service Hématologie, Chambery (G.M.P.), Department of Hematology, CHU Montpellier, University of Montpellier, Montpellier (G.C.), and Hospices Civils de Lyon, Centre Hospitalier Lyon-Sud, University of Lyon, Pierre-Benite (G.A.S.) - all in France; the Department of Lymphoma and Myeloma, University of Texas M.D. Anderson Cancer Center, Houston (N.H.F.); the Department of Medicine, Memorial Sloan Kettering Cancer Center, New York (M.L.P.); the Department of Medicine, Division of Medical Oncology, University of Washington, Seattle (E.N.L.); Sarah Cannon Research Institute-Tennessee Oncology, Nashville (I.W.F.); Washington University School of Medicine, Siteman Cancer Center, St. Louis (N.L.B.); the Department of Hematology, Hospital Universitario de Salamanca and Instituto de Investigación Biomédica de Salamanca, Centro de Investigación Biomédica en Red de Cáncer, Salamanca (A.M.G.-S.), and the Department of Hematology, Hospital Clinic de Barcelona, Barcelona (A.L.-G.) - both in Spain; CHU de Québec, Hôpital de l'Enfant-Jésus, Quebec (J.-F.L.), and British Columbia Cancer Centre for Lymphoid Cancer, University of British Columbia, Vancouver (L.H.S.) - both in Canada; the Department of Hematology and Oncology, Tokai University Hospital, Kanagawa, Japan (K.A.); Instituto Português de Oncologia Lisboa Francisco Gentil Departamento de Hematologia, Lisbon (M.G.S.); the Department of Hematology, CHU Université Catholique de Louvain Namur, Yvoir (M.A.), and the Department of Hematology, Ziekenhuis Netwerk Antwerpen Stuivenberg, Antwerp (P.Z.) - both in Belgium; the Department of Hematology, National Cancer Center Hospital, Tokyo, Japan (K.T.); and Celgene, Summit, NJ (D.L., J.W.)
| | - Pierre Feugier
- From Université Lille, Centre Hospitalier Universitaire (CHU), Groupe de Recherche sur les formes Injectables et les Technologies Associées, Lille (F.M.), CHU Régional de Nancy, Service d'Hématologie, Vandoeuvre lès Nancy (P.F.), Institut Paoli-Calmettes (R.B.) and Department of Pathology, Institut Paoli-Calmettes, Centre de Recherche en Cancerologie de Marseille, INSERM, Centre National de la Recherche Scientifique, Aix-Marseille Université (L.X.), Marseille, Centre Henri Becquerel, Unité 1245 and Département d'Hématologie, Université de Rouen, Rouen (H.T.), Institut d'Hématologie de Basse Normandie, Caen (C.F.), CHU Le Bocage Service d'Hématologie Clinique, Dijon (R.-O.C.), Hôpital Henri Mondor Unité Hémopathies Lymphoïdes, Créteil (C.H.), Centre Hospitalier Départemental Vendée Service d'Onco-Hématologie, La Roche sur Yon (H.M.), Institut Universitaire du Cancer de Toulouse Oncopole Service d'Hématologie, Toulouse (L.Y.), CHU Bordeaux, Service d'Hématologie, Bordeaux (K.B.), Hôpital Saint Louis Service d'Onco-Hématologie, Paris (P.B.), Gustave Roussy Cancer, Villejuif (V.R.), Centre Hospitalier Annecy Genevois Service, Annecy (N.D.), CHU de Nantes-Hôtel Dieu Service d'Hématologie Clinique, Centre de Recherche en Cancerologie et Immunologie, INSERM, Centre National de la Recherche Scientifique, Université de Nantes, Nantes (S.L.G.), Centre Hospitalier Métropole Savoie Service Hématologie, Chambery (G.M.P.), Department of Hematology, CHU Montpellier, University of Montpellier, Montpellier (G.C.), and Hospices Civils de Lyon, Centre Hospitalier Lyon-Sud, University of Lyon, Pierre-Benite (G.A.S.) - all in France; the Department of Lymphoma and Myeloma, University of Texas M.D. Anderson Cancer Center, Houston (N.H.F.); the Department of Medicine, Memorial Sloan Kettering Cancer Center, New York (M.L.P.); the Department of Medicine, Division of Medical Oncology, University of Washington, Seattle (E.N.L.); Sarah Cannon Research Institute-Tennessee Oncology, Nashville (I.W.F.); Washington University School of Medicine, Siteman Cancer Center, St. Louis (N.L.B.); the Department of Hematology, Hospital Universitario de Salamanca and Instituto de Investigación Biomédica de Salamanca, Centro de Investigación Biomédica en Red de Cáncer, Salamanca (A.M.G.-S.), and the Department of Hematology, Hospital Clinic de Barcelona, Barcelona (A.L.-G.) - both in Spain; CHU de Québec, Hôpital de l'Enfant-Jésus, Quebec (J.-F.L.), and British Columbia Cancer Centre for Lymphoid Cancer, University of British Columbia, Vancouver (L.H.S.) - both in Canada; the Department of Hematology and Oncology, Tokai University Hospital, Kanagawa, Japan (K.A.); Instituto Português de Oncologia Lisboa Francisco Gentil Departamento de Hematologia, Lisbon (M.G.S.); the Department of Hematology, CHU Université Catholique de Louvain Namur, Yvoir (M.A.), and the Department of Hematology, Ziekenhuis Netwerk Antwerpen Stuivenberg, Antwerp (P.Z.) - both in Belgium; the Department of Hematology, National Cancer Center Hospital, Tokyo, Japan (K.T.); and Celgene, Summit, NJ (D.L., J.W.)
| | - Reda Bouabdallah
- From Université Lille, Centre Hospitalier Universitaire (CHU), Groupe de Recherche sur les formes Injectables et les Technologies Associées, Lille (F.M.), CHU Régional de Nancy, Service d'Hématologie, Vandoeuvre lès Nancy (P.F.), Institut Paoli-Calmettes (R.B.) and Department of Pathology, Institut Paoli-Calmettes, Centre de Recherche en Cancerologie de Marseille, INSERM, Centre National de la Recherche Scientifique, Aix-Marseille Université (L.X.), Marseille, Centre Henri Becquerel, Unité 1245 and Département d'Hématologie, Université de Rouen, Rouen (H.T.), Institut d'Hématologie de Basse Normandie, Caen (C.F.), CHU Le Bocage Service d'Hématologie Clinique, Dijon (R.-O.C.), Hôpital Henri Mondor Unité Hémopathies Lymphoïdes, Créteil (C.H.), Centre Hospitalier Départemental Vendée Service d'Onco-Hématologie, La Roche sur Yon (H.M.), Institut Universitaire du Cancer de Toulouse Oncopole Service d'Hématologie, Toulouse (L.Y.), CHU Bordeaux, Service d'Hématologie, Bordeaux (K.B.), Hôpital Saint Louis Service d'Onco-Hématologie, Paris (P.B.), Gustave Roussy Cancer, Villejuif (V.R.), Centre Hospitalier Annecy Genevois Service, Annecy (N.D.), CHU de Nantes-Hôtel Dieu Service d'Hématologie Clinique, Centre de Recherche en Cancerologie et Immunologie, INSERM, Centre National de la Recherche Scientifique, Université de Nantes, Nantes (S.L.G.), Centre Hospitalier Métropole Savoie Service Hématologie, Chambery (G.M.P.), Department of Hematology, CHU Montpellier, University of Montpellier, Montpellier (G.C.), and Hospices Civils de Lyon, Centre Hospitalier Lyon-Sud, University of Lyon, Pierre-Benite (G.A.S.) - all in France; the Department of Lymphoma and Myeloma, University of Texas M.D. Anderson Cancer Center, Houston (N.H.F.); the Department of Medicine, Memorial Sloan Kettering Cancer Center, New York (M.L.P.); the Department of Medicine, Division of Medical Oncology, University of Washington, Seattle (E.N.L.); Sarah Cannon Research Institute-Tennessee Oncology, Nashville (I.W.F.); Washington University School of Medicine, Siteman Cancer Center, St. Louis (N.L.B.); the Department of Hematology, Hospital Universitario de Salamanca and Instituto de Investigación Biomédica de Salamanca, Centro de Investigación Biomédica en Red de Cáncer, Salamanca (A.M.G.-S.), and the Department of Hematology, Hospital Clinic de Barcelona, Barcelona (A.L.-G.) - both in Spain; CHU de Québec, Hôpital de l'Enfant-Jésus, Quebec (J.-F.L.), and British Columbia Cancer Centre for Lymphoid Cancer, University of British Columbia, Vancouver (L.H.S.) - both in Canada; the Department of Hematology and Oncology, Tokai University Hospital, Kanagawa, Japan (K.A.); Instituto Português de Oncologia Lisboa Francisco Gentil Departamento de Hematologia, Lisbon (M.G.S.); the Department of Hematology, CHU Université Catholique de Louvain Namur, Yvoir (M.A.), and the Department of Hematology, Ziekenhuis Netwerk Antwerpen Stuivenberg, Antwerp (P.Z.) - both in Belgium; the Department of Hematology, National Cancer Center Hospital, Tokyo, Japan (K.T.); and Celgene, Summit, NJ (D.L., J.W.)
| | - Hervé Tilly
- From Université Lille, Centre Hospitalier Universitaire (CHU), Groupe de Recherche sur les formes Injectables et les Technologies Associées, Lille (F.M.), CHU Régional de Nancy, Service d'Hématologie, Vandoeuvre lès Nancy (P.F.), Institut Paoli-Calmettes (R.B.) and Department of Pathology, Institut Paoli-Calmettes, Centre de Recherche en Cancerologie de Marseille, INSERM, Centre National de la Recherche Scientifique, Aix-Marseille Université (L.X.), Marseille, Centre Henri Becquerel, Unité 1245 and Département d'Hématologie, Université de Rouen, Rouen (H.T.), Institut d'Hématologie de Basse Normandie, Caen (C.F.), CHU Le Bocage Service d'Hématologie Clinique, Dijon (R.-O.C.), Hôpital Henri Mondor Unité Hémopathies Lymphoïdes, Créteil (C.H.), Centre Hospitalier Départemental Vendée Service d'Onco-Hématologie, La Roche sur Yon (H.M.), Institut Universitaire du Cancer de Toulouse Oncopole Service d'Hématologie, Toulouse (L.Y.), CHU Bordeaux, Service d'Hématologie, Bordeaux (K.B.), Hôpital Saint Louis Service d'Onco-Hématologie, Paris (P.B.), Gustave Roussy Cancer, Villejuif (V.R.), Centre Hospitalier Annecy Genevois Service, Annecy (N.D.), CHU de Nantes-Hôtel Dieu Service d'Hématologie Clinique, Centre de Recherche en Cancerologie et Immunologie, INSERM, Centre National de la Recherche Scientifique, Université de Nantes, Nantes (S.L.G.), Centre Hospitalier Métropole Savoie Service Hématologie, Chambery (G.M.P.), Department of Hematology, CHU Montpellier, University of Montpellier, Montpellier (G.C.), and Hospices Civils de Lyon, Centre Hospitalier Lyon-Sud, University of Lyon, Pierre-Benite (G.A.S.) - all in France; the Department of Lymphoma and Myeloma, University of Texas M.D. Anderson Cancer Center, Houston (N.H.F.); the Department of Medicine, Memorial Sloan Kettering Cancer Center, New York (M.L.P.); the Department of Medicine, Division of Medical Oncology, University of Washington, Seattle (E.N.L.); Sarah Cannon Research Institute-Tennessee Oncology, Nashville (I.W.F.); Washington University School of Medicine, Siteman Cancer Center, St. Louis (N.L.B.); the Department of Hematology, Hospital Universitario de Salamanca and Instituto de Investigación Biomédica de Salamanca, Centro de Investigación Biomédica en Red de Cáncer, Salamanca (A.M.G.-S.), and the Department of Hematology, Hospital Clinic de Barcelona, Barcelona (A.L.-G.) - both in Spain; CHU de Québec, Hôpital de l'Enfant-Jésus, Quebec (J.-F.L.), and British Columbia Cancer Centre for Lymphoid Cancer, University of British Columbia, Vancouver (L.H.S.) - both in Canada; the Department of Hematology and Oncology, Tokai University Hospital, Kanagawa, Japan (K.A.); Instituto Português de Oncologia Lisboa Francisco Gentil Departamento de Hematologia, Lisbon (M.G.S.); the Department of Hematology, CHU Université Catholique de Louvain Namur, Yvoir (M.A.), and the Department of Hematology, Ziekenhuis Netwerk Antwerpen Stuivenberg, Antwerp (P.Z.) - both in Belgium; the Department of Hematology, National Cancer Center Hospital, Tokyo, Japan (K.T.); and Celgene, Summit, NJ (D.L., J.W.)
| | - M Lia Palomba
- From Université Lille, Centre Hospitalier Universitaire (CHU), Groupe de Recherche sur les formes Injectables et les Technologies Associées, Lille (F.M.), CHU Régional de Nancy, Service d'Hématologie, Vandoeuvre lès Nancy (P.F.), Institut Paoli-Calmettes (R.B.) and Department of Pathology, Institut Paoli-Calmettes, Centre de Recherche en Cancerologie de Marseille, INSERM, Centre National de la Recherche Scientifique, Aix-Marseille Université (L.X.), Marseille, Centre Henri Becquerel, Unité 1245 and Département d'Hématologie, Université de Rouen, Rouen (H.T.), Institut d'Hématologie de Basse Normandie, Caen (C.F.), CHU Le Bocage Service d'Hématologie Clinique, Dijon (R.-O.C.), Hôpital Henri Mondor Unité Hémopathies Lymphoïdes, Créteil (C.H.), Centre Hospitalier Départemental Vendée Service d'Onco-Hématologie, La Roche sur Yon (H.M.), Institut Universitaire du Cancer de Toulouse Oncopole Service d'Hématologie, Toulouse (L.Y.), CHU Bordeaux, Service d'Hématologie, Bordeaux (K.B.), Hôpital Saint Louis Service d'Onco-Hématologie, Paris (P.B.), Gustave Roussy Cancer, Villejuif (V.R.), Centre Hospitalier Annecy Genevois Service, Annecy (N.D.), CHU de Nantes-Hôtel Dieu Service d'Hématologie Clinique, Centre de Recherche en Cancerologie et Immunologie, INSERM, Centre National de la Recherche Scientifique, Université de Nantes, Nantes (S.L.G.), Centre Hospitalier Métropole Savoie Service Hématologie, Chambery (G.M.P.), Department of Hematology, CHU Montpellier, University of Montpellier, Montpellier (G.C.), and Hospices Civils de Lyon, Centre Hospitalier Lyon-Sud, University of Lyon, Pierre-Benite (G.A.S.) - all in France; the Department of Lymphoma and Myeloma, University of Texas M.D. Anderson Cancer Center, Houston (N.H.F.); the Department of Medicine, Memorial Sloan Kettering Cancer Center, New York (M.L.P.); the Department of Medicine, Division of Medical Oncology, University of Washington, Seattle (E.N.L.); Sarah Cannon Research Institute-Tennessee Oncology, Nashville (I.W.F.); Washington University School of Medicine, Siteman Cancer Center, St. Louis (N.L.B.); the Department of Hematology, Hospital Universitario de Salamanca and Instituto de Investigación Biomédica de Salamanca, Centro de Investigación Biomédica en Red de Cáncer, Salamanca (A.M.G.-S.), and the Department of Hematology, Hospital Clinic de Barcelona, Barcelona (A.L.-G.) - both in Spain; CHU de Québec, Hôpital de l'Enfant-Jésus, Quebec (J.-F.L.), and British Columbia Cancer Centre for Lymphoid Cancer, University of British Columbia, Vancouver (L.H.S.) - both in Canada; the Department of Hematology and Oncology, Tokai University Hospital, Kanagawa, Japan (K.A.); Instituto Português de Oncologia Lisboa Francisco Gentil Departamento de Hematologia, Lisbon (M.G.S.); the Department of Hematology, CHU Université Catholique de Louvain Namur, Yvoir (M.A.), and the Department of Hematology, Ziekenhuis Netwerk Antwerpen Stuivenberg, Antwerp (P.Z.) - both in Belgium; the Department of Hematology, National Cancer Center Hospital, Tokyo, Japan (K.T.); and Celgene, Summit, NJ (D.L., J.W.)
| | - Christophe Fruchart
- From Université Lille, Centre Hospitalier Universitaire (CHU), Groupe de Recherche sur les formes Injectables et les Technologies Associées, Lille (F.M.), CHU Régional de Nancy, Service d'Hématologie, Vandoeuvre lès Nancy (P.F.), Institut Paoli-Calmettes (R.B.) and Department of Pathology, Institut Paoli-Calmettes, Centre de Recherche en Cancerologie de Marseille, INSERM, Centre National de la Recherche Scientifique, Aix-Marseille Université (L.X.), Marseille, Centre Henri Becquerel, Unité 1245 and Département d'Hématologie, Université de Rouen, Rouen (H.T.), Institut d'Hématologie de Basse Normandie, Caen (C.F.), CHU Le Bocage Service d'Hématologie Clinique, Dijon (R.-O.C.), Hôpital Henri Mondor Unité Hémopathies Lymphoïdes, Créteil (C.H.), Centre Hospitalier Départemental Vendée Service d'Onco-Hématologie, La Roche sur Yon (H.M.), Institut Universitaire du Cancer de Toulouse Oncopole Service d'Hématologie, Toulouse (L.Y.), CHU Bordeaux, Service d'Hématologie, Bordeaux (K.B.), Hôpital Saint Louis Service d'Onco-Hématologie, Paris (P.B.), Gustave Roussy Cancer, Villejuif (V.R.), Centre Hospitalier Annecy Genevois Service, Annecy (N.D.), CHU de Nantes-Hôtel Dieu Service d'Hématologie Clinique, Centre de Recherche en Cancerologie et Immunologie, INSERM, Centre National de la Recherche Scientifique, Université de Nantes, Nantes (S.L.G.), Centre Hospitalier Métropole Savoie Service Hématologie, Chambery (G.M.P.), Department of Hematology, CHU Montpellier, University of Montpellier, Montpellier (G.C.), and Hospices Civils de Lyon, Centre Hospitalier Lyon-Sud, University of Lyon, Pierre-Benite (G.A.S.) - all in France; the Department of Lymphoma and Myeloma, University of Texas M.D. Anderson Cancer Center, Houston (N.H.F.); the Department of Medicine, Memorial Sloan Kettering Cancer Center, New York (M.L.P.); the Department of Medicine, Division of Medical Oncology, University of Washington, Seattle (E.N.L.); Sarah Cannon Research Institute-Tennessee Oncology, Nashville (I.W.F.); Washington University School of Medicine, Siteman Cancer Center, St. Louis (N.L.B.); the Department of Hematology, Hospital Universitario de Salamanca and Instituto de Investigación Biomédica de Salamanca, Centro de Investigación Biomédica en Red de Cáncer, Salamanca (A.M.G.-S.), and the Department of Hematology, Hospital Clinic de Barcelona, Barcelona (A.L.-G.) - both in Spain; CHU de Québec, Hôpital de l'Enfant-Jésus, Quebec (J.-F.L.), and British Columbia Cancer Centre for Lymphoid Cancer, University of British Columbia, Vancouver (L.H.S.) - both in Canada; the Department of Hematology and Oncology, Tokai University Hospital, Kanagawa, Japan (K.A.); Instituto Português de Oncologia Lisboa Francisco Gentil Departamento de Hematologia, Lisbon (M.G.S.); the Department of Hematology, CHU Université Catholique de Louvain Namur, Yvoir (M.A.), and the Department of Hematology, Ziekenhuis Netwerk Antwerpen Stuivenberg, Antwerp (P.Z.) - both in Belgium; the Department of Hematology, National Cancer Center Hospital, Tokyo, Japan (K.T.); and Celgene, Summit, NJ (D.L., J.W.)
| | - Edward N Libby
- From Université Lille, Centre Hospitalier Universitaire (CHU), Groupe de Recherche sur les formes Injectables et les Technologies Associées, Lille (F.M.), CHU Régional de Nancy, Service d'Hématologie, Vandoeuvre lès Nancy (P.F.), Institut Paoli-Calmettes (R.B.) and Department of Pathology, Institut Paoli-Calmettes, Centre de Recherche en Cancerologie de Marseille, INSERM, Centre National de la Recherche Scientifique, Aix-Marseille Université (L.X.), Marseille, Centre Henri Becquerel, Unité 1245 and Département d'Hématologie, Université de Rouen, Rouen (H.T.), Institut d'Hématologie de Basse Normandie, Caen (C.F.), CHU Le Bocage Service d'Hématologie Clinique, Dijon (R.-O.C.), Hôpital Henri Mondor Unité Hémopathies Lymphoïdes, Créteil (C.H.), Centre Hospitalier Départemental Vendée Service d'Onco-Hématologie, La Roche sur Yon (H.M.), Institut Universitaire du Cancer de Toulouse Oncopole Service d'Hématologie, Toulouse (L.Y.), CHU Bordeaux, Service d'Hématologie, Bordeaux (K.B.), Hôpital Saint Louis Service d'Onco-Hématologie, Paris (P.B.), Gustave Roussy Cancer, Villejuif (V.R.), Centre Hospitalier Annecy Genevois Service, Annecy (N.D.), CHU de Nantes-Hôtel Dieu Service d'Hématologie Clinique, Centre de Recherche en Cancerologie et Immunologie, INSERM, Centre National de la Recherche Scientifique, Université de Nantes, Nantes (S.L.G.), Centre Hospitalier Métropole Savoie Service Hématologie, Chambery (G.M.P.), Department of Hematology, CHU Montpellier, University of Montpellier, Montpellier (G.C.), and Hospices Civils de Lyon, Centre Hospitalier Lyon-Sud, University of Lyon, Pierre-Benite (G.A.S.) - all in France; the Department of Lymphoma and Myeloma, University of Texas M.D. Anderson Cancer Center, Houston (N.H.F.); the Department of Medicine, Memorial Sloan Kettering Cancer Center, New York (M.L.P.); the Department of Medicine, Division of Medical Oncology, University of Washington, Seattle (E.N.L.); Sarah Cannon Research Institute-Tennessee Oncology, Nashville (I.W.F.); Washington University School of Medicine, Siteman Cancer Center, St. Louis (N.L.B.); the Department of Hematology, Hospital Universitario de Salamanca and Instituto de Investigación Biomédica de Salamanca, Centro de Investigación Biomédica en Red de Cáncer, Salamanca (A.M.G.-S.), and the Department of Hematology, Hospital Clinic de Barcelona, Barcelona (A.L.-G.) - both in Spain; CHU de Québec, Hôpital de l'Enfant-Jésus, Quebec (J.-F.L.), and British Columbia Cancer Centre for Lymphoid Cancer, University of British Columbia, Vancouver (L.H.S.) - both in Canada; the Department of Hematology and Oncology, Tokai University Hospital, Kanagawa, Japan (K.A.); Instituto Português de Oncologia Lisboa Francisco Gentil Departamento de Hematologia, Lisbon (M.G.S.); the Department of Hematology, CHU Université Catholique de Louvain Namur, Yvoir (M.A.), and the Department of Hematology, Ziekenhuis Netwerk Antwerpen Stuivenberg, Antwerp (P.Z.) - both in Belgium; the Department of Hematology, National Cancer Center Hospital, Tokyo, Japan (K.T.); and Celgene, Summit, NJ (D.L., J.W.)
| | - Rene-Olivier Casasnovas
- From Université Lille, Centre Hospitalier Universitaire (CHU), Groupe de Recherche sur les formes Injectables et les Technologies Associées, Lille (F.M.), CHU Régional de Nancy, Service d'Hématologie, Vandoeuvre lès Nancy (P.F.), Institut Paoli-Calmettes (R.B.) and Department of Pathology, Institut Paoli-Calmettes, Centre de Recherche en Cancerologie de Marseille, INSERM, Centre National de la Recherche Scientifique, Aix-Marseille Université (L.X.), Marseille, Centre Henri Becquerel, Unité 1245 and Département d'Hématologie, Université de Rouen, Rouen (H.T.), Institut d'Hématologie de Basse Normandie, Caen (C.F.), CHU Le Bocage Service d'Hématologie Clinique, Dijon (R.-O.C.), Hôpital Henri Mondor Unité Hémopathies Lymphoïdes, Créteil (C.H.), Centre Hospitalier Départemental Vendée Service d'Onco-Hématologie, La Roche sur Yon (H.M.), Institut Universitaire du Cancer de Toulouse Oncopole Service d'Hématologie, Toulouse (L.Y.), CHU Bordeaux, Service d'Hématologie, Bordeaux (K.B.), Hôpital Saint Louis Service d'Onco-Hématologie, Paris (P.B.), Gustave Roussy Cancer, Villejuif (V.R.), Centre Hospitalier Annecy Genevois Service, Annecy (N.D.), CHU de Nantes-Hôtel Dieu Service d'Hématologie Clinique, Centre de Recherche en Cancerologie et Immunologie, INSERM, Centre National de la Recherche Scientifique, Université de Nantes, Nantes (S.L.G.), Centre Hospitalier Métropole Savoie Service Hématologie, Chambery (G.M.P.), Department of Hematology, CHU Montpellier, University of Montpellier, Montpellier (G.C.), and Hospices Civils de Lyon, Centre Hospitalier Lyon-Sud, University of Lyon, Pierre-Benite (G.A.S.) - all in France; the Department of Lymphoma and Myeloma, University of Texas M.D. Anderson Cancer Center, Houston (N.H.F.); the Department of Medicine, Memorial Sloan Kettering Cancer Center, New York (M.L.P.); the Department of Medicine, Division of Medical Oncology, University of Washington, Seattle (E.N.L.); Sarah Cannon Research Institute-Tennessee Oncology, Nashville (I.W.F.); Washington University School of Medicine, Siteman Cancer Center, St. Louis (N.L.B.); the Department of Hematology, Hospital Universitario de Salamanca and Instituto de Investigación Biomédica de Salamanca, Centro de Investigación Biomédica en Red de Cáncer, Salamanca (A.M.G.-S.), and the Department of Hematology, Hospital Clinic de Barcelona, Barcelona (A.L.-G.) - both in Spain; CHU de Québec, Hôpital de l'Enfant-Jésus, Quebec (J.-F.L.), and British Columbia Cancer Centre for Lymphoid Cancer, University of British Columbia, Vancouver (L.H.S.) - both in Canada; the Department of Hematology and Oncology, Tokai University Hospital, Kanagawa, Japan (K.A.); Instituto Português de Oncologia Lisboa Francisco Gentil Departamento de Hematologia, Lisbon (M.G.S.); the Department of Hematology, CHU Université Catholique de Louvain Namur, Yvoir (M.A.), and the Department of Hematology, Ziekenhuis Netwerk Antwerpen Stuivenberg, Antwerp (P.Z.) - both in Belgium; the Department of Hematology, National Cancer Center Hospital, Tokyo, Japan (K.T.); and Celgene, Summit, NJ (D.L., J.W.)
| | - Ian W Flinn
- From Université Lille, Centre Hospitalier Universitaire (CHU), Groupe de Recherche sur les formes Injectables et les Technologies Associées, Lille (F.M.), CHU Régional de Nancy, Service d'Hématologie, Vandoeuvre lès Nancy (P.F.), Institut Paoli-Calmettes (R.B.) and Department of Pathology, Institut Paoli-Calmettes, Centre de Recherche en Cancerologie de Marseille, INSERM, Centre National de la Recherche Scientifique, Aix-Marseille Université (L.X.), Marseille, Centre Henri Becquerel, Unité 1245 and Département d'Hématologie, Université de Rouen, Rouen (H.T.), Institut d'Hématologie de Basse Normandie, Caen (C.F.), CHU Le Bocage Service d'Hématologie Clinique, Dijon (R.-O.C.), Hôpital Henri Mondor Unité Hémopathies Lymphoïdes, Créteil (C.H.), Centre Hospitalier Départemental Vendée Service d'Onco-Hématologie, La Roche sur Yon (H.M.), Institut Universitaire du Cancer de Toulouse Oncopole Service d'Hématologie, Toulouse (L.Y.), CHU Bordeaux, Service d'Hématologie, Bordeaux (K.B.), Hôpital Saint Louis Service d'Onco-Hématologie, Paris (P.B.), Gustave Roussy Cancer, Villejuif (V.R.), Centre Hospitalier Annecy Genevois Service, Annecy (N.D.), CHU de Nantes-Hôtel Dieu Service d'Hématologie Clinique, Centre de Recherche en Cancerologie et Immunologie, INSERM, Centre National de la Recherche Scientifique, Université de Nantes, Nantes (S.L.G.), Centre Hospitalier Métropole Savoie Service Hématologie, Chambery (G.M.P.), Department of Hematology, CHU Montpellier, University of Montpellier, Montpellier (G.C.), and Hospices Civils de Lyon, Centre Hospitalier Lyon-Sud, University of Lyon, Pierre-Benite (G.A.S.) - all in France; the Department of Lymphoma and Myeloma, University of Texas M.D. Anderson Cancer Center, Houston (N.H.F.); the Department of Medicine, Memorial Sloan Kettering Cancer Center, New York (M.L.P.); the Department of Medicine, Division of Medical Oncology, University of Washington, Seattle (E.N.L.); Sarah Cannon Research Institute-Tennessee Oncology, Nashville (I.W.F.); Washington University School of Medicine, Siteman Cancer Center, St. Louis (N.L.B.); the Department of Hematology, Hospital Universitario de Salamanca and Instituto de Investigación Biomédica de Salamanca, Centro de Investigación Biomédica en Red de Cáncer, Salamanca (A.M.G.-S.), and the Department of Hematology, Hospital Clinic de Barcelona, Barcelona (A.L.-G.) - both in Spain; CHU de Québec, Hôpital de l'Enfant-Jésus, Quebec (J.-F.L.), and British Columbia Cancer Centre for Lymphoid Cancer, University of British Columbia, Vancouver (L.H.S.) - both in Canada; the Department of Hematology and Oncology, Tokai University Hospital, Kanagawa, Japan (K.A.); Instituto Português de Oncologia Lisboa Francisco Gentil Departamento de Hematologia, Lisbon (M.G.S.); the Department of Hematology, CHU Université Catholique de Louvain Namur, Yvoir (M.A.), and the Department of Hematology, Ziekenhuis Netwerk Antwerpen Stuivenberg, Antwerp (P.Z.) - both in Belgium; the Department of Hematology, National Cancer Center Hospital, Tokyo, Japan (K.T.); and Celgene, Summit, NJ (D.L., J.W.)
