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Wall JS, Martin EB, Lands R, Ramchandren R, Stuckey A, Heidel RE, Whittle B, Powell D, Richey T, Williams AD, Foster JS, Guthrie S, Kennel SJ. Cardiac Amyloid Detection by PET/CT Imaging of Iodine ( 124I) Evuzamitide ( 124I-p5+14): A Phase 1/2 Study. JACC Cardiovasc Imaging 2023; 16:1433-1448. [PMID: 37940323 DOI: 10.1016/j.jcmg.2023.08.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Revised: 08/07/2023] [Accepted: 08/21/2023] [Indexed: 11/10/2023]
Abstract
BACKGROUND The noninvasive detection of cardiac amyloid, as well as deposits in other vital organs, is critical for early diagnosis and quantitative disease monitoring. Positron emission tomography is an intrinsically quantitative imaging modality suitable for high-resolution amyloid detection. OBJECTIVES This study sought to evaluate the safety and efficacy of a novel amyloid-reactive peptide, designated p5+14, labeled with iodine-124 (124I), in patients with diverse types of systemic amyloidosis. METHODS In a single-site, open label phase 1/2 study (NCT03678259), the safety, biodistribution, and sensitivity of a single intravenous infusion of 124I-evuzamitide was assessed in patients with systemic amyloidosis (n = 50), asymptomatic transthyretin sequence variant carriers (n = 2), and healthy volunteers (n = 5). Subjects were administered 1.4 ± 0.2 mg of 124I-evuzamitide (71.5 ± 12.4 MBq) and positron emission tomography/x-ray computed tomography images acquired at 5.2 hours (Q25-Q75: 4.9-5.4 hours) postinfusion. Images were assessed visually and semi-quantitatively for positive uptake of radiotracer in the heart and other major organs. RESULTS Uptake of 124I-evuzamitide in the heart and other abdominothoracic organs was consistent with the patient's clinical presentation and the type of amyloidosis. The patient- and cardiac-associated sensitivity for imaging and clinical observations was 93.6% (95% CI: 82.8%-97.8%) and 96.2% (95% CI: 81.8%-99.8%), respectively. Semi-quantitative uptake of the radiotracer correlated significantly with serum N-terminal pro-B-type natriuretic peptide measurements in patients with light chain-associated amyloidosis. Cardiac uptake was not observed in any healthy volunteers. The agent was well tolerated, with 1 drug-related adverse event and no deaths. CONCLUSIONS 124I-evuzamitide is an amyloid-binding radiotracer capable of detecting cardiac amyloid in patients with high sensitivity.
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Affiliation(s)
- Jonathan S Wall
- Department of Medicine, University of Tennessee Graduate School of Medicine, Knoxville, Tennessee, USA.
| | - Emily B Martin
- Department of Medicine, University of Tennessee Graduate School of Medicine, Knoxville, Tennessee, USA
| | - Ronald Lands
- Department of Medicine, University of Tennessee Graduate School of Medicine, Knoxville, Tennessee, USA
| | | | - Alan Stuckey
- Department of Medicine, University of Tennessee Graduate School of Medicine, Knoxville, Tennessee, USA
| | - R Eric Heidel
- Department of Surgery, University of Tennessee Graduate School of Medicine, Knoxville, Tennessee, USA
| | - Bryan Whittle
- Department of Radiology, University of Tennessee Medical Center, Knoxville, Tennessee, USA
| | - Dustin Powell
- Hendersonville Radiologic Consultants, Hendersonville, North Carolina, USA
| | - Tina Richey
- Department of Medicine, University of Tennessee Graduate School of Medicine, Knoxville, Tennessee, USA
| | - Angela D Williams
- Department of Medicine, University of Tennessee Graduate School of Medicine, Knoxville, Tennessee, USA
| | - James S Foster
- Department of Medicine, University of Tennessee Graduate School of Medicine, Knoxville, Tennessee, USA
| | | | - Stephen J Kennel
- Department of Medicine, University of Tennessee Graduate School of Medicine, Knoxville, Tennessee, USA
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Ramchandren R, Johnson P, Ghosh N, Ruan J, Ardeshna KM, Johnson R, Verhoef G, Cunningham D, de Vos S, Kassam S, Fayad L, Radford J, Bailly S, Offner F, Morgan D, Munoz J, Ping J, Szafer-Glusman E, Eckert K, Neuenburg JK, Goy A. The iR 2 regimen (ibrutinib plus lenalidomide and rituximab) for relapsed/refractory DLBCL: A multicentre, non-randomised, open-label phase 2 study. EClinicalMedicine 2023; 56:101779. [PMID: 36618900 PMCID: PMC9813677 DOI: 10.1016/j.eclinm.2022.101779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Revised: 11/17/2022] [Accepted: 11/22/2022] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND This phase 1b/2 PCYC-1123-CA study evaluated efficacy and safety of the combination of ibrutinib, lenalidomide, and rituximab (iR2 regimen) in patients with relapsed/refractory diffuse large B-cell lymphoma (DLBCL) ineligible for stem cell transplantation. METHODS In phase 2, patients with relapsed/refractory non-germinal centre B-cell-like DLBCL received oral ibrutinib 560 mg once daily and oral lenalidomide 20 mg or 25 mg once daily on Days 1-21 of each 28-day cycle until disease progression or unacceptable toxicity and intravenous rituximab 375 mg/m2 on Day 1 of Cycles 1-6. The primary endpoint was overall response rate (ORR) in the response-evaluable population (received any study treatment and had ≥1 post-baseline disease assessment). The study was done at 24 academic and community hospitals in Belgium, Germany, United Kingdom, and USA. This study was registered with ClinicalTrials.gov, NCT02077166. FINDINGS Between March 13, 2014 and October 2, 2018, 89 patients were enrolled with a median time on study of 35.0 months. Best ORR in the response-evaluable population (n = 85) was 49% (95% confidence interval [CI], 38-61) across dose cohorts and 53% (95% CI, 39-67) and 44% (95% CI, 26-62) in the 20 mg and 25 mg lenalidomide cohorts, respectively, with complete responses in 24/85 (28%), 17/53 (32%), and 7/32 (22%) patients, respectively. Grade 3/4 adverse events (AEs) occurred in 81/89 patients (91%), most frequently neutropenia (36/89; 40%), maculopapular rash (16/89; 18%), anaemia (12/89; 13%), and diarrhoea (9/89; 10%). Serious adverse events occurred in 57/89 patients (64%). Fatal AEs occurred in 12/89 patients (13%); causes of death were worsening of DLBCL (n = 7), pneumonia (n = 3), sepsis (n = 1), and cardiac arrest (n = 1). INTERPRETATION The most frequent AEs (diarrhoea, neutropenia, fatigue, cough, anaemia, peripheral oedema, and maculopapular rash) were consistent with known safety profiles of the individual drugs. The iR2 regimen demonstrated antitumour activity with durable responses in patients with relapsed/refractory DLBCL. FUNDING Pharmacyclics LLC, an AbbVie Company.
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Affiliation(s)
- Radhakrishnan Ramchandren
- Division of Hematology/Oncology, University of Tennessee Health Science Center, Knoxville, TN, USA
- Corresponding author. University of Tennessee Health Science Center, 1926 Alcoa Highway, Building F, Suite 410, Knoxville, TN 37920, USA.
| | - Peter Johnson
- Cancer Research UK Clinical Centre, Southampton General Hospital, Southampton, UK
| | - Nilanjan Ghosh
- Levine Cancer Institute, Atrium Health, Charlotte, NC, USA
| | - Jia Ruan
- Division of Hematology and Medical Oncology, Weill Cornell Medicine, New York, NY, USA
| | - Kirit M. Ardeshna
- University College London/UCL Hospitals, Biomedical Research Centre, London, UK
| | - Roderick Johnson
- Leeds Cancer Centre at St. James's University Hospital, Leeds, UK
| | - Gregor Verhoef
- Department of Haematology, UZ Leuven – Campus Gasthuisberg, Leuven, Belgium
| | - David Cunningham
- Gastrointestinal and Lymphoma Unit, The Royal Marsden NHS Foundation Trust – Royal Marsden Hospital, London, UK
| | - Sven de Vos
- Division of Hematology/Oncology, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | - Shireen Kassam
- Haematology Department, King's College Hospital, London, UK
| | - Luis Fayad
- Department of Lymphoma-Myeloma, University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - John Radford
- Division of Cancer Sciences, The University of Manchester and the Christie NHS Foundation Trust, Manchester, UK
| | - Sarah Bailly
- Cliniques Universitaires Saint-Luc, Université Catholique de Louvain Brussels, Brussels, Belgium
| | - Fritz Offner
- Department of Clinical Hematology, Universitair Ziekenhuis Gent, Ghent, Belgium
| | - David Morgan
- Division of Hematology and Oncology, Vanderbilt-Ingram Cancer Center, Nashville, TN, USA
| | - Javier Munoz
- Department of Hematology, Banner MD Anderson Cancer Center, Gilbert, AZ, USA
| | - Jerry Ping
- Pharmacyclics LLC, an AbbVie Company, South San Francisco, CA, USA
| | | | - Karl Eckert
- Pharmacyclics LLC, an AbbVie Company, South San Francisco, CA, USA
| | | | - Andre Goy
- Department of Hematology & Oncology, John Theurer Cancer Center at Hackensack University Medical Center, Hackensack, NJ, USA
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Mei M, Perini G, Ramchandren R. Editorial: Advances in the treatment of Hodgkin lymphoma. Front Oncol 2023; 13:1164081. [PMID: 36925934 PMCID: PMC10013146 DOI: 10.3389/fonc.2023.1164081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2023] [Accepted: 02/14/2023] [Indexed: 03/04/2023] Open
Affiliation(s)
- Matthew Mei
- Department of Hematology and Hematopoietic Cell Transplantation, City of Hope, Duarte, CA, United States
| | | | - Radhakrishnan Ramchandren
- Division of Hematology/Oncology, University of Tennessee Health Science Center, Knoxville, TN, United States
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Iqbal M, Tun H, Joffe E, Grommes C, Nowakowski G, Lunning M, Ramchandren R, Li CC, Zhao W, Martinez E, von Roemeling R, Earhart R, McMahon M, Isufi I, Leslie L, Rosenthal A. CTIM-34. PRELIMINARY SAFETY AND EFFICACY DATA ON TWO PATIENTS WITH RELAPSED/REFRACTORY CNS LYMPHOMA TREATED WITH EMAVUSERTIB (CA-4948) AND IBRUTINIB COMBINATION: A SUBSET ANALYSIS OF TAKEAIM LYMPHOMA TRIAL. Neuro Oncol 2022. [PMCID: PMC9660877 DOI: 10.1093/neuonc/noac209.266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Abstract
BACKGROUND
Emavusertib, an oral interleukin-1 receptor-associated kinase 4 (IRAK4) inhibitor, targets toll-like receptor (TLR) and interleukin-1 receptor (IL-1R) signaling pathway in B-cell proliferation. IRAK4 forms a Myddosome complex with MYD88 adaptor protein and drives overactivation of NF-κB, causing inflammation and tumor growth. Emavusertib has been reported to be well tolerated and active as monotherapy in heavily pretreated relapsed/refractory (R/R) non-Hodgkin lymphoma (NHL). In a murine PDX model of primary CNS lymphoma (PCNSL), emavusertib crossed the blood-brain barrier, resulting in tumor response and prolonged survival. In combination with Bruton tyrosine kinase (BTK) inhibitors, emavusertib showed in vivo anti-cancer synergy in B-cell NHL.
