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Hawkes EA, Phillips T, Budde LE, Santoro A, Saba NS, Roncolato F, Gregory GP, Verhoef G, Offner F, Quero C, Radford J, Giannopoulos K, Stevens D, Thall A, Huang B, Laird AD, Sandner R, Ansell SM. Avelumab in Combination Regimens for Relapsed/Refractory DLBCL: Results from the Phase Ib JAVELIN DLBCL Study. Target Oncol 2021; 16:761-771. [PMID: 34687398 PMCID: PMC8613117 DOI: 10.1007/s11523-021-00849-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/05/2021] [Indexed: 01/01/2023]
Abstract
Background Relapsed/refractory (R/R) diffuse large B-cell lymphoma (DLBCL) is associated with a poor prognosis despite the availability of multiple treatment options. Preliminary evidence suggests that DLBCL may be responsive to programmed death ligand 1 (PD-L1)/programmed death 1 inhibitors. Objective The JAVELIN DLBCL study was conducted to assess whether a combination of agents could augment and sustain the antitumor immunity of avelumab, an anti-PD-L1 antibody, in R/R DLBCL. Methods This was a multicenter, randomized, open-label, parallel-arm study with a phase Ib and a phase III component. Reported here are the results from the phase Ib study, wherein 29 adult patients with DLBCL were randomized 1:1:1 to receive avelumab in combination with utomilumab (an immunoglobulin G2 4-1BB agonist) and rituximab (arm A), avelumab in combination with utomilumab and azacitidine (arm B), or avelumab in combination with bendamustine and rituximab (arm C). The primary endpoints were dose-limiting toxicities and objective response as assessed by the investigator per Lugano Response Classification criteria. Results Of the seven patients in arm A, one (14.3%) experienced two grade 3 dose-limiting toxicities (herpes zoster and ophthalmic herpes zoster); no dose-limiting toxicities were reported in arms B or C. No new safety concerns emerged for avelumab. One partial response was reported in arm A, three complete responses in arm C, and no responses in arm B. Given the insufficient antitumor activity in arms A and B and the infeasibility of expanding arm C, the study was discontinued before initiation of the phase III component. Conclusions The low level of clinical activity suggests that PD-L1 inhibitor activity may be limited in R/R DLBCL. ClinicalTrials.gov Identifier NCT02951156. Supplementary Information The online version contains supplementary material available at 10.1007/s11523-021-00849-8.
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Affiliation(s)
- Eliza A Hawkes
- Olivia Newton-John Cancer Research Institute, Austin Health, 145 Studley Road, Heidelberg, VIC, Australia.
| | - Tycel Phillips
- University of Michigan Health System, Ann Arbor, MI, USA
| | | | - Armando Santoro
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Italy
- Humanitas Clinical and Research Center IRCCS, Rozzano-Milano, Italy
| | - Nakhle S Saba
- Section of Hematology and Medical Oncology, Deming Department of Medicine, Tulane University, New Orleans, LA, USA
| | | | - Gareth P Gregory
- School of Clinical Sciences at Monash Health, Monash University, Melbourne, VIC, Australia
| | | | | | - Cristina Quero
- Hospital Universitario Virgen de la Victoria, Málaga, Spain
| | - John Radford
- NIHR Manchester Clinical Research Facility, The Christie NHS Foundation Trust and University of Manchester, Manchester, UK
| | - Krzysztof Giannopoulos
- Experimental Hematooncology Department, St. John's Cancer Center, Medical University of Lublin, Lublin, Poland
| | - Don Stevens
- Norton Cancer Institute, Louisville, KY, USA
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Karadwal A, Chatterjee S, Pathak K, Sabharwal R. Diffused mixed B-cell non-Hodgkin lymphoma of mandible. J Oral Maxillofac Pathol 2020; 24:S77-S81. [PMID: 32189910 PMCID: PMC7069130 DOI: 10.4103/jomfp.jomfp_310_18] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2018] [Revised: 09/06/2019] [Accepted: 01/16/2020] [Indexed: 12/29/2022] Open
Abstract
Lymphomas are the third-most common cancer of the oral cavity after squamous cell carcinomas and salivary gland tumors. It is characterized by proliferation of lymphoid cells and their precursor. Diffuse B-cell non-Hodgkin lymphoma is the most common histological type of lymphoma in the head-and-neck region and most commonly affects older men in their seventh decade of life.
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Affiliation(s)
- Asha Karadwal
- Department of Oral Pathology, MM College of Dental Sciences and Research, Ambala, Haryana, India
| | - Shailja Chatterjee
- Department of Oral Pathology, MM College of Dental Sciences and Research, Ambala, Haryana, India
| | - Kush Pathak
- Department of Oral Pathology, MM College of Dental Sciences and Research, Ambala, Haryana, India
| | - Robin Sabharwal
- Department of Oral Pathology, MM College of Dental Sciences and Research, Ambala, Haryana, India
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