| | - Corinne Haioun
- From Université Lille, Centre Hospitalier Universitaire (CHU), Groupe de Recherche sur les formes Injectables et les Technologies Associées, Lille (F.M.), CHU Régional de Nancy, Service d'Hématologie, Vandoeuvre lès Nancy (P.F.), Institut Paoli-Calmettes (R.B.) and Department of Pathology, Institut Paoli-Calmettes, Centre de Recherche en Cancerologie de Marseille, INSERM, Centre National de la Recherche Scientifique, Aix-Marseille Université (L.X.), Marseille, Centre Henri Becquerel, Unité 1245 and Département d'Hématologie, Université de Rouen, Rouen (H.T.), Institut d'Hématologie de Basse Normandie, Caen (C.F.), CHU Le Bocage Service d'Hématologie Clinique, Dijon (R.-O.C.), Hôpital Henri Mondor Unité Hémopathies Lymphoïdes, Créteil (C.H.), Centre Hospitalier Départemental Vendée Service d'Onco-Hématologie, La Roche sur Yon (H.M.), Institut Universitaire du Cancer de Toulouse Oncopole Service d'Hématologie, Toulouse (L.Y.), CHU Bordeaux, Service d'Hématologie, Bordeaux (K.B.), Hôpital Saint Louis Service d'Onco-Hématologie, Paris (P.B.), Gustave Roussy Cancer, Villejuif (V.R.), Centre Hospitalier Annecy Genevois Service, Annecy (N.D.), CHU de Nantes-Hôtel Dieu Service d'Hématologie Clinique, Centre de Recherche en Cancerologie et Immunologie, INSERM, Centre National de la Recherche Scientifique, Université de Nantes, Nantes (S.L.G.), Centre Hospitalier Métropole Savoie Service Hématologie, Chambery (G.M.P.), Department of Hematology, CHU Montpellier, University of Montpellier, Montpellier (G.C.), and Hospices Civils de Lyon, Centre Hospitalier Lyon-Sud, University of Lyon, Pierre-Benite (G.A.S.) - all in France; the Department of Lymphoma and Myeloma, University of Texas M.D. Anderson Cancer Center, Houston (N.H.F.); the Department of Medicine, Memorial Sloan Kettering Cancer Center, New York (M.L.P.); the Department of Medicine, Division of Medical Oncology, University of Washington, Seattle (E.N.L.); Sarah Cannon Research Institute-Tennessee Oncology, Nashville (I.W.F.); Washington University School of Medicine, Siteman Cancer Center, St. Louis (N.L.B.); the Department of Hematology, Hospital Universitario de Salamanca and Instituto de Investigación Biomédica de Salamanca, Centro de Investigación Biomédica en Red de Cáncer, Salamanca (A.M.G.-S.), and the Department of Hematology, Hospital Clinic de Barcelona, Barcelona (A.L.-G.) - both in Spain; CHU de Québec, Hôpital de l'Enfant-Jésus, Quebec (J.-F.L.), and British Columbia Cancer Centre for Lymphoid Cancer, University of British Columbia, Vancouver (L.H.S.) - both in Canada; the Department of Hematology and Oncology, Tokai University Hospital, Kanagawa, Japan (K.A.); Instituto Português de Oncologia Lisboa Francisco Gentil Departamento de Hematologia, Lisbon (M.G.S.); the Department of Hematology, CHU Université Catholique de Louvain Namur, Yvoir (M.A.), and the Department of Hematology, Ziekenhuis Netwerk Antwerpen Stuivenberg, Antwerp (P.Z.) - both in Belgium; the Department of Hematology, National Cancer Center Hospital, Tokyo, Japan (K.T.); and Celgene, Summit, NJ (D.L., J.W.)
| | - Hervé Maisonneuve
- From Université Lille, Centre Hospitalier Universitaire (CHU), Groupe de Recherche sur les formes Injectables et les Technologies Associées, Lille (F.M.), CHU Régional de Nancy, Service d'Hématologie, Vandoeuvre lès Nancy (P.F.), Institut Paoli-Calmettes (R.B.) and Department of Pathology, Institut Paoli-Calmettes, Centre de Recherche en Cancerologie de Marseille, INSERM, Centre National de la Recherche Scientifique, Aix-Marseille Université (L.X.), Marseille, Centre Henri Becquerel, Unité 1245 and Département d'Hématologie, Université de Rouen, Rouen (H.T.), Institut d'Hématologie de Basse Normandie, Caen (C.F.), CHU Le Bocage Service d'Hématologie Clinique, Dijon (R.-O.C.), Hôpital Henri Mondor Unité Hémopathies Lymphoïdes, Créteil (C.H.), Centre Hospitalier Départemental Vendée Service d'Onco-Hématologie, La Roche sur Yon (H.M.), Institut Universitaire du Cancer de Toulouse Oncopole Service d'Hématologie, Toulouse (L.Y.), CHU Bordeaux, Service d'Hématologie, Bordeaux (K.B.), Hôpital Saint Louis Service d'Onco-Hématologie, Paris (P.B.), Gustave Roussy Cancer, Villejuif (V.R.), Centre Hospitalier Annecy Genevois Service, Annecy (N.D.), CHU de Nantes-Hôtel Dieu Service d'Hématologie Clinique, Centre de Recherche en Cancerologie et Immunologie, INSERM, Centre National de la Recherche Scientifique, Université de Nantes, Nantes (S.L.G.), Centre Hospitalier Métropole Savoie Service Hématologie, Chambery (G.M.P.), Department of Hematology, CHU Montpellier, University of Montpellier, Montpellier (G.C.), and Hospices Civils de Lyon, Centre Hospitalier Lyon-Sud, University of Lyon, Pierre-Benite (G.A.S.) - all in France; the Department of Lymphoma and Myeloma, University of Texas M.D. Anderson Cancer Center, Houston (N.H.F.); the Department of Medicine, Memorial Sloan Kettering Cancer Center, New York (M.L.P.); the Department of Medicine, Division of Medical Oncology, University of Washington, Seattle (E.N.L.); Sarah Cannon Research Institute-Tennessee Oncology, Nashville (I.W.F.); Washington University School of Medicine, Siteman Cancer Center, St. Louis (N.L.B.); the Department of Hematology, Hospital Universitario de Salamanca and Instituto de Investigación Biomédica de Salamanca, Centro de Investigación Biomédica en Red de Cáncer, Salamanca (A.M.G.-S.), and the Department of Hematology, Hospital Clinic de Barcelona, Barcelona (A.L.-G.) - both in Spain; CHU de Québec, Hôpital de l'Enfant-Jésus, Quebec (J.-F.L.), and British Columbia Cancer Centre for Lymphoid Cancer, University of British Columbia, Vancouver (L.H.S.) - both in Canada; the Department of Hematology and Oncology, Tokai University Hospital, Kanagawa, Japan (K.A.); Instituto Português de Oncologia Lisboa Francisco Gentil Departamento de Hematologia, Lisbon (M.G.S.); the Department of Hematology, CHU Université Catholique de Louvain Namur, Yvoir (M.A.), and the Department of Hematology, Ziekenhuis Netwerk Antwerpen Stuivenberg, Antwerp (P.Z.) - both in Belgium; the Department of Hematology, National Cancer Center Hospital, Tokyo, Japan (K.T.); and Celgene, Summit, NJ (D.L., J.W.)
| | - Loic Ysebaert
- From Université Lille, Centre Hospitalier Universitaire (CHU), Groupe de Recherche sur les formes Injectables et les Technologies Associées, Lille (F.M.), CHU Régional de Nancy, Service d'Hématologie, Vandoeuvre lès Nancy (P.F.), Institut Paoli-Calmettes (R.B.) and Department of Pathology, Institut Paoli-Calmettes, Centre de Recherche en Cancerologie de Marseille, INSERM, Centre National de la Recherche Scientifique, Aix-Marseille Université (L.X.), Marseille, Centre Henri Becquerel, Unité 1245 and Département d'Hématologie, Université de Rouen, Rouen (H.T.), Institut d'Hématologie de Basse Normandie, Caen (C.F.), CHU Le Bocage Service d'Hématologie Clinique, Dijon (R.-O.C.), Hôpital Henri Mondor Unité Hémopathies Lymphoïdes, Créteil (C.H.), Centre Hospitalier Départemental Vendée Service d'Onco-Hématologie, La Roche sur Yon (H.M.), Institut Universitaire du Cancer de Toulouse Oncopole Service d'Hématologie, Toulouse (L.Y.), CHU Bordeaux, Service d'Hématologie, Bordeaux (K.B.), Hôpital Saint Louis Service d'Onco-Hématologie, Paris (P.B.), Gustave Roussy Cancer, Villejuif (V.R.), Centre Hospitalier Annecy Genevois Service, Annecy (N.D.), CHU de Nantes-Hôtel Dieu Service d'Hématologie Clinique, Centre de Recherche en Cancerologie et Immunologie, INSERM, Centre National de la Recherche Scientifique, Université de Nantes, Nantes (S.L.G.), Centre Hospitalier Métropole Savoie Service Hématologie, Chambery (G.M.P.), Department of Hematology, CHU Montpellier, University of Montpellier, Montpellier (G.C.), and Hospices Civils de Lyon, Centre Hospitalier Lyon-Sud, University of Lyon, Pierre-Benite (G.A.S.) - all in France; the Department of Lymphoma and Myeloma, University of Texas M.D. Anderson Cancer Center, Houston (N.H.F.); the Department of Medicine, Memorial Sloan Kettering Cancer Center, New York (M.L.P.); the Department of Medicine, Division of Medical Oncology, University of Washington, Seattle (E.N.L.); Sarah Cannon Research Institute-Tennessee Oncology, Nashville (I.W.F.); Washington University School of Medicine, Siteman Cancer Center, St. Louis (N.L.B.); the Department of Hematology, Hospital Universitario de Salamanca and Instituto de Investigación Biomédica de Salamanca, Centro de Investigación Biomédica en Red de Cáncer, Salamanca (A.M.G.-S.), and the Department of Hematology, Hospital Clinic de Barcelona, Barcelona (A.L.-G.) - both in Spain; CHU de Québec, Hôpital de l'Enfant-Jésus, Quebec (J.-F.L.), and British Columbia Cancer Centre for Lymphoid Cancer, University of British Columbia, Vancouver (L.H.S.) - both in Canada; the Department of Hematology and Oncology, Tokai University Hospital, Kanagawa, Japan (K.A.); Instituto Português de Oncologia Lisboa Francisco Gentil Departamento de Hematologia, Lisbon (M.G.S.); the Department of Hematology, CHU Université Catholique de Louvain Namur, Yvoir (M.A.), and the Department of Hematology, Ziekenhuis Netwerk Antwerpen Stuivenberg, Antwerp (P.Z.) - both in Belgium; the Department of Hematology, National Cancer Center Hospital, Tokyo, Japan (K.T.); and Celgene, Summit, NJ (D.L., J.W.)
| | - Nancy L Bartlett
- From Université Lille, Centre Hospitalier Universitaire (CHU), Groupe de Recherche sur les formes Injectables et les Technologies Associées, Lille (F.M.), CHU Régional de Nancy, Service d'Hématologie, Vandoeuvre lès Nancy (P.F.), Institut Paoli-Calmettes (R.B.) and Department of Pathology, Institut Paoli-Calmettes, Centre de Recherche en Cancerologie de Marseille, INSERM, Centre National de la Recherche Scientifique, Aix-Marseille Université (L.X.), Marseille, Centre Henri Becquerel, Unité 1245 and Département d'Hématologie, Université de Rouen, Rouen (H.T.), Institut d'Hématologie de Basse Normandie, Caen (C.F.), CHU Le Bocage Service d'Hématologie Clinique, Dijon (R.-O.C.), Hôpital Henri Mondor Unité Hémopathies Lymphoïdes, Créteil (C.H.), Centre Hospitalier Départemental Vendée Service d'Onco-Hématologie, La Roche sur Yon (H.M.), Institut Universitaire du Cancer de Toulouse Oncopole Service d'Hématologie, Toulouse (L.Y.), CHU Bordeaux, Service d'Hématologie, Bordeaux (K.B.), Hôpital Saint Louis Service d'Onco-Hématologie, Paris (P.B.), Gustave Roussy Cancer, Villejuif (V.R.), Centre Hospitalier Annecy Genevois Service, Annecy (N.D.), CHU de Nantes-Hôtel Dieu Service d'Hématologie Clinique, Centre de Recherche en Cancerologie et Immunologie, INSERM, Centre National de la Recherche Scientifique, Université de Nantes, Nantes (S.L.G.), Centre Hospitalier Métropole Savoie Service Hématologie, Chambery (G.M.P.), Department of Hematology, CHU Montpellier, University of Montpellier, Montpellier (G.C.), and Hospices Civils de Lyon, Centre Hospitalier Lyon-Sud, University of Lyon, Pierre-Benite (G.A.S.) - all in France; the Department of Lymphoma and Myeloma, University of Texas M.D. Anderson Cancer Center, Houston (N.H.F.); the Department of Medicine, Memorial Sloan Kettering Cancer Center, New York (M.L.P.); the Department of Medicine, Division of Medical Oncology, University of Washington, Seattle (E.N.L.); Sarah Cannon Research Institute-Tennessee Oncology, Nashville (I.W.F.); Washington University School of Medicine, Siteman Cancer Center, St. Louis (N.L.B.); the Department of Hematology, Hospital Universitario de Salamanca and Instituto de Investigación Biomédica de Salamanca, Centro de Investigación Biomédica en Red de Cáncer, Salamanca (A.M.G.-S.), and the Department of Hematology, Hospital Clinic de Barcelona, Barcelona (A.L.-G.) - both in Spain; CHU de Québec, Hôpital de l'Enfant-Jésus, Quebec (J.-F.L.), and British Columbia Cancer Centre for Lymphoid Cancer, University of British Columbia, Vancouver (L.H.S.) - both in Canada; the Department of Hematology and Oncology, Tokai University Hospital, Kanagawa, Japan (K.A.); Instituto Português de Oncologia Lisboa Francisco Gentil Departamento de Hematologia, Lisbon (M.G.S.); the Department of Hematology, CHU Université Catholique de Louvain Namur, Yvoir (M.A.), and the Department of Hematology, Ziekenhuis Netwerk Antwerpen Stuivenberg, Antwerp (P.Z.) - both in Belgium; the Department of Hematology, National Cancer Center Hospital, Tokyo, Japan (K.T.); and Celgene, Summit, NJ (D.L., J.W.)
| | - Kamal Bouabdallah
- From Université Lille, Centre Hospitalier Universitaire (CHU), Groupe de Recherche sur les formes Injectables et les Technologies Associées, Lille (F.M.), CHU Régional de Nancy, Service d'Hématologie, Vandoeuvre lès Nancy (P.F.), Institut Paoli-Calmettes (R.B.) and Department of Pathology, Institut Paoli-Calmettes, Centre de Recherche en Cancerologie de Marseille, INSERM, Centre National de la Recherche Scientifique, Aix-Marseille Université (L.X.), Marseille, Centre Henri Becquerel, Unité 1245 and Département d'Hématologie, Université de Rouen, Rouen (H.T.), Institut d'Hématologie de Basse Normandie, Caen (C.F.), CHU Le Bocage Service d'Hématologie Clinique, Dijon (R.-O.C.), Hôpital Henri Mondor Unité Hémopathies Lymphoïdes, Créteil (C.H.), Centre Hospitalier Départemental Vendée Service d'Onco-Hématologie, La Roche sur Yon (H.M.), Institut Universitaire du Cancer de Toulouse Oncopole Service d'Hématologie, Toulouse (L.Y.), CHU Bordeaux, Service d'Hématologie, Bordeaux (K.B.), Hôpital Saint Louis Service d'Onco-Hématologie, Paris (P.B.), Gustave Roussy Cancer, Villejuif (V.R.), Centre Hospitalier Annecy Genevois Service, Annecy (N.D.), CHU de Nantes-Hôtel Dieu Service d'Hématologie Clinique, Centre de Recherche en Cancerologie et Immunologie, INSERM, Centre National de la Recherche Scientifique, Université de Nantes, Nantes (S.L.G.), Centre Hospitalier Métropole Savoie Service Hématologie, Chambery (G.M.P.), Department of Hematology, CHU Montpellier, University of Montpellier, Montpellier (G.C.), and Hospices Civils de Lyon, Centre Hospitalier Lyon-Sud, University of Lyon, Pierre-Benite (G.A.S.) - all in France; the Department of Lymphoma and Myeloma, University of Texas M.D. Anderson Cancer Center, Houston (N.H.F.); the Department of Medicine, Memorial Sloan Kettering Cancer Center, New York (M.L.P.); the Department of Medicine, Division of Medical Oncology, University of Washington, Seattle (E.N.L.); Sarah Cannon Research Institute-Tennessee Oncology, Nashville (I.W.F.); Washington University School of Medicine, Siteman Cancer Center, St. Louis (N.L.B.); the Department of Hematology, Hospital Universitario de Salamanca and Instituto de Investigación Biomédica de Salamanca, Centro de Investigación Biomédica en Red de Cáncer, Salamanca (A.M.G.-S.), and the Department of Hematology, Hospital Clinic de Barcelona, Barcelona (A.L.-G.) - both in Spain; CHU de Québec, Hôpital de l'Enfant-Jésus, Quebec (J.-F.L.), and British Columbia Cancer Centre for Lymphoid Cancer, University of British Columbia, Vancouver (L.H.S.) - both in Canada; the Department of Hematology and Oncology, Tokai University Hospital, Kanagawa, Japan (K.A.); Instituto Português de Oncologia Lisboa Francisco Gentil Departamento de Hematologia, Lisbon (M.G.S.); the Department of Hematology, CHU Université Catholique de Louvain Namur, Yvoir (M.A.), and the Department of Hematology, Ziekenhuis Netwerk Antwerpen Stuivenberg, Antwerp (P.Z.) - both in Belgium; the Department of Hematology, National Cancer Center Hospital, Tokyo, Japan (K.T.); and Celgene, Summit, NJ (D.L., J.W.)
| | - Pauline Brice
- From Université Lille, Centre Hospitalier Universitaire (CHU), Groupe de Recherche sur les formes Injectables et les Technologies Associées, Lille (F.M.), CHU Régional de Nancy, Service d'Hématologie, Vandoeuvre lès Nancy (P.F.), Institut Paoli-Calmettes (R.B.) and Department of Pathology, Institut Paoli-Calmettes, Centre de Recherche en Cancerologie de Marseille, INSERM, Centre National de la Recherche Scientifique, Aix-Marseille Université (L.X.), Marseille, Centre Henri Becquerel, Unité 1245 and Département d'Hématologie, Université de Rouen, Rouen (H.T.), Institut d'Hématologie de Basse Normandie, Caen (C.F.), CHU Le Bocage Service d'Hématologie Clinique, Dijon (R.-O.C.), Hôpital Henri Mondor Unité Hémopathies Lymphoïdes, Créteil (C.H.), Centre Hospitalier Départemental Vendée Service d'Onco-Hématologie, La Roche sur Yon (H.M.), Institut Universitaire du Cancer de Toulouse Oncopole Service d'Hématologie, Toulouse (L.Y.), CHU Bordeaux, Service d'Hématologie, Bordeaux (K.B.), Hôpital Saint Louis Service d'Onco-Hématologie, Paris (P.B.), Gustave Roussy Cancer, Villejuif (V.R.), Centre Hospitalier Annecy Genevois Service, Annecy (N.D.), CHU de Nantes-Hôtel Dieu Service d'Hématologie Clinique, Centre de Recherche en Cancerologie et Immunologie, INSERM, Centre National de la Recherche Scientifique, Université de Nantes, Nantes (S.L.G.), Centre Hospitalier Métropole Savoie Service Hématologie, Chambery (G.M.P.), Department of Hematology, CHU Montpellier, University of Montpellier, Montpellier (G.C.), and Hospices Civils de Lyon, Centre Hospitalier Lyon-Sud, University of Lyon, Pierre-Benite (G.A.S.) - all in France; the Department of Lymphoma and Myeloma, University of Texas M.D. Anderson Cancer Center, Houston (N.H.F.); the Department of Medicine, Memorial Sloan Kettering Cancer Center, New York (M.L.P.); the Department of Medicine, Division of Medical Oncology, University of Washington, Seattle (E.N.L.); Sarah Cannon Research Institute-Tennessee Oncology, Nashville (I.W.F.); Washington University School of Medicine, Siteman Cancer Center, St. Louis (N.L.B.); the Department of Hematology, Hospital Universitario de Salamanca and Instituto de Investigación Biomédica de Salamanca, Centro de Investigación Biomédica en Red de Cáncer, Salamanca (A.M.G.-S.), and the Department of Hematology, Hospital Clinic de Barcelona, Barcelona (A.L.-G.) - both in Spain; CHU de Québec, Hôpital de l'Enfant-Jésus, Quebec (J.-F.L.), and British Columbia Cancer Centre for Lymphoid Cancer, University of British Columbia, Vancouver (L.H.S.) - both in Canada; the Department of Hematology and Oncology, Tokai University Hospital, Kanagawa, Japan (K.A.); Instituto Português de Oncologia Lisboa Francisco Gentil Departamento de Hematologia, Lisbon (M.G.S.); the Department of Hematology, CHU Université Catholique de Louvain Namur, Yvoir (M.A.), and the Department of Hematology, Ziekenhuis Netwerk Antwerpen Stuivenberg, Antwerp (P.Z.) - both in Belgium; the Department of Hematology, National Cancer Center Hospital, Tokyo, Japan (K.T.); and Celgene, Summit, NJ (D.L., J.W.)
| | - Vincent Ribrag
- From Université Lille, Centre Hospitalier Universitaire (CHU), Groupe de Recherche sur les formes Injectables et les Technologies Associées, Lille (F.M.), CHU Régional de Nancy, Service d'Hématologie, Vandoeuvre lès Nancy (P.F.), Institut Paoli-Calmettes (R.B.) and Department of Pathology, Institut Paoli-Calmettes, Centre de Recherche en Cancerologie de Marseille, INSERM, Centre National de la Recherche Scientifique, Aix-Marseille Université (L.X.), Marseille, Centre Henri Becquerel, Unité 1245 and Département d'Hématologie, Université de Rouen, Rouen (H.T.), Institut d'Hématologie de Basse Normandie, Caen (C.F.), CHU Le Bocage Service d'Hématologie Clinique, Dijon (R.-O.C.), Hôpital Henri Mondor Unité Hémopathies Lymphoïdes, Créteil (C.H.), Centre Hospitalier Départemental Vendée Service d'Onco-Hématologie, La Roche sur Yon (H.M.), Institut Universitaire du Cancer de Toulouse Oncopole Service d'Hématologie, Toulouse (L.Y.), CHU Bordeaux, Service d'Hématologie, Bordeaux (K.B.), Hôpital Saint Louis Service d'Onco-Hématologie, Paris (P.B.), Gustave Roussy Cancer, Villejuif (V.R.), Centre Hospitalier Annecy Genevois Service, Annecy (N.D.), CHU de Nantes-Hôtel Dieu Service d'Hématologie Clinique, Centre de Recherche en Cancerologie et Immunologie, INSERM, Centre National de la Recherche Scientifique, Université de Nantes, Nantes (S.L.G.), Centre Hospitalier Métropole Savoie Service Hématologie, Chambery (G.M.P.), Department of Hematology, CHU Montpellier, University of Montpellier, Montpellier (G.C.), and Hospices Civils de Lyon, Centre Hospitalier Lyon-Sud, University of Lyon, Pierre-Benite (G.A.S.) - all in France; the Department of Lymphoma and Myeloma, University of Texas M.D. Anderson Cancer Center, Houston (N.H.F.); the Department of Medicine, Memorial Sloan Kettering Cancer Center, New York (M.L.P.); the Department of Medicine, Division of Medical Oncology, University of Washington, Seattle (E.N.L.); Sarah Cannon Research Institute-Tennessee Oncology, Nashville (I.W.F.); Washington University School of Medicine, Siteman Cancer Center, St. Louis (N.L.B.); the Department of Hematology, Hospital Universitario de Salamanca and Instituto de Investigación Biomédica de Salamanca, Centro de Investigación Biomédica en Red de Cáncer, Salamanca (A.M.G.-S.), and the Department of Hematology, Hospital Clinic de Barcelona, Barcelona (A.L.-G.) - both in Spain; CHU de Québec, Hôpital de l'Enfant-Jésus, Quebec (J.-F.L.), and British Columbia Cancer Centre for Lymphoid Cancer, University of British Columbia, Vancouver (L.H.S.) - both in Canada; the Department of Hematology and Oncology, Tokai University Hospital, Kanagawa, Japan (K.A.); Instituto Português de Oncologia Lisboa Francisco Gentil Departamento de Hematologia, Lisbon (M.G.S.); the Department of Hematology, CHU Université Catholique de Louvain Namur, Yvoir (M.A.), and the Department of Hematology, Ziekenhuis Netwerk Antwerpen Stuivenberg, Antwerp (P.Z.) - both in Belgium; the Department of Hematology, National Cancer Center Hospital, Tokyo, Japan (K.T.); and Celgene, Summit, NJ (D.L., J.W.)
| | - Nicolas Daguindau
- From Université Lille, Centre Hospitalier Universitaire (CHU), Groupe de Recherche sur les formes Injectables et les Technologies Associées, Lille (F.M.), CHU Régional de Nancy, Service d'Hématologie, Vandoeuvre lès Nancy (P.F.), Institut Paoli-Calmettes (R.B.) and Department of Pathology, Institut Paoli-Calmettes, Centre de Recherche en Cancerologie de Marseille, INSERM, Centre National de la Recherche Scientifique, Aix-Marseille Université (L.X.), Marseille, Centre Henri Becquerel, Unité 1245 and Département d'Hématologie, Université de Rouen, Rouen (H.T.), Institut d'Hématologie de Basse Normandie, Caen (C.F.), CHU Le Bocage Service d'Hématologie Clinique, Dijon (R.-O.C.), Hôpital Henri Mondor Unité Hémopathies Lymphoïdes, Créteil (C.H.), Centre Hospitalier Départemental Vendée Service d'Onco-Hématologie, La Roche sur Yon (H.M.), Institut Universitaire du Cancer de Toulouse Oncopole Service d'Hématologie, Toulouse (L.Y.), CHU Bordeaux, Service d'Hématologie, Bordeaux (K.B.), Hôpital Saint Louis Service d'Onco-Hématologie, Paris (P.B.), Gustave Roussy Cancer, Villejuif (V.R.), Centre Hospitalier Annecy Genevois Service, Annecy (N.D.), CHU de Nantes-Hôtel Dieu Service d'Hématologie Clinique, Centre de Recherche en Cancerologie et Immunologie, INSERM, Centre National de la Recherche Scientifique, Université de Nantes, Nantes (S.L.G.), Centre Hospitalier Métropole Savoie Service Hématologie, Chambery (G.M.P.), Department of Hematology, CHU Montpellier, University of Montpellier, Montpellier (G.C.), and Hospices Civils de Lyon, Centre Hospitalier Lyon-Sud, University of Lyon, Pierre-Benite (G.A.S.) - all in France; the Department of Lymphoma and Myeloma, University of Texas M.D. Anderson Cancer Center, Houston (N.H.F.); the Department of Medicine, Memorial Sloan Kettering Cancer Center, New York (M.L.P.); the Department of Medicine, Division of Medical Oncology, University of Washington, Seattle (E.N.L.); Sarah Cannon Research Institute-Tennessee Oncology, Nashville (I.W.F.); Washington University School of Medicine, Siteman Cancer Center, St. Louis (N.L.B.); the Department of Hematology, Hospital Universitario de Salamanca and Instituto de Investigación Biomédica de Salamanca, Centro de Investigación Biomédica en Red de Cáncer, Salamanca (A.M.G.-S.), and the Department of Hematology, Hospital Clinic de Barcelona, Barcelona (A.L.-G.) - both in Spain; CHU de Québec, Hôpital de l'Enfant-Jésus, Quebec (J.-F.L.), and British Columbia Cancer Centre for Lymphoid Cancer, University of British Columbia, Vancouver (L.H.S.) - both in Canada; the Department of Hematology and Oncology, Tokai University Hospital, Kanagawa, Japan (K.A.); Instituto Português de Oncologia Lisboa Francisco Gentil Departamento de Hematologia, Lisbon (M.G.S.); the Department of Hematology, CHU Université Catholique de Louvain Namur, Yvoir (M.A.), and the Department of Hematology, Ziekenhuis Netwerk Antwerpen Stuivenberg, Antwerp (P.Z.) - both in Belgium; the Department of Hematology, National Cancer Center Hospital, Tokyo, Japan (K.T.); and Celgene, Summit, NJ (D.L., J.W.)