METHODS
This is an ongoing open-label trial (NCT03328078) in patients with R/R NHL. Currently, we are in the dose escalation portion of combination therapy to evaluate safety and efficacy following treatment of emavusertib at dose levels of 200 or 300mg BID with ibrutinib at full prescribed dose. As of May 6th, 2022, 13 patients have been treated with emavusertib+ibrutinib combination therapy.
RESULTS
Among the 13 patients, two were diagnosed with R/R PCNSL and had several prior lines of anti-cancer therapy. Emavusertib in combination with ibrutinib (560 mg daily) appeared to be well tolerated in these two subjects. One patient experienced Gr3 treatment-related adverse events (thrombocytopenia, muscle weakness, pain). The preliminary efficacy data demonstrated one CR and one SD. The patient who achieved CR after the combination therapy was originally intolerant to high-dose methotrexate based chemoimmunotherapy and did not achieve complete remission after switching to ibrutinib, providing early clinical evidence of CNS penetration and anti-tumor activity of emavusertib.
CONCLUSION
In R/R PCNSL, these preliminary data suggest that combination therapy has a tolerable safety profile with promising anti-cancer activity and may overcome ibrutinib resistance.
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Affiliation(s)
| | - Han Tun
- Mayo Clinic , Jacksonville, FL , USA
| | - Erel Joffe
- Memorial Sloan Kettering Cancer Center , New York , USA
| | | | | | | | | | | | | | | | | | | | | | | | - Lori Leslie
- John Theurer Cancer Center , Hackensack , USA
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5
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Ansell SM, Radford J, Connors JM, Długosz-Danecka M, Kim WS, Gallamini A, Ramchandren R, Friedberg JW, Advani R, Hutchings M, Evens AM, Smolewski P, Savage KJ, Bartlett NL, Eom HS, Abramson JS, Dong C, Campana F, Fenton K, Puhlmann M, Straus DJ. Overall Survival with Brentuximab Vedotin in Stage III or IV Hodgkin's Lymphoma. N Engl J Med 2022; 387:310-320. [PMID: 35830649 DOI: 10.1056/nejmoa2206125] [Citation(s) in RCA: 78] [Impact Index Per Article: 39.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
BACKGROUND Five-year follow-up in a trial involving patients with previously untreated stage III or IV classic Hodgkin's lymphoma showed long-term progression-free survival benefits with first-line therapy with brentuximab vedotin, a CD30-directed antibody-drug conjugate, plus doxorubicin, vinblastine, and dacarbazine (A+AVD), as compared with doxorubicin, bleomycin, vinblastine, and dacarbazine (ABVD). A planned interim analysis indicated a potential benefit with regard to overall survival; data from a median of 6 years of follow-up are now available. METHODS We randomly assigned patients in a 1:1 ratio to receive up to six cycles of A+AVD or ABVD. The primary end point, modified progression-free survival, has been reported previously. The key secondary end point was overall survival in the intention-to-treat population. Safety was also assessed. RESULTS A total of 664 patients were assigned to receive A+AVD and 670 to receive ABVD. At a median follow-up of 73.0 months, 39 patients in the A+AVD group and 64 in the ABVD group had died (hazard ratio, 0.59; 95% confidence interval [CI], 0.40 to 0.88; P = 0.009). The 6-year overall survival estimates were 93.9% (95% CI, 91.6 to 95.5) in the A+AVD group and 89.4% (95% CI, 86.6 to 91.7) in the ABVD group. Progression-free survival was longer with A+AVD than with ABVD (hazard ratio for disease progression or death, 0.68; 95% CI, 0.53 to 0.86). Fewer patients in the A+AVD group than in the ABVD group received subsequent therapy, including transplantation, and fewer second cancers were reported with A+AVD (in 23 vs. 32 patients). Primary prophylaxis with granulocyte colony-stimulating factor was recommended after an increased incidence of febrile neutropenia was observed with A+AVD. More patients had peripheral neuropathy with A+AVD than with ABVD, but most patients in the two groups had resolution or amelioration of the event by the last follow-up. CONCLUSIONS Patients who received A+AVD for the treatment of stage III or IV Hodgkin's lymphoma had a survival advantage over those who received ABVD. (Funded by Takeda Development Center Americas and Seagen; ECHELON-1 ClinicalTrials.gov number, NCT01712490; EudraCT number, 2011-005450-60.).
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Affiliation(s)
- Stephen M Ansell
- From the Division of Hematology, Mayo Clinic, Rochester, MN (S.M.A.); the University of Manchester and the Christie NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, United Kingdom (J.R.); BC Cancer Centre for Lymphoid Cancer, Vancouver (J.M.C., K.J.S.); Maria Sklodowska-Curie National Research Institute of Oncology, Krakow (M.D.-D.), and the Department of Experimental Hematology, Medical University of Lodz, Lodz (P.S.) - both in Poland; the Division of Hematology-Oncology, Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (W.-S.K.), and the Department of Hematology-Oncology, Center for Hematologic Malignancy, National Cancer Center, Goyang (H.-S.E.) - both in South Korea; Research and Innovation Department, Antoine-Lacassagne Cancer Center, Nice, France (A.G.); the University of Tennessee Graduate School of Medicine, Knoxville (R.R.); Wilmot Cancer Institute, University of Rochester, Rochester (J.W.F.), and the Department of Medicine, Lymphoma Service, Memorial Sloan Kettering Cancer Center, New York (D.J.S.) - both in New York; the Department of Medicine, Division of Oncology, Stanford University, Stanford, CA (R.A.); the Department of Hematology, Rigshospitalet, Copenhagen University Hospital, Copenhagen (M.H.); the Division of Blood Disorders, Rutgers Cancer Institute of New Jersey, New Brunswick (A.M.E.); Washington University School of Medicine Siteman Cancer Center, St. Louis (N.L.B.); Massachusetts General Hospital, Boston (J.S.A.), and Takeda Development Center Americas, Lexington (C.D., F.C.) - both in Massachusetts; and Seagen, Bothell, WA (K.F., M.P.)
| | - John Radford
- From the Division of Hematology, Mayo Clinic, Rochester, MN (S.M.A.); the University of Manchester and the Christie NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, United Kingdom (J.R.); BC Cancer Centre for Lymphoid Cancer, Vancouver (J.M.C., K.J.S.); Maria Sklodowska-Curie National Research Institute of Oncology, Krakow (M.D.-D.), and the Department of Experimental Hematology, Medical University of Lodz, Lodz (P.S.) - both in Poland; the Division of Hematology-Oncology, Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (W.-S.K.), and the Department of Hematology-Oncology, Center for Hematologic Malignancy, National Cancer Center, Goyang (H.-S.E.) - both in South Korea; Research and Innovation Department, Antoine-Lacassagne Cancer Center, Nice, France (A.G.); the University of Tennessee Graduate School of Medicine, Knoxville (R.R.); Wilmot Cancer Institute, University of Rochester, Rochester (J.W.F.), and the Department of Medicine, Lymphoma Service, Memorial Sloan Kettering Cancer Center, New York (D.J.S.) - both in New York; the Department of Medicine, Division of Oncology, Stanford University, Stanford, CA (R.A.); the Department of Hematology, Rigshospitalet, Copenhagen University Hospital, Copenhagen (M.H.); the Division of Blood Disorders, Rutgers Cancer Institute of New Jersey, New Brunswick (A.M.E.); Washington University School of Medicine Siteman Cancer Center, St. Louis (N.L.B.); Massachusetts General Hospital, Boston (J.S.A.), and Takeda Development Center Americas, Lexington (C.D., F.C.) - both in Massachusetts; and Seagen, Bothell, WA (K.F., M.P.)
| | - Joseph M Connors
- From the Division of Hematology, Mayo Clinic, Rochester, MN (S.M.A.); the University of Manchester and the Christie NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, United Kingdom (J.R.); BC Cancer Centre for Lymphoid Cancer, Vancouver (J.M.C., K.J.S.); Maria Sklodowska-Curie National Research Institute of Oncology, Krakow (M.D.-D.), and the Department of Experimental Hematology, Medical University of Lodz, Lodz (P.S.) - both in Poland; the Division of Hematology-Oncology, Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (W.-S.K.), and the Department of Hematology-Oncology, Center for Hematologic Malignancy, National Cancer Center, Goyang (H.-S.E.) - both in South Korea; Research and Innovation Department, Antoine-Lacassagne Cancer Center, Nice, France (A.G.); the University of Tennessee Graduate School of Medicine, Knoxville (R.R.); Wilmot Cancer Institute, University of Rochester, Rochester (J.W.F.), and the Department of Medicine, Lymphoma Service, Memorial Sloan Kettering Cancer Center, New York (D.J.S.) - both in New York; the Department of Medicine, Division of Oncology, Stanford University, Stanford, CA (R.A.); the Department of Hematology, Rigshospitalet, Copenhagen University Hospital, Copenhagen (M.H.); the Division of Blood Disorders, Rutgers Cancer Institute of New Jersey, New Brunswick (A.M.E.); Washington University School of Medicine Siteman Cancer Center, St. Louis (N.L.B.); Massachusetts General Hospital, Boston (J.S.A.), and Takeda Development Center Americas, Lexington (C.D., F.C.) - both in Massachusetts; and Seagen, Bothell, WA (K.F., M.P.)