| | - Steven Le Gouill
- From Université Lille, Centre Hospitalier Universitaire (CHU), Groupe de Recherche sur les formes Injectables et les Technologies Associées, Lille (F.M.), CHU Régional de Nancy, Service d'Hématologie, Vandoeuvre lès Nancy (P.F.), Institut Paoli-Calmettes (R.B.) and Department of Pathology, Institut Paoli-Calmettes, Centre de Recherche en Cancerologie de Marseille, INSERM, Centre National de la Recherche Scientifique, Aix-Marseille Université (L.X.), Marseille, Centre Henri Becquerel, Unité 1245 and Département d'Hématologie, Université de Rouen, Rouen (H.T.), Institut d'Hématologie de Basse Normandie, Caen (C.F.), CHU Le Bocage Service d'Hématologie Clinique, Dijon (R.-O.C.), Hôpital Henri Mondor Unité Hémopathies Lymphoïdes, Créteil (C.H.), Centre Hospitalier Départemental Vendée Service d'Onco-Hématologie, La Roche sur Yon (H.M.), Institut Universitaire du Cancer de Toulouse Oncopole Service d'Hématologie, Toulouse (L.Y.), CHU Bordeaux, Service d'Hématologie, Bordeaux (K.B.), Hôpital Saint Louis Service d'Onco-Hématologie, Paris (P.B.), Gustave Roussy Cancer, Villejuif (V.R.), Centre Hospitalier Annecy Genevois Service, Annecy (N.D.), CHU de Nantes-Hôtel Dieu Service d'Hématologie Clinique, Centre de Recherche en Cancerologie et Immunologie, INSERM, Centre National de la Recherche Scientifique, Université de Nantes, Nantes (S.L.G.), Centre Hospitalier Métropole Savoie Service Hématologie, Chambery (G.M.P.), Department of Hematology, CHU Montpellier, University of Montpellier, Montpellier (G.C.), and Hospices Civils de Lyon, Centre Hospitalier Lyon-Sud, University of Lyon, Pierre-Benite (G.A.S.) - all in France; the Department of Lymphoma and Myeloma, University of Texas M.D. Anderson Cancer Center, Houston (N.H.F.); the Department of Medicine, Memorial Sloan Kettering Cancer Center, New York (M.L.P.); the Department of Medicine, Division of Medical Oncology, University of Washington, Seattle (E.N.L.); Sarah Cannon Research Institute-Tennessee Oncology, Nashville (I.W.F.); Washington University School of Medicine, Siteman Cancer Center, St. Louis (N.L.B.); the Department of Hematology, Hospital Universitario de Salamanca and Instituto de Investigación Biomédica de Salamanca, Centro de Investigación Biomédica en Red de Cáncer, Salamanca (A.M.G.-S.), and the Department of Hematology, Hospital Clinic de Barcelona, Barcelona (A.L.-G.) - both in Spain; CHU de Québec, Hôpital de l'Enfant-Jésus, Quebec (J.-F.L.), and British Columbia Cancer Centre for Lymphoid Cancer, University of British Columbia, Vancouver (L.H.S.) - both in Canada; the Department of Hematology and Oncology, Tokai University Hospital, Kanagawa, Japan (K.A.); Instituto Português de Oncologia Lisboa Francisco Gentil Departamento de Hematologia, Lisbon (M.G.S.); the Department of Hematology, CHU Université Catholique de Louvain Namur, Yvoir (M.A.), and the Department of Hematology, Ziekenhuis Netwerk Antwerpen Stuivenberg, Antwerp (P.Z.) - both in Belgium; the Department of Hematology, National Cancer Center Hospital, Tokyo, Japan (K.T.); and Celgene, Summit, NJ (D.L., J.W.)
| | - Gian M Pica
- From Université Lille, Centre Hospitalier Universitaire (CHU), Groupe de Recherche sur les formes Injectables et les Technologies Associées, Lille (F.M.), CHU Régional de Nancy, Service d'Hématologie, Vandoeuvre lès Nancy (P.F.), Institut Paoli-Calmettes (R.B.) and Department of Pathology, Institut Paoli-Calmettes, Centre de Recherche en Cancerologie de Marseille, INSERM, Centre National de la Recherche Scientifique, Aix-Marseille Université (L.X.), Marseille, Centre Henri Becquerel, Unité 1245 and Département d'Hématologie, Université de Rouen, Rouen (H.T.), Institut d'Hématologie de Basse Normandie, Caen (C.F.), CHU Le Bocage Service d'Hématologie Clinique, Dijon (R.-O.C.), Hôpital Henri Mondor Unité Hémopathies Lymphoïdes, Créteil (C.H.), Centre Hospitalier Départemental Vendée Service d'Onco-Hématologie, La Roche sur Yon (H.M.), Institut Universitaire du Cancer de Toulouse Oncopole Service d'Hématologie, Toulouse (L.Y.), CHU Bordeaux, Service d'Hématologie, Bordeaux (K.B.), Hôpital Saint Louis Service d'Onco-Hématologie, Paris (P.B.), Gustave Roussy Cancer, Villejuif (V.R.), Centre Hospitalier Annecy Genevois Service, Annecy (N.D.), CHU de Nantes-Hôtel Dieu Service d'Hématologie Clinique, Centre de Recherche en Cancerologie et Immunologie, INSERM, Centre National de la Recherche Scientifique, Université de Nantes, Nantes (S.L.G.), Centre Hospitalier Métropole Savoie Service Hématologie, Chambery (G.M.P.), Department of Hematology, CHU Montpellier, University of Montpellier, Montpellier (G.C.), and Hospices Civils de Lyon, Centre Hospitalier Lyon-Sud, University of Lyon, Pierre-Benite (G.A.S.) - all in France; the Department of Lymphoma and Myeloma, University of Texas M.D. Anderson Cancer Center, Houston (N.H.F.); the Department of Medicine, Memorial Sloan Kettering Cancer Center, New York (M.L.P.); the Department of Medicine, Division of Medical Oncology, University of Washington, Seattle (E.N.L.); Sarah Cannon Research Institute-Tennessee Oncology, Nashville (I.W.F.); Washington University School of Medicine, Siteman Cancer Center, St. Louis (N.L.B.); the Department of Hematology, Hospital Universitario de Salamanca and Instituto de Investigación Biomédica de Salamanca, Centro de Investigación Biomédica en Red de Cáncer, Salamanca (A.M.G.-S.), and the Department of Hematology, Hospital Clinic de Barcelona, Barcelona (A.L.-G.) - both in Spain; CHU de Québec, Hôpital de l'Enfant-Jésus, Quebec (J.-F.L.), and British Columbia Cancer Centre for Lymphoid Cancer, University of British Columbia, Vancouver (L.H.S.) - both in Canada; the Department of Hematology and Oncology, Tokai University Hospital, Kanagawa, Japan (K.A.); Instituto Português de Oncologia Lisboa Francisco Gentil Departamento de Hematologia, Lisbon (M.G.S.); the Department of Hematology, CHU Université Catholique de Louvain Namur, Yvoir (M.A.), and the Department of Hematology, Ziekenhuis Netwerk Antwerpen Stuivenberg, Antwerp (P.Z.) - both in Belgium; the Department of Hematology, National Cancer Center Hospital, Tokyo, Japan (K.T.); and Celgene, Summit, NJ (D.L., J.W.)
| | - Alejandro Martin Garcia-Sancho
- From Université Lille, Centre Hospitalier Universitaire (CHU), Groupe de Recherche sur les formes Injectables et les Technologies Associées, Lille (F.M.), CHU Régional de Nancy, Service d'Hématologie, Vandoeuvre lès Nancy (P.F.), Institut Paoli-Calmettes (R.B.) and Department of Pathology, Institut Paoli-Calmettes, Centre de Recherche en Cancerologie de Marseille, INSERM, Centre National de la Recherche Scientifique, Aix-Marseille Université (L.X.), Marseille, Centre Henri Becquerel, Unité 1245 and Département d'Hématologie, Université de Rouen, Rouen (H.T.), Institut d'Hématologie de Basse Normandie, Caen (C.F.), CHU Le Bocage Service d'Hématologie Clinique, Dijon (R.-O.C.), Hôpital Henri Mondor Unité Hémopathies Lymphoïdes, Créteil (C.H.), Centre Hospitalier Départemental Vendée Service d'Onco-Hématologie, La Roche sur Yon (H.M.), Institut Universitaire du Cancer de Toulouse Oncopole Service d'Hématologie, Toulouse (L.Y.), CHU Bordeaux, Service d'Hématologie, Bordeaux (K.B.), Hôpital Saint Louis Service d'Onco-Hématologie, Paris (P.B.), Gustave Roussy Cancer, Villejuif (V.R.), Centre Hospitalier Annecy Genevois Service, Annecy (N.D.), CHU de Nantes-Hôtel Dieu Service d'Hématologie Clinique, Centre de Recherche en Cancerologie et Immunologie, INSERM, Centre National de la Recherche Scientifique, Université de Nantes, Nantes (S.L.G.), Centre Hospitalier Métropole Savoie Service Hématologie, Chambery (G.M.P.), Department of Hematology, CHU Montpellier, University of Montpellier, Montpellier (G.C.), and Hospices Civils de Lyon, Centre Hospitalier Lyon-Sud, University of Lyon, Pierre-Benite (G.A.S.) - all in France; the Department of Lymphoma and Myeloma, University of Texas M.D. Anderson Cancer Center, Houston (N.H.F.); the Department of Medicine, Memorial Sloan Kettering Cancer Center, New York (M.L.P.); the Department of Medicine, Division of Medical Oncology, University of Washington, Seattle (E.N.L.); Sarah Cannon Research Institute-Tennessee Oncology, Nashville (I.W.F.); Washington University School of Medicine, Siteman Cancer Center, St. Louis (N.L.B.); the Department of Hematology, Hospital Universitario de Salamanca and Instituto de Investigación Biomédica de Salamanca, Centro de Investigación Biomédica en Red de Cáncer, Salamanca (A.M.G.-S.), and the Department of Hematology, Hospital Clinic de Barcelona, Barcelona (A.L.-G.) - both in Spain; CHU de Québec, Hôpital de l'Enfant-Jésus, Quebec (J.-F.L.), and British Columbia Cancer Centre for Lymphoid Cancer, University of British Columbia, Vancouver (L.H.S.) - both in Canada; the Department of Hematology and Oncology, Tokai University Hospital, Kanagawa, Japan (K.A.); Instituto Português de Oncologia Lisboa Francisco Gentil Departamento de Hematologia, Lisbon (M.G.S.); the Department of Hematology, CHU Université Catholique de Louvain Namur, Yvoir (M.A.), and the Department of Hematology, Ziekenhuis Netwerk Antwerpen Stuivenberg, Antwerp (P.Z.) - both in Belgium; the Department of Hematology, National Cancer Center Hospital, Tokyo, Japan (K.T.); and Celgene, Summit, NJ (D.L., J.W.)
| | - Armando López-Guillermo
- From Université Lille, Centre Hospitalier Universitaire (CHU), Groupe de Recherche sur les formes Injectables et les Technologies Associées, Lille (F.M.), CHU Régional de Nancy, Service d'Hématologie, Vandoeuvre lès Nancy (P.F.), Institut Paoli-Calmettes (R.B.) and Department of Pathology, Institut Paoli-Calmettes, Centre de Recherche en Cancerologie de Marseille, INSERM, Centre National de la Recherche Scientifique, Aix-Marseille Université (L.X.), Marseille, Centre Henri Becquerel, Unité 1245 and Département d'Hématologie, Université de Rouen, Rouen (H.T.), Institut d'Hématologie de Basse Normandie, Caen (C.F.), CHU Le Bocage Service d'Hématologie Clinique, Dijon (R.-O.C.), Hôpital Henri Mondor Unité Hémopathies Lymphoïdes, Créteil (C.H.), Centre Hospitalier Départemental Vendée Service d'Onco-Hématologie, La Roche sur Yon (H.M.), Institut Universitaire du Cancer de Toulouse Oncopole Service d'Hématologie, Toulouse (L.Y.), CHU Bordeaux, Service d'Hématologie, Bordeaux (K.B.), Hôpital Saint Louis Service d'Onco-Hématologie, Paris (P.B.), Gustave Roussy Cancer, Villejuif (V.R.), Centre Hospitalier Annecy Genevois Service, Annecy (N.D.), CHU de Nantes-Hôtel Dieu Service d'Hématologie Clinique, Centre de Recherche en Cancerologie et Immunologie, INSERM, Centre National de la Recherche Scientifique, Université de Nantes, Nantes (S.L.G.), Centre Hospitalier Métropole Savoie Service Hématologie, Chambery (G.M.P.), Department of Hematology, CHU Montpellier, University of Montpellier, Montpellier (G.C.), and Hospices Civils de Lyon, Centre Hospitalier Lyon-Sud, University of Lyon, Pierre-Benite (G.A.S.) - all in France; the Department of Lymphoma and Myeloma, University of Texas M.D. Anderson Cancer Center, Houston (N.H.F.); the Department of Medicine, Memorial Sloan Kettering Cancer Center, New York (M.L.P.); the Department of Medicine, Division of Medical Oncology, University of Washington, Seattle (E.N.L.); Sarah Cannon Research Institute-Tennessee Oncology, Nashville (I.W.F.); Washington University School of Medicine, Siteman Cancer Center, St. Louis (N.L.B.); the Department of Hematology, Hospital Universitario de Salamanca and Instituto de Investigación Biomédica de Salamanca, Centro de Investigación Biomédica en Red de Cáncer, Salamanca (A.M.G.-S.), and the Department of Hematology, Hospital Clinic de Barcelona, Barcelona (A.L.-G.) - both in Spain; CHU de Québec, Hôpital de l'Enfant-Jésus, Quebec (J.-F.L.), and British Columbia Cancer Centre for Lymphoid Cancer, University of British Columbia, Vancouver (L.H.S.) - both in Canada; the Department of Hematology and Oncology, Tokai University Hospital, Kanagawa, Japan (K.A.); Instituto Português de Oncologia Lisboa Francisco Gentil Departamento de Hematologia, Lisbon (M.G.S.); the Department of Hematology, CHU Université Catholique de Louvain Namur, Yvoir (M.A.), and the Department of Hematology, Ziekenhuis Netwerk Antwerpen Stuivenberg, Antwerp (P.Z.) - both in Belgium; the Department of Hematology, National Cancer Center Hospital, Tokyo, Japan (K.T.); and Celgene, Summit, NJ (D.L., J.W.)
| | - Jean-François Larouche
- From Université Lille, Centre Hospitalier Universitaire (CHU), Groupe de Recherche sur les formes Injectables et les Technologies Associées, Lille (F.M.), CHU Régional de Nancy, Service d'Hématologie, Vandoeuvre lès Nancy (P.F.), Institut Paoli-Calmettes (R.B.) and Department of Pathology, Institut Paoli-Calmettes, Centre de Recherche en Cancerologie de Marseille, INSERM, Centre National de la Recherche Scientifique, Aix-Marseille Université (L.X.), Marseille, Centre Henri Becquerel, Unité 1245 and Département d'Hématologie, Université de Rouen, Rouen (H.T.), Institut d'Hématologie de Basse Normandie, Caen (C.F.), CHU Le Bocage Service d'Hématologie Clinique, Dijon (R.-O.C.), Hôpital Henri Mondor Unité Hémopathies Lymphoïdes, Créteil (C.H.), Centre Hospitalier Départemental Vendée Service d'Onco-Hématologie, La Roche sur Yon (H.M.), Institut Universitaire du Cancer de Toulouse Oncopole Service d'Hématologie, Toulouse (L.Y.), CHU Bordeaux, Service d'Hématologie, Bordeaux (K.B.), Hôpital Saint Louis Service d'Onco-Hématologie, Paris (P.B.), Gustave Roussy Cancer, Villejuif (V.R.), Centre Hospitalier Annecy Genevois Service, Annecy (N.D.), CHU de Nantes-Hôtel Dieu Service d'Hématologie Clinique, Centre de Recherche en Cancerologie et Immunologie, INSERM, Centre National de la Recherche Scientifique, Université de Nantes, Nantes (S.L.G.), Centre Hospitalier Métropole Savoie Service Hématologie, Chambery (G.M.P.), Department of Hematology, CHU Montpellier, University of Montpellier, Montpellier (G.C.), and Hospices Civils de Lyon, Centre Hospitalier Lyon-Sud, University of Lyon, Pierre-Benite (G.A.S.) - all in France; the Department of Lymphoma and Myeloma, University of Texas M.D. Anderson Cancer Center, Houston (N.H.F.); the Department of Medicine, Memorial Sloan Kettering Cancer Center, New York (M.L.P.); the Department of Medicine, Division of Medical Oncology, University of Washington, Seattle (E.N.L.); Sarah Cannon Research Institute-Tennessee Oncology, Nashville (I.W.F.); Washington University School of Medicine, Siteman Cancer Center, St. Louis (N.L.B.); the Department of Hematology, Hospital Universitario de Salamanca and Instituto de Investigación Biomédica de Salamanca, Centro de Investigación Biomédica en Red de Cáncer, Salamanca (A.M.G.-S.), and the Department of Hematology, Hospital Clinic de Barcelona, Barcelona (A.L.-G.) - both in Spain; CHU de Québec, Hôpital de l'Enfant-Jésus, Quebec (J.-F.L.), and British Columbia Cancer Centre for Lymphoid Cancer, University of British Columbia, Vancouver (L.H.S.) - both in Canada; the Department of Hematology and Oncology, Tokai University Hospital, Kanagawa, Japan (K.A.); Instituto Português de Oncologia Lisboa Francisco Gentil Departamento de Hematologia, Lisbon (M.G.S.); the Department of Hematology, CHU Université Catholique de Louvain Namur, Yvoir (M.A.), and the Department of Hematology, Ziekenhuis Netwerk Antwerpen Stuivenberg, Antwerp (P.Z.) - both in Belgium; the Department of Hematology, National Cancer Center Hospital, Tokyo, Japan (K.T.); and Celgene, Summit, NJ (D.L., J.W.)
| | - Kiyoshi Ando
- From Université Lille, Centre Hospitalier Universitaire (CHU), Groupe de Recherche sur les formes Injectables et les Technologies Associées, Lille (F.M.), CHU Régional de Nancy, Service d'Hématologie, Vandoeuvre lès Nancy (P.F.), Institut Paoli-Calmettes (R.B.) and Department of Pathology, Institut Paoli-Calmettes, Centre de Recherche en Cancerologie de Marseille, INSERM, Centre National de la Recherche Scientifique, Aix-Marseille Université (L.X.), Marseille, Centre Henri Becquerel, Unité 1245 and Département d'Hématologie, Université de Rouen, Rouen (H.T.), Institut d'Hématologie de Basse Normandie, Caen (C.F.), CHU Le Bocage Service d'Hématologie Clinique, Dijon (R.-O.C.), Hôpital Henri Mondor Unité Hémopathies Lymphoïdes, Créteil (C.H.), Centre Hospitalier Départemental Vendée Service d'Onco-Hématologie, La Roche sur Yon (H.M.), Institut Universitaire du Cancer de Toulouse Oncopole Service d'Hématologie, Toulouse (L.Y.), CHU Bordeaux, Service d'Hématologie, Bordeaux (K.B.), Hôpital Saint Louis Service d'Onco-Hématologie, Paris (P.B.), Gustave Roussy Cancer, Villejuif (V.R.), Centre Hospitalier Annecy Genevois Service, Annecy (N.D.), CHU de Nantes-Hôtel Dieu Service d'Hématologie Clinique, Centre de Recherche en Cancerologie et Immunologie, INSERM, Centre National de la Recherche Scientifique, Université de Nantes, Nantes (S.L.G.), Centre Hospitalier Métropole Savoie Service Hématologie, Chambery (G.M.P.), Department of Hematology, CHU Montpellier, University of Montpellier, Montpellier (G.C.), and Hospices Civils de Lyon, Centre Hospitalier Lyon-Sud, University of Lyon, Pierre-Benite (G.A.S.) - all in France; the Department of Lymphoma and Myeloma, University of Texas M.D. Anderson Cancer Center, Houston (N.H.F.); the Department of Medicine, Memorial Sloan Kettering Cancer Center, New York (M.L.P.); the Department of Medicine, Division of Medical Oncology, University of Washington, Seattle (E.N.L.); Sarah Cannon Research Institute-Tennessee Oncology, Nashville (I.W.F.); Washington University School of Medicine, Siteman Cancer Center, St. Louis (N.L.B.); the Department of Hematology, Hospital Universitario de Salamanca and Instituto de Investigación Biomédica de Salamanca, Centro de Investigación Biomédica en Red de Cáncer, Salamanca (A.M.G.-S.), and the Department of Hematology, Hospital Clinic de Barcelona, Barcelona (A.L.-G.) - both in Spain; CHU de Québec, Hôpital de l'Enfant-Jésus, Quebec (J.-F.L.), and British Columbia Cancer Centre for Lymphoid Cancer, University of British Columbia, Vancouver (L.H.S.) - both in Canada; the Department of Hematology and Oncology, Tokai University Hospital, Kanagawa, Japan (K.A.); Instituto Português de Oncologia Lisboa Francisco Gentil Departamento de Hematologia, Lisbon (M.G.S.); the Department of Hematology, CHU Université Catholique de Louvain Namur, Yvoir (M.A.), and the Department of Hematology, Ziekenhuis Netwerk Antwerpen Stuivenberg, Antwerp (P.Z.) - both in Belgium; the Department of Hematology, National Cancer Center Hospital, Tokyo, Japan (K.T.); and Celgene, Summit, NJ (D.L., J.W.)
| | - Maria Gomes da Silva
- From Université Lille, Centre Hospitalier Universitaire (CHU), Groupe de Recherche sur les formes Injectables et les Technologies Associées, Lille (F.M.), CHU Régional de Nancy, Service d'Hématologie, Vandoeuvre lès Nancy (P.F.), Institut Paoli-Calmettes (R.B.) and Department of Pathology, Institut Paoli-Calmettes, Centre de Recherche en Cancerologie de Marseille, INSERM, Centre National de la Recherche Scientifique, Aix-Marseille Université (L.X.), Marseille, Centre Henri Becquerel, Unité 1245 and Département d'Hématologie, Université de Rouen, Rouen (H.T.), Institut d'Hématologie de Basse Normandie, Caen (C.F.), CHU Le Bocage Service d'Hématologie Clinique, Dijon (R.-O.C.), Hôpital Henri Mondor Unité Hémopathies Lymphoïdes, Créteil (C.H.), Centre Hospitalier Départemental Vendée Service d'Onco-Hématologie, La Roche sur Yon (H.M.), Institut Universitaire du Cancer de Toulouse Oncopole Service d'Hématologie, Toulouse (L.Y.), CHU Bordeaux, Service d'Hématologie, Bordeaux (K.B.), Hôpital Saint Louis Service d'Onco-Hématologie, Paris (P.B.), Gustave Roussy Cancer, Villejuif (V.R.), Centre Hospitalier Annecy Genevois Service, Annecy (N.D.), CHU de Nantes-Hôtel Dieu Service d'Hématologie Clinique, Centre de Recherche en Cancerologie et Immunologie, INSERM, Centre National de la Recherche Scientifique, Université de Nantes, Nantes (S.L.G.), Centre Hospitalier Métropole Savoie Service Hématologie, Chambery (G.M.P.), Department of Hematology, CHU Montpellier, University of Montpellier, Montpellier (G.C.), and Hospices Civils de Lyon, Centre Hospitalier Lyon-Sud, University of Lyon, Pierre-Benite (G.A.S.) - all in France; the Department of Lymphoma and Myeloma, University of Texas M.D. Anderson Cancer Center, Houston (N.H.F.); the Department of Medicine, Memorial Sloan Kettering Cancer Center, New York (M.L.P.); the Department of Medicine, Division of Medical Oncology, University of Washington, Seattle (E.N.L.); Sarah Cannon Research Institute-Tennessee Oncology, Nashville (I.W.F.); Washington University School of Medicine, Siteman Cancer Center, St. Louis (N.L.B.); the Department of Hematology, Hospital Universitario de Salamanca and Instituto de Investigación Biomédica de Salamanca, Centro de Investigación Biomédica en Red de Cáncer, Salamanca (A.M.G.-S.), and the Department of Hematology, Hospital Clinic de Barcelona, Barcelona (A.L.-G.) - both in Spain; CHU de Québec, Hôpital de l'Enfant-Jésus, Quebec (J.-F.L.), and British Columbia Cancer Centre for Lymphoid Cancer, University of British Columbia, Vancouver (L.H.S.) - both in Canada; the Department of Hematology and Oncology, Tokai University Hospital, Kanagawa, Japan (K.A.); Instituto Português de Oncologia Lisboa Francisco Gentil Departamento de Hematologia, Lisbon (M.G.S.); the Department of Hematology, CHU Université Catholique de Louvain Namur, Yvoir (M.A.), and the Department of Hematology, Ziekenhuis Netwerk Antwerpen Stuivenberg, Antwerp (P.Z.) - both in Belgium; the Department of Hematology, National Cancer Center Hospital, Tokyo, Japan (K.T.); and Celgene, Summit, NJ (D.L., J.W.)
| | - Marc André
- From Université Lille, Centre Hospitalier Universitaire (CHU), Groupe de Recherche sur les formes Injectables et les Technologies Associées, Lille (F.M.), CHU Régional de Nancy, Service d'Hématologie, Vandoeuvre lès Nancy (P.F.), Institut Paoli-Calmettes (R.B.) and Department of Pathology, Institut Paoli-Calmettes, Centre de Recherche en Cancerologie de Marseille, INSERM, Centre National de la Recherche Scientifique, Aix-Marseille Université (L.X.), Marseille, Centre Henri Becquerel, Unité 1245 and Département d'Hématologie, Université de Rouen, Rouen (H.T.), Institut d'Hématologie de Basse Normandie, Caen (C.F.), CHU Le Bocage Service d'Hématologie Clinique, Dijon (R.-O.C.), Hôpital Henri Mondor Unité Hémopathies Lymphoïdes, Créteil (C.H.), Centre Hospitalier Départemental Vendée Service d'Onco-Hématologie, La Roche sur Yon (H.M.), Institut Universitaire du Cancer de Toulouse Oncopole Service d'Hématologie, Toulouse (L.Y.), CHU Bordeaux, Service d'Hématologie, Bordeaux (K.B.), Hôpital Saint Louis Service d'Onco-Hématologie, Paris (P.B.), Gustave Roussy Cancer, Villejuif (V.R.), Centre Hospitalier Annecy Genevois Service, Annecy (N.D.), CHU de Nantes-Hôtel Dieu Service d'Hématologie Clinique, Centre de Recherche en Cancerologie et Immunologie, INSERM, Centre National de la Recherche Scientifique, Université de Nantes, Nantes (S.L.G.), Centre Hospitalier Métropole Savoie Service Hématologie, Chambery (G.M.P.), Department of Hematology, CHU Montpellier, University of Montpellier, Montpellier (G.C.), and Hospices Civils de Lyon, Centre Hospitalier Lyon-Sud, University of Lyon, Pierre-Benite (G.A.S.) - all in France; the Department of Lymphoma and Myeloma, University of Texas M.D. Anderson Cancer Center, Houston (N.H.F.); the Department of Medicine, Memorial Sloan Kettering Cancer Center, New York (M.L.P.); the Department of Medicine, Division of Medical Oncology, University of Washington, Seattle (E.N.L.); Sarah Cannon Research Institute-Tennessee Oncology, Nashville (I.W.F.); Washington University School of Medicine, Siteman Cancer Center, St. Louis (N.L.B.); the Department of Hematology, Hospital Universitario de Salamanca and Instituto de Investigación Biomédica de Salamanca, Centro de Investigación Biomédica en Red de Cáncer, Salamanca (A.M.G.-S.), and the Department of Hematology, Hospital Clinic de Barcelona, Barcelona (A.L.-G.) - both in Spain; CHU de Québec, Hôpital de l'Enfant-Jésus, Quebec (J.-F.L.), and British Columbia Cancer Centre for Lymphoid Cancer, University of British Columbia, Vancouver (L.H.S.) - both in Canada; the Department of Hematology and Oncology, Tokai University Hospital, Kanagawa, Japan (K.A.); Instituto Português de Oncologia Lisboa Francisco Gentil Departamento de Hematologia, Lisbon (M.G.S.); the Department of Hematology, CHU Université Catholique de Louvain Namur, Yvoir (M.A.), and the Department of Hematology, Ziekenhuis Netwerk Antwerpen Stuivenberg, Antwerp (P.Z.) - both in Belgium; the Department of Hematology, National Cancer Center Hospital, Tokyo, Japan (K.T.); and Celgene, Summit, NJ (D.L., J.W.)
| | - Pierre Zachée
- From Université Lille, Centre Hospitalier Universitaire (CHU), Groupe de Recherche sur les formes Injectables et les Technologies Associées, Lille (F.M.), CHU Régional de Nancy, Service d'Hématologie, Vandoeuvre lès Nancy (P.F.), Institut Paoli-Calmettes (R.B.) and Department of Pathology, Institut Paoli-Calmettes, Centre de Recherche en Cancerologie de Marseille, INSERM, Centre National de la Recherche Scientifique, Aix-Marseille Université (L.X.), Marseille, Centre Henri Becquerel, Unité 1245 and Département d'Hématologie, Université de Rouen, Rouen (H.T.), Institut d'Hématologie de Basse Normandie, Caen (C.F.), CHU Le Bocage Service d'Hématologie Clinique, Dijon (R.-O.C.), Hôpital Henri Mondor Unité Hémopathies Lymphoïdes, Créteil (C.H.), Centre Hospitalier Départemental Vendée Service d'Onco-Hématologie, La Roche sur Yon (H.M.), Institut Universitaire du Cancer de Toulouse Oncopole Service d'Hématologie, Toulouse (L.Y.), CHU Bordeaux, Service d'Hématologie, Bordeaux (K.B.), Hôpital Saint Louis Service d'Onco-Hématologie, Paris (P.B.), Gustave Roussy Cancer, Villejuif (V.R.), Centre Hospitalier Annecy Genevois Service, Annecy (N.D.), CHU de Nantes-Hôtel Dieu Service d'Hématologie Clinique, Centre de Recherche en Cancerologie et Immunologie, INSERM, Centre National de la Recherche Scientifique, Université de Nantes, Nantes (S.L.G.), Centre Hospitalier Métropole Savoie Service Hématologie, Chambery (G.M.P.), Department of Hematology, CHU Montpellier, University of Montpellier, Montpellier (G.C.), and Hospices Civils de Lyon, Centre Hospitalier Lyon-Sud, University of Lyon, Pierre-Benite (G.A.S.) - all in France; the Department of Lymphoma and Myeloma, University of Texas M.D. Anderson Cancer Center, Houston (N.H.F.); the Department of Medicine, Memorial Sloan Kettering Cancer Center, New York (M.L.P.); the Department of Medicine, Division of Medical Oncology, University of Washington, Seattle (E.N.L.); Sarah Cannon Research Institute-Tennessee Oncology, Nashville (I.W.F.); Washington University School of Medicine, Siteman Cancer Center, St. Louis (N.L.B.); the Department of Hematology, Hospital Universitario de Salamanca and Instituto de Investigación Biomédica de Salamanca, Centro de Investigación Biomédica en Red de Cáncer, Salamanca (A.M.G.-S.), and the Department of Hematology, Hospital Clinic de Barcelona, Barcelona (A.L.-G.) - both in Spain; CHU de Québec, Hôpital de l'Enfant-Jésus, Quebec (J.-F.L.), and British Columbia Cancer Centre for Lymphoid Cancer, University of British Columbia, Vancouver (L.H.S.) - both in Canada; the Department of Hematology and Oncology, Tokai University Hospital, Kanagawa, Japan (K.A.); Instituto Português de Oncologia Lisboa Francisco Gentil Departamento de Hematologia, Lisbon (M.G.S.); the Department of Hematology, CHU Université Catholique de Louvain Namur, Yvoir (M.A.), and the Department of Hematology, Ziekenhuis Netwerk Antwerpen Stuivenberg, Antwerp (P.Z.) - both in Belgium; the Department of Hematology, National Cancer Center Hospital, Tokyo, Japan (K.T.); and Celgene, Summit, NJ (D.L., J.W.)
| | - Laurie H Sehn
- From Université Lille, Centre Hospitalier Universitaire (CHU), Groupe de Recherche sur les formes Injectables et les Technologies Associées, Lille (F.M.), CHU Régional de Nancy, Service d'Hématologie, Vandoeuvre lès Nancy (P.F.), Institut Paoli-Calmettes (R.B.) and Department of Pathology, Institut Paoli-Calmettes, Centre de Recherche en Cancerologie de Marseille, INSERM, Centre National de la Recherche Scientifique, Aix-Marseille Université (L.X.), Marseille, Centre Henri Becquerel, Unité 1245 and Département d'Hématologie, Université de Rouen, Rouen (H.T.), Institut d'Hématologie de Basse Normandie, Caen (C.F.), CHU Le Bocage Service d'Hématologie Clinique, Dijon (R.-O.C.), Hôpital Henri Mondor Unité Hémopathies Lymphoïdes, Créteil (C.H.), Centre Hospitalier Départemental Vendée Service d'Onco-Hématologie, La Roche sur Yon (H.M.), Institut Universitaire du Cancer de Toulouse Oncopole Service d'Hématologie, Toulouse (L.Y.), CHU Bordeaux, Service d'Hématologie, Bordeaux (K.B.), Hôpital Saint Louis Service d'Onco-Hématologie, Paris (P.B.), Gustave Roussy Cancer, Villejuif (V.R.), Centre Hospitalier Annecy Genevois Service, Annecy (N.D.), CHU de Nantes-Hôtel Dieu Service d'Hématologie Clinique, Centre de Recherche en Cancerologie et Immunologie, INSERM, Centre National de la Recherche Scientifique, Université de Nantes, Nantes (S.L.G.), Centre Hospitalier Métropole Savoie Service Hématologie, Chambery (G.M.P.), Department of Hematology, CHU Montpellier, University of Montpellier, Montpellier (G.C.), and Hospices Civils de Lyon, Centre Hospitalier Lyon-Sud, University of Lyon, Pierre-Benite (G.A.S.) - all in France; the Department of Lymphoma and Myeloma, University of Texas M.D. Anderson Cancer Center, Houston (N.H.F.); the Department of Medicine, Memorial Sloan Kettering Cancer Center, New York (M.L.P.); the Department of Medicine, Division of Medical Oncology, University of Washington, Seattle (E.N.L.); Sarah Cannon Research Institute-Tennessee Oncology, Nashville (I.W.F.); Washington University School of Medicine, Siteman Cancer Center, St. Louis (N.L.B.); the Department of Hematology, Hospital Universitario de Salamanca and Instituto de Investigación Biomédica de Salamanca, Centro de Investigación Biomédica en Red de Cáncer, Salamanca (A.M.G.-S.), and the Department of Hematology, Hospital Clinic de Barcelona, Barcelona (A.L.-G.) - both in Spain; CHU de Québec, Hôpital de l'Enfant-Jésus, Quebec (J.-F.L.), and British Columbia Cancer Centre for Lymphoid Cancer, University of British Columbia, Vancouver (L.H.S.) - both in Canada; the Department of Hematology and Oncology, Tokai University Hospital, Kanagawa, Japan (K.A.); Instituto Português de Oncologia Lisboa Francisco Gentil Departamento de Hematologia, Lisbon (M.G.S.); the Department of Hematology, CHU Université Catholique de Louvain Namur, Yvoir (M.A.), and the Department of Hematology, Ziekenhuis Netwerk Antwerpen Stuivenberg, Antwerp (P.Z.) - both in Belgium; the Department of Hematology, National Cancer Center Hospital, Tokyo, Japan (K.T.); and Celgene, Summit, NJ (D.L., J.W.)
| | - Kensei Tobinai
- From Université Lille, Centre Hospitalier Universitaire (CHU), Groupe de Recherche sur les formes Injectables et les Technologies Associées, Lille (F.M.), CHU Régional de Nancy, Service d'Hématologie, Vandoeuvre lès Nancy (P.F.), Institut Paoli-Calmettes (R.B.) and Department of Pathology, Institut Paoli-Calmettes, Centre de Recherche en Cancerologie de Marseille, INSERM, Centre National de la Recherche Scientifique, Aix-Marseille Université (L.X.), Marseille, Centre Henri Becquerel, Unité 1245 and Département d'Hématologie, Université de Rouen, Rouen (H.T.), Institut d'Hématologie de Basse Normandie, Caen (C.F.), CHU Le Bocage Service d'Hématologie Clinique, Dijon (R.-O.C.), Hôpital Henri Mondor Unité Hémopathies Lymphoïdes, Créteil (C.H.), Centre Hospitalier Départemental Vendée Service d'Onco-Hématologie, La Roche sur Yon (H.M.), Institut Universitaire du Cancer de Toulouse Oncopole Service d'Hématologie, Toulouse (L.Y.), CHU Bordeaux, Service d'Hématologie, Bordeaux (K.B.), Hôpital Saint Louis Service d'Onco-Hématologie, Paris (P.B.), Gustave Roussy Cancer, Villejuif (V.R.), Centre Hospitalier Annecy Genevois Service, Annecy (N.D.), CHU de Nantes-Hôtel Dieu Service d'Hématologie Clinique, Centre de Recherche en Cancerologie et Immunologie, INSERM, Centre National de la Recherche Scientifique, Université de Nantes, Nantes (S.L.G.), Centre Hospitalier Métropole Savoie Service Hématologie, Chambery (G.M.P.), Department of Hematology, CHU Montpellier, University of Montpellier, Montpellier (G.C.), and Hospices Civils de Lyon, Centre Hospitalier Lyon-Sud, University of Lyon, Pierre-Benite (G.A.S.) - all in France; the Department of Lymphoma and Myeloma, University of Texas M.D. Anderson Cancer Center, Houston (N.H.F.); the Department of Medicine, Memorial Sloan Kettering Cancer Center, New York (M.L.P.); the Department of Medicine, Division of Medical Oncology, University of Washington, Seattle (E.N.L.); Sarah Cannon Research Institute-Tennessee Oncology, Nashville (I.W.F.); Washington University School of Medicine, Siteman Cancer Center, St. Louis (N.L.B.); the Department of Hematology, Hospital Universitario de Salamanca and Instituto de Investigación Biomédica de Salamanca, Centro de Investigación Biomédica en Red de Cáncer, Salamanca (A.M.G.-S.), and the Department of Hematology, Hospital Clinic de Barcelona, Barcelona (A.L.-G.) - both in Spain; CHU de Québec, Hôpital de l'Enfant-Jésus, Quebec (J.-F.L.), and British Columbia Cancer Centre for Lymphoid Cancer, University of British Columbia, Vancouver (L.H.S.) - both in Canada; the Department of Hematology and Oncology, Tokai University Hospital, Kanagawa, Japan (K.A.); Instituto Português de Oncologia Lisboa Francisco Gentil Departamento de Hematologia, Lisbon (M.G.S.); the Department of Hematology, CHU Université Catholique de Louvain Namur, Yvoir (M.A.), and the Department of Hematology, Ziekenhuis Netwerk Antwerpen Stuivenberg, Antwerp (P.Z.) - both in Belgium; the Department of Hematology, National Cancer Center Hospital, Tokyo, Japan (K.T.); and Celgene, Summit, NJ (D.L., J.W.)
| | - Guillaume Cartron
- From Université Lille, Centre Hospitalier Universitaire (CHU), Groupe de Recherche sur les formes Injectables et les Technologies Associées, Lille (F.M.), CHU Régional de Nancy, Service d'Hématologie, Vandoeuvre lès Nancy (P.F.), Institut Paoli-Calmettes (R.B.) and Department of Pathology, Institut Paoli-Calmettes, Centre de Recherche en Cancerologie de Marseille, INSERM, Centre National de la Recherche Scientifique, Aix-Marseille Université (L.X.), Marseille, Centre Henri Becquerel, Unité 1245 and Département d'Hématologie, Université de Rouen, Rouen (H.T.), Institut d'Hématologie de Basse Normandie, Caen (C.F.), CHU Le Bocage Service d'Hématologie Clinique, Dijon (R.-O.C.), Hôpital Henri Mondor Unité Hémopathies Lymphoïdes, Créteil (C.H.), Centre Hospitalier Départemental Vendée Service d'Onco-Hématologie, La Roche sur Yon (H.M.), Institut Universitaire du Cancer de Toulouse Oncopole Service d'Hématologie, Toulouse (L.Y.), CHU Bordeaux, Service d'Hématologie, Bordeaux (K.B.), Hôpital Saint Louis Service d'Onco-Hématologie, Paris (P.B.), Gustave Roussy Cancer, Villejuif (V.R.), Centre Hospitalier Annecy Genevois Service, Annecy (N.D.), CHU de Nantes-Hôtel Dieu Service d'Hématologie Clinique, Centre de Recherche en Cancerologie et Immunologie, INSERM, Centre National de la Recherche Scientifique, Université de Nantes, Nantes (S.L.G.), Centre Hospitalier Métropole Savoie Service Hématologie, Chambery (G.M.P.), Department of Hematology, CHU Montpellier, University of Montpellier, Montpellier (G.C.), and Hospices Civils de Lyon, Centre Hospitalier Lyon-Sud, University of Lyon, Pierre-Benite (G.A.S.) - all in France; the Department of Lymphoma and Myeloma, University of Texas M.D. Anderson Cancer Center, Houston (N.H.F.); the Department of Medicine, Memorial Sloan Kettering Cancer Center, New York (M.L.P.); the Department of Medicine, Division of Medical Oncology, University of Washington, Seattle (E.N.L.); Sarah Cannon Research Institute-Tennessee Oncology, Nashville (I.W.F.); Washington University School of Medicine, Siteman Cancer Center, St. Louis (N.L.B.); the Department of Hematology, Hospital Universitario de Salamanca and Instituto de Investigación Biomédica de Salamanca, Centro de Investigación Biomédica en Red de Cáncer, Salamanca (A.M.G.-S.), and the Department of Hematology, Hospital Clinic de Barcelona, Barcelona (A.L.-G.) - both in Spain; CHU de Québec, Hôpital de l'Enfant-Jésus, Quebec (J.-F.L.), and British Columbia Cancer Centre for Lymphoid Cancer, University of British Columbia, Vancouver (L.H.S.) - both in Canada; the Department of Hematology and Oncology, Tokai University Hospital, Kanagawa, Japan (K.A.); Instituto Português de Oncologia Lisboa Francisco Gentil Departamento de Hematologia, Lisbon (M.G.S.); the Department of Hematology, CHU Université Catholique de Louvain Namur, Yvoir (M.A.), and the Department of Hematology, Ziekenhuis Netwerk Antwerpen Stuivenberg, Antwerp (P.Z.) - both in Belgium; the Department of Hematology, National Cancer Center Hospital, Tokyo, Japan (K.T.); and Celgene, Summit, NJ (D.L., J.W.)
| | - David Liu
- From Université Lille, Centre Hospitalier Universitaire (CHU), Groupe de Recherche sur les formes Injectables et les Technologies Associées, Lille (F.M.), CHU Régional de Nancy, Service d'Hématologie, Vandoeuvre lès Nancy (P.F.), Institut Paoli-Calmettes (R.B.) and Department of Pathology, Institut Paoli-Calmettes, Centre de Recherche en Cancerologie de Marseille, INSERM, Centre National de la Recherche Scientifique, Aix-Marseille Université (L.X.), Marseille, Centre Henri Becquerel, Unité 1245 and Département d'Hématologie, Université de Rouen, Rouen (H.T.), Institut d'Hématologie de Basse Normandie, Caen (C.F.), CHU Le Bocage Service d'Hématologie Clinique, Dijon (R.-O.C.), Hôpital Henri Mondor Unité Hémopathies Lymphoïdes, Créteil (C.H.), Centre Hospitalier Départemental Vendée Service d'Onco-Hématologie, La Roche sur Yon (H.M.), Institut Universitaire du Cancer de Toulouse Oncopole Service d'Hématologie, Toulouse (L.Y.), CHU Bordeaux, Service d'Hématologie, Bordeaux (K.B.), Hôpital Saint Louis Service d'Onco-Hématologie, Paris (P.B.), Gustave Roussy Cancer, Villejuif (V.R.), Centre Hospitalier Annecy Genevois Service, Annecy (N.D.), CHU de Nantes-Hôtel Dieu Service d'Hématologie Clinique, Centre de Recherche en Cancerologie et Immunologie, INSERM, Centre National de la Recherche Scientifique, Université de Nantes, Nantes (S.L.G.), Centre Hospitalier Métropole Savoie Service Hématologie, Chambery (G.M.P.), Department of Hematology, CHU Montpellier, University of Montpellier, Montpellier (G.C.), and Hospices Civils de Lyon, Centre Hospitalier Lyon-Sud, University of Lyon, Pierre-Benite (G.A.S.) - all in France; the Department of Lymphoma and Myeloma, University of Texas M.D. Anderson Cancer Center, Houston (N.H.F.); the Department of Medicine, Memorial Sloan Kettering Cancer Center, New York (M.L.P.); the Department of Medicine, Division of Medical Oncology, University of Washington, Seattle (E.N.L.); Sarah Cannon Research Institute-Tennessee Oncology, Nashville (I.W.F.); Washington University School of Medicine, Siteman Cancer Center, St. Louis (N.L.B.); the Department of Hematology, Hospital Universitario de Salamanca and Instituto de Investigación Biomédica de Salamanca, Centro de Investigación Biomédica en Red de Cáncer, Salamanca (A.M.G.-S.), and the Department of Hematology, Hospital Clinic de Barcelona, Barcelona (A.L.-G.) - both in Spain; CHU de Québec, Hôpital de l'Enfant-Jésus, Quebec (J.-F.L.), and British Columbia Cancer Centre for Lymphoid Cancer, University of British Columbia, Vancouver (L.H.S.) - both in Canada; the Department of Hematology and Oncology, Tokai University Hospital, Kanagawa, Japan (K.A.); Instituto Português de Oncologia Lisboa Francisco Gentil Departamento de Hematologia, Lisbon (M.G.S.); the Department of Hematology, CHU Université Catholique de Louvain Namur, Yvoir (M.A.), and the Department of Hematology, Ziekenhuis Netwerk Antwerpen Stuivenberg, Antwerp (P.Z.) - both in Belgium; the Department of Hematology, National Cancer Center Hospital, Tokyo, Japan (K.T.); and Celgene, Summit, NJ (D.L., J.W.)
| | - Jianming Wang
- From Université Lille, Centre Hospitalier Universitaire (CHU), Groupe de Recherche sur les formes Injectables et les Technologies Associées, Lille (F.M.), CHU Régional de Nancy, Service d'Hématologie, Vandoeuvre lès Nancy (P.F.), Institut Paoli-Calmettes (R.B.) and Department of Pathology, Institut Paoli-Calmettes, Centre de Recherche en Cancerologie de Marseille, INSERM, Centre National de la Recherche Scientifique, Aix-Marseille Université (L.X.), Marseille, Centre Henri Becquerel, Unité 1245 and Département d'Hématologie, Université de Rouen, Rouen (H.T.), Institut d'Hématologie de Basse Normandie, Caen (C.F.), CHU Le Bocage Service d'Hématologie Clinique, Dijon (R.-O.C.), Hôpital Henri Mondor Unité Hémopathies Lymphoïdes, Créteil (C.H.), Centre Hospitalier Départemental Vendée Service d'Onco-Hématologie, La Roche sur Yon (H.M.), Institut Universitaire du Cancer de Toulouse Oncopole Service d'Hématologie, Toulouse (L.Y.), CHU Bordeaux, Service d'Hématologie, Bordeaux (K.B.), Hôpital Saint Louis Service d'Onco-Hématologie, Paris (P.B.), Gustave Roussy Cancer, Villejuif (V.R.), Centre Hospitalier Annecy Genevois Service, Annecy (N.D.), CHU de Nantes-Hôtel Dieu Service d'Hématologie Clinique, Centre de Recherche en Cancerologie et Immunologie, INSERM, Centre National de la Recherche Scientifique, Université de Nantes, Nantes (S.L.G.), Centre Hospitalier Métropole Savoie Service Hématologie, Chambery (G.M.P.), Department of Hematology, CHU Montpellier, University of Montpellier, Montpellier (G.C.), and Hospices Civils de Lyon, Centre Hospitalier Lyon-Sud, University of Lyon, Pierre-Benite (G.A.S.) - all in France; the Department of Lymphoma and Myeloma, University of Texas M.D. Anderson Cancer Center, Houston (N.H.F.); the Department of Medicine, Memorial Sloan Kettering Cancer Center, New York (M.L.P.); the Department of Medicine, Division of Medical Oncology, University of Washington, Seattle (E.N.L.); Sarah Cannon Research Institute-Tennessee Oncology, Nashville (I.W.F.); Washington University School of Medicine, Siteman Cancer Center, St. Louis (N.L.B.); the Department of Hematology, Hospital Universitario de Salamanca and Instituto de Investigación Biomédica de Salamanca, Centro de Investigación Biomédica en Red de Cáncer, Salamanca (A.M.G.-S.), and the Department of Hematology, Hospital Clinic de Barcelona, Barcelona (A.L.-G.) - both in Spain; CHU de Québec, Hôpital de l'Enfant-Jésus, Quebec (J.-F.L.), and British Columbia Cancer Centre for Lymphoid Cancer, University of British Columbia, Vancouver (L.H.S.) - both in Canada; the Department of Hematology and Oncology, Tokai University Hospital, Kanagawa, Japan (K.A.); Instituto Português de Oncologia Lisboa Francisco Gentil Departamento de Hematologia, Lisbon (M.G.S.); the Department of Hematology, CHU Université Catholique de Louvain Namur, Yvoir (M.A.), and the Department of Hematology, Ziekenhuis Netwerk Antwerpen Stuivenberg, Antwerp (P.Z.) - both in Belgium; the Department of Hematology, National Cancer Center Hospital, Tokyo, Japan (K.T.); and Celgene, Summit, NJ (D.L., J.W.)
| | - Luc Xerri
- From Université Lille, Centre Hospitalier Universitaire (CHU), Groupe de Recherche sur les formes Injectables et les Technologies Associées, Lille (F.M.), CHU Régional de Nancy, Service d'Hématologie, Vandoeuvre lès Nancy (P.F.), Institut Paoli-Calmettes (R.B.) and Department of Pathology, Institut Paoli-Calmettes, Centre de Recherche en Cancerologie de Marseille, INSERM, Centre National de la Recherche Scientifique, Aix-Marseille Université (L.X.), Marseille, Centre Henri Becquerel, Unité 1245 and Département d'Hématologie, Université de Rouen, Rouen (H.T.), Institut d'Hématologie de Basse Normandie, Caen (C.F.), CHU Le Bocage Service d'Hématologie Clinique, Dijon (R.-O.C.), Hôpital Henri Mondor Unité Hémopathies Lymphoïdes, Créteil (C.H.), Centre Hospitalier Départemental Vendée Service d'Onco-Hématologie, La Roche sur Yon (H.M.), Institut Universitaire du Cancer de Toulouse Oncopole Service d'Hématologie, Toulouse (L.Y.), CHU Bordeaux, Service d'Hématologie, Bordeaux (K.B.), Hôpital Saint Louis Service d'Onco-Hématologie, Paris (P.B.), Gustave Roussy Cancer, Villejuif (V.R.), Centre Hospitalier Annecy Genevois Service, Annecy (N.D.), CHU de Nantes-Hôtel Dieu Service d'Hématologie Clinique, Centre de Recherche en Cancerologie et Immunologie, INSERM, Centre National de la Recherche Scientifique, Université de Nantes, Nantes (S.L.G.), Centre Hospitalier Métropole Savoie Service Hématologie, Chambery (G.M.P.), Department of Hematology, CHU Montpellier, University of Montpellier, Montpellier (G.C.), and Hospices Civils de Lyon, Centre Hospitalier Lyon-Sud, University of Lyon, Pierre-Benite (G.A.S.) - all in France; the Department of Lymphoma and Myeloma, University of Texas M.D. Anderson Cancer Center, Houston (N.H.F.); the Department of Medicine, Memorial Sloan Kettering Cancer Center, New York (M.L.P.); the Department of Medicine, Division of Medical Oncology, University of Washington, Seattle (E.N.L.); Sarah Cannon Research Institute-Tennessee Oncology, Nashville (I.W.F.); Washington University School of Medicine, Siteman Cancer Center, St. Louis (N.L.B.); the Department of Hematology, Hospital Universitario de Salamanca and Instituto de Investigación Biomédica de Salamanca, Centro de Investigación Biomédica en Red de Cáncer, Salamanca (A.M.G.-S.), and the Department of Hematology, Hospital Clinic de Barcelona, Barcelona (A.L.-G.) - both in Spain; CHU de Québec, Hôpital de l'Enfant-Jésus, Quebec (J.-F.L.), and British Columbia Cancer Centre for Lymphoid Cancer, University of British Columbia, Vancouver (L.H.S.) - both in Canada; the Department of Hematology and Oncology, Tokai University Hospital, Kanagawa, Japan (K.A.); Instituto Português de Oncologia Lisboa Francisco Gentil Departamento de Hematologia, Lisbon (M.G.S.); the Department of Hematology, CHU Université Catholique de Louvain Namur, Yvoir (M.A.), and the Department of Hematology, Ziekenhuis Netwerk Antwerpen Stuivenberg, Antwerp (P.Z.) - both in Belgium; the Department of Hematology, National Cancer Center Hospital, Tokyo, Japan (K.T.); and Celgene, Summit, NJ (D.L., J.W.)
| | - Gilles A Salles
- From Université Lille, Centre Hospitalier Universitaire (CHU), Groupe de Recherche sur les formes Injectables et les Technologies Associées, Lille (F.M.), CHU Régional de Nancy, Service d'Hématologie, Vandoeuvre lès Nancy (P.F.), Institut Paoli-Calmettes (R.B.) and Department of Pathology, Institut Paoli-Calmettes, Centre de Recherche en Cancerologie de Marseille, INSERM, Centre National de la Recherche Scientifique, Aix-Marseille Université (L.X.), Marseille, Centre Henri Becquerel, Unité 1245 and Département d'Hématologie, Université de Rouen, Rouen (H.T.), Institut d'Hématologie de Basse Normandie, Caen (C.F.), CHU Le Bocage Service d'Hématologie Clinique, Dijon (R.-O.C.), Hôpital Henri Mondor Unité Hémopathies Lymphoïdes, Créteil (C.H.), Centre Hospitalier Départemental Vendée Service d'Onco-Hématologie, La Roche sur Yon (H.M.), Institut Universitaire du Cancer de Toulouse Oncopole Service d'Hématologie, Toulouse (L.Y.), CHU Bordeaux, Service d'Hématologie, Bordeaux (K.B.), Hôpital Saint Louis Service d'Onco-Hématologie, Paris (P.B.), Gustave Roussy Cancer, Villejuif (V.R.), Centre Hospitalier Annecy Genevois Service, Annecy (N.D.), CHU de Nantes-Hôtel Dieu Service d'Hématologie Clinique, Centre de Recherche en Cancerologie et Immunologie, INSERM, Centre National de la Recherche Scientifique, Université de Nantes, Nantes (S.L.G.), Centre Hospitalier Métropole Savoie Service Hématologie, Chambery (G.M.P.), Department of Hematology, CHU Montpellier, University of Montpellier, Montpellier (G.C.), and Hospices Civils de Lyon, Centre Hospitalier Lyon-Sud, University of Lyon, Pierre-Benite (G.A.S.) - all in France; the Department of Lymphoma and Myeloma, University of Texas M.D. Anderson Cancer Center, Houston (N.H.F.); the Department of Medicine, Memorial Sloan Kettering Cancer Center, New York (M.L.P.); the Department of Medicine, Division of Medical Oncology, University of Washington, Seattle (E.N.L.); Sarah Cannon Research Institute-Tennessee Oncology, Nashville (I.W.F.); Washington University School of Medicine, Siteman Cancer Center, St. Louis (N.L.B.); the Department of Hematology, Hospital Universitario de Salamanca and Instituto de Investigación Biomédica de Salamanca, Centro de Investigación Biomédica en Red de Cáncer, Salamanca (A.M.G.-S.), and the Department of Hematology, Hospital Clinic de Barcelona, Barcelona (A.L.-G.) - both in Spain; CHU de Québec, Hôpital de l'Enfant-Jésus, Quebec (J.-F.L.), and British Columbia Cancer Centre for Lymphoid Cancer, University of British Columbia, Vancouver (L.H.S.) - both in Canada; the Department of Hematology and Oncology, Tokai University Hospital, Kanagawa, Japan (K.A.); Instituto Português de Oncologia Lisboa Francisco Gentil Departamento de Hematologia, Lisbon (M.G.S.); the Department of Hematology, CHU Université Catholique de Louvain Namur, Yvoir (M.A.), and the Department of Hematology, Ziekenhuis Netwerk Antwerpen Stuivenberg, Antwerp (P.Z.) - both in Belgium; the Department of Hematology, National Cancer Center Hospital, Tokyo, Japan (K.T.); and Celgene, Summit, NJ (D.L., J.W.)