| | - Monika Długosz-Danecka
- From the Division of Hematology, Mayo Clinic, Rochester, MN (S.M.A.); the University of Manchester and the Christie NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, United Kingdom (J.R.); BC Cancer Centre for Lymphoid Cancer, Vancouver (J.M.C., K.J.S.); Maria Sklodowska-Curie National Research Institute of Oncology, Krakow (M.D.-D.), and the Department of Experimental Hematology, Medical University of Lodz, Lodz (P.S.) - both in Poland; the Division of Hematology-Oncology, Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (W.-S.K.), and the Department of Hematology-Oncology, Center for Hematologic Malignancy, National Cancer Center, Goyang (H.-S.E.) - both in South Korea; Research and Innovation Department, Antoine-Lacassagne Cancer Center, Nice, France (A.G.); the University of Tennessee Graduate School of Medicine, Knoxville (R.R.); Wilmot Cancer Institute, University of Rochester, Rochester (J.W.F.), and the Department of Medicine, Lymphoma Service, Memorial Sloan Kettering Cancer Center, New York (D.J.S.) - both in New York; the Department of Medicine, Division of Oncology, Stanford University, Stanford, CA (R.A.); the Department of Hematology, Rigshospitalet, Copenhagen University Hospital, Copenhagen (M.H.); the Division of Blood Disorders, Rutgers Cancer Institute of New Jersey, New Brunswick (A.M.E.); Washington University School of Medicine Siteman Cancer Center, St. Louis (N.L.B.); Massachusetts General Hospital, Boston (J.S.A.), and Takeda Development Center Americas, Lexington (C.D., F.C.) - both in Massachusetts; and Seagen, Bothell, WA (K.F., M.P.)
| | - Won-Seog Kim
- From the Division of Hematology, Mayo Clinic, Rochester, MN (S.M.A.); the University of Manchester and the Christie NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, United Kingdom (J.R.); BC Cancer Centre for Lymphoid Cancer, Vancouver (J.M.C., K.J.S.); Maria Sklodowska-Curie National Research Institute of Oncology, Krakow (M.D.-D.), and the Department of Experimental Hematology, Medical University of Lodz, Lodz (P.S.) - both in Poland; the Division of Hematology-Oncology, Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (W.-S.K.), and the Department of Hematology-Oncology, Center for Hematologic Malignancy, National Cancer Center, Goyang (H.-S.E.) - both in South Korea; Research and Innovation Department, Antoine-Lacassagne Cancer Center, Nice, France (A.G.); the University of Tennessee Graduate School of Medicine, Knoxville (R.R.); Wilmot Cancer Institute, University of Rochester, Rochester (J.W.F.), and the Department of Medicine, Lymphoma Service, Memorial Sloan Kettering Cancer Center, New York (D.J.S.) - both in New York; the Department of Medicine, Division of Oncology, Stanford University, Stanford, CA (R.A.); the Department of Hematology, Rigshospitalet, Copenhagen University Hospital, Copenhagen (M.H.); the Division of Blood Disorders, Rutgers Cancer Institute of New Jersey, New Brunswick (A.M.E.); Washington University School of Medicine Siteman Cancer Center, St. Louis (N.L.B.); Massachusetts General Hospital, Boston (J.S.A.), and Takeda Development Center Americas, Lexington (C.D., F.C.) - both in Massachusetts; and Seagen, Bothell, WA (K.F., M.P.)
| | - Andrea Gallamini
- From the Division of Hematology, Mayo Clinic, Rochester, MN (S.M.A.); the University of Manchester and the Christie NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, United Kingdom (J.R.); BC Cancer Centre for Lymphoid Cancer, Vancouver (J.M.C., K.J.S.); Maria Sklodowska-Curie National Research Institute of Oncology, Krakow (M.D.-D.), and the Department of Experimental Hematology, Medical University of Lodz, Lodz (P.S.) - both in Poland; the Division of Hematology-Oncology, Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (W.-S.K.), and the Department of Hematology-Oncology, Center for Hematologic Malignancy, National Cancer Center, Goyang (H.-S.E.) - both in South Korea; Research and Innovation Department, Antoine-Lacassagne Cancer Center, Nice, France (A.G.); the University of Tennessee Graduate School of Medicine, Knoxville (R.R.); Wilmot Cancer Institute, University of Rochester, Rochester (J.W.F.), and the Department of Medicine, Lymphoma Service, Memorial Sloan Kettering Cancer Center, New York (D.J.S.) - both in New York; the Department of Medicine, Division of Oncology, Stanford University, Stanford, CA (R.A.); the Department of Hematology, Rigshospitalet, Copenhagen University Hospital, Copenhagen (M.H.); the Division of Blood Disorders, Rutgers Cancer Institute of New Jersey, New Brunswick (A.M.E.); Washington University School of Medicine Siteman Cancer Center, St. Louis (N.L.B.); Massachusetts General Hospital, Boston (J.S.A.), and Takeda Development Center Americas, Lexington (C.D., F.C.) - both in Massachusetts; and Seagen, Bothell, WA (K.F., M.P.)
| | - Radhakrishnan Ramchandren
- From the Division of Hematology, Mayo Clinic, Rochester, MN (S.M.A.); the University of Manchester and the Christie NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, United Kingdom (J.R.); BC Cancer Centre for Lymphoid Cancer, Vancouver (J.M.C., K.J.S.); Maria Sklodowska-Curie National Research Institute of Oncology, Krakow (M.D.-D.), and the Department of Experimental Hematology, Medical University of Lodz, Lodz (P.S.) - both in Poland; the Division of Hematology-Oncology, Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (W.-S.K.), and the Department of Hematology-Oncology, Center for Hematologic Malignancy, National Cancer Center, Goyang (H.-S.E.) - both in South Korea; Research and Innovation Department, Antoine-Lacassagne Cancer Center, Nice, France (A.G.); the University of Tennessee Graduate School of Medicine, Knoxville (R.R.); Wilmot Cancer Institute, University of Rochester, Rochester (J.W.F.), and the Department of Medicine, Lymphoma Service, Memorial Sloan Kettering Cancer Center, New York (D.J.S.) - both in New York; the Department of Medicine, Division of Oncology, Stanford University, Stanford, CA (R.A.); the Department of Hematology, Rigshospitalet, Copenhagen University Hospital, Copenhagen (M.H.); the Division of Blood Disorders, Rutgers Cancer Institute of New Jersey, New Brunswick (A.M.E.); Washington University School of Medicine Siteman Cancer Center, St. Louis (N.L.B.); Massachusetts General Hospital, Boston (J.S.A.), and Takeda Development Center Americas, Lexington (C.D., F.C.) - both in Massachusetts; and Seagen, Bothell, WA (K.F., M.P.)
| | - Jonathan W Friedberg
- From the Division of Hematology, Mayo Clinic, Rochester, MN (S.M.A.); the University of Manchester and the Christie NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, United Kingdom (J.R.); BC Cancer Centre for Lymphoid Cancer, Vancouver (J.M.C., K.J.S.); Maria Sklodowska-Curie National Research Institute of Oncology, Krakow (M.D.-D.), and the Department of Experimental Hematology, Medical University of Lodz, Lodz (P.S.) - both in Poland; the Division of Hematology-Oncology, Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (W.-S.K.), and the Department of Hematology-Oncology, Center for Hematologic Malignancy, National Cancer Center, Goyang (H.-S.E.) - both in South Korea; Research and Innovation Department, Antoine-Lacassagne Cancer Center, Nice, France (A.G.); the University of Tennessee Graduate School of Medicine, Knoxville (R.R.); Wilmot Cancer Institute, University of Rochester, Rochester (J.W.F.), and the Department of Medicine, Lymphoma Service, Memorial Sloan Kettering Cancer Center, New York (D.J.S.) - both in New York; the Department of Medicine, Division of Oncology, Stanford University, Stanford, CA (R.A.); the Department of Hematology, Rigshospitalet, Copenhagen University Hospital, Copenhagen (M.H.); the Division of Blood Disorders, Rutgers Cancer Institute of New Jersey, New Brunswick (A.M.E.); Washington University School of Medicine Siteman Cancer Center, St. Louis (N.L.B.); Massachusetts General Hospital, Boston (J.S.A.), and Takeda Development Center Americas, Lexington (C.D., F.C.) - both in Massachusetts; and Seagen, Bothell, WA (K.F., M.P.)
| | - Ranjana Advani
- From the Division of Hematology, Mayo Clinic, Rochester, MN (S.M.A.); the University of Manchester and the Christie NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, United Kingdom (J.R.); BC Cancer Centre for Lymphoid Cancer, Vancouver (J.M.C., K.J.S.); Maria Sklodowska-Curie National Research Institute of Oncology, Krakow (M.D.-D.), and the Department of Experimental Hematology, Medical University of Lodz, Lodz (P.S.) - both in Poland; the Division of Hematology-Oncology, Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (W.-S.K.), and the Department of Hematology-Oncology, Center for Hematologic Malignancy, National Cancer Center, Goyang (H.-S.E.) - both in South Korea; Research and Innovation Department, Antoine-Lacassagne Cancer Center, Nice, France (A.G.); the University of Tennessee Graduate School of Medicine, Knoxville (R.R.); Wilmot Cancer Institute, University of Rochester, Rochester (J.W.F.), and the Department of Medicine, Lymphoma Service, Memorial Sloan Kettering Cancer Center, New York (D.J.S.) - both in New York; the Department of Medicine, Division of Oncology, Stanford University, Stanford, CA (R.A.); the Department of Hematology, Rigshospitalet, Copenhagen University Hospital, Copenhagen (M.H.); the Division of Blood Disorders, Rutgers Cancer Institute of New Jersey, New Brunswick (A.M.E.); Washington University School of Medicine Siteman Cancer Center, St. Louis (N.L.B.); Massachusetts General Hospital, Boston (J.S.A.), and Takeda Development Center Americas, Lexington (C.D., F.C.) - both in Massachusetts; and Seagen, Bothell, WA (K.F., M.P.)