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Kurtz DM, Scherer F, Jin MC, Soo J, Craig AFM, Esfahani MS, Chabon JJ, Stehr H, Liu CL, Tibshirani R, Maeda LS, Gupta NK, Khodadoust MS, Advani RH, Levy R, Newman AM, Dührsen U, Hüttmann A, Meignan M, Casasnovas RO, Westin JR, Roschewski M, Wilson WH, Gaidano G, Rossi D, Diehn M, Alizadeh AA. Circulating Tumor DNA Measurements As Early Outcome Predictors in Diffuse Large B-Cell Lymphoma. J Clin Oncol 2018; 36:2845-2853. [PMID: 30125215 DOI: 10.1200/jco.2018.78.5246] [Citation(s) in RCA: 282] [Impact Index Per Article: 47.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
PURPOSE Outcomes for patients with diffuse large B-cell lymphoma remain heterogeneous, with existing methods failing to consistently predict treatment failure. We examined the additional prognostic value of circulating tumor DNA (ctDNA) before and during therapy for predicting patient outcomes. PATIENTS AND METHODS We studied the dynamics of ctDNA from 217 patients treated at six centers, using a training and validation framework. We densely characterized early ctDNA dynamics during therapy using cancer personalized profiling by deep sequencing to define response-associated thresholds within a discovery set. These thresholds were assessed in two independent validation sets. Finally, we assessed the prognostic value of ctDNA in the context of established risk factors, including the International Prognostic Index and interim positron emission tomography/computed tomography scans. RESULTS Before therapy, ctDNA was detectable in 98% of patients; pretreatment levels were prognostic in both front-line and salvage settings. In the discovery set, ctDNA levels changed rapidly, with a 2-log decrease after one cycle (early molecular response [EMR]) and a 2.5-log decrease after two cycles (major molecular response [MMR]) stratifying outcomes. In the first validation set, patients receiving front-line therapy achieving EMR or MMR had superior outcomes at 24 months (EMR: EFS, 83% v 50%; P = .0015; MMR: EFS, 82% v 46%; P < .001). EMR also predicted superior 24-month outcomes in patients receiving salvage therapy in the first validation set (EFS, 100% v 13%; P = .011). The prognostic value of EMR and MMR was further confirmed in the second validation set. In multivariable analyses including International Prognostic Index and interim positron emission tomography/computed tomography scans across both cohorts, molecular response was independently prognostic of outcomes, including event-free and overall survival. CONCLUSION Pretreatment ctDNA levels and molecular responses are independently prognostic of outcomes in aggressive lymphomas. These risk factors could potentially guide future personalized risk-directed approaches.
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Affiliation(s)
- David M Kurtz
- David M. Kurtz, Florian Scherer, Michael C. Jin, Joanne Soo, Alexander F.M. Craig, Mohammad Shahrokh Esfahani, Jacob J. Chabon, Henning Stehr, Chih Long Liu, Robert Tibshirani, Lauren S. Maeda, Neel K. Gupta, Michael S. Khodadoust, Ranjana H. Advani, Ronald Levy, Aaron M. Newman, Maximilian Diehn, and Ash A. Alizadeh, Stanford University, Stanford, CA; Florian Scherer, University Medical Center Freiburg, Freiburg; Ulrich Dührsen and Andreas Hüttmann, University Hospital Essen, Essen, Germany; Michel Meignan, Hôpitaux Universitaires Henri Mondor, Creteil; René-Olivier Casasnovas, Hôpital Le Bocage, Centre Hospitalier Universitaire, Dijon, France; Jason R. Westin, University of Texas MD Anderson Cancer Center, Houston, TX; Mark Roschewski and Wyndham H. Wilson, National Cancer Institute, National Institutes of Health, Bethesda, MD; Gianluca Gaidano and Davide Rossi, University of Eastern Piedmont, Novara, Italy; and Davide Rossi, Oncology Institute of Southern Switzerland and Institute of Oncology Research, Bellinzona, Switzerland
| | - Florian Scherer
- David M. Kurtz, Florian Scherer, Michael C. Jin, Joanne Soo, Alexander F.M. Craig, Mohammad Shahrokh Esfahani, Jacob J. Chabon, Henning Stehr, Chih Long Liu, Robert Tibshirani, Lauren S. Maeda, Neel K. Gupta, Michael S. Khodadoust, Ranjana H. Advani, Ronald Levy, Aaron M. Newman, Maximilian Diehn, and Ash A. Alizadeh, Stanford University, Stanford, CA; Florian Scherer, University Medical Center Freiburg, Freiburg; Ulrich Dührsen and Andreas Hüttmann, University Hospital Essen, Essen, Germany; Michel Meignan, Hôpitaux Universitaires Henri Mondor, Creteil; René-Olivier Casasnovas, Hôpital Le Bocage, Centre Hospitalier Universitaire, Dijon, France; Jason R. Westin, University of Texas MD Anderson Cancer Center, Houston, TX; Mark Roschewski and Wyndham H. Wilson, National Cancer Institute, National Institutes of Health, Bethesda, MD; Gianluca Gaidano and Davide Rossi, University of Eastern Piedmont, Novara, Italy; and Davide Rossi, Oncology Institute of Southern Switzerland and Institute of Oncology Research, Bellinzona, Switzerland
| | - Michael C Jin
- David M. Kurtz, Florian Scherer, Michael C. Jin, Joanne Soo, Alexander F.M. Craig, Mohammad Shahrokh Esfahani, Jacob J. Chabon, Henning Stehr, Chih Long Liu, Robert Tibshirani, Lauren S. Maeda, Neel K. Gupta, Michael S. Khodadoust, Ranjana H. Advani, Ronald Levy, Aaron M. Newman, Maximilian Diehn, and Ash A. Alizadeh, Stanford University, Stanford, CA; Florian Scherer, University Medical Center Freiburg, Freiburg; Ulrich Dührsen and Andreas Hüttmann, University Hospital Essen, Essen, Germany; Michel Meignan, Hôpitaux Universitaires Henri Mondor, Creteil; René-Olivier Casasnovas, Hôpital Le Bocage, Centre Hospitalier Universitaire, Dijon, France; Jason R. Westin, University of Texas MD Anderson Cancer Center, Houston, TX; Mark Roschewski and Wyndham H. Wilson, National Cancer Institute, National Institutes of Health, Bethesda, MD; Gianluca Gaidano and Davide Rossi, University of Eastern Piedmont, Novara, Italy; and Davide Rossi, Oncology Institute of Southern Switzerland and Institute of Oncology Research, Bellinzona, Switzerland
| | - Joanne Soo
- David M. Kurtz, Florian Scherer, Michael C. Jin, Joanne Soo, Alexander F.M. Craig, Mohammad Shahrokh Esfahani, Jacob J. Chabon, Henning Stehr, Chih Long Liu, Robert Tibshirani, Lauren S. Maeda, Neel K. Gupta, Michael S. Khodadoust, Ranjana H. Advani, Ronald Levy, Aaron M. Newman, Maximilian Diehn, and Ash A. Alizadeh, Stanford University, Stanford, CA; Florian Scherer, University Medical Center Freiburg, Freiburg; Ulrich Dührsen and Andreas Hüttmann, University Hospital Essen, Essen, Germany; Michel Meignan, Hôpitaux Universitaires Henri Mondor, Creteil; René-Olivier Casasnovas, Hôpital Le Bocage, Centre Hospitalier Universitaire, Dijon, France; Jason R. Westin, University of Texas MD Anderson Cancer Center, Houston, TX; Mark Roschewski and Wyndham H. Wilson, National Cancer Institute, National Institutes of Health, Bethesda, MD; Gianluca Gaidano and Davide Rossi, University of Eastern Piedmont, Novara, Italy; and Davide Rossi, Oncology Institute of Southern Switzerland and Institute of Oncology Research, Bellinzona, Switzerland
| | - Alexander F M Craig
- David M. Kurtz, Florian Scherer, Michael C. Jin, Joanne Soo, Alexander F.M. Craig, Mohammad Shahrokh Esfahani, Jacob J. Chabon, Henning Stehr, Chih Long Liu, Robert Tibshirani, Lauren S. Maeda, Neel K. Gupta, Michael S. Khodadoust, Ranjana H. Advani, Ronald Levy, Aaron M. Newman, Maximilian Diehn, and Ash A. Alizadeh, Stanford University, Stanford, CA; Florian Scherer, University Medical Center Freiburg, Freiburg; Ulrich Dührsen and Andreas Hüttmann, University Hospital Essen, Essen, Germany; Michel Meignan, Hôpitaux Universitaires Henri Mondor, Creteil; René-Olivier Casasnovas, Hôpital Le Bocage, Centre Hospitalier Universitaire, Dijon, France; Jason R. Westin, University of Texas MD Anderson Cancer Center, Houston, TX; Mark Roschewski and Wyndham H. Wilson, National Cancer Institute, National Institutes of Health, Bethesda, MD; Gianluca Gaidano and Davide Rossi, University of Eastern Piedmont, Novara, Italy; and Davide Rossi, Oncology Institute of Southern Switzerland and Institute of Oncology Research, Bellinzona, Switzerland
| | - Mohammad Shahrokh Esfahani
- David M. Kurtz, Florian Scherer, Michael C. Jin, Joanne Soo, Alexander F.M. Craig, Mohammad Shahrokh Esfahani, Jacob J. Chabon, Henning Stehr, Chih Long Liu, Robert Tibshirani, Lauren S. Maeda, Neel K. Gupta, Michael S. Khodadoust, Ranjana H. Advani, Ronald Levy, Aaron M. Newman, Maximilian Diehn, and Ash A. Alizadeh, Stanford University, Stanford, CA; Florian Scherer, University Medical Center Freiburg, Freiburg; Ulrich Dührsen and Andreas Hüttmann, University Hospital Essen, Essen, Germany; Michel Meignan, Hôpitaux Universitaires Henri Mondor, Creteil; René-Olivier Casasnovas, Hôpital Le Bocage, Centre Hospitalier Universitaire, Dijon, France; Jason R. Westin, University of Texas MD Anderson Cancer Center, Houston, TX; Mark Roschewski and Wyndham H. Wilson, National Cancer Institute, National Institutes of Health, Bethesda, MD; Gianluca Gaidano and Davide Rossi, University of Eastern Piedmont, Novara, Italy; and Davide Rossi, Oncology Institute of Southern Switzerland and Institute of Oncology Research, Bellinzona, Switzerland
| | - Jacob J Chabon
- David M. Kurtz, Florian Scherer, Michael C. Jin, Joanne Soo, Alexander F.M. Craig, Mohammad Shahrokh Esfahani, Jacob J. Chabon, Henning Stehr, Chih Long Liu, Robert Tibshirani, Lauren S. Maeda, Neel K. Gupta, Michael S. Khodadoust, Ranjana H. Advani, Ronald Levy, Aaron M. Newman, Maximilian Diehn, and Ash A. Alizadeh, Stanford University, Stanford, CA; Florian Scherer, University Medical Center Freiburg, Freiburg; Ulrich Dührsen and Andreas Hüttmann, University Hospital Essen, Essen, Germany; Michel Meignan, Hôpitaux Universitaires Henri Mondor, Creteil; René-Olivier Casasnovas, Hôpital Le Bocage, Centre Hospitalier Universitaire, Dijon, France; Jason R. Westin, University of Texas MD Anderson Cancer Center, Houston, TX; Mark Roschewski and Wyndham H. Wilson, National Cancer Institute, National Institutes of Health, Bethesda, MD; Gianluca Gaidano and Davide Rossi, University of Eastern Piedmont, Novara, Italy; and Davide Rossi, Oncology Institute of Southern Switzerland and Institute of Oncology Research, Bellinzona, Switzerland
| | - Henning Stehr
- David M. Kurtz, Florian Scherer, Michael C. Jin, Joanne Soo, Alexander F.M. Craig, Mohammad Shahrokh Esfahani, Jacob J. Chabon, Henning Stehr, Chih Long Liu, Robert Tibshirani, Lauren S. Maeda, Neel K. Gupta, Michael S. Khodadoust, Ranjana H. Advani, Ronald Levy, Aaron M. Newman, Maximilian Diehn, and Ash A. Alizadeh, Stanford University, Stanford, CA; Florian Scherer, University Medical Center Freiburg, Freiburg; Ulrich Dührsen and Andreas Hüttmann, University Hospital Essen, Essen, Germany; Michel Meignan, Hôpitaux Universitaires Henri Mondor, Creteil; René-Olivier Casasnovas, Hôpital Le Bocage, Centre Hospitalier Universitaire, Dijon, France; Jason R. Westin, University of Texas MD Anderson Cancer Center, Houston, TX; Mark Roschewski and Wyndham H. Wilson, National Cancer Institute, National Institutes of Health, Bethesda, MD; Gianluca Gaidano and Davide Rossi, University of Eastern Piedmont, Novara, Italy; and Davide Rossi, Oncology Institute of Southern Switzerland and Institute of Oncology Research, Bellinzona, Switzerland
| | - Chih Long Liu
- David M. Kurtz, Florian Scherer, Michael C. Jin, Joanne Soo, Alexander F.M. Craig, Mohammad Shahrokh Esfahani, Jacob J. Chabon, Henning Stehr, Chih Long Liu, Robert Tibshirani, Lauren S. Maeda, Neel K. Gupta, Michael S. Khodadoust, Ranjana H. Advani, Ronald Levy, Aaron M. Newman, Maximilian Diehn, and Ash A. Alizadeh, Stanford University, Stanford, CA; Florian Scherer, University Medical Center Freiburg, Freiburg; Ulrich Dührsen and Andreas Hüttmann, University Hospital Essen, Essen, Germany; Michel Meignan, Hôpitaux Universitaires Henri Mondor, Creteil; René-Olivier Casasnovas, Hôpital Le Bocage, Centre Hospitalier Universitaire, Dijon, France; Jason R. Westin, University of Texas MD Anderson Cancer Center, Houston, TX; Mark Roschewski and Wyndham H. Wilson, National Cancer Institute, National Institutes of Health, Bethesda, MD; Gianluca Gaidano and Davide Rossi, University of Eastern Piedmont, Novara, Italy; and Davide Rossi, Oncology Institute of Southern Switzerland and Institute of Oncology Research, Bellinzona, Switzerland
| | - Robert Tibshirani
- David M. Kurtz, Florian Scherer, Michael C. Jin, Joanne Soo, Alexander F.M. Craig, Mohammad Shahrokh Esfahani, Jacob J. Chabon, Henning Stehr, Chih Long Liu, Robert Tibshirani, Lauren S. Maeda, Neel K. Gupta, Michael S. Khodadoust, Ranjana H. Advani, Ronald Levy, Aaron M. Newman, Maximilian Diehn, and Ash A. Alizadeh, Stanford University, Stanford, CA; Florian Scherer, University Medical Center Freiburg, Freiburg; Ulrich Dührsen and Andreas Hüttmann, University Hospital Essen, Essen, Germany; Michel Meignan, Hôpitaux Universitaires Henri Mondor, Creteil; René-Olivier Casasnovas, Hôpital Le Bocage, Centre Hospitalier Universitaire, Dijon, France; Jason R. Westin, University of Texas MD Anderson Cancer Center, Houston, TX; Mark Roschewski and Wyndham H. Wilson, National Cancer Institute, National Institutes of Health, Bethesda, MD; Gianluca Gaidano and Davide Rossi, University of Eastern Piedmont, Novara, Italy; and Davide Rossi, Oncology Institute of Southern Switzerland and Institute of Oncology Research, Bellinzona, Switzerland
| | - Lauren S Maeda
- David M. Kurtz, Florian Scherer, Michael C. Jin, Joanne Soo, Alexander F.M. Craig, Mohammad Shahrokh Esfahani, Jacob J. Chabon, Henning Stehr, Chih Long Liu, Robert Tibshirani, Lauren S. Maeda, Neel K. Gupta, Michael S. Khodadoust, Ranjana H. Advani, Ronald Levy, Aaron M. Newman, Maximilian Diehn, and Ash A. Alizadeh, Stanford University, Stanford, CA; Florian Scherer, University Medical Center Freiburg, Freiburg; Ulrich Dührsen and Andreas Hüttmann, University Hospital Essen, Essen, Germany; Michel Meignan, Hôpitaux Universitaires Henri Mondor, Creteil; René-Olivier Casasnovas, Hôpital Le Bocage, Centre Hospitalier Universitaire, Dijon, France; Jason R. Westin, University of Texas MD Anderson Cancer Center, Houston, TX; Mark Roschewski and Wyndham H. Wilson, National Cancer Institute, National Institutes of Health, Bethesda, MD; Gianluca Gaidano and Davide Rossi, University of Eastern Piedmont, Novara, Italy; and Davide Rossi, Oncology Institute of Southern Switzerland and Institute of Oncology Research, Bellinzona, Switzerland
| | - Neel K Gupta
- David M. Kurtz, Florian Scherer, Michael C. Jin, Joanne Soo, Alexander F.M. Craig, Mohammad Shahrokh Esfahani, Jacob J. Chabon, Henning Stehr, Chih Long Liu, Robert Tibshirani, Lauren S. Maeda, Neel K. Gupta, Michael S. Khodadoust, Ranjana H. Advani, Ronald Levy, Aaron M. Newman, Maximilian Diehn, and Ash A. Alizadeh, Stanford University, Stanford, CA; Florian Scherer, University Medical Center Freiburg, Freiburg; Ulrich Dührsen and Andreas Hüttmann, University Hospital Essen, Essen, Germany; Michel Meignan, Hôpitaux Universitaires Henri Mondor, Creteil; René-Olivier Casasnovas, Hôpital Le Bocage, Centre Hospitalier Universitaire, Dijon, France; Jason R. Westin, University of Texas MD Anderson Cancer Center, Houston, TX; Mark Roschewski and Wyndham H. Wilson, National Cancer Institute, National Institutes of Health, Bethesda, MD; Gianluca Gaidano and Davide Rossi, University of Eastern Piedmont, Novara, Italy; and Davide Rossi, Oncology Institute of Southern Switzerland and Institute of Oncology Research, Bellinzona, Switzerland
| | - Michael S Khodadoust
- David M. Kurtz, Florian Scherer, Michael C. Jin, Joanne Soo, Alexander F.M. Craig, Mohammad Shahrokh Esfahani, Jacob J. Chabon, Henning Stehr, Chih Long Liu, Robert Tibshirani, Lauren S. Maeda, Neel K. Gupta, Michael S. Khodadoust, Ranjana H. Advani, Ronald Levy, Aaron M. Newman, Maximilian Diehn, and Ash A. Alizadeh, Stanford University, Stanford, CA; Florian Scherer, University Medical Center Freiburg, Freiburg; Ulrich Dührsen and Andreas Hüttmann, University Hospital Essen, Essen, Germany; Michel Meignan, Hôpitaux Universitaires Henri Mondor, Creteil; René-Olivier Casasnovas, Hôpital Le Bocage, Centre Hospitalier Universitaire, Dijon, France; Jason R. Westin, University of Texas MD Anderson Cancer Center, Houston, TX; Mark Roschewski and Wyndham H. Wilson, National Cancer Institute, National Institutes of Health, Bethesda, MD; Gianluca Gaidano and Davide Rossi, University of Eastern Piedmont, Novara, Italy; and Davide Rossi, Oncology Institute of Southern Switzerland and Institute of Oncology Research, Bellinzona, Switzerland
| | - Ranjana H Advani
- David M. Kurtz, Florian Scherer, Michael C. Jin, Joanne Soo, Alexander F.M. Craig, Mohammad Shahrokh Esfahani, Jacob J. Chabon, Henning Stehr, Chih Long Liu, Robert Tibshirani, Lauren S. Maeda, Neel K. Gupta, Michael S. Khodadoust, Ranjana H. Advani, Ronald Levy, Aaron M. Newman, Maximilian Diehn, and Ash A. Alizadeh, Stanford University, Stanford, CA; Florian Scherer, University Medical Center Freiburg, Freiburg; Ulrich Dührsen and Andreas Hüttmann, University Hospital Essen, Essen, Germany; Michel Meignan, Hôpitaux Universitaires Henri Mondor, Creteil; René-Olivier Casasnovas, Hôpital Le Bocage, Centre Hospitalier Universitaire, Dijon, France; Jason R. Westin, University of Texas MD Anderson Cancer Center, Houston, TX; Mark Roschewski and Wyndham H. Wilson, National Cancer Institute, National Institutes of Health, Bethesda, MD; Gianluca Gaidano and Davide Rossi, University of Eastern Piedmont, Novara, Italy; and Davide Rossi, Oncology Institute of Southern Switzerland and Institute of Oncology Research, Bellinzona, Switzerland
| | - Ronald Levy
- David M. Kurtz, Florian Scherer, Michael C. Jin, Joanne Soo, Alexander F.M. Craig, Mohammad Shahrokh Esfahani, Jacob J. Chabon, Henning Stehr, Chih Long Liu, Robert Tibshirani, Lauren S. Maeda, Neel K. Gupta, Michael S. Khodadoust, Ranjana H. Advani, Ronald Levy, Aaron M. Newman, Maximilian Diehn, and Ash A. Alizadeh, Stanford University, Stanford, CA; Florian Scherer, University Medical Center Freiburg, Freiburg; Ulrich Dührsen and Andreas Hüttmann, University Hospital Essen, Essen, Germany; Michel Meignan, Hôpitaux Universitaires Henri Mondor, Creteil; René-Olivier Casasnovas, Hôpital Le Bocage, Centre Hospitalier Universitaire, Dijon, France; Jason R. Westin, University of Texas MD Anderson Cancer Center, Houston, TX; Mark Roschewski and Wyndham H. Wilson, National Cancer Institute, National Institutes of Health, Bethesda, MD; Gianluca Gaidano and Davide Rossi, University of Eastern Piedmont, Novara, Italy; and Davide Rossi, Oncology Institute of Southern Switzerland and Institute of Oncology Research, Bellinzona, Switzerland
| | - Aaron M Newman
- David M. Kurtz, Florian Scherer, Michael C. Jin, Joanne Soo, Alexander F.M. Craig, Mohammad Shahrokh Esfahani, Jacob J. Chabon, Henning Stehr, Chih Long Liu, Robert Tibshirani, Lauren S. Maeda, Neel K. Gupta, Michael S. Khodadoust, Ranjana H. Advani, Ronald Levy, Aaron M. Newman, Maximilian Diehn, and Ash A. Alizadeh, Stanford University, Stanford, CA; Florian Scherer, University Medical Center Freiburg, Freiburg; Ulrich Dührsen and Andreas Hüttmann, University Hospital Essen, Essen, Germany; Michel Meignan, Hôpitaux Universitaires Henri Mondor, Creteil; René-Olivier Casasnovas, Hôpital Le Bocage, Centre Hospitalier Universitaire, Dijon, France; Jason R. Westin, University of Texas MD Anderson Cancer Center, Houston, TX; Mark Roschewski and Wyndham H. Wilson, National Cancer Institute, National Institutes of Health, Bethesda, MD; Gianluca Gaidano and Davide Rossi, University of Eastern Piedmont, Novara, Italy; and Davide Rossi, Oncology Institute of Southern Switzerland and Institute of Oncology Research, Bellinzona, Switzerland
| | - Ulrich Dührsen
- David M. Kurtz, Florian Scherer, Michael C. Jin, Joanne Soo, Alexander F.M. Craig, Mohammad Shahrokh Esfahani, Jacob J. Chabon, Henning Stehr, Chih Long Liu, Robert Tibshirani, Lauren S. Maeda, Neel K. Gupta, Michael S. Khodadoust, Ranjana H. Advani, Ronald Levy, Aaron M. Newman, Maximilian Diehn, and Ash A. Alizadeh, Stanford University, Stanford, CA; Florian Scherer, University Medical Center Freiburg, Freiburg; Ulrich Dührsen and Andreas Hüttmann, University Hospital Essen, Essen, Germany; Michel Meignan, Hôpitaux Universitaires Henri Mondor, Creteil; René-Olivier Casasnovas, Hôpital Le Bocage, Centre Hospitalier Universitaire, Dijon, France; Jason R. Westin, University of Texas MD Anderson Cancer Center, Houston, TX; Mark Roschewski and Wyndham H. Wilson, National Cancer Institute, National Institutes of Health, Bethesda, MD; Gianluca Gaidano and Davide Rossi, University of Eastern Piedmont, Novara, Italy; and Davide Rossi, Oncology Institute of Southern Switzerland and Institute of Oncology Research, Bellinzona, Switzerland
| | - Andreas Hüttmann
- David M. Kurtz, Florian Scherer, Michael C. Jin, Joanne Soo, Alexander F.M. Craig, Mohammad Shahrokh Esfahani, Jacob J. Chabon, Henning Stehr, Chih Long Liu, Robert Tibshirani, Lauren S. Maeda, Neel K. Gupta, Michael S. Khodadoust, Ranjana H. Advani, Ronald Levy, Aaron M. Newman, Maximilian Diehn, and Ash A. Alizadeh, Stanford University, Stanford, CA; Florian Scherer, University Medical Center Freiburg, Freiburg; Ulrich Dührsen and Andreas Hüttmann, University Hospital Essen, Essen, Germany; Michel Meignan, Hôpitaux Universitaires Henri Mondor, Creteil; René-Olivier Casasnovas, Hôpital Le Bocage, Centre Hospitalier Universitaire, Dijon, France; Jason R. Westin, University of Texas MD Anderson Cancer Center, Houston, TX; Mark Roschewski and Wyndham H. Wilson, National Cancer Institute, National Institutes of Health, Bethesda, MD; Gianluca Gaidano and Davide Rossi, University of Eastern Piedmont, Novara, Italy; and Davide Rossi, Oncology Institute of Southern Switzerland and Institute of Oncology Research, Bellinzona, Switzerland
| | - Michel Meignan
- David M. Kurtz, Florian Scherer, Michael C. Jin, Joanne Soo, Alexander F.M. Craig, Mohammad Shahrokh Esfahani, Jacob J. Chabon, Henning Stehr, Chih Long Liu, Robert Tibshirani, Lauren S. Maeda, Neel K. Gupta, Michael S. Khodadoust, Ranjana H. Advani, Ronald Levy, Aaron M. Newman, Maximilian Diehn, and Ash A. Alizadeh, Stanford University, Stanford, CA; Florian Scherer, University Medical Center Freiburg, Freiburg; Ulrich Dührsen and Andreas Hüttmann, University Hospital Essen, Essen, Germany; Michel Meignan, Hôpitaux Universitaires Henri Mondor, Creteil; René-Olivier Casasnovas, Hôpital Le Bocage, Centre Hospitalier Universitaire, Dijon, France; Jason R. Westin, University of Texas MD Anderson Cancer Center, Houston, TX; Mark Roschewski and Wyndham H. Wilson, National Cancer Institute, National Institutes of Health, Bethesda, MD; Gianluca Gaidano and Davide Rossi, University of Eastern Piedmont, Novara, Italy; and Davide Rossi, Oncology Institute of Southern Switzerland and Institute of Oncology Research, Bellinzona, Switzerland
| | - René-Olivier Casasnovas
- David M. Kurtz, Florian Scherer, Michael C. Jin, Joanne Soo, Alexander F.M. Craig, Mohammad Shahrokh Esfahani, Jacob J. Chabon, Henning Stehr, Chih Long Liu, Robert Tibshirani, Lauren S. Maeda, Neel K. Gupta, Michael S. Khodadoust, Ranjana H. Advani, Ronald Levy, Aaron M. Newman, Maximilian Diehn, and Ash A. Alizadeh, Stanford University, Stanford, CA; Florian Scherer, University Medical Center Freiburg, Freiburg; Ulrich Dührsen and Andreas Hüttmann, University Hospital Essen, Essen, Germany; Michel Meignan, Hôpitaux Universitaires Henri Mondor, Creteil; René-Olivier Casasnovas, Hôpital Le Bocage, Centre Hospitalier Universitaire, Dijon, France; Jason R. Westin, University of Texas MD Anderson Cancer Center, Houston, TX; Mark Roschewski and Wyndham H. Wilson, National Cancer Institute, National Institutes of Health, Bethesda, MD; Gianluca Gaidano and Davide Rossi, University of Eastern Piedmont, Novara, Italy; and Davide Rossi, Oncology Institute of Southern Switzerland and Institute of Oncology Research, Bellinzona, Switzerland
| | - Jason R Westin
- David M. Kurtz, Florian Scherer, Michael C. Jin, Joanne Soo, Alexander F.M. Craig, Mohammad Shahrokh Esfahani, Jacob J. Chabon, Henning Stehr, Chih Long Liu, Robert Tibshirani, Lauren S. Maeda, Neel K. Gupta, Michael S. Khodadoust, Ranjana H. Advani, Ronald Levy, Aaron M. Newman, Maximilian Diehn, and Ash A. Alizadeh, Stanford University, Stanford, CA; Florian Scherer, University Medical Center Freiburg, Freiburg; Ulrich Dührsen and Andreas Hüttmann, University Hospital Essen, Essen, Germany; Michel Meignan, Hôpitaux Universitaires Henri Mondor, Creteil; René-Olivier Casasnovas, Hôpital Le Bocage, Centre Hospitalier Universitaire, Dijon, France; Jason R. Westin, University of Texas MD Anderson Cancer Center, Houston, TX; Mark Roschewski and Wyndham H. Wilson, National Cancer Institute, National Institutes of Health, Bethesda, MD; Gianluca Gaidano and Davide Rossi, University of Eastern Piedmont, Novara, Italy; and Davide Rossi, Oncology Institute of Southern Switzerland and Institute of Oncology Research, Bellinzona, Switzerland
| | - Mark Roschewski
- David M. Kurtz, Florian Scherer, Michael C. Jin, Joanne Soo, Alexander F.M. Craig, Mohammad Shahrokh Esfahani, Jacob J. Chabon, Henning Stehr, Chih Long Liu, Robert Tibshirani, Lauren S. Maeda, Neel K. Gupta, Michael S. Khodadoust, Ranjana H. Advani, Ronald Levy, Aaron M. Newman, Maximilian Diehn, and Ash A. Alizadeh, Stanford University, Stanford, CA; Florian Scherer, University Medical Center Freiburg, Freiburg; Ulrich Dührsen and Andreas Hüttmann, University Hospital Essen, Essen, Germany; Michel Meignan, Hôpitaux Universitaires Henri Mondor, Creteil; René-Olivier Casasnovas, Hôpital Le Bocage, Centre Hospitalier Universitaire, Dijon, France; Jason R. Westin, University of Texas MD Anderson Cancer Center, Houston, TX; Mark Roschewski and Wyndham H. Wilson, National Cancer Institute, National Institutes of Health, Bethesda, MD; Gianluca Gaidano and Davide Rossi, University of Eastern Piedmont, Novara, Italy; and Davide Rossi, Oncology Institute of Southern Switzerland and Institute of Oncology Research, Bellinzona, Switzerland
| | - Wyndham H Wilson
- David M. Kurtz, Florian Scherer, Michael C. Jin, Joanne Soo, Alexander F.M. Craig, Mohammad Shahrokh Esfahani, Jacob J. Chabon, Henning Stehr, Chih Long Liu, Robert Tibshirani, Lauren S. Maeda, Neel K. Gupta, Michael S. Khodadoust, Ranjana H. Advani, Ronald Levy, Aaron M. Newman, Maximilian Diehn, and Ash A. Alizadeh, Stanford University, Stanford, CA; Florian Scherer, University Medical Center Freiburg, Freiburg; Ulrich Dührsen and Andreas Hüttmann, University Hospital Essen, Essen, Germany; Michel Meignan, Hôpitaux Universitaires Henri Mondor, Creteil; René-Olivier Casasnovas, Hôpital Le Bocage, Centre Hospitalier Universitaire, Dijon, France; Jason R. Westin, University of Texas MD Anderson Cancer Center, Houston, TX; Mark Roschewski and Wyndham H. Wilson, National Cancer Institute, National Institutes of Health, Bethesda, MD; Gianluca Gaidano and Davide Rossi, University of Eastern Piedmont, Novara, Italy; and Davide Rossi, Oncology Institute of Southern Switzerland and Institute of Oncology Research, Bellinzona, Switzerland
| | - Gianluca Gaidano
- David M. Kurtz, Florian Scherer, Michael C. Jin, Joanne Soo, Alexander F.M. Craig, Mohammad Shahrokh Esfahani, Jacob J. Chabon, Henning Stehr, Chih Long Liu, Robert Tibshirani, Lauren S. Maeda, Neel K. Gupta, Michael S. Khodadoust, Ranjana H. Advani, Ronald Levy, Aaron M. Newman, Maximilian Diehn, and Ash A. Alizadeh, Stanford University, Stanford, CA; Florian Scherer, University Medical Center Freiburg, Freiburg; Ulrich Dührsen and Andreas Hüttmann, University Hospital Essen, Essen, Germany; Michel Meignan, Hôpitaux Universitaires Henri Mondor, Creteil; René-Olivier Casasnovas, Hôpital Le Bocage, Centre Hospitalier Universitaire, Dijon, France; Jason R. Westin, University of Texas MD Anderson Cancer Center, Houston, TX; Mark Roschewski and Wyndham H. Wilson, National Cancer Institute, National Institutes of Health, Bethesda, MD; Gianluca Gaidano and Davide Rossi, University of Eastern Piedmont, Novara, Italy; and Davide Rossi, Oncology Institute of Southern Switzerland and Institute of Oncology Research, Bellinzona, Switzerland
| | - Davide Rossi
- David M. Kurtz, Florian Scherer, Michael C. Jin, Joanne Soo, Alexander F.M. Craig, Mohammad Shahrokh Esfahani, Jacob J. Chabon, Henning Stehr, Chih Long Liu, Robert Tibshirani, Lauren S. Maeda, Neel K. Gupta, Michael S. Khodadoust, Ranjana H. Advani, Ronald Levy, Aaron M. Newman, Maximilian Diehn, and Ash A. Alizadeh, Stanford University, Stanford, CA; Florian Scherer, University Medical Center Freiburg, Freiburg; Ulrich Dührsen and Andreas Hüttmann, University Hospital Essen, Essen, Germany; Michel Meignan, Hôpitaux Universitaires Henri Mondor, Creteil; René-Olivier Casasnovas, Hôpital Le Bocage, Centre Hospitalier Universitaire, Dijon, France; Jason R. Westin, University of Texas MD Anderson Cancer Center, Houston, TX; Mark Roschewski and Wyndham H. Wilson, National Cancer Institute, National Institutes of Health, Bethesda, MD; Gianluca Gaidano and Davide Rossi, University of Eastern Piedmont, Novara, Italy; and Davide Rossi, Oncology Institute of Southern Switzerland and Institute of Oncology Research, Bellinzona, Switzerland
| | - Maximilian Diehn
- David M. Kurtz, Florian Scherer, Michael C. Jin, Joanne Soo, Alexander F.M. Craig, Mohammad Shahrokh Esfahani, Jacob J. Chabon, Henning Stehr, Chih Long Liu, Robert Tibshirani, Lauren S. Maeda, Neel K. Gupta, Michael S. Khodadoust, Ranjana H. Advani, Ronald Levy, Aaron M. Newman, Maximilian Diehn, and Ash A. Alizadeh, Stanford University, Stanford, CA; Florian Scherer, University Medical Center Freiburg, Freiburg; Ulrich Dührsen and Andreas Hüttmann, University Hospital Essen, Essen, Germany; Michel Meignan, Hôpitaux Universitaires Henri Mondor, Creteil; René-Olivier Casasnovas, Hôpital Le Bocage, Centre Hospitalier Universitaire, Dijon, France; Jason R. Westin, University of Texas MD Anderson Cancer Center, Houston, TX; Mark Roschewski and Wyndham H. Wilson, National Cancer Institute, National Institutes of Health, Bethesda, MD; Gianluca Gaidano and Davide Rossi, University of Eastern Piedmont, Novara, Italy; and Davide Rossi, Oncology Institute of Southern Switzerland and Institute of Oncology Research, Bellinzona, Switzerland
| | - Ash A Alizadeh
- David M. Kurtz, Florian Scherer, Michael C. Jin, Joanne Soo, Alexander F.M. Craig, Mohammad Shahrokh Esfahani, Jacob J. Chabon, Henning Stehr, Chih Long Liu, Robert Tibshirani, Lauren S. Maeda, Neel K. Gupta, Michael S. Khodadoust, Ranjana H. Advani, Ronald Levy, Aaron M. Newman, Maximilian Diehn, and Ash A. Alizadeh, Stanford University, Stanford, CA; Florian Scherer, University Medical Center Freiburg, Freiburg; Ulrich Dührsen and Andreas Hüttmann, University Hospital Essen, Essen, Germany; Michel Meignan, Hôpitaux Universitaires Henri Mondor, Creteil; René-Olivier Casasnovas, Hôpital Le Bocage, Centre Hospitalier Universitaire, Dijon, France; Jason R. Westin, University of Texas MD Anderson Cancer Center, Houston, TX; Mark Roschewski and Wyndham H. Wilson, National Cancer Institute, National Institutes of Health, Bethesda, MD; Gianluca Gaidano and Davide Rossi, University of Eastern Piedmont, Novara, Italy; and Davide Rossi, Oncology Institute of Southern Switzerland and Institute of Oncology Research, Bellinzona, Switzerland
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Shi Q, Schmitz N, Ou FS, Dixon JG, Cunningham D, Pfreundschuh M, Seymour JF, Jaeger U, Habermann TM, Haioun C, Tilly H, Ghesquieres H, Merli F, Ziepert M, Herbrecht R, Flament J, Fu T, Coiffier B, Flowers CR. Progression-Free Survival as a Surrogate End Point for Overall Survival in First-Line Diffuse Large B-Cell Lymphoma: An Individual Patient-Level Analysis of Multiple Randomized Trials (SEAL). J Clin Oncol 2018; 36:2593-2602. [PMID: 29975624 DOI: 10.1200/jco.2018.77.9124] [Citation(s) in RCA: 60] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Purpose Overall survival (OS) is the definitive and best-established primary efficacy end point to evaluate diffuse large B-cell lymphoma (DLBCL) therapies, but it requires prolonged follow-up. An earlier end point assessed post-treatment would expedite clinical trial conduct and accelerate patient access to effective new therapies. Our objective was to formally evaluate progression-free survival (PFS) and PFS at 24 months (PFS24) as surrogate end points for OS in first-line DLBCL. Patients and Methods Individual patient data were analyzed from 7,507 patients from 13 multicenter randomized controlled trials of active treatment in previously untreated DLBCL, published after 2002, with sufficient PFS data to predict treatment effects on OS. Trial-level surrogacy examining the correlation of treatment effect estimates of PFS/PFS24 and OS was evaluated using both linear regression ( R2WLS) and Copula bivariable ( R2Copula) models. Prespecified criteria for surrogacy required either R2WLS or R2Copula ≥ 0.80 and neither < 0.7, with lower-bound 95% CI > 0.60. Results Trial-level surrogacy for PFS was strong ( R2WLS = 0.83; R2Copula = 0.85) and met the predefined criteria for surrogacy. At the patient level, PFS strongly correlated with OS. The surrogate threshold effect had a hazard ratio of 0.89. Surrogacy was consistent across comparisons with or without rituximab and with rituximab maintenance trials. Trial-level surrogacy for PFS24 was relatively strong ( R2WLS = 0.77; R2Copula = 0.78) but did not meet prespecified criteria. At the patient level, PFS24 significantly correlated with OS. The surrogate threshold effect had an odds ratio of 1.51. Conclusion This large pooled analysis of individual patient data supports PFS as a surrogate end point for OS in future randomized controlled trials evaluating chemoimmunotherapy in DLBCL. Use of this end point may expedite therapeutic development with the intent of bringing novel therapies to this patient population years before OS results are mature.
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Affiliation(s)
- Qian Shi
- Qian Shi, Fang-Shu Ou, Jesse G. Dixon, and Thomas M. Habermann, Mayo Clinic, Rochester, MN; Norbert Schmitz, University of Muenster, Muenster; Michael Pfreundschuh, Universität des Saarlandes, Homburg; Marita Ziepert, University of Leipzig, Leipzig, Germany; David Cunningham, The Royal Marsden Hospital, Surrey, United Kingdom; John F. Seymour, Peter MacCallum Cancer Centre and University of Melbourne, Melbourne, Victoria, Australia; Ulrich Jaeger, Medical University of Vienna, Vienna, Austria; Corinne Haioun, Hôpital Henri Mondor, Assistance Publique-Hôpitaux de Paris, Créteil; Hervé Tilly, Institut National de la Santé et de la Recherche Médicale U1245, Université de Rouen, Rouen; Hervé Ghesquieres and Bertrand Coiffier, Centre Hospitalier Lyon-Sud, Pierre-Benite; Raoul Herbrecht, Hôpital de Hautepierre, Strasbourg, France; Francesco Merli, Azienda Unità Sanitaria Locale-Istituto di Ricovero e Cura a Carattere Scientifico, Reggio Emilia, Italy; Jocelyne Flament, Celgene, Boudry, Switzerland; Tommy Fu, Celgene, Summit, NJ; and Christopher R. Flowers, Emory University, Atlanta, GA
| | - Norbert Schmitz
- Qian Shi, Fang-Shu Ou, Jesse G. Dixon, and Thomas M. Habermann, Mayo Clinic, Rochester, MN; Norbert Schmitz, University of Muenster, Muenster; Michael Pfreundschuh, Universität des Saarlandes, Homburg; Marita Ziepert, University of Leipzig, Leipzig, Germany; David Cunningham, The Royal Marsden Hospital, Surrey, United Kingdom; John F. Seymour, Peter MacCallum Cancer Centre and University of Melbourne, Melbourne, Victoria, Australia; Ulrich Jaeger, Medical University of Vienna, Vienna, Austria; Corinne Haioun, Hôpital Henri Mondor, Assistance Publique-Hôpitaux de Paris, Créteil; Hervé Tilly, Institut National de la Santé et de la Recherche Médicale U1245, Université de Rouen, Rouen; Hervé Ghesquieres and Bertrand Coiffier, Centre Hospitalier Lyon-Sud, Pierre-Benite; Raoul Herbrecht, Hôpital de Hautepierre, Strasbourg, France; Francesco Merli, Azienda Unità Sanitaria Locale-Istituto di Ricovero e Cura a Carattere Scientifico, Reggio Emilia, Italy; Jocelyne Flament, Celgene, Boudry, Switzerland; Tommy Fu, Celgene, Summit, NJ; and Christopher R. Flowers, Emory University, Atlanta, GA
| | - Fang-Shu Ou
- Qian Shi, Fang-Shu Ou, Jesse G. Dixon, and Thomas M. Habermann, Mayo Clinic, Rochester, MN; Norbert Schmitz, University of Muenster, Muenster; Michael Pfreundschuh, Universität des Saarlandes, Homburg; Marita Ziepert, University of Leipzig, Leipzig, Germany; David Cunningham, The Royal Marsden Hospital, Surrey, United Kingdom; John F. Seymour, Peter MacCallum Cancer Centre and University of Melbourne, Melbourne, Victoria, Australia; Ulrich Jaeger, Medical University of Vienna, Vienna, Austria; Corinne Haioun, Hôpital Henri Mondor, Assistance Publique-Hôpitaux de Paris, Créteil; Hervé Tilly, Institut National de la Santé et de la Recherche Médicale U1245, Université de Rouen, Rouen; Hervé Ghesquieres and Bertrand Coiffier, Centre Hospitalier Lyon-Sud, Pierre-Benite; Raoul Herbrecht, Hôpital de Hautepierre, Strasbourg, France; Francesco Merli, Azienda Unità Sanitaria Locale-Istituto di Ricovero e Cura a Carattere Scientifico, Reggio Emilia, Italy; Jocelyne Flament, Celgene, Boudry, Switzerland; Tommy Fu, Celgene, Summit, NJ; and Christopher R. Flowers, Emory University, Atlanta, GA
| | - Jesse G Dixon
- Qian Shi, Fang-Shu Ou, Jesse G. Dixon, and Thomas M. Habermann, Mayo Clinic, Rochester, MN; Norbert Schmitz, University of Muenster, Muenster; Michael Pfreundschuh, Universität des Saarlandes, Homburg; Marita Ziepert, University of Leipzig, Leipzig, Germany; David Cunningham, The Royal Marsden Hospital, Surrey, United Kingdom; John F. Seymour, Peter MacCallum Cancer Centre and University of Melbourne, Melbourne, Victoria, Australia; Ulrich Jaeger, Medical University of Vienna, Vienna, Austria; Corinne Haioun, Hôpital Henri Mondor, Assistance Publique-Hôpitaux de Paris, Créteil; Hervé Tilly, Institut National de la Santé et de la Recherche Médicale U1245, Université de Rouen, Rouen; Hervé Ghesquieres and Bertrand Coiffier, Centre Hospitalier Lyon-Sud, Pierre-Benite; Raoul Herbrecht, Hôpital de Hautepierre, Strasbourg, France; Francesco Merli, Azienda Unità Sanitaria Locale-Istituto di Ricovero e Cura a Carattere Scientifico, Reggio Emilia, Italy; Jocelyne Flament, Celgene, Boudry, Switzerland; Tommy Fu, Celgene, Summit, NJ; and Christopher R. Flowers, Emory University, Atlanta, GA
| | - David Cunningham
- Qian Shi, Fang-Shu Ou, Jesse G. Dixon, and Thomas M. Habermann, Mayo Clinic, Rochester, MN; Norbert Schmitz, University of Muenster, Muenster; Michael Pfreundschuh, Universität des Saarlandes, Homburg; Marita Ziepert, University of Leipzig, Leipzig, Germany; David Cunningham, The Royal Marsden Hospital, Surrey, United Kingdom; John F. Seymour, Peter MacCallum Cancer Centre and University of Melbourne, Melbourne, Victoria, Australia; Ulrich Jaeger, Medical University of Vienna, Vienna, Austria; Corinne Haioun, Hôpital Henri Mondor, Assistance Publique-Hôpitaux de Paris, Créteil; Hervé Tilly, Institut National de la Santé et de la Recherche Médicale U1245, Université de Rouen, Rouen; Hervé Ghesquieres and Bertrand Coiffier, Centre Hospitalier Lyon-Sud, Pierre-Benite; Raoul Herbrecht, Hôpital de Hautepierre, Strasbourg, France; Francesco Merli, Azienda Unità Sanitaria Locale-Istituto di Ricovero e Cura a Carattere Scientifico, Reggio Emilia, Italy; Jocelyne Flament, Celgene, Boudry, Switzerland; Tommy Fu, Celgene, Summit, NJ; and Christopher R. Flowers, Emory University, Atlanta, GA
| | - Michael Pfreundschuh
- Qian Shi, Fang-Shu Ou, Jesse G. Dixon, and Thomas M. Habermann, Mayo Clinic, Rochester, MN; Norbert Schmitz, University of Muenster, Muenster; Michael Pfreundschuh, Universität des Saarlandes, Homburg; Marita Ziepert, University of Leipzig, Leipzig, Germany; David Cunningham, The Royal Marsden Hospital, Surrey, United Kingdom; John F. Seymour, Peter MacCallum Cancer Centre and University of Melbourne, Melbourne, Victoria, Australia; Ulrich Jaeger, Medical University of Vienna, Vienna, Austria; Corinne Haioun, Hôpital Henri Mondor, Assistance Publique-Hôpitaux de Paris, Créteil; Hervé Tilly, Institut National de la Santé et de la Recherche Médicale U1245, Université de Rouen, Rouen; Hervé Ghesquieres and Bertrand Coiffier, Centre Hospitalier Lyon-Sud, Pierre-Benite; Raoul Herbrecht, Hôpital de Hautepierre, Strasbourg, France; Francesco Merli, Azienda Unità Sanitaria Locale-Istituto di Ricovero e Cura a Carattere Scientifico, Reggio Emilia, Italy; Jocelyne Flament, Celgene, Boudry, Switzerland; Tommy Fu, Celgene, Summit, NJ; and Christopher R. Flowers, Emory University, Atlanta, GA
| | - John F Seymour
- Qian Shi, Fang-Shu Ou, Jesse G. Dixon, and Thomas M. Habermann, Mayo Clinic, Rochester, MN; Norbert Schmitz, University of Muenster, Muenster; Michael Pfreundschuh, Universität des Saarlandes, Homburg; Marita Ziepert, University of Leipzig, Leipzig, Germany; David Cunningham, The Royal Marsden Hospital, Surrey, United Kingdom; John F. Seymour, Peter MacCallum Cancer Centre and University of Melbourne, Melbourne, Victoria, Australia; Ulrich Jaeger, Medical University of Vienna, Vienna, Austria; Corinne Haioun, Hôpital Henri Mondor, Assistance Publique-Hôpitaux de Paris, Créteil; Hervé Tilly, Institut National de la Santé et de la Recherche Médicale U1245, Université de Rouen, Rouen; Hervé Ghesquieres and Bertrand Coiffier, Centre Hospitalier Lyon-Sud, Pierre-Benite; Raoul Herbrecht, Hôpital de Hautepierre, Strasbourg, France; Francesco Merli, Azienda Unità Sanitaria Locale-Istituto di Ricovero e Cura a Carattere Scientifico, Reggio Emilia, Italy; Jocelyne Flament, Celgene, Boudry, Switzerland; Tommy Fu, Celgene, Summit, NJ; and Christopher R. Flowers, Emory University, Atlanta, GA
| | - Ulrich Jaeger
- Qian Shi, Fang-Shu Ou, Jesse G. Dixon, and Thomas M. Habermann, Mayo Clinic, Rochester, MN; Norbert Schmitz, University of Muenster, Muenster; Michael Pfreundschuh, Universität des Saarlandes, Homburg; Marita Ziepert, University of Leipzig, Leipzig, Germany; David Cunningham, The Royal Marsden Hospital, Surrey, United Kingdom; John F. Seymour, Peter MacCallum Cancer Centre and University of Melbourne, Melbourne, Victoria, Australia; Ulrich Jaeger, Medical University of Vienna, Vienna, Austria; Corinne Haioun, Hôpital Henri Mondor, Assistance Publique-Hôpitaux de Paris, Créteil; Hervé Tilly, Institut National de la Santé et de la Recherche Médicale U1245, Université de Rouen, Rouen; Hervé Ghesquieres and Bertrand Coiffier, Centre Hospitalier Lyon-Sud, Pierre-Benite; Raoul Herbrecht, Hôpital de Hautepierre, Strasbourg, France; Francesco Merli, Azienda Unità Sanitaria Locale-Istituto di Ricovero e Cura a Carattere Scientifico, Reggio Emilia, Italy; Jocelyne Flament, Celgene, Boudry, Switzerland; Tommy Fu, Celgene, Summit, NJ; and Christopher R. Flowers, Emory University, Atlanta, GA
| | - Thomas M Habermann
- Qian Shi, Fang-Shu Ou, Jesse G. Dixon, and Thomas M. Habermann, Mayo Clinic, Rochester, MN; Norbert Schmitz, University of Muenster, Muenster; Michael Pfreundschuh, Universität des Saarlandes, Homburg; Marita Ziepert, University of Leipzig, Leipzig, Germany; David Cunningham, The Royal Marsden Hospital, Surrey, United Kingdom; John F. Seymour, Peter MacCallum Cancer Centre and University of Melbourne, Melbourne, Victoria, Australia; Ulrich Jaeger, Medical University of Vienna, Vienna, Austria; Corinne Haioun, Hôpital Henri Mondor, Assistance Publique-Hôpitaux de Paris, Créteil; Hervé Tilly, Institut National de la Santé et de la Recherche Médicale U1245, Université de Rouen, Rouen; Hervé Ghesquieres and Bertrand Coiffier, Centre Hospitalier Lyon-Sud, Pierre-Benite; Raoul Herbrecht, Hôpital de Hautepierre, Strasbourg, France; Francesco Merli, Azienda Unità Sanitaria Locale-Istituto di Ricovero e Cura a Carattere Scientifico, Reggio Emilia, Italy; Jocelyne Flament, Celgene, Boudry, Switzerland; Tommy Fu, Celgene, Summit, NJ; and Christopher R. Flowers, Emory University, Atlanta, GA
| | - Corinne Haioun
- Qian Shi, Fang-Shu Ou, Jesse G. Dixon, and Thomas M. Habermann, Mayo Clinic, Rochester, MN; Norbert Schmitz, University of Muenster, Muenster; Michael Pfreundschuh, Universität des Saarlandes, Homburg; Marita Ziepert, University of Leipzig, Leipzig, Germany; David Cunningham, The Royal Marsden Hospital, Surrey, United Kingdom; John F. Seymour, Peter MacCallum Cancer Centre and University of Melbourne, Melbourne, Victoria, Australia; Ulrich Jaeger, Medical University of Vienna, Vienna, Austria; Corinne Haioun, Hôpital Henri Mondor, Assistance Publique-Hôpitaux de Paris, Créteil; Hervé Tilly, Institut National de la Santé et de la Recherche Médicale U1245, Université de Rouen, Rouen; Hervé Ghesquieres and Bertrand Coiffier, Centre Hospitalier Lyon-Sud, Pierre-Benite; Raoul Herbrecht, Hôpital de Hautepierre, Strasbourg, France; Francesco Merli, Azienda Unità Sanitaria Locale-Istituto di Ricovero e Cura a Carattere Scientifico, Reggio Emilia, Italy; Jocelyne Flament, Celgene, Boudry, Switzerland; Tommy Fu, Celgene, Summit, NJ; and Christopher R. Flowers, Emory University, Atlanta, GA
| | - Hervé Tilly
- Qian Shi, Fang-Shu Ou, Jesse G. Dixon, and Thomas M. Habermann, Mayo Clinic, Rochester, MN; Norbert Schmitz, University of Muenster, Muenster; Michael Pfreundschuh, Universität des Saarlandes, Homburg; Marita Ziepert, University of Leipzig, Leipzig, Germany; David Cunningham, The Royal Marsden Hospital, Surrey, United Kingdom; John F. Seymour, Peter MacCallum Cancer Centre and University of Melbourne, Melbourne, Victoria, Australia; Ulrich Jaeger, Medical University of Vienna, Vienna, Austria; Corinne Haioun, Hôpital Henri Mondor, Assistance Publique-Hôpitaux de Paris, Créteil; Hervé Tilly, Institut National de la Santé et de la Recherche Médicale U1245, Université de Rouen, Rouen; Hervé Ghesquieres and Bertrand Coiffier, Centre Hospitalier Lyon-Sud, Pierre-Benite; Raoul Herbrecht, Hôpital de Hautepierre, Strasbourg, France; Francesco Merli, Azienda Unità Sanitaria Locale-Istituto di Ricovero e Cura a Carattere Scientifico, Reggio Emilia, Italy; Jocelyne Flament, Celgene, Boudry, Switzerland; Tommy Fu, Celgene, Summit, NJ; and Christopher R. Flowers, Emory University, Atlanta, GA
| | - Hervé Ghesquieres
- Qian Shi, Fang-Shu Ou, Jesse G. Dixon, and Thomas M. Habermann, Mayo Clinic, Rochester, MN; Norbert Schmitz, University of Muenster, Muenster; Michael Pfreundschuh, Universität des Saarlandes, Homburg; Marita Ziepert, University of Leipzig, Leipzig, Germany; David Cunningham, The Royal Marsden Hospital, Surrey, United Kingdom; John F. Seymour, Peter MacCallum Cancer Centre and University of Melbourne, Melbourne, Victoria, Australia; Ulrich Jaeger, Medical University of Vienna, Vienna, Austria; Corinne Haioun, Hôpital Henri Mondor, Assistance Publique-Hôpitaux de Paris, Créteil; Hervé Tilly, Institut National de la Santé et de la Recherche Médicale U1245, Université de Rouen, Rouen; Hervé Ghesquieres and Bertrand Coiffier, Centre Hospitalier Lyon-Sud, Pierre-Benite; Raoul Herbrecht, Hôpital de Hautepierre, Strasbourg, France; Francesco Merli, Azienda Unità Sanitaria Locale-Istituto di Ricovero e Cura a Carattere Scientifico, Reggio Emilia, Italy; Jocelyne Flament, Celgene, Boudry, Switzerland; Tommy Fu, Celgene, Summit, NJ; and Christopher R. Flowers, Emory University, Atlanta, GA
| | - Francesco Merli
- Qian Shi, Fang-Shu Ou, Jesse G. Dixon, and Thomas M. Habermann, Mayo Clinic, Rochester, MN; Norbert Schmitz, University of Muenster, Muenster; Michael Pfreundschuh, Universität des Saarlandes, Homburg; Marita Ziepert, University of Leipzig, Leipzig, Germany; David Cunningham, The Royal Marsden Hospital, Surrey, United Kingdom; John F. Seymour, Peter MacCallum Cancer Centre and University of Melbourne, Melbourne, Victoria, Australia; Ulrich Jaeger, Medical University of Vienna, Vienna, Austria; Corinne Haioun, Hôpital Henri Mondor, Assistance Publique-Hôpitaux de Paris, Créteil; Hervé Tilly, Institut National de la Santé et de la Recherche Médicale U1245, Université de Rouen, Rouen; Hervé Ghesquieres and Bertrand Coiffier, Centre Hospitalier Lyon-Sud, Pierre-Benite; Raoul Herbrecht, Hôpital de Hautepierre, Strasbourg, France; Francesco Merli, Azienda Unità Sanitaria Locale-Istituto di Ricovero e Cura a Carattere Scientifico, Reggio Emilia, Italy; Jocelyne Flament, Celgene, Boudry, Switzerland; Tommy Fu, Celgene, Summit, NJ; and Christopher R. Flowers, Emory University, Atlanta, GA
| | - Marita Ziepert
- Qian Shi, Fang-Shu Ou, Jesse G. Dixon, and Thomas M. Habermann, Mayo Clinic, Rochester, MN; Norbert Schmitz, University of Muenster, Muenster; Michael Pfreundschuh, Universität des Saarlandes, Homburg; Marita Ziepert, University of Leipzig, Leipzig, Germany; David Cunningham, The Royal Marsden Hospital, Surrey, United Kingdom; John F. Seymour, Peter MacCallum Cancer Centre and University of Melbourne, Melbourne, Victoria, Australia; Ulrich Jaeger, Medical University of Vienna, Vienna, Austria; Corinne Haioun, Hôpital Henri Mondor, Assistance Publique-Hôpitaux de Paris, Créteil; Hervé Tilly, Institut National de la Santé et de la Recherche Médicale U1245, Université de Rouen, Rouen; Hervé Ghesquieres and Bertrand Coiffier, Centre Hospitalier Lyon-Sud, Pierre-Benite; Raoul Herbrecht, Hôpital de Hautepierre, Strasbourg, France; Francesco Merli, Azienda Unità Sanitaria Locale-Istituto di Ricovero e Cura a Carattere Scientifico, Reggio Emilia, Italy; Jocelyne Flament, Celgene, Boudry, Switzerland; Tommy Fu, Celgene, Summit, NJ; and Christopher R. Flowers, Emory University, Atlanta, GA
| | - Raoul Herbrecht
- Qian Shi, Fang-Shu Ou, Jesse G. Dixon, and Thomas M. Habermann, Mayo Clinic, Rochester, MN; Norbert Schmitz, University of Muenster, Muenster; Michael Pfreundschuh, Universität des Saarlandes, Homburg; Marita Ziepert, University of Leipzig, Leipzig, Germany; David Cunningham, The Royal Marsden Hospital, Surrey, United Kingdom; John F. Seymour, Peter MacCallum Cancer Centre and University of Melbourne, Melbourne, Victoria, Australia; Ulrich Jaeger, Medical University of Vienna, Vienna, Austria; Corinne Haioun, Hôpital Henri Mondor, Assistance Publique-Hôpitaux de Paris, Créteil; Hervé Tilly, Institut National de la Santé et de la Recherche Médicale U1245, Université de Rouen, Rouen; Hervé Ghesquieres and Bertrand Coiffier, Centre Hospitalier Lyon-Sud, Pierre-Benite; Raoul Herbrecht, Hôpital de Hautepierre, Strasbourg, France; Francesco Merli, Azienda Unità Sanitaria Locale-Istituto di Ricovero e Cura a Carattere Scientifico, Reggio Emilia, Italy; Jocelyne Flament, Celgene, Boudry, Switzerland; Tommy Fu, Celgene, Summit, NJ; and Christopher R. Flowers, Emory University, Atlanta, GA
| | - Jocelyne Flament
- Qian Shi, Fang-Shu Ou, Jesse G. Dixon, and Thomas M. Habermann, Mayo Clinic, Rochester, MN; Norbert Schmitz, University of Muenster, Muenster; Michael Pfreundschuh, Universität des Saarlandes, Homburg; Marita Ziepert, University of Leipzig, Leipzig, Germany; David Cunningham, The Royal Marsden Hospital, Surrey, United Kingdom; John F. Seymour, Peter MacCallum Cancer Centre and University of Melbourne, Melbourne, Victoria, Australia; Ulrich Jaeger, Medical University of Vienna, Vienna, Austria; Corinne Haioun, Hôpital Henri Mondor, Assistance Publique-Hôpitaux de Paris, Créteil; Hervé Tilly, Institut National de la Santé et de la Recherche Médicale U1245, Université de Rouen, Rouen; Hervé Ghesquieres and Bertrand Coiffier, Centre Hospitalier Lyon-Sud, Pierre-Benite; Raoul Herbrecht, Hôpital de Hautepierre, Strasbourg, France; Francesco Merli, Azienda Unità Sanitaria Locale-Istituto di Ricovero e Cura a Carattere Scientifico, Reggio Emilia, Italy; Jocelyne Flament, Celgene, Boudry, Switzerland; Tommy Fu, Celgene, Summit, NJ; and Christopher R. Flowers, Emory University, Atlanta, GA
| | - Tommy Fu