| | - Martin Hutchings
- From the Division of Hematology, Mayo Clinic, Rochester, MN (S.M.A.); the University of Manchester and the Christie NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, United Kingdom (J.R.); BC Cancer Centre for Lymphoid Cancer, Vancouver (J.M.C., K.J.S.); Maria Sklodowska-Curie National Research Institute of Oncology, Krakow (M.D.-D.), and the Department of Experimental Hematology, Medical University of Lodz, Lodz (P.S.) - both in Poland; the Division of Hematology-Oncology, Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (W.-S.K.), and the Department of Hematology-Oncology, Center for Hematologic Malignancy, National Cancer Center, Goyang (H.-S.E.) - both in South Korea; Research and Innovation Department, Antoine-Lacassagne Cancer Center, Nice, France (A.G.); the University of Tennessee Graduate School of Medicine, Knoxville (R.R.); Wilmot Cancer Institute, University of Rochester, Rochester (J.W.F.), and the Department of Medicine, Lymphoma Service, Memorial Sloan Kettering Cancer Center, New York (D.J.S.) - both in New York; the Department of Medicine, Division of Oncology, Stanford University, Stanford, CA (R.A.); the Department of Hematology, Rigshospitalet, Copenhagen University Hospital, Copenhagen (M.H.); the Division of Blood Disorders, Rutgers Cancer Institute of New Jersey, New Brunswick (A.M.E.); Washington University School of Medicine Siteman Cancer Center, St. Louis (N.L.B.); Massachusetts General Hospital, Boston (J.S.A.), and Takeda Development Center Americas, Lexington (C.D., F.C.) - both in Massachusetts; and Seagen, Bothell, WA (K.F., M.P.)
| | - Andrew M Evens
- From the Division of Hematology, Mayo Clinic, Rochester, MN (S.M.A.); the University of Manchester and the Christie NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, United Kingdom (J.R.); BC Cancer Centre for Lymphoid Cancer, Vancouver (J.M.C., K.J.S.); Maria Sklodowska-Curie National Research Institute of Oncology, Krakow (M.D.-D.), and the Department of Experimental Hematology, Medical University of Lodz, Lodz (P.S.) - both in Poland; the Division of Hematology-Oncology, Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (W.-S.K.), and the Department of Hematology-Oncology, Center for Hematologic Malignancy, National Cancer Center, Goyang (H.-S.E.) - both in South Korea; Research and Innovation Department, Antoine-Lacassagne Cancer Center, Nice, France (A.G.); the University of Tennessee Graduate School of Medicine, Knoxville (R.R.); Wilmot Cancer Institute, University of Rochester, Rochester (J.W.F.), and the Department of Medicine, Lymphoma Service, Memorial Sloan Kettering Cancer Center, New York (D.J.S.) - both in New York; the Department of Medicine, Division of Oncology, Stanford University, Stanford, CA (R.A.); the Department of Hematology, Rigshospitalet, Copenhagen University Hospital, Copenhagen (M.H.); the Division of Blood Disorders, Rutgers Cancer Institute of New Jersey, New Brunswick (A.M.E.); Washington University School of Medicine Siteman Cancer Center, St. Louis (N.L.B.); Massachusetts General Hospital, Boston (J.S.A.), and Takeda Development Center Americas, Lexington (C.D., F.C.) - both in Massachusetts; and Seagen, Bothell, WA (K.F., M.P.)
| | - Piotr Smolewski
- From the Division of Hematology, Mayo Clinic, Rochester, MN (S.M.A.); the University of Manchester and the Christie NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, United Kingdom (J.R.); BC Cancer Centre for Lymphoid Cancer, Vancouver (J.M.C., K.J.S.); Maria Sklodowska-Curie National Research Institute of Oncology, Krakow (M.D.-D.), and the Department of Experimental Hematology, Medical University of Lodz, Lodz (P.S.) - both in Poland; the Division of Hematology-Oncology, Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (W.-S.K.), and the Department of Hematology-Oncology, Center for Hematologic Malignancy, National Cancer Center, Goyang (H.-S.E.) - both in South Korea; Research and Innovation Department, Antoine-Lacassagne Cancer Center, Nice, France (A.G.); the University of Tennessee Graduate School of Medicine, Knoxville (R.R.); Wilmot Cancer Institute, University of Rochester, Rochester (J.W.F.), and the Department of Medicine, Lymphoma Service, Memorial Sloan Kettering Cancer Center, New York (D.J.S.) - both in New York; the Department of Medicine, Division of Oncology, Stanford University, Stanford, CA (R.A.); the Department of Hematology, Rigshospitalet, Copenhagen University Hospital, Copenhagen (M.H.); the Division of Blood Disorders, Rutgers Cancer Institute of New Jersey, New Brunswick (A.M.E.); Washington University School of Medicine Siteman Cancer Center, St. Louis (N.L.B.); Massachusetts General Hospital, Boston (J.S.A.), and Takeda Development Center Americas, Lexington (C.D., F.C.) - both in Massachusetts; and Seagen, Bothell, WA (K.F., M.P.)
| | - Kerry J Savage
- From the Division of Hematology, Mayo Clinic, Rochester, MN (S.M.A.); the University of Manchester and the Christie NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, United Kingdom (J.R.); BC Cancer Centre for Lymphoid Cancer, Vancouver (J.M.C., K.J.S.); Maria Sklodowska-Curie National Research Institute of Oncology, Krakow (M.D.-D.), and the Department of Experimental Hematology, Medical University of Lodz, Lodz (P.S.) - both in Poland; the Division of Hematology-Oncology, Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (W.-S.K.), and the Department of Hematology-Oncology, Center for Hematologic Malignancy, National Cancer Center, Goyang (H.-S.E.) - both in South Korea; Research and Innovation Department, Antoine-Lacassagne Cancer Center, Nice, France (A.G.); the University of Tennessee Graduate School of Medicine, Knoxville (R.R.); Wilmot Cancer Institute, University of Rochester, Rochester (J.W.F.), and the Department of Medicine, Lymphoma Service, Memorial Sloan Kettering Cancer Center, New York (D.J.S.) - both in New York; the Department of Medicine, Division of Oncology, Stanford University, Stanford, CA (R.A.); the Department of Hematology, Rigshospitalet, Copenhagen University Hospital, Copenhagen (M.H.); the Division of Blood Disorders, Rutgers Cancer Institute of New Jersey, New Brunswick (A.M.E.); Washington University School of Medicine Siteman Cancer Center, St. Louis (N.L.B.); Massachusetts General Hospital, Boston (J.S.A.), and Takeda Development Center Americas, Lexington (C.D., F.C.) - both in Massachusetts; and Seagen, Bothell, WA (K.F., M.P.)
| | - Nancy L Bartlett
- From the Division of Hematology, Mayo Clinic, Rochester, MN (S.M.A.); the University of Manchester and the Christie NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, United Kingdom (J.R.); BC Cancer Centre for Lymphoid Cancer, Vancouver (J.M.C., K.J.S.); Maria Sklodowska-Curie National Research Institute of Oncology, Krakow (M.D.-D.), and the Department of Experimental Hematology, Medical University of Lodz, Lodz (P.S.) - both in Poland; the Division of Hematology-Oncology, Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (W.-S.K.), and the Department of Hematology-Oncology, Center for Hematologic Malignancy, National Cancer Center, Goyang (H.-S.E.) - both in South Korea; Research and Innovation Department, Antoine-Lacassagne Cancer Center, Nice, France (A.G.); the University of Tennessee Graduate School of Medicine, Knoxville (R.R.); Wilmot Cancer Institute, University of Rochester, Rochester (J.W.F.), and the Department of Medicine, Lymphoma Service, Memorial Sloan Kettering Cancer Center, New York (D.J.S.) - both in New York; the Department of Medicine, Division of Oncology, Stanford University, Stanford, CA (R.A.); the Department of Hematology, Rigshospitalet, Copenhagen University Hospital, Copenhagen (M.H.); the Division of Blood Disorders, Rutgers Cancer Institute of New Jersey, New Brunswick (A.M.E.); Washington University School of Medicine Siteman Cancer Center, St. Louis (N.L.B.); Massachusetts General Hospital, Boston (J.S.A.), and Takeda Development Center Americas, Lexington (C.D., F.C.) - both in Massachusetts; and Seagen, Bothell, WA (K.F., M.P.)
| | - Hyeon-Seok Eom
- From the Division of Hematology, Mayo Clinic, Rochester, MN (S.M.A.); the University of Manchester and the Christie NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, United Kingdom (J.R.); BC Cancer Centre for Lymphoid Cancer, Vancouver (J.M.C., K.J.S.); Maria Sklodowska-Curie National Research Institute of Oncology, Krakow (M.D.-D.), and the Department of Experimental Hematology, Medical University of Lodz, Lodz (P.S.) - both in Poland; the Division of Hematology-Oncology, Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (W.-S.K.), and the Department of Hematology-Oncology, Center for Hematologic Malignancy, National Cancer Center, Goyang (H.-S.E.) - both in South Korea; Research and Innovation Department, Antoine-Lacassagne Cancer Center, Nice, France (A.G.); the University of Tennessee Graduate School of Medicine, Knoxville (R.R.); Wilmot Cancer Institute, University of Rochester, Rochester (J.W.F.), and the Department of Medicine, Lymphoma Service, Memorial Sloan Kettering Cancer Center, New York (D.J.S.) - both in New York; the Department of Medicine, Division of Oncology, Stanford University, Stanford, CA (R.A.); the Department of Hematology, Rigshospitalet, Copenhagen University Hospital, Copenhagen (M.H.); the Division of Blood Disorders, Rutgers Cancer Institute of New Jersey, New Brunswick (A.M.E.); Washington University School of Medicine Siteman Cancer Center, St. Louis (N.L.B.); Massachusetts General Hospital, Boston (J.S.A.), and Takeda Development Center Americas, Lexington (C.D., F.C.) - both in Massachusetts; and Seagen, Bothell, WA (K.F., M.P.)
| | - Jeremy S Abramson
- From the Division of Hematology, Mayo Clinic, Rochester, MN (S.M.A.); the University of Manchester and the Christie NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, United Kingdom (J.R.); BC Cancer Centre for Lymphoid Cancer, Vancouver (J.M.C., K.J.S.); Maria Sklodowska-Curie National Research Institute of Oncology, Krakow (M.D.-D.), and the Department of Experimental Hematology, Medical University of Lodz, Lodz (P.S.) - both in Poland; the Division of Hematology-Oncology, Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (W.-S.K.), and the Department of Hematology-Oncology, Center for Hematologic Malignancy, National Cancer Center, Goyang (H.-S.E.) - both in South Korea; Research and Innovation Department, Antoine-Lacassagne Cancer Center, Nice, France (A.G.); the University of Tennessee Graduate School of Medicine, Knoxville (R.R.); Wilmot Cancer Institute, University of Rochester, Rochester (J.W.F.), and the Department of Medicine, Lymphoma Service, Memorial Sloan Kettering Cancer Center, New York (D.J.S.) - both in New York; the Department of Medicine, Division of Oncology, Stanford University, Stanford, CA (R.A.); the Department of Hematology, Rigshospitalet, Copenhagen University Hospital, Copenhagen (M.H.); the Division of Blood Disorders, Rutgers Cancer Institute of New Jersey, New Brunswick (A.M.E.); Washington University School of Medicine Siteman Cancer Center, St. Louis (N.L.B.); Massachusetts General Hospital, Boston (J.S.A.), and Takeda Development Center Americas, Lexington (C.D., F.C.) - both in Massachusetts; and Seagen, Bothell, WA (K.F., M.P.)
| | - Cassie Dong
- From the Division of Hematology, Mayo Clinic, Rochester, MN (S.M.A.); the University of Manchester and the Christie NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, United Kingdom (J.R.); BC Cancer Centre for Lymphoid Cancer, Vancouver (J.M.C., K.J.S.); Maria Sklodowska-Curie National Research Institute of Oncology, Krakow (M.D.-D.), and the Department of Experimental Hematology, Medical University of Lodz, Lodz (P.S.) - both in Poland; the Division of Hematology-Oncology, Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (W.-S.K.), and the Department of Hematology-Oncology, Center for Hematologic Malignancy, National Cancer Center, Goyang (H.-S.E.) - both in South Korea; Research and Innovation Department, Antoine-Lacassagne Cancer Center, Nice, France (A.G.); the University of Tennessee Graduate School of Medicine, Knoxville (R.R.); Wilmot Cancer Institute, University of Rochester, Rochester (J.W.F.), and the Department of Medicine, Lymphoma Service, Memorial Sloan Kettering Cancer Center, New York (D.J.S.) - both in New York; the Department of Medicine, Division of Oncology, Stanford University, Stanford, CA (R.A.); the Department of Hematology, Rigshospitalet, Copenhagen University Hospital, Copenhagen (M.H.); the Division of Blood Disorders, Rutgers Cancer Institute of New Jersey, New Brunswick (A.M.E.); Washington University School of Medicine Siteman Cancer Center, St. Louis (N.L.B.); Massachusetts General Hospital, Boston (J.S.A.), and Takeda Development Center Americas, Lexington (C.D., F.C.) - both in Massachusetts; and Seagen, Bothell, WA (K.F., M.P.)
| | - Frank Campana
- From the Division of Hematology, Mayo Clinic, Rochester, MN (S.M.A.); the University of Manchester and the Christie NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, United Kingdom (J.R.); BC Cancer Centre for Lymphoid Cancer, Vancouver (J.M.C., K.J.S.); Maria Sklodowska-Curie National Research Institute of Oncology, Krakow (M.D.-D.), and the Department of Experimental Hematology, Medical University of Lodz, Lodz (P.S.) - both in Poland; the Division of Hematology-Oncology, Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (W.-S.K.), and the Department of Hematology-Oncology, Center for Hematologic Malignancy, National Cancer Center, Goyang (H.-S.E.) - both in South Korea; Research and Innovation Department, Antoine-Lacassagne Cancer Center, Nice, France (A.G.); the University of Tennessee Graduate School of Medicine, Knoxville (R.R.); Wilmot Cancer Institute, University of Rochester, Rochester (J.W.F.), and the Department of Medicine, Lymphoma Service, Memorial Sloan Kettering Cancer Center, New York (D.J.S.) - both in New York; the Department of Medicine, Division of Oncology, Stanford University, Stanford, CA (R.A.); the Department of Hematology, Rigshospitalet, Copenhagen University Hospital, Copenhagen (M.H.); the Division of Blood Disorders, Rutgers Cancer Institute of New Jersey, New Brunswick (A.M.E.); Washington University School of Medicine Siteman Cancer Center, St. Louis (N.L.B.); Massachusetts General Hospital, Boston (J.S.A.), and Takeda Development Center Americas, Lexington (C.D., F.C.) - both in Massachusetts; and Seagen, Bothell, WA (K.F., M.P.)
| | - Keenan Fenton
- From the Division of Hematology, Mayo Clinic, Rochester, MN (S.M.A.); the University of Manchester and the Christie NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, United Kingdom (J.R.); BC Cancer Centre for Lymphoid Cancer, Vancouver (J.M.C., K.J.S.); Maria Sklodowska-Curie National Research Institute of Oncology, Krakow (M.D.-D.), and the Department of Experimental Hematology, Medical University of Lodz, Lodz (P.S.) - both in Poland; the Division of Hematology-Oncology, Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (W.-S.K.), and the Department of Hematology-Oncology, Center for Hematologic Malignancy, National Cancer Center, Goyang (H.-S.E.) - both in South Korea; Research and Innovation Department, Antoine-Lacassagne Cancer Center, Nice, France (A.G.); the University of Tennessee Graduate School of Medicine, Knoxville (R.R.); Wilmot Cancer Institute, University of Rochester, Rochester (J.W.F.), and the Department of Medicine, Lymphoma Service, Memorial Sloan Kettering Cancer Center, New York (D.J.S.) - both in New York; the Department of Medicine, Division of Oncology, Stanford University, Stanford, CA (R.A.); the Department of Hematology, Rigshospitalet, Copenhagen University Hospital, Copenhagen (M.H.); the Division of Blood Disorders, Rutgers Cancer Institute of New Jersey, New Brunswick (A.M.E.); Washington University School of Medicine Siteman Cancer Center, St. Louis (N.L.B.); Massachusetts General Hospital, Boston (J.S.A.), and Takeda Development Center Americas, Lexington (C.D., F.C.) - both in Massachusetts; and Seagen, Bothell, WA (K.F., M.P.)
| | - Markus Puhlmann
- From the Division of Hematology, Mayo Clinic, Rochester, MN (S.M.A.); the University of Manchester and the Christie NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, United Kingdom (J.R.); BC Cancer Centre for Lymphoid Cancer, Vancouver (J.M.C., K.J.S.); Maria Sklodowska-Curie National Research Institute of Oncology, Krakow (M.D.-D.), and the Department of Experimental Hematology, Medical University of Lodz, Lodz (P.S.) - both in Poland; the Division of Hematology-Oncology, Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (W.-S.K.), and the Department of Hematology-Oncology, Center for Hematologic Malignancy, National Cancer Center, Goyang (H.-S.E.) - both in South Korea; Research and Innovation Department, Antoine-Lacassagne Cancer Center, Nice, France (A.G.); the University of Tennessee Graduate School of Medicine, Knoxville (R.R.); Wilmot Cancer Institute, University of Rochester, Rochester (J.W.F.), and the Department of Medicine, Lymphoma Service, Memorial Sloan Kettering Cancer Center, New York (D.J.S.) - both in New York; the Department of Medicine, Division of Oncology, Stanford University, Stanford, CA (R.A.); the Department of Hematology, Rigshospitalet, Copenhagen University Hospital, Copenhagen (M.H.); the Division of Blood Disorders, Rutgers Cancer Institute of New Jersey, New Brunswick (A.M.E.); Washington University School of Medicine Siteman Cancer Center, St. Louis (N.L.B.); Massachusetts General Hospital, Boston (J.S.A.), and Takeda Development Center Americas, Lexington (C.D., F.C.) - both in Massachusetts; and Seagen, Bothell, WA (K.F., M.P.)
| | - David J Straus
- From the Division of Hematology, Mayo Clinic, Rochester, MN (S.M.A.); the University of Manchester and the Christie NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, United Kingdom (J.R.); BC Cancer Centre for Lymphoid Cancer, Vancouver (J.M.C., K.J.S.); Maria Sklodowska-Curie National Research Institute of Oncology, Krakow (M.D.-D.), and the Department of Experimental Hematology, Medical University of Lodz, Lodz (P.S.) - both in Poland; the Division of Hematology-Oncology, Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (W.-S.K.), and the Department of Hematology-Oncology, Center for Hematologic Malignancy, National Cancer Center, Goyang (H.-S.E.) - both in South Korea; Research and Innovation Department, Antoine-Lacassagne Cancer Center, Nice, France (A.G.); the University of Tennessee Graduate School of Medicine, Knoxville (R.R.); Wilmot Cancer Institute, University of Rochester, Rochester (J.W.F.), and the Department of Medicine, Lymphoma Service, Memorial Sloan Kettering Cancer Center, New York (D.J.S.) - both in New York; the Department of Medicine, Division of Oncology, Stanford University, Stanford, CA (R.A.); the Department of Hematology, Rigshospitalet, Copenhagen University Hospital, Copenhagen (M.H.); the Division of Blood Disorders, Rutgers Cancer Institute of New Jersey, New Brunswick (A.M.E.); Washington University School of Medicine Siteman Cancer Center, St. Louis (N.L.B.); Massachusetts General Hospital, Boston (J.S.A.), and Takeda Development Center Americas, Lexington (C.D., F.C.) - both in Massachusetts; and Seagen, Bothell, WA (K.F., M.P.)