- Qian Shi, Fang-Shu Ou, Jesse G. Dixon, and Thomas M. Habermann, Mayo Clinic, Rochester, MN; Norbert Schmitz, University of Muenster, Muenster; Michael Pfreundschuh, Universität des Saarlandes, Homburg; Marita Ziepert, University of Leipzig, Leipzig, Germany; David Cunningham, The Royal Marsden Hospital, Surrey, United Kingdom; John F. Seymour, Peter MacCallum Cancer Centre and University of Melbourne, Melbourne, Victoria, Australia; Ulrich Jaeger, Medical University of Vienna, Vienna, Austria; Corinne Haioun, Hôpital Henri Mondor, Assistance Publique-Hôpitaux de Paris, Créteil; Hervé Tilly, Institut National de la Santé et de la Recherche Médicale U1245, Université de Rouen, Rouen; Hervé Ghesquieres and Bertrand Coiffier, Centre Hospitalier Lyon-Sud, Pierre-Benite; Raoul Herbrecht, Hôpital de Hautepierre, Strasbourg, France; Francesco Merli, Azienda Unità Sanitaria Locale-Istituto di Ricovero e Cura a Carattere Scientifico, Reggio Emilia, Italy; Jocelyne Flament, Celgene, Boudry, Switzerland; Tommy Fu, Celgene, Summit, NJ; and Christopher R. Flowers, Emory University, Atlanta, GA
| | - Bertrand Coiffier
- Qian Shi, Fang-Shu Ou, Jesse G. Dixon, and Thomas M. Habermann, Mayo Clinic, Rochester, MN; Norbert Schmitz, University of Muenster, Muenster; Michael Pfreundschuh, Universität des Saarlandes, Homburg; Marita Ziepert, University of Leipzig, Leipzig, Germany; David Cunningham, The Royal Marsden Hospital, Surrey, United Kingdom; John F. Seymour, Peter MacCallum Cancer Centre and University of Melbourne, Melbourne, Victoria, Australia; Ulrich Jaeger, Medical University of Vienna, Vienna, Austria; Corinne Haioun, Hôpital Henri Mondor, Assistance Publique-Hôpitaux de Paris, Créteil; Hervé Tilly, Institut National de la Santé et de la Recherche Médicale U1245, Université de Rouen, Rouen; Hervé Ghesquieres and Bertrand Coiffier, Centre Hospitalier Lyon-Sud, Pierre-Benite; Raoul Herbrecht, Hôpital de Hautepierre, Strasbourg, France; Francesco Merli, Azienda Unità Sanitaria Locale-Istituto di Ricovero e Cura a Carattere Scientifico, Reggio Emilia, Italy; Jocelyne Flament, Celgene, Boudry, Switzerland; Tommy Fu, Celgene, Summit, NJ; and Christopher R. Flowers, Emory University, Atlanta, GA
| | - Christopher R Flowers
- Qian Shi, Fang-Shu Ou, Jesse G. Dixon, and Thomas M. Habermann, Mayo Clinic, Rochester, MN; Norbert Schmitz, University of Muenster, Muenster; Michael Pfreundschuh, Universität des Saarlandes, Homburg; Marita Ziepert, University of Leipzig, Leipzig, Germany; David Cunningham, The Royal Marsden Hospital, Surrey, United Kingdom; John F. Seymour, Peter MacCallum Cancer Centre and University of Melbourne, Melbourne, Victoria, Australia; Ulrich Jaeger, Medical University of Vienna, Vienna, Austria; Corinne Haioun, Hôpital Henri Mondor, Assistance Publique-Hôpitaux de Paris, Créteil; Hervé Tilly, Institut National de la Santé et de la Recherche Médicale U1245, Université de Rouen, Rouen; Hervé Ghesquieres and Bertrand Coiffier, Centre Hospitalier Lyon-Sud, Pierre-Benite; Raoul Herbrecht, Hôpital de Hautepierre, Strasbourg, France; Francesco Merli, Azienda Unità Sanitaria Locale-Istituto di Ricovero e Cura a Carattere Scientifico, Reggio Emilia, Italy; Jocelyne Flament, Celgene, Boudry, Switzerland; Tommy Fu, Celgene, Summit, NJ; and Christopher R. Flowers, Emory University, Atlanta, GA
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Stathis A, Iasonos A, Seymour JF, Thieblemont C, Ribrag V, Zucca E, Younes A. Report of the 14th International Conference on Malignant Lymphoma (ICML) Closed Workshop on Future Design of Clinical Trials in Lymphomas. Clin Cancer Res 2018. [PMID: 29535129 DOI: 10.1158/1078-0432.ccr-17-3021] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The 14th ICML held in Lugano in June 2017 was preceded by a closed workshop (organized in collaboration with the American Association for Cancer Research and the European School of Oncology) where experts in preclinical and clinical research in lymphomas met to discuss the current drug development landscape focusing on critical open questions that need to be addressed in the future to permit a more efficient drug development paradigm in lymphoma. Topics discussed included both preclinical models that can be used to test new drugs and drug combinations, as well as the optimal design of clinical trials and the endpoints that should be used to facilitate accelerated progress. This report represents a summary of the workshop. Clin Cancer Res; 24(13); 2993-8. ©2018 AACR.
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Affiliation(s)
| | - Alexia Iasonos
- Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - John F Seymour
- Department of Hematology, Peter MacCallum Cancer Center and Royal Melbourne Hospital, and University of Melbourne, Victoria, Australia
| | - Catherine Thieblemont
- Hemato-oncology Department, Assistance Publique-Hôpitaux de Paris (APHP), Hôpital Saint-Louis, Paris, France
| | - Vincent Ribrag
- DITEP, Gustave Roussy Comprehensive Cancer Center, Villejuif, France
| | - Emanuele Zucca
- Oncology Institute of Southern Switzerland, Bellinzona, Switzerland.,Institute of Oncology Research, Bellinzona, Switzerland.,Medical Oncology, University of Bern, Switzerland
| | - Anas Younes
- Memorial Sloan Kettering Cancer Center, New York, NY, USA.
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Buyse M, Burzykowski T, Saad ED. The search for surrogate endpoints for immunotherapy trials. ANNALS OF TRANSLATIONAL MEDICINE 2018; 6:231. [PMID: 30023394 DOI: 10.21037/atm.2018.05.16] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Marc Buyse
- International Drug Development Institute, San Francisco, CA, USA.,Interuniversity Institute for Biostatistics and statistical Bioinformatics (I-BioStat), Hasselt University, Hasselt, Belgium
| | - Tomasz Burzykowski
- Interuniversity Institute for Biostatistics and statistical Bioinformatics (I-BioStat), Hasselt University, Hasselt, Belgium.,International Drug Development Institute, Louvain-la-Neuve, Belgium
| | - Everardo D Saad
- International Drug Development Institute, Louvain-la-Neuve, Belgium
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Casulo C, Nastoupil L, Fowler NH, Friedberg JW, Flowers CR. Unmet needs in the first-line treatment of follicular lymphoma. Ann Oncol 2018; 28:2094-2106. [PMID: 28430865 DOI: 10.1093/annonc/mdx189] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
For the majority of patients with newly diagnosed follicular lymphoma (FL), current treatments, while not curative, allow for long remission durations. However, several important needs remain unaddressed. Studies have consistently shown that ∼20% of patients with FL experience disease progression within 2 years of first-line treatment, and consequently have a 50% risk of death in 5 years. Better characterization of this group of patients at diagnosis may provide insight into those in need of alternate or intensive therapies, facilitate a precision approach to inform clinical trials, and allow for improved patient counseling. Prognostic methods to date have employed clinical parameters, genomic methods, and a wide assortment of biological and biochemical markers, but none so far has been able to adequately identify this high-risk population. Advances in the first-line treatment of FL with chemoimmunotherapy have led to a median progression-free survival (PFS) of approximately 7 years; creating a challenge in the development of clinical trials where PFS is a primary end point. A surrogate end point that accurately predicts PFS would allow for new treatments to reach patients with FL sooner, or lessen toxicity, time, and expense to those patients requiring little to no therapy. Quality of response to treatment may predict PFS and overall survival in FL; as such complete response rates, either alone or in conjunction with PET imaging or minimal residual disease negativity, are being studied as surrogates, with complete response at 30 months after induction providing the strongest surrogacy evidence to date. A better understanding of how to optimize quality of life in the context of this chronic illness is another important focus deserving of further study. Ongoing efforts to address these important unmet needs are herein discussed.
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Affiliation(s)
- C Casulo
- Department of Medicine, Hematology/Oncology, WIlmot Cancer Institute, University of Rochester Medical Center, Rochester, New York
| | - L Nastoupil
- Department of Lymphoma/Myeloma, MD Anderson Cancer Center, Houston
| | - N H Fowler
- Department of Lymphoma/Myeloma, MD Anderson Cancer Center, Houston
| | - J W Friedberg
- Department of Medicine, Hematology/Oncology, WIlmot Cancer Institute, University of Rochester Medical Center, Rochester, New York
| | - C R Flowers
- Department of Bone Marrow and Stem Cell Transplantation, Winship Cancer Institute, Emory University, Atlanta, USA
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A simplified scoring system in de novo follicular lymphoma treated initially with immunochemotherapy. Blood 2018; 132:49-58. [PMID: 29666118 DOI: 10.1182/blood-2017-11-816405] [Citation(s) in RCA: 114] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2017] [Accepted: 04/08/2018] [Indexed: 01/06/2023] Open
Abstract
In follicular lymphoma (FL), no prognostic index has been built based solely on a cohort of patients treated with initial immunochemotherapy. There is currently a need to define parsimonious clinical models for trial stratification and to add on biomolecular factors. Here, we confirmed the validity of both the follicular lymphoma international prognostic index (FLIPI) and the FLIPI2 in the large prospective PRIMA trial cohort of 1135 patients treated with initial R-chemotherapy ± R maintenance. Furthermore, we developed a new prognostic tool comprising only 2 simple parameters (bone marrow involvement and β2-microglobulin [β2m]) to predict progression-free survival (PFS). The final simplified score, called the PRIMA-PI (PRIMA-prognostic index), comprised 3 risk categories: high (β2m > 3 mg/L), low (β2m ≤ 3 mg/L without bone marrow involvement), and intermediate (β2m ≤ 3 mg/L with bone marrow involvement). Five-year PFS rates were 69%, 55%, and 37% in the low-, intermediate-, and high-risk groups, respectively (P < .0001). In addition, achieving event-free survival (EFS) or not at 24 months (EFS24) was a strong posttreatment prognostic parameter for subsequent overall survival, and the PRIMA-PI was correlated with EFS24. The results were confirmed in a pooled external validation cohort of 479 patients from the FL2000 LYSA trial and the University of Iowa/Mayo Clinic Lymphoma Specialized Program of Research Excellence Molecular Epidemiology Resource. Five-year EFS in the validation cohort was 77%, 57%, and 44% in the PRIMA-PI low-, intermediate-, and high-risk groups, respectively (P < .0001). The PRIMA-PI is a novel and easy-to-compute prognostic index for patients initially treated with immunochemotherapy. This could serve as a basis for building more sophisticated and integrated biomolecular scores.
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Chavez JC, Locke FL. CAR T cell therapy for B-cell lymphomas. Best Pract Res Clin Haematol 2018; 31:135-146. [PMID: 29909914 DOI: 10.1016/j.beha.2018.04.001] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2018] [Revised: 04/09/2018] [Accepted: 04/09/2018] [Indexed: 01/15/2023]
Abstract
B-cell non-Hodgkin's lymphoma (NHLs)is a very heterogonous malignancy with diffuse large B-cell lymphoma (DLBCL) and follicular lymphoma (FL) as the most common subtypes. Standard treatment with anti-CD20 based chemoimmunotherapy is usually very effective for disease control. However a significant proportion of patients with high-risk features (double hit lymphoma, transformed lymphomas or early relapses) will become refractory to standard therapies and will have limited alternatives for cure. Adoptive therapy with chimeric antigen receptor (CAR) T-cells is a new paradigm for effective treatment of poor prognosis lymphomas. Here we review the biology of poor risk DLBCL and FL, the rationale for CAR T-cell therapy in malignant lymphoma and the efficacy/toxicity profile of CD19 directed CAR T cell therapy for DLBCL and FL from early single center studies to multicenter/global clinical trial with different CAR T cell constructs.
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Affiliation(s)
- Julio C Chavez
- Department of Malignant Hematology, Moffitt Cancer Center, Tampa, USA
| | - Frederick L Locke
- Department of Blood and Marrow Transplantation, Moffitt Cancer Center, Tampa, USA.
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Shadman M, Li H, Rimsza L, Leonard JP, Kaminski MS, Braziel RM, Spier CM, Gopal AK, Maloney DG, Cheson BD, Dakhil S, LeBlanc M, Smith SM, Fisher RI, Friedberg JW, Press OW. Continued Excellent Outcomes in Previously Untreated Patients With Follicular Lymphoma After Treatment With CHOP Plus Rituximab or CHOP Plus 131I-Tositumomab: Long-Term Follow-Up of Phase III Randomized Study SWOG-S0016. J Clin Oncol 2018; 36:697-703. [PMID: 29356608 PMCID: PMC6553811 DOI: 10.1200/jco.2017.74.5083] [Citation(s) in RCA: 53] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Purpose SWOG S0016 was a phase III randomized study that compared the safety and efficacy of R-CHOP (rituximab plus cyclophosphamide, doxorubicin, vincristine, and prednisone) with CHOP-RIT (CHOP followed by consolidation with iodine-133-tositumomab radioimmunotherapy) for previously untreated patients with follicular lymphoma. Understanding the long-term outcome of patients provides a benchmark for novel treatment regimens for FL. Patients and Methods Between 2001 and 2008, 531 previously untreated patients with FL were randomly assigned to receive either six cycles of R-CHOP or six cycles of CHOP-RIT. Patients with advanced-stage disease (bulky stage II, III, or IV) of any pathologic grade (1, 2, or 3) were eligible. Results After a median follow-up of 10.3 years, 10-year estimates of progression-free and overall survival were 49% and 78% among all patients, respectively. Patients in the CHOP-RIT arm had significantly better 10-year progression-free survival compared with patients in the R-CHOP arm (56% v 42%; P = .01), but 10-year overall survival was not different between the two arms (75% v 81%; P = .13). There was no significant difference between the CHOP-RIT and R-CHOP arms in regard to incidence of second malignancies (15.1% v 16.1%; P = .81) or myelodysplastic syndrome or acute myeloid leukemia (4.9% v 1.8%; P = .058). The estimated 10-year cumulative incidences of death resulting from second malignancies were not different (7.1% v 3.2%; P = .16), but cumulative incidence of death resulting from myelodysplastic syndrome or acute myeloid leukemia was higher in the CHOP-RIT arm compared with the R-CHOP arm (4% v 0.9%; P = .02). Conclusion Given these outstanding outcomes, immunochemotherapy should remain the standard induction approach for patients with high-risk FL until long-term follow-up of alternative approaches demonstrates superiority.
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Affiliation(s)
- Mazyar Shadman
- Mazyar Shadman, Ajay K. Gopal, David G. Maloney, and Oliver W. Press, University of Washington and Fred Hutchinson Cancer Research Center; Hongli Li and Michael LeBlanc, SWOG Statistical Center, Seattle, WA; Lisa Rimsza, Mayo Clinic Arizona, Scottsdale; Catherine M. Spier, University of Arizona, Tucson, AZ; John P. Leonard, Weill Cornell Medical College, New York; Jonathan W. Friedberg, Wilmot Cancer Institute, University of Rochester, Rochester, NY; Mark S. Kaminski, University of Michigan Health System, Ann Arbor, MI; Rita M. Braziel, Oregon Health & Science University, Portland, OR; Bruce D. Cheson, Lombardi Comprehensive Cancer Center, Georgetown University Hospital, Washington, DC; Shaker Dakhil, University of Kansas School of Medicine–Wichita, Wichita, KS; Sonali M. Smith, University of Chicago Medicine, Chicago, IL; and Richard I. Fisher, Fox Chase Cancer Center and Temple University School of Medicine, Philadelphia, PA
| | - Hongli Li
- Mazyar Shadman, Ajay K. Gopal, David G. Maloney, and Oliver W. Press, University of Washington and Fred Hutchinson Cancer Research Center; Hongli Li and Michael LeBlanc, SWOG Statistical Center, Seattle, WA; Lisa Rimsza, Mayo Clinic Arizona, Scottsdale; Catherine M. Spier, University of Arizona, Tucson, AZ; John P. Leonard, Weill Cornell Medical College, New York; Jonathan W. Friedberg, Wilmot Cancer Institute, University of Rochester, Rochester, NY; Mark S. Kaminski, University of Michigan Health System, Ann Arbor, MI; Rita M. Braziel, Oregon Health & Science University, Portland, OR; Bruce D. Cheson, Lombardi Comprehensive Cancer Center, Georgetown University Hospital, Washington, DC; Shaker Dakhil, University of Kansas School of Medicine–Wichita, Wichita, KS; Sonali M. Smith, University of Chicago Medicine, Chicago, IL; and Richard I. Fisher, Fox Chase Cancer Center and Temple University School of Medicine, Philadelphia, PA
| | - Lisa Rimsza
- Mazyar Shadman, Ajay K. Gopal, David G. Maloney, and Oliver W. Press, University of Washington and Fred Hutchinson Cancer Research Center; Hongli Li and Michael LeBlanc, SWOG Statistical Center, Seattle, WA; Lisa Rimsza, Mayo Clinic Arizona, Scottsdale; Catherine M. Spier, University of Arizona, Tucson, AZ; John P. Leonard, Weill Cornell Medical College, New York; Jonathan W. Friedberg, Wilmot Cancer Institute, University of Rochester, Rochester, NY; Mark S. Kaminski, University of Michigan Health System, Ann Arbor, MI; Rita M. Braziel, Oregon Health & Science University, Portland, OR; Bruce D. Cheson, Lombardi Comprehensive Cancer Center, Georgetown University Hospital, Washington, DC; Shaker Dakhil, University of Kansas School of Medicine–Wichita, Wichita, KS; Sonali M. Smith, University of Chicago Medicine, Chicago, IL; and Richard I. Fisher, Fox Chase Cancer Center and Temple University School of Medicine, Philadelphia, PA
| | - John P. Leonard
- Mazyar Shadman, Ajay K. Gopal, David G. Maloney, and Oliver W. Press, University of Washington and Fred Hutchinson Cancer Research Center; Hongli Li and Michael LeBlanc, SWOG Statistical Center, Seattle, WA; Lisa Rimsza, Mayo Clinic Arizona, Scottsdale; Catherine M. Spier, University of Arizona, Tucson, AZ; John P. Leonard, Weill Cornell Medical College, New York; Jonathan W. Friedberg, Wilmot Cancer Institute, University of Rochester, Rochester, NY; Mark S. Kaminski, University of Michigan Health System, Ann Arbor, MI; Rita M. Braziel, Oregon Health & Science University, Portland, OR; Bruce D. Cheson, Lombardi Comprehensive Cancer Center, Georgetown University Hospital, Washington, DC; Shaker Dakhil, University of Kansas School of Medicine–Wichita, Wichita, KS; Sonali M. Smith, University of Chicago Medicine, Chicago, IL; and Richard I. Fisher, Fox Chase Cancer Center and Temple University School of Medicine, Philadelphia, PA
| | - Mark S. Kaminski
- Mazyar Shadman, Ajay K. Gopal, David G. Maloney, and Oliver W. Press, University of Washington and Fred Hutchinson Cancer Research Center; Hongli Li and Michael LeBlanc, SWOG Statistical Center, Seattle, WA; Lisa Rimsza, Mayo Clinic Arizona, Scottsdale; Catherine M. Spier, University of Arizona, Tucson, AZ; John P. Leonard, Weill Cornell Medical College, New York; Jonathan W. Friedberg, Wilmot Cancer Institute, University of Rochester, Rochester, NY; Mark S. Kaminski, University of Michigan Health System, Ann Arbor, MI; Rita M. Braziel, Oregon Health & Science University, Portland, OR; Bruce D. Cheson, Lombardi Comprehensive Cancer Center, Georgetown University Hospital, Washington, DC; Shaker Dakhil, University of Kansas School of Medicine–Wichita, Wichita, KS; Sonali M. Smith, University of Chicago Medicine, Chicago, IL; and Richard I. Fisher, Fox Chase Cancer Center and Temple University School of Medicine, Philadelphia, PA
| | - Rita M. Braziel
- Mazyar Shadman, Ajay K. Gopal, David G. Maloney, and Oliver W. Press, University of Washington and Fred Hutchinson Cancer Research Center; Hongli Li and Michael LeBlanc, SWOG Statistical Center, Seattle, WA; Lisa Rimsza, Mayo Clinic Arizona, Scottsdale; Catherine M. Spier, University of Arizona, Tucson, AZ; John P. Leonard, Weill Cornell Medical College, New York; Jonathan W. Friedberg, Wilmot Cancer Institute, University of Rochester, Rochester, NY; Mark S. Kaminski, University of Michigan Health System, Ann Arbor, MI; Rita M. Braziel, Oregon Health & Science University, Portland, OR; Bruce D. Cheson, Lombardi Comprehensive Cancer Center, Georgetown University Hospital, Washington, DC; Shaker Dakhil, University of Kansas School of Medicine–Wichita, Wichita, KS; Sonali M. Smith, University of Chicago Medicine, Chicago, IL; and Richard I. Fisher, Fox Chase Cancer Center and Temple University School of Medicine, Philadelphia, PA
| | - Catherine M. Spier
- Mazyar Shadman, Ajay K. Gopal, David G. Maloney, and Oliver W. Press, University of Washington and Fred Hutchinson Cancer Research Center; Hongli Li and Michael LeBlanc, SWOG Statistical Center, Seattle, WA; Lisa Rimsza, Mayo Clinic Arizona, Scottsdale; Catherine M. Spier, University of Arizona, Tucson, AZ; John P. Leonard, Weill Cornell Medical College, New York; Jonathan W. Friedberg, Wilmot Cancer Institute, University of Rochester, Rochester, NY; Mark S. Kaminski, University of Michigan Health System, Ann Arbor, MI; Rita M. Braziel, Oregon Health & Science University, Portland, OR; Bruce D. Cheson, Lombardi Comprehensive Cancer Center, Georgetown University Hospital, Washington, DC; Shaker Dakhil, University of Kansas School of Medicine–Wichita, Wichita, KS; Sonali M. Smith, University of Chicago Medicine, Chicago, IL; and Richard I. Fisher, Fox Chase Cancer Center and Temple University School of Medicine, Philadelphia, PA
| | - Ajay K. Gopal
- Mazyar Shadman, Ajay K. Gopal, David G. Maloney, and Oliver W. Press, University of Washington and Fred Hutchinson Cancer Research Center; Hongli Li and Michael LeBlanc, SWOG Statistical Center, Seattle, WA; Lisa Rimsza, Mayo Clinic Arizona, Scottsdale; Catherine M. Spier, University of Arizona, Tucson, AZ; John P. Leonard, Weill Cornell Medical College, New York; Jonathan W. Friedberg, Wilmot Cancer Institute, University of Rochester, Rochester, NY; Mark S. Kaminski, University of Michigan Health System, Ann Arbor, MI; Rita M. Braziel, Oregon Health & Science University, Portland, OR; Bruce D. Cheson, Lombardi Comprehensive Cancer Center, Georgetown University Hospital, Washington, DC; Shaker Dakhil, University of Kansas School of Medicine–Wichita, Wichita, KS; Sonali M. Smith, University of Chicago Medicine, Chicago, IL; and Richard I. Fisher, Fox Chase Cancer Center and Temple University School of Medicine, Philadelphia, PA
| | - David G. Maloney
- Mazyar Shadman, Ajay K. Gopal, David G. Maloney, and Oliver W. Press, University of Washington and Fred Hutchinson Cancer Research Center; Hongli Li and Michael LeBlanc, SWOG Statistical Center, Seattle, WA; Lisa Rimsza, Mayo Clinic Arizona, Scottsdale; Catherine M. Spier, University of Arizona, Tucson, AZ; John P. Leonard, Weill Cornell Medical College, New York; Jonathan W. Friedberg, Wilmot Cancer Institute, University of Rochester, Rochester, NY; Mark S. Kaminski, University of Michigan Health System, Ann Arbor, MI; Rita M. Braziel, Oregon Health & Science University, Portland, OR; Bruce D. Cheson, Lombardi Comprehensive Cancer Center, Georgetown University Hospital, Washington, DC; Shaker Dakhil, University of Kansas School of Medicine–Wichita, Wichita, KS; Sonali M. Smith, University of Chicago Medicine, Chicago, IL; and Richard I. Fisher, Fox Chase Cancer Center and Temple University School of Medicine, Philadelphia, PA
| | - Bruce D. Cheson
- Mazyar Shadman, Ajay K. Gopal, David G. Maloney, and Oliver W. Press, University of Washington and Fred Hutchinson Cancer Research Center; Hongli Li and Michael LeBlanc, SWOG Statistical Center, Seattle, WA; Lisa Rimsza, Mayo Clinic Arizona, Scottsdale; Catherine M. Spier, University of Arizona, Tucson, AZ; John P. Leonard, Weill Cornell Medical College, New York; Jonathan W. Friedberg, Wilmot Cancer Institute, University of Rochester, Rochester, NY; Mark S. Kaminski, University of Michigan Health System, Ann Arbor, MI; Rita M. Braziel, Oregon Health & Science University, Portland, OR; Bruce D. Cheson, Lombardi Comprehensive Cancer Center, Georgetown University Hospital, Washington, DC; Shaker Dakhil, University of Kansas School of Medicine–Wichita, Wichita, KS; Sonali M. Smith, University of Chicago Medicine, Chicago, IL; and Richard I. Fisher, Fox Chase Cancer Center and Temple University School of Medicine, Philadelphia, PA
| | - Shaker Dakhil
- Mazyar Shadman, Ajay K. Gopal, David G. Maloney, and Oliver W. Press, University of Washington and Fred Hutchinson Cancer Research Center; Hongli Li and Michael LeBlanc, SWOG Statistical Center, Seattle, WA; Lisa Rimsza, Mayo Clinic Arizona, Scottsdale; Catherine M. Spier, University of Arizona, Tucson, AZ; John P. Leonard, Weill Cornell Medical College, New York; Jonathan W. Friedberg, Wilmot Cancer Institute, University of Rochester, Rochester, NY; Mark S. Kaminski, University of Michigan Health System, Ann Arbor, MI; Rita M. Braziel, Oregon Health & Science University, Portland, OR; Bruce D. Cheson, Lombardi Comprehensive Cancer Center, Georgetown University Hospital, Washington, DC; Shaker Dakhil, University of Kansas School of Medicine–Wichita, Wichita, KS; Sonali M. Smith, University of Chicago Medicine, Chicago, IL; and Richard I. Fisher, Fox Chase Cancer Center and Temple University School of Medicine, Philadelphia, PA
| | - Michael LeBlanc
- Mazyar Shadman, Ajay K. Gopal, David G. Maloney, and Oliver W. Press, University of Washington and Fred Hutchinson Cancer Research Center; Hongli Li and Michael LeBlanc, SWOG Statistical Center, Seattle, WA; Lisa Rimsza, Mayo Clinic Arizona, Scottsdale; Catherine M. Spier, University of Arizona, Tucson, AZ; John P. Leonard, Weill Cornell Medical College, New York; Jonathan W. Friedberg, Wilmot Cancer Institute, University of Rochester, Rochester, NY; Mark S. Kaminski, University of Michigan Health System, Ann Arbor, MI; Rita M. Braziel, Oregon Health & Science University, Portland, OR; Bruce D. Cheson, Lombardi Comprehensive Cancer Center, Georgetown University Hospital, Washington, DC; Shaker Dakhil, University of Kansas School of Medicine–Wichita, Wichita, KS; Sonali M. Smith, University of Chicago Medicine, Chicago, IL; and Richard I. Fisher, Fox Chase Cancer Center and Temple University School of Medicine, Philadelphia, PA