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Hamid MS, Rutherford SC, Jang H, Kim S, Patel K, Bartlett NL, Malecek MK, Watkins MP, Maddocks KJ, Bond DA, Feldman TA, Magarelli G, Advani RH, Spinner MA, Evens AM, Shah M, Ahmed S, Stephens DM, Allen P, Tees MT, Karmali R, Cheson BD, Yazdy MS, Strouse C, Bailey NA, Pagel JM, Ramchandren R. Outcomes Among Classical Hodgkin Lymphoma Patients After an Interim PET Scan: A Real-World Experience. Clin Lymphoma Myeloma Leuk 2022; 22:e435-e442. [PMID: 35093285 DOI: 10.1016/j.clml.2021.12.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Revised: 11/17/2021] [Accepted: 12/18/2021] [Indexed: 06/14/2023]
Abstract
INTRODUCTION The utility of dose escalation after positive positron emission tomography following 2 cycles of ABVD (PET2) for Hodgkin Lymphoma (HL) remains controversial. We describe the United States real-world practice patterns for PET2 positive patients. PATIENTS AND METHODS Data was collected from 15 sites on PET2 positive HL patients after receiving frontline treatment between January, 2015 and June, 2019. Descriptive analyses between those with therapy change and those continuing initial therapy were assessed. RESULTS A total of 129 patients were identified; 111 (86%) were treated with ABVD therapy and 18 (14%) with an alternate regimen. At PET2 assessment, 74.4% (96/129) had Deauville score (DS) 4 and 25.6% (33/129) had DS 5. Of the 66 limited stage (LS) patients with PET2 DS score of 4/5, 77.3% (51/66) continued initial therapy and 22.7% (15/66) changed to escalated therapy. The 12-month progression-free survival (PFS) for DS 4/5 LS patients was 67.0% (95% CI; 54.9-81.7) for patients without escalation compared with 51.4% (95% CI; 30.8-85.8) for those who escalated. Of the 63 DS 4/5 patients with advanced stage (AS) disease, 76.2% (48/63) continued initial therapy and 23.8% (15/63) changed to escalated therapy. The 12-month PFS for DS 4/5 AS patients was 38.3% (95% CI: 26.3%-55.7%) for patients without escalation compared with 57.1% (95% CI: 36.3-89.9) for those with escalation. CONCLUSION A minority of PET2 positive HL patients undergo therapy escalation and outcomes remain overall suboptimal. Improved prognostics markers and better therapeutics are required to improve outcomes for high-risk PET2 positive HL patients.
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Affiliation(s)
| | | | | | | | | | - Nancy L Bartlett
- Washington University Medical University at St. Louis, St. Louis, MO
| | - Mary-Kate Malecek
- Washington University Medical University at St. Louis, St. Louis, MO
| | - Marcus P Watkins
- Washington University Medical University at St. Louis, St. Louis, MO
| | - Kami J Maddocks
- The James Comprehensive Cancer Center, The Ohio State University, Columbus, OH
| | - David A Bond
- The James Comprehensive Cancer Center, The Ohio State University, Columbus, OH
| | - Tatyana A Feldman
- John Theurer Cancer Center at Hackensack Meridian Health, Hackensack, NJ
| | - Gabriela Magarelli
- John Theurer Cancer Center at Hackensack Meridian Health, Hackensack, NJ
| | | | | | - Andrew M Evens
- Rutgers Cancer Institute of New Jersey, New Brunswick, NJ
| | - Mansi Shah
- Rutgers Cancer Institute of New Jersey, New Brunswick, NJ
| | | | | | - Pamela Allen
- Winship Cancer Institute at Emory University, Atlanta, GA
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Patel K, Sano D, Maris M, Lesokhin AM, Von Keudell G, Doucette K, Ramchandren R, Pavlov D, Uger RA, Molloy N, Bruns I, Scheuber A, Iyer SP. TTI-622-01: A phase 1a/1b dose-escalation and expansion trial of TTI-622 in patients with advanced hematologic malignancies, including diffuse large B-cell lymphoma (DLBCL). J Clin Oncol 2022. [DOI: 10.1200/jco.2022.40.16_suppl.tps7595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
TPS7595 Background: CD47 is an innate immune checkpoint that binds signal regulatory protein alpha (SIRPα) and delivers a "don’t eat me" signal to suppress macrophage phagocytosis. Overexpression of CD47 on cancer cells serves as a mechanism of immune surveillance evasion, and is associated with poor prognosis in both hematologic and solid malignancies. TTI-622 is a fusion protein consisting of the CD47-binding domain of human SIRPα linked to the Fc region of human IgG4. It is designed to enhance phagocytosis and antitumor activity by preventing CD47 from delivering its inhibitory signal as well as generating a moderate pro-phagocytic signal via IgG4 Fc. Importantly, unlike many CD47-blocking agents, TTI-622 does not bind to human red blood cells. Preclinical studies demonstrate that TTI-622 induces macrophage-mediated phagocytosis of different malignant cell lines, including DLBCL cells, decreases tumor growth and improves survival in a DLBCL xenograft tumor model. Anti-CD47 antibody enhances rituximab stimulated macrophage-mediated phagocytosis of non-GCB DLBCL cell lines (Bouwstra et al, Cancer Immunol Res. 2019). The ongoing phase 1a part of this study has been previously described. Here we describe 2 cohorts within the phase 1b part of the study that are intended to determine the safety and preliminary efficacy of TTI-622 when given in combination with anti-CD20 targeting agent in patients with CD20+ relapsed/refractory (RR) DLBCL. Methods: TTI-622-01 is a multi-center Phase 1a/1b study. Phase 1a was designed to determine the MTD, pharmacokinetics (PK), pharmacodynamics, and preliminary antitumor activity of QW, Q2W, and Q3W single-agent TTI-622 in R/R lymphoma using a 3+3 dose escalation schema. Phase 1b, ongoing, will determine the safety, recommended dose and preliminary efficacy of TTI-622 in combination with select approved anticancer treatments for patients with hematological malignancies including, but not limited to anti-CD20 therapy in patients with CD20+ RR DLBCL. Secondary objectives are to further characterize safety, PK and immunogenicity of TTI-622 when combined with approved therapies. Patients will be enrolled in 2 cohorts exploring different doses of TTI-622 in combination with anti-CD20 therapy. Cohorts will open in a staggered manner. In each cohort 3 patients will be dosed and followed for 28 days before expanding enrolment to additional 27 patients per cohort. Key eligibility criteria include: age ≥18 years; relapsed and/or refractory disease after ≥1 prior line of therapy; not eligible for or have progressed after high dose chemotherapy (HDT)/auto-SCT; ≥1 site of measurable disease (Lugano 2014 classification); ECOG PS ≤2; adequate organ functions, no known CNS involvement; no prior anti-CD47 or anti-SIRPα therapy. Patient recruitment is planned or ongoing at 40 sites worldwide. Clinical trial information: NCT03530683.
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Affiliation(s)
| | - Dahlia Sano
- Karmanos Cancer Institute/Wayne State University, Detroit, MI
| | - Michael Maris
- Colorado Blood Cancer Institute and Sarah Cannon Research Institute, Denver, CO
| | - Alexander M. Lesokhin
- Myeloma Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY
| | | | | | | | | | - Robert A. Uger
- Trillium Therapeutics Inc., a Pfizer Company, Mississauga, ON, Canada
| | - Naomi Molloy
- Trillium Therapeutics, a Pfizer Company, Mississauga, ON, Canada
| | - Ingmar Bruns
- Trillium Therapeutics Inc., a Pfizer Company, Mississauga, ON, Canada
| | - Anita Scheuber
- Trillium Therapeutics Inc., a Pfizer Company, Mississauga, ON, Canada
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8
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Ansell SM, Connors JM, Radford JA, Kim WS, Gallamini A, Ramchandren R, Friedberg JW, Advani RH, Hutchings M, Evens AM, Smolewski P, Savage KJ, Bartlett NL, Eom HS, Abramson JS, Dong C, Campana F, Fenton K, Puhlmann M, Straus DJ. First-line brentuximab vedotin plus chemotherapy to improve overall survival in patients with stage III/IV classical Hodgkin lymphoma: An updated analysis of ECHELON-1. J Clin Oncol 2022. [DOI: 10.1200/jco.2022.40.16_suppl.7503] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
7503 Background: To date, an overall survival (OS) benefit from upfront treatment for new treatment combinations over existing approaches has rarely been shown in first-line classical Hodgkin lymphoma (cHL). With the introduction of newer active therapies for relapsed/refractory disease, demonstration of improved OS with first-line therapy has been challenging. In ECHELON-1 (NCT01712490), 5-year follow-up analyses supported the long-term progression-free survival (PFS) benefit with first-line brentuximab vedotin, doxorubicin, vinblastine, and dacarbazine (A+AVD) vs doxorubicin, bleomycin, vinblastine, and dacarbazine (ABVD) in patients (pts) with stage III/IV cHL, independent of interim positron emission tomography status. A+AVD had a manageable long-term safety profile, with numerically fewer second malignancies and a greater number of pregnancies reported vs ABVD (Connors et al, NEJM 2018; Straus et al, Lancet Haematol 2021). We report a prespecified OS analysis after approximately 6 years’ follow-up (cut-off, June 1, 2021). Methods: Pts were randomized 1:1 to receive up to 6 cycles of A+AVD (n = 664) or ABVD (n = 670) on day 1 and 15 every 28 days. OS was the key secondary endpoint and was an event-driven, pre-specified, alpha-controlled analysis in the intention to treat population. Results: At a median follow-up of 73 months, 39 and 64 OS events occurred in A+AVD and ABVD arms, respectively: OS significantly favored A+AVD vs ABVD (HR 0.590; 95% confidence interval [CI] 0.396–0.879; p = 0.009). Estimated 6-year OS rates (95% CI) were 93.9% (91.6–95.5) vs 89.4% (86.6–91.7) with A+AVD vs ABVD, respectively. There was a consistent OS benefit for A+AVD vs ABVD across prespecified subgroups. The 6-year PFS estimate was 82.3% (79.1–85.0) vs 74.5% (70.8–77.7) with A+AVD vs ABVD, respectively (HR 0.678 [95% CI 0.532–0.863]). Overall, A+AVD had a comparable long-term safety profile to ABVD. Treatment-emergent peripheral neuropathy continued to resolve or improve in both arms, with 86% (379/443) and 87% (249/286) of cases in the A+AVD and ABVD arms either completely resolving (72% vs 79%) or improving (14% vs 8%) by last follow-up. Fewer second malignancies were reported in the A+AVD vs ABVD arm (23 vs 32). More female patients reported pregnancy (49 vs 28) or live births (42 vs 19 in females) in the A+AVD vs the ABVD arm; no stillbirths were reported. No new safety signals were identified. Conclusions: A+AVD treatment resulted in a statistically significant 41% reduction in the risk of death vs ABVD, with a manageable safety profile consistent with prior reports. These outcomes confirm A+AVD as a preferred option for pts with previously untreated stage III/IV cHL. Clinical trial information: NCT01712490.
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Affiliation(s)
| | - Joseph M. Connors
- BC Cancer Centre for Lymphoid Cancer and Department of Medical Oncology, Vancouver, BC, Canada
| | - John A. Radford
- University of Manchester, Christie Hospital NHS Foundation Trust, Manchester, United Kingdom
| | - Won Seog Kim
- Division of Hematology-Oncology, Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Andrea Gallamini
- Research Innovation and Statistics, Antoine-Lacassagne Cancer Centre, Nice, France
| | | | - Jonathan W. Friedberg
- James P. Wilmot Cancer Institute, University of Rochester Medical Center, Rochester, NY
| | - Ranjana H. Advani
- Department of Medicine, Division of Oncology, Stanford University, Stanford, CA
| | - Martin Hutchings
- Department of Hematology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Andrew M. Evens
- Division of Blood Disorders, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ
| | - Piotr Smolewski
- Department of Experimental Hematology, Medical University of Lodz, Lodz, Poland
| | - Kerry J. Savage
- BC Cancer Centre for Lymphoid Cancer and Department of Medical Oncology, Vancouver, BC, Canada
| | - Nancy L. Bartlett
- Washington University School of Medicine Siteman Cancer Center, St. Louis, MO
| | - Hyeon Seok Eom
- Center for Hematologic Malignancy, National Cancer Center, Goyang, South Korea
| | | | - Cassie Dong
- Takeda Development Center Americas, Inc. (TDCA), Lexington, MA
| | - Frank Campana
- Takeda Development Center Americas, Inc. (TDCA), Lexington, MA
| | | | | | - David J. Straus
- Department of Medicine, Lymphoma Service, Memorial Sloan Kettering Cancer Center, New York, NY
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9
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Joffe E, Nowakowski G, Tun H, Rosenthal A, Lunning M, Ramchandren R, Li CC, Zhou L, Martinez E, von Roemeling R, Earhart R, McMahon M, Isufi I, Leslie L. P1121: TAKEAIM LYMPHOMA- AN OPEN-LABEL, DOSE ESCALATION AND EXPANSION TRIAL OF EMAVUSERTIB (CA-4948) IN COMBINATION WITH IBRUTINIB IN PATIENTS WITH RELAPSED OR REFRACTORY HEMATOLOGIC MALIGNANCIES. Hemasphere 2022. [PMCID: PMC9430533 DOI: 10.1097/01.hs9.0000847352.16311.ea] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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10
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Joffe E, Nowakowski GS, Tun HW, Rosenthal AC, Lunning MA, Ramchandren R, Li CC, Zhou L, Martinez E, Von Roemeling RW, Earhart RH, McMahon M, Isufi I, Leslie LA. Open-label, dose-escalation, and expansion trial of CA-4948 in combination with ibrutinib in patients with relapsed or refractory hematologic malignancies. J Clin Oncol 2022. [DOI: 10.1200/jco.2022.40.16_suppl.7575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
7575 Background: CA-4948 is a novel oral inhibitor of interleukin-1 receptor-associated kinase 4 (IRAK4), which is essential for toll-like receptor (TLR) and interleukin-1 receptor (IL-1R) signaling in B cell proliferation. IRAK4 forms a Myddosome complex with MYD88 adaptor protein and drives overactivation of nuclear factor-kappa B (NF-κB), causing inflammation and tumor growth. CA-4948 has been reported to be well tolerated and active as monotherapy in heavily pretreated patients with relapsed/refractory (R/R) non-Hodgkin lymphoma (NHL). Preclinical studies demonstrated that tumor resistance and survival via IRAK4 activation could be delayed or reversed. CA-4948 crossed the blood-brain barrier in a murine PDX model of pCNS lymphoma, resulting in tumor response and prolonged survival. In combination with Bruton tyrosine kinase (BTK) inhibitors, CA-4948 showed in vivo synergy in B-cell NHL. Here we will present an update on the preliminary efficacy data of CA-4948+ibrutinib in R/R hematologic malignancies. Methods: This is an ongoing open-label trial (NCT03328078) of CA-4948 as monotherapy and in combination with ibrutinib. Part A1 (completed) dose escalation of CA-4948 as monotherapy; the recommended phase 2 dose (RP2D) is 300 mg BID with continuous oral dosing. Part A2 (dose escalation in combination with ibrutinib), and Part B (a basket design of 4 expansion cohorts of CA-4948 and ibrutinib: BTK-naïve MZL, DLBCL, or PCNSL and NHL with adaptive resistance to ibrutinib). The primary endpoints of Parts A1 and A2 include safety, tolerability, and RP2D. The primary endpoints of Part B include CR or ORR, with key secondary endpoints of DOR, DCR, PFS and OS following treatment of CA-4948 at dose levels of 200 (DL1) or 300 mg BID (DL2) with ibrutinib at full prescribed dose. Results: As of December 7th, 2021, 35 heavily pretreated NHL patients have received CA-4948 monotherapy (median age 66 years, range 50-87), of which six patients have been on CA-4948 for approximately 1 year or longer, suggesting CA-4948 has a long-term acceptable safety and tolerability profile at RP2D (dose level of 300 mg BID). In Part A2, 10 patients are treated with CA-4948+ibrutinib (median age 65 years, range 56-82). Median number of prior lines of anti-cancer therapies is 3 (range 1-8). No DLTs were observed at 200 or 300 mg dose levels to date. The preliminary efficacy data of seven evaluable patients with combination therapy showed 1 CR (MCL), 2 PR (MCL and MZL), 3 SD, and 1 PD, 3 of whom had failed prior ibrutinib. The preliminary data indicate the combination therapy may overcome ibrutinib resistance. Conclusions: CA-4948 as a monotherapy and in combination with ibrutinib is well tolerated with an acceptable long term safety profile and promising efficacy. Part A2 is transitioning to Part B basket cohorts of MZL, ABC-DLBCL, PCNSL and NHL with adaptive resistance to ibrutinib. Clinical trial information: 03328078.
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Affiliation(s)
- Erel Joffe
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY
| | | | - Han W. Tun
- Division of Hematology/Oncology, Mayo Clinic, Jacksonville, FL
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Patel K, Orlowski RZ, Doucette K, Maris M, Pianko MJ, Ramchandren R, Stevens DA, Vesole DH, Uger RA, Scheuber A, Molloy N, Bruns I, Lesokhin AM. TTI-622-01: A phase 1a/1b dose-escalation and expansion trial of TTI-622 in patients with advanced hematologic malignancies, including multiple myeloma. J Clin Oncol 2022. [DOI: 10.1200/jco.2022.40.16_suppl.tps8071] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
TPS8071 Background: CD47 is an innate immune checkpoint that binds signal regulatory protein alpha (SIRPα) and delivers a "don’t eat me" signal to suppress macrophage phagocytosis. TTI-622 is a fusion protein consisting of the CD47-binding domain of human SIRPα linked to the Fc region of human IgG4. It is designed to enhance phagocytosis and antitumor activity by preventing CD47 from delivering its inhibitory signal as well as generating a moderate pro-phagocytic signal via IgG4 Fc. CD47 is significantly increased in multiple myeloma (MM) bone marrow mononuclear cells and expression inversely correlates with survival in patients. Relapsed/Refractory (R/R) MM shows particularly high expression of CD47. Preclinical studies demonstrate that the addition of proteasome inhibitors to CD47 blockade significantly increases phagocytosis of MM cells in vitro and anti-myeloma activity in vivo. The ongoing phase 1a part of this study has been previously described. The phase 1b part of the study will determine the safety and efficacy of TTI-622 when given as monotherapy or in combination with selected approved anticancer treatments in patients with hematological malignancies where new treatments with novel mechanism of action are needed. Here we describe 5 RRMM cohorts within phase 1b of the study. Methods: TTI-622-01 is a multi-center Phase 1a/1b study. Phase 1a was designed to determine the MTD, pharmacokinetics (PK), pharmacodynamics, and preliminary antitumor activity of QW, Q2W, and Q3W single-agent TTI-622 in R/R lymphoma using a 3+3 dose escalation schema. Phase 1b, ongoing, will determine the safety and recommended dose of TTI-622 to be given as single agent and in combination with carfilzomib + dexamethasone (Kd) in RRMM and will evaluate the preliminary efficacy. Secondary objectives are to further characterize the safety, PK and immunogenicity of TTI-622 when combined with Kd. Patients will be enrolled in 5 separate cohorts: 3 cohorts will explore different doses and administration schedules of TTI-622 combined with the approved dose of Kd; 2 cohorts will explore different doses of TTI-622 monotherapy. Cohorts will be opened in a staggered manner. In each cohort 3 patients will be dosed and followed for 28 days (21 days in the monotherapy) before expanding enrolment to approximately an additional 27 patients. Key eligibility criteria include: relapse or progression following ≥3 prior lines of therapy (including a proteasome inhibitor, an immunomodulatory drug, and an anti-CD38 antibody), carfilzomib-refractory progressive and measurable disease per IMWG at study entry; age ≥18 years; ECOG performance status ≤2; adequate organ functions; no known CNS involvement; no prior anti-CD47 or anti-SIRPα therapy. Patient recruitment is planned or ongoing at 40 sites worldwide. Clinical trial information: NCT03530683.
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Affiliation(s)
| | | | | | - Michael Maris
- Colorado Blood Cancer Institute and Sarah Cannon Research Institute, Denver, CO
| | | | | | | | | | - Robert A. Uger
- Trillium Therapeutics Inc., a Pfizer Company, Mississauga, ON, Canada
| | - Anita Scheuber
- Trillium Therapeutics Inc., a Pfizer Company, Mississauga, ON, Canada
| | - Naomi Molloy
- Trillium Therapeutics, a Pfizer Company, Mississauga, ON, Canada
| | - Ingmar Bruns
- Trillium Therapeutics Inc., a Pfizer Company, Mississauga, ON, Canada
| | - Alexander M. Lesokhin
- Myeloma Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY
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12
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Shah H, Jang H, Singh P, Kosti J, Kin A, Alavi A, Ratanatharathorn V, Ayash L, Uberti J, Ramchandren R, Kim S, Deol A. Improved post-ASCT survival of relapsed/refractory classical Hodgkin lymphoma patients in the era of novel agents. Leuk Lymphoma 2021; 63:813-820. [PMID: 34781825 DOI: 10.1080/10428194.2021.2002322] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Utilization of novel agents such as brentuximab vedotin (BV) and check-point inhibitors (CI) has increased in patients with relapsed/refractory (r/r) classical Hodgkin Lymphoma (cHL). We conducted a retrospective study of 209 patients who had ASCT for r/r cHL at our institution and compared outcomes of those who had ASCT from 2010-2018 (cohort 2, n = 110) with those who had ASCT between 2000 and 2009 (cohort 1, n = 99). The median OS was 7.6 years for cohort 1 [HR 2.08; 95% CI 1.14-3.80; p = 0.017] and not reached for cohort 2; with 4-year improved OS difference of 15% (80% vs 65%) in cohort 2 vs cohort 1. The median PFS of cohort 1 was 30 months vs 39 months for cohort 2[HR 1.24; 95% CI 0.82-1.88; p = 0.3]. This study highlights improved OS of r/r cHL patients who have received ASCT in the novel agent era due to the exposure to agents such as BV and CIs.
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Affiliation(s)
- Harsh Shah
- Huntsman Cancer Center, University of Utah, Salt Lake City, UT, USA
| | - Hyejeong Jang
- Karmanos Cancer Institute, Wayne State University, Detroit, MI, USA
| | - Paramveer Singh
- Karmanos Cancer Institute, Wayne State University, Detroit, MI, USA
| | - Jorgena Kosti
- Karmanos Cancer Institute, Wayne State University, Detroit, MI, USA
| | - Andrew Kin
- Karmanos Cancer Institute, Wayne State University, Detroit, MI, USA
| | - Asif Alavi
- Karmanos Cancer Institute, Wayne State University, Detroit, MI, USA
| | | | - Lois Ayash
- Karmanos Cancer Institute, Wayne State University, Detroit, MI, USA
| | - Joseph Uberti
- Karmanos Cancer Institute, Wayne State University, Detroit, MI, USA
| | | | - Seongho Kim
- Karmanos Cancer Institute, Wayne State University, Detroit, MI, USA
| | - Abhinav Deol
- Karmanos Cancer Institute, Wayne State University, Detroit, MI, USA
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13
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Wang M, Ramchandren R, Chen R, Karlin L, Chong G, Jurczak W, Wu KL, Bishton M, Collins GP, Eliadis P, Peyrade F, Lee Y, Eckert K, Neuenburg JK, Tam CS. Concurrent ibrutinib plus venetoclax in relapsed/refractory mantle cell lymphoma: the safety run-in of the phase 3 SYMPATICO study. J Hematol Oncol 2021; 14:179. [PMID: 34717692 PMCID: PMC8556975 DOI: 10.1186/s13045-021-01188-x] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Accepted: 10/12/2021] [Indexed: 12/26/2022] Open
Abstract
Ibrutinib plus venetoclax, given with an ibrutinib lead-in, has shown encouraging clinical activity in early phase studies in mantle cell lymphoma (MCL). The ongoing phase 3 SYMPATICO study evaluates the safety and efficacy of concurrently administered, once-daily, all-oral ibrutinib plus venetoclax in patients with relapsed/refractory MCL. A safety run-in (SRI) cohort was conducted to inform whether an ibrutinib lead-in should be implemented for the randomized portion. Patients received concurrent ibrutinib 560 mg continuously plus venetoclax in a 5-week ramp-up to venetoclax 400 mg for up to 2 years. The primary endpoint was occurrence of tumor lysis syndrome (TLS) and dose-limiting toxicities (DLTs). The SRI cohort enrolled 21 patients; six and 15 were in low- or increased-risk categories for TLS, respectively. During the 5-week venetoclax ramp-up, three patients had DLTs, and one patient at increased risk for TLS had a laboratory TLS; no additional TLS events occurred during follow-up. With a median follow-up of 31 months, the overall response rate was 81% (17/21); 62% (13/21) of patients had a complete response. SRI data informed that the randomized portion should proceed with concurrent ibrutinib plus venetoclax, with no ibrutinib lead-in. Ibrutinib plus venetoclax demonstrated promising efficacy; no new safety signals were observed.Trial registration: ClinicalTrials.gov, NCT03112174. Registered 13 April 2017, https://clinicaltrials.gov/ct2/show/NCT03112174 .
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Affiliation(s)
- Michael Wang
- Department of Lymphoma and Myeloma, University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd #368, Houston, TX, 77030, USA.
| | | | - Robert Chen
- City of Hope National Medical Center, Duarte, CA, USA
| | | | - Geoffrey Chong
- Olivia Newton-John Cancer Centre, Heidelberg, VIC, Australia
| | - Wojciech Jurczak
- Sklodowska Curie National Research Institute of Oncology, Kraków, Poland
| | - Ka Lung Wu
- Ziekenhuis Netwerk Antwerpen, Antwerp, Belgium
| | - Mark Bishton
- Nottinghamshire University Hospitals, Nottingham, UK
| | - Graham P Collins
- NIHR Oxford Biomedical Research Centre, Churchill Hospital, Oxford, UK
| | - Paul Eliadis
- Icon Cancer Centre, South Brisbane, QLD, Australia
| | | | - Yihua Lee
- Pharmacyclics LLC, an AbbVie Company, Sunnyvale, CA, USA
| | - Karl Eckert
- Pharmacyclics LLC, an AbbVie Company, Sunnyvale, CA, USA
| | | | - Constantine S Tam
- Peter MacCallum Cancer Centre, Royal Melbourne Hospital, St Vincent's Hospital, University of Melbourne, Melbourne, VIC, Australia
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14
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Merryman RW, Castagna L, Giordano L, Ho VT, Corradini P, Guidetti A, Casadei B, Bond DA, Jaglowski S, Spinner MA, Arai S, Lowsky R, Shah GL, Perales MA, De Colella JMS, Blaise D, Herrera AF, Shouse G, Spilleboudt C, Ansell SM, Nieto Y, Badar T, Hamadani M, Feldman TA, Dahncke L, Singh AK, McGuirk JP, Nishihori T, Chavez J, Serritella AV, Kline J, Mohty M, Dulery R, Stamatoulas A, Houot R, Manson G, Moles-Moreau MP, Orvain C, Bouabdallah K, Modi D, Ramchandren R, Lekakis L, Beitinjaneh A, Frigault MJ, Chen YB, Lynch RC, Smith SD, Rao U, Byrne M, Romancik JT, Cohen JB, Nathan S, Phillips T, Joyce RM, Rahimian M, Bashey A, Ballard HJ, Svoboda J, Torri V, Sollini M, De Philippis C, Magagnoli M, Santoro A, Armand P, Zinzani PL, Carlo-Stella C. Allogeneic transplantation after PD-1 blockade for classic Hodgkin lymphoma. Leukemia 2021; 35:2672-2683. [PMID: 33658659 DOI: 10.1038/s41375-021-01193-6] [Citation(s) in RCA: 42] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Revised: 01/19/2021] [Accepted: 02/08/2021] [Indexed: 12/17/2022]
Abstract
Anti-PD-1 monoclonal antibodies yield high response rates in patients with relapsed/refractory classic Hodgkin lymphoma (cHL), but most patients will eventually progress. Allogeneic hematopoietic cell transplantation (alloHCT) after PD-1 blockade may be associated with increased toxicity, raising challenging questions about the role, timing, and optimal method of transplantation in this setting. To address these questions, we assembled a retrospective cohort of 209 cHL patients who underwent alloHCT after PD-1 blockade. With a median follow-up among survivors of 24 months, the 2-year cumulative incidences (CIs) of non-relapse mortality and relapse were 14 and 18%, respectively; the 2-year graft-versus-host disease (GVHD) and relapse-free survival (GRFS), progression-free survival (PFS), and overall survival were 47%, 69%, and 82%, respectively. The 180-day CI of grade 3-4 acute GVHD was 15%, while the 2-year CI of chronic GVHD was 34%. In multivariable analyses, a longer interval from PD-1 to alloHCT was associated with less frequent severe acute GVHD, while additional treatment between PD-1 and alloHCT was associated with a higher risk of relapse. Notably, post-transplant cyclophosphamide (PTCy)-based GVHD prophylaxis was associated with significant improvements in PFS and GRFS. While awaiting prospective clinical trials, PTCy-based GVHD prophylaxis may be considered the optimal transplantation strategy for this patient population.
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Affiliation(s)
- Reid W Merryman
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA.
| | - Luca Castagna
- Department of Oncology and Hematology, Humanitas Clinical and Research Center-IRCCS, Rozzano-Milano, Italy
| | - Laura Giordano
- Department of Oncology and Hematology, Humanitas Clinical and Research Center-IRCCS, Rozzano-Milano, Italy
| | - Vincent T Ho
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Paolo Corradini
- Division of Hematology and Bone Marrow Transplantation, Fondazione IRCCS Istituto Nazionale dei Tumori, University of Milano, Milano, Italy
| | - Anna Guidetti
- Division of Hematology and Bone Marrow Transplantation, Fondazione IRCCS Istituto Nazionale dei Tumori, University of Milano, Milano, Italy
| | - Beatrice Casadei
- Istituto di Ematologia "Seràgnoli", Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale Università Degli Studi, Bologna, Italia
| | - David A Bond
- Division of Hematology, The Ohio State University, Columbus, OH, USA
| | | | - Michael A Spinner
- Department of Medicine, Stanford University Medical Center, Stanford, CA, USA
| | - Sally Arai
- Department of Medicine, Stanford University Medical Center, Stanford, CA, USA
| | - Robert Lowsky
- Department of Medicine, Stanford University Medical Center, Stanford, CA, USA
| | - Gunjan L Shah
- Department of Medicine, Adult Bone Marrow Transplantation Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Miguel-Angel Perales
- Department of Medicine, Adult Bone Marrow Transplantation Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Jean Marc Schiano De Colella
- Programme de Transplantation & Therapie Cellulaire, Centre de Recherche en Cancérologie de Marseille, Institut Paoli Calmettes, Marseille, France
| | - Didier Blaise
- Institut Paoli-Calmettes, Aix Marseille University, CNRS, INSERM, CRCM, Marseille, France
| | - Alex F Herrera
- Department of Hematology and Hematopoietic Cell Transplantation, City of Hope, Duarte, CA, USA
| | - Geoffrey Shouse
- Department of Hematology and Hematopoietic Cell Transplantation, City of Hope, Duarte, CA, USA
| | | | | | - Yago Nieto
- Department of Stem Cell Transplantation and Cellular Therapy, The University of Texas M.D. Anderson Cancer Center, Houston, TX, USA
| | - Talha Badar
- Division of Hematology and Oncology, Mayo Clinic, Jacksonville, FL, USA
| | - Mehdi Hamadani
- BMT & Cellular Therapy Program, Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Tatyana A Feldman
- John Theurer Cancer Center at HMH, Hackensack Meridian Health School of Medicine, Hackensack, NJ, USA
| | - Lori Dahncke
- John Theurer