| | - Sonali M. Smith
- Mazyar Shadman, Ajay K. Gopal, David G. Maloney, and Oliver W. Press, University of Washington and Fred Hutchinson Cancer Research Center; Hongli Li and Michael LeBlanc, SWOG Statistical Center, Seattle, WA; Lisa Rimsza, Mayo Clinic Arizona, Scottsdale; Catherine M. Spier, University of Arizona, Tucson, AZ; John P. Leonard, Weill Cornell Medical College, New York; Jonathan W. Friedberg, Wilmot Cancer Institute, University of Rochester, Rochester, NY; Mark S. Kaminski, University of Michigan Health System, Ann Arbor, MI; Rita M. Braziel, Oregon Health & Science University, Portland, OR; Bruce D. Cheson, Lombardi Comprehensive Cancer Center, Georgetown University Hospital, Washington, DC; Shaker Dakhil, University of Kansas School of Medicine–Wichita, Wichita, KS; Sonali M. Smith, University of Chicago Medicine, Chicago, IL; and Richard I. Fisher, Fox Chase Cancer Center and Temple University School of Medicine, Philadelphia, PA
| | - Richard I. Fisher
- Mazyar Shadman, Ajay K. Gopal, David G. Maloney, and Oliver W. Press, University of Washington and Fred Hutchinson Cancer Research Center; Hongli Li and Michael LeBlanc, SWOG Statistical Center, Seattle, WA; Lisa Rimsza, Mayo Clinic Arizona, Scottsdale; Catherine M. Spier, University of Arizona, Tucson, AZ; John P. Leonard, Weill Cornell Medical College, New York; Jonathan W. Friedberg, Wilmot Cancer Institute, University of Rochester, Rochester, NY; Mark S. Kaminski, University of Michigan Health System, Ann Arbor, MI; Rita M. Braziel, Oregon Health & Science University, Portland, OR; Bruce D. Cheson, Lombardi Comprehensive Cancer Center, Georgetown University Hospital, Washington, DC; Shaker Dakhil, University of Kansas School of Medicine–Wichita, Wichita, KS; Sonali M. Smith, University of Chicago Medicine, Chicago, IL; and Richard I. Fisher, Fox Chase Cancer Center and Temple University School of Medicine, Philadelphia, PA
| | - Jonathan W. Friedberg
- Mazyar Shadman, Ajay K. Gopal, David G. Maloney, and Oliver W. Press, University of Washington and Fred Hutchinson Cancer Research Center; Hongli Li and Michael LeBlanc, SWOG Statistical Center, Seattle, WA; Lisa Rimsza, Mayo Clinic Arizona, Scottsdale; Catherine M. Spier, University of Arizona, Tucson, AZ; John P. Leonard, Weill Cornell Medical College, New York; Jonathan W. Friedberg, Wilmot Cancer Institute, University of Rochester, Rochester, NY; Mark S. Kaminski, University of Michigan Health System, Ann Arbor, MI; Rita M. Braziel, Oregon Health & Science University, Portland, OR; Bruce D. Cheson, Lombardi Comprehensive Cancer Center, Georgetown University Hospital, Washington, DC; Shaker Dakhil, University of Kansas School of Medicine–Wichita, Wichita, KS; Sonali M. Smith, University of Chicago Medicine, Chicago, IL; and Richard I. Fisher, Fox Chase Cancer Center and Temple University School of Medicine, Philadelphia, PA
| | - Oliver W. Press
- Mazyar Shadman, Ajay K. Gopal, David G. Maloney, and Oliver W. Press, University of Washington and Fred Hutchinson Cancer Research Center; Hongli Li and Michael LeBlanc, SWOG Statistical Center, Seattle, WA; Lisa Rimsza, Mayo Clinic Arizona, Scottsdale; Catherine M. Spier, University of Arizona, Tucson, AZ; John P. Leonard, Weill Cornell Medical College, New York; Jonathan W. Friedberg, Wilmot Cancer Institute, University of Rochester, Rochester, NY; Mark S. Kaminski, University of Michigan Health System, Ann Arbor, MI; Rita M. Braziel, Oregon Health & Science University, Portland, OR; Bruce D. Cheson, Lombardi Comprehensive Cancer Center, Georgetown University Hospital, Washington, DC; Shaker Dakhil, University of Kansas School of Medicine–Wichita, Wichita, KS; Sonali M. Smith, University of Chicago Medicine, Chicago, IL; and Richard I. Fisher, Fox Chase Cancer Center and Temple University School of Medicine, Philadelphia, PA
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Mushti SL, Mulkey F, Sridhara R. Evaluation of Overall Response Rate and Progression-Free Survival as Potential Surrogate Endpoints for Overall Survival in Immunotherapy Trials. Clin Cancer Res 2018; 24:2268-2275. [PMID: 29326281 DOI: 10.1158/1078-0432.ccr-17-1902] [Citation(s) in RCA: 114] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2017] [Revised: 10/16/2017] [Accepted: 01/02/2018] [Indexed: 11/16/2022]
Abstract
Purpose: With the approval of immunotherapies for a variety of indications, methods to assess treatment benefit addressing the response patterns observed are important. We evaluated RECIST criteria-based overall response rate (ORR) and progression-free survival (PFS) as potential surrogate endpoints of overall survival (OS), and explored a modified definition of PFS by altering the threshold percentage determining disease progression to assess the association with survival benefit in immunotherapy trials.Experimental Design: Thirteen randomized, multicenter, active-control trials containing immunotherapeutic agents submitted to the FDA were analyzed. Associations between treatment effects of ORR, PFS, modified PFS, and OS were evaluated at individual and trial levels. Patient-level responder analysis was performed for PFS and OS.Results: The coefficient of determination (R²) measured the strength of associations, where values near 1 imply surrogacy and values close to 0 suggest no association. At the trial level, the association between hazard ratios (HR) of PFS and OS was R2 = 0.1303, and between the odds ratio (OR) of ORR and HR of OS was R2 = 0.1277. At the individual level, the Spearman rank correlation coefficient between PFS and OS was 0.61. Trial-level associations between modified PFS and OS ranged between 0.07 and 0.1, and individual-level correlations were approximately 0.6. HRs of PFS and OS for responders versus nonresponders were 0.129 [95% confidence interval (CI), 0.11-0.15] and 0.118 (95% CI, 0.11-0.13), respectively.Conclusions: Although responders exhibited longer survival and PFS than nonresponders, the trial-level and individual-level associations were weak between PFS/ORR and OS. Modifications to PFS did not improve associations. Clin Cancer Res; 24(10); 2268-75. ©2018 AACRSee related commentary by Korn and Freidlin, p. 2239.
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Affiliation(s)
- Sirisha L Mushti
- Office of Biostatistics, Center for Drug Evaluation and Research, U.S. Food and Drug Administration, Silver Spring, Maryland.
| | - Flora Mulkey
- Office of Biostatistics, Center for Drug Evaluation and Research, U.S. Food and Drug Administration, Silver Spring, Maryland
| | - Rajeshwari Sridhara
- Office of Biostatistics, Center for Drug Evaluation and Research, U.S. Food and Drug Administration, Silver Spring, Maryland
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Martin P, Jung SH, Pitcher B, Bartlett NL, Blum KA, Shea T, Hsi ED, Ruan J, Smith SE, Leonard JP, Cheson BD. A phase II trial of lenalidomide plus rituximab in previously untreated follicular non-Hodgkin's lymphoma (NHL): CALGB 50803 (Alliance). Ann Oncol 2017; 28:2806-2812. [PMID: 28945884 PMCID: PMC5789808 DOI: 10.1093/annonc/mdx496] [Citation(s) in RCA: 62] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND This multicenter, phase II trial tested the tolerability and efficacy of lenalidomide plus rituximab in patients with previously untreated follicular lymphoma (FL). PATIENTS AND METHODS Patients with grade 1-3a FL, stage 3-4 or bulky stage 2, FL international prognostic index (FLIPI) 0-2, and no prior therapy were eligible to receive rituximab 375 mg/m2 weekly during cycle 1 and day 1 of cycles 4, 6, 8, and 10, plus lenalidomide 20-25 mg on days 1-21 for twelve 28-day cycles. The primary objectives were to evaluate response rates [complete (CR) and overall] and time to progression. Secondary objectives included toxicity, response according to polymorphisms in FcgR2A and FcgR3A, and changes in circulating pro-angiogenic cells. RESULTS From October 2010 to September 2011, 66 patients were enrolled. Median age was 53 years, 34 were female, 15 had bulky disease, 21 were FLIPI 0-1, 43 FLIPI 2, and 2 FLIPI 3. One patient withdrew before receiving treatment. Fifty-one patients completed 12 cycles of lenalidomide. Reasons for discontinuation included withdrawal (n = 6), adverse events (n = 6), progression (n = 2). Grade 3-4 hematologic toxicity included neutropenia (21%), lymphopenia (9%), and thrombocytopenia (2%), infection (11%), and rash (8%). Grade 1-2 toxicity included fatigue (78%), diarrhea (37%), rash (32%), and febrile neutropenia in one patient. The overall response rate was 95%; the CR rate was 72% (95% confidence interval, 60% to 83%). With a median follow-up of 5 years, the 2- and 5-year progression-free survival were 86% and 70%, respectively, and the 5-year overall survival was 100%. There was no association between CR rate or PFS and FLIPI, histological grade, bulky disease, FcgR2A/FcgR3A polymorphism, or change in circulating endothelial cell/hematopoietic progenitor cell. CONCLUSION Lenalidomide plus rituximab was associated with low rates of grade 3-4 toxicity, yielded a CR rate and PFS similar to chemotherapy-based treatment and may represent a reasonable alternative to immunochemotherapy in previously untreated FL. CLINICALTRIALS.GOV IDENTIFIER NCT01145495.
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Affiliation(s)
- P Martin
- Department of Medicine, Weill Cornell Medicine, New York.
| | - S-H Jung
- Alliance Statistics and Data Center, Duke University Medical Center, Durham
| | - B Pitcher
- Alliance Statistics and Data Center, Duke University Medical Center, Durham
| | - N L Bartlett
- Internal Medicine, Division of Oncology, Washington University School of Medicine, St. Louis
| | - K A Blum
- The Ohio State University Medical Center, Columbus
| | - T Shea
- Oncology, University of North Carolina at Chapel Hill, Chapel Hill
| | - E D Hsi
- Clinical Pathology, Cleveland Clinic, Cleveland
| | - J Ruan
- Department of Medicine, Weill Cornell Medicine, New York
| | - S E Smith
- Alliance Protocol Office, University of Chicago, Chicago
| | - J P Leonard
- Department of Medicine, Weill Cornell Medicine, New York
| | - B D Cheson
- Hematology/Oncology, Georgetown University Hospital, Washington, USA
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Jiménez-Ubieto A, Grande C, Caballero D, Yáñez L, Novelli S, Hernández MT, Manzanares M, Arranz R, Ferreiro JJ, Bobillo S, Mercadal S, Galego A, Jiménez JL, Moraleda JM, Vallejo C, Albo C, Pérez E, Marrero C, Magnano L, Palomera L, Jarque I, Coria E, Rodriguez A, Martín A, López-Guillermo A, Salar A, Lahuerta JJ. Progression-free survival at 2 years post-autologous transplant: a surrogate end point for overall survival in follicular lymphoma. Cancer Med 2017; 6:2766-2774. [PMID: 29076254 PMCID: PMC5727300 DOI: 10.1002/cam4.1217] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2017] [Revised: 07/05/2017] [Accepted: 08/31/2017] [Indexed: 01/19/2023] Open
Abstract
Overall survival (OS) is the gold‐standard end point for studies evaluating autologous stem cell transplantation (ASCT) in follicular lymphoma (FL), but assessment may be elusive due to the lengthy disease course. We analyzed the validity of two earlier end points, proposed in the setting of first‐line chemo‐/immunotherapy, as surrogates for OS—progression‐free survival (PFS) status at 24 months (PFS24) and complete response at 30 months (CR30) post‐ASCT. We also have investigated the clinical features of patients with early progression after ASCT. Data were available for 626 chemosensitive FL patients who received ASCT between 1989 and 2007. Median follow‐up was 12.2 years from ASCT. In the PFS24 analysis, 153 (24%) patients progressed within 24 months and 447 were alive and progression‐free at 24 months post‐ASCT (26 who died without disease progressions within 24 months were excluded). Early progression was associated with shorter OS (hazard ratio [HR], 6.8; P = 0.00001). In the subgroup of patients who received an ASCT in the setting or relapse after being exposed to rituximab, the HR was 11.3 (95% CI, 3.9–30.2; P < 0.00001). In the CR30 analysis, 183 of 596 (31%) response‐evaluable patients progressed/died with 30 months post‐ASCT. The absence of CR30 was associated with shorter OS (HR, 7.8; P < 0.00001), including in patients with prior rituximab (HR, 8.2). PFS24 and CR30 post‐ASCT are associated with poor outcomes and should be primary end points. Further research is needed to identify this population to be offered alternative treatments.
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Affiliation(s)
| | - Carlos Grande
- Hospital Universitario, 12 de Octubre, Madrid, Spain
| | | | - Lucrecia Yáñez
- Hospital Universitario Marqués de Valdecilla, Santander, Spain
| | | | | | | | - Reyes Arranz
- Hospital Universitario La Princesa, Madrid, Spain
| | | | | | - Santiago Mercadal
- Hospital Universitario de Bellvitge, l'Hospitalet de Llobregat, Spain
| | | | | | | | | | | | - Elena Pérez
- Hospital Universitario Morales de Messeguer, Murcia, Spain
| | - Carmen Marrero
- Hospital Universitario Nuestra Señora de La Candelaria, Tenerife, Spain
| | | | - Luis Palomera
- Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain
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82
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Sarraf Yazdy M, Cheson BD. Impact of obinutuzumab alone and in combination for follicular lymphoma. BLOOD AND LYMPHATIC CANCER-TARGETS AND THERAPY 2017; 7:73-83. [PMID: 31360086 PMCID: PMC6467363 DOI: 10.2147/blctt.s114173] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
Although rituximab-based chemoimmunotherapy prolongs the survival of patients with follicular lymphoma (FL), this disease is considered incurable in most patients. Thus, new therapies are needed not only for those in the relapsed/refractory setting, but also for initial treatment. Obinutuzumab (G, GA101) is a third-generation, fully humanized type II glycoengineered, anti-CD20 monoclonal antibody that results in increased direct cell death and antibody-dependent, cell-mediated cytotoxicity/phagocytosis compared to rituximab. Obinutuzumab has significant antitumor activity when used alone or in combinations in untreated or relapsed refractory FL patients. Studies have demonstrated its ability to prolong progression-free survival and, in some cases, overall survival, and to eliminate minimal residual disease. Several ongoing trials are investigating combinations with chemotherapy, immunomodulators, targeted drugs, and immunotherapy agents. G is generally well tolerated, with associated adverse effects including infusion-related reactions, neutropenia, thrombocytopenia, and reactivation of hepatitis B virus. Future studies with this antibody should focus on identifying predictive markers and developing chemotherapy-free combinations that will improve the outcome of patients with FL.
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Affiliation(s)
- Maryam Sarraf Yazdy
- Division of Hematology-Oncology, Georgetown University Hospital, Lombardi Comprehensive Cancer Center, Washington, DC, USA,
| | - Bruce D Cheson
- Division of Hematology-Oncology, Georgetown University Hospital, Lombardi Comprehensive Cancer Center, Washington, DC, USA,
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83
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Sorigue M, Sancho JM. Current prognostic and predictive factors in follicular lymphoma. Ann Hematol 2017; 97:209-227. [PMID: 29032510 DOI: 10.1007/s00277-017-3154-z] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2017] [Accepted: 10/09/2017] [Indexed: 12/27/2022]
Abstract
Follicular lymphoma (FL) is generally considered an indolent disorder. With modern day treatments, long remissions are often achieved both in the front-line and relapsed setting. However, a subset of patients has a more aggressive course and a worse outcome. Their identification is the main purpose of modern day prognostic tools. In this review, we attempt to summarize the evidence concerning prognostic and predictive factors in FL, including (1) pre-treatment factors, from baseline clinical characteristics and imaging tests to histological grade, the microenvironment and genomic abnormalities; (2) post-treatment factors, i.e., depth of response, measured both by imaging tests and minimal residual disease; (3) factors at relapse and duration of response; and (4) prognostic factors in histological transformation. We conclude that, despite the existence of numerous tools, the availability of some of them is still limited; they generally suffer from notable downsides, and most have unproven predictive value, thus having scarce bearing on the choice of regimen at present. However, with the technological and scientific developments of the last few years, the potential for these prognostic factors is promising, particularly in combination, which will probably, in time, help guide therapeutic decisions.
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MESH Headings
- Antineoplastic Combined Chemotherapy Protocols
- Bone Marrow/drug effects
- Bone Marrow/metabolism
- Bone Marrow/pathology
- Chromosomes, Human, Pair 14/chemistry
- Chromosomes, Human, Pair 18/chemistry
- Clinical Trials as Topic
- Disease-Free Survival
- Humans
- Lymphoma, Follicular/diagnostic imaging
- Lymphoma, Follicular/drug therapy
- Lymphoma, Follicular/genetics
- Lymphoma, Follicular/mortality
- Mutation
- Neoplasm Grading
- Neoplasm, Residual/diagnostic imaging
- Neoplasm, Residual/drug therapy
- Neoplasm, Residual/genetics
- Neoplasm, Residual/mortality
- Positron-Emission Tomography
- Prognosis
- Recurrence
- Risk Factors
- Translocation, Genetic
- Tumor Suppressor Protein p53/genetics
- Tumor Suppressor Protein p53/metabolism
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Affiliation(s)
- Marc Sorigue
- Department of Hematology, ICO-Hospital Germans Trias i Pujol, Institut de Recerca Josep Carreras, Universitat Autònoma de Barcelona, Ctra. Canyet, 08916, Badalona, Spain.
| | - Juan-Manuel Sancho
- Department of Hematology, ICO-Hospital Germans Trias i Pujol, Institut de Recerca Josep Carreras, Universitat Autònoma de Barcelona, Ctra. Canyet, 08916, Badalona, Spain
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84
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Sargent DJ, Shi Q, Flowers CR, Schmitz N, Habermann TM, Flament J, Fu T, Coiffier B. The Search for Surrogate Endpoints in Trials in Diffuse Large B-Cell Lymphoma: The Surrogate Endpoints for Aggressive Lymphoma Project. Oncologist 2017; 22:1415-1418. [PMID: 28798271 PMCID: PMC5728027 DOI: 10.1634/theoncologist.2017-0177] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2017] [Accepted: 07/20/2017] [Indexed: 11/17/2022] Open
Abstract
This commentary describes the progress of the SEAL [Surrogate Endpoints for Aggressive Lymphoma] research group and invites collaboration in sharing data to continue building a large database of individual patient data from multiple clinical trials in DLBCL.
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Affiliation(s)
- Daniel J Sargent
- Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota, USA
| | - Qian Shi
- Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota, USA
| | - Christopher R Flowers
- Department of Bone Marrow and Stem Cell Transplantation, Winship Cancer Institute of Emory University, Atlanta, Georgia, USA
| | - Norbert Schmitz
- Department of Internal Medicine A, Hematology, Oncology and Pneumonology, University Hospital Muenster, Muenster, Germany
| | | | | | - Tommy Fu
- Celgene Corporation, Summit, New Jersey, USA
| | - Bertrand Coiffier
- Department of Hematology, Centre Hospitalier Lyon-Sud, Pierre-Benite, France
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85
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Jurczak W, Moreira I, Kanakasetty GB, Munhoz E, Echeveste MA, Giri P, Castro N, Pereira J, Akria L, Alexeev S, Osmanov E, Zhu P, Alexandrova S, Zubel A, Harlin O, Amersdorffer J. Rituximab biosimilar and reference rituximab in patients with previously untreated advanced follicular lymphoma (ASSIST-FL): primary results from a confirmatory phase 3, double-blind, randomised, controlled study. LANCET HAEMATOLOGY 2017; 4:e350-e361. [PMID: 28712941 DOI: 10.1016/s2352-3026(17)30106-0] [Citation(s) in RCA: 61] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/04/2017] [Revised: 06/01/2017] [Accepted: 06/01/2017] [Indexed: 12/29/2022]
Abstract
BACKGROUND GP2013 is a rituximab biosimilar developed to stringent development guidelines, including non-clinical and preclinical investigations and clinical trials in rheumatoid arthritis and follicular lymphoma. We aimed to compare the efficacy, safety, tolerability, pharmacokinetics, and pharmacodynamics of GP2013 plus cyclophosphamide, vincristine, and prednisone (GP2013-CVP) with rituximab-CVP (R-CVP) in patients with follicular lymphoma. METHODS In this phase 3, multinational, double-blind, randomised, controlled trial, adults (aged 18 years or older) with previously untreated, advanced stage (Ann Arbor stage III or IV) follicular lymphoma of WHO histological grades 1, 2, or 3a were randomly assigned (1:1) using interactive response technology to eight cycles of GP2013-CVP or R-CVP (combination phase), followed by monotherapy maintenance in responders for a 2-year period. Randomisation was stratified by Follicular Lymphoma International Prognostic Index risk group and geographic region. The primary endpoint was comparability in overall response, with equivalence concluded if the entire 95% CI was within a margin of -12% to 12%. The primary endpoint was analysed using the per-protocol set, which included all patients who received at least one (partial or complete) dose of investigational treatment and who did not have any major protocol deviations. The trial is registered with ClinicalTrials.gov, number NCT01419665, and is ongoing. FINDINGS Between Dec 1, 2011, and Jan 15, 2015, 858 patients were screened for eligibility. 314 patients were randomly assigned to GP2013, of whom 312 were given GP2013, and 315 were assigned to reference rituximab. Median follow-up was 11·6 months (IQR 5·8-18·2) for the primary analysis. The primary endpoint, equivalence of overall response, was met (271 [87%] of 311 patients with GP2013 and 274 [88%] of 313 patients with reference rituximab achieved an overall response; difference -0·40% [95% CI -5·94 to 5·14]). Occurrence of adverse events and serious adverse events was similar between the treatment groups (289 [93%] of 312 patients in the GP2013-CVP group had an adverse event and 71 [23%] of 312 patients had a serious adverse event; 288 [91%] of 315 patients in the R-CVP group had an adverse event and 63 [20%] had a serious adverse event). The most common adverse event was neutropenia (80 [26%] of 312 patients in the GP2013-CVP group and 93 [30%] of 315 patients in the R-CVP group in the combination phase and 23 [10%] of 231 patients in the GP2013-CVP group and 13 [6%] of 231 patients in the R-CVP group in the maintenance phase). The most common grade 3 or 4 adverse event during the combination and maintenance phase was neutropenia (55 [18%] of 312 patients in the GP2013-CVP group and 65 [21%] of 315 patients in the R-CVP group in the combination phase and 17 [7%] of 231 patients in the GP2013-CVP group and nine [4%] of 231 patients in the R-CVP group in the maintenance phase). The occurrence of anti-drug antibodies was similar in the treatment groups (five [2%] of 268 patients in the GP2013-CVP; three [1%] in the R-CVP group). INTERPRETATION Our results show that GP2013 represents a viable rituximab biosimilar candidate for patients with previously untreated advanced follicular lymphoma. The introduction of biosimilars provides additional therapeutic options with potential to increase access to effective and life-saving biological therapies such as rituximab. FUNDING Hexal.
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Affiliation(s)
- Wojciech Jurczak
- Department of Hematology, Jagiellonian University, Krakow, Poland.
| | - Ilídia Moreira
- Portuguese Institute of Oncology of Porto Francisco Gentil, Porto, Portugal
| | | | | | | | | | | | - Juliana Pereira
- Hospital das Clinicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | | | - Sergey Alexeev
- N N Petrov Research Institute of Oncology, St Petersburg, Russia
| | - Eugeniy Osmanov
- Blokhin Cancer Research Center under the Russian Academy of Medical Sciences, Moscow, Russia
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Yazdy MS, Ujjani C. Current challenges in the management of follicular lymphoma. Int J Hematol Oncol 2017; 6:13-24. [PMID: 30302218 PMCID: PMC6171972 DOI: 10.2217/ijh-2017-0003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2017] [Accepted: 03/24/2017] [Indexed: 12/29/2022] Open
Abstract
Although typically indolent in nature, follicular lymphoma remains an ongoing challenge for practicing oncologists. While response rates >90% can be achieved with rituximab-based chemoimmunotherapy in advanced stage patients, the complete remission rates are substantially lower and patients inevitably relapse. The inability to achieve a complete remission and an early progression of disease have recently been determined to be indicative of poorer long-term outcomes. A greater understanding of the pathogenesis of follicular lymphoma has enabled the development of targeted therapies, which may improve standard treatment approaches. Examples include lenalidomide and obinutuzumab, which are currently in front-line Phase III investigation. Other therapies of interest include small molecule inhibitors, immune checkpoint inhibitors and chimeric antigen receptor T cells.
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Affiliation(s)
- Maryam Sarraf Yazdy
- Lombardi Comprehensive Cancer Center, Medstar Georgetown University Hospital, Washington, DC 20007, USA
| | - Chaitra Ujjani
- Lombardi Comprehensive Cancer Center, Medstar Georgetown University Hospital, Washington, DC 20007, USA
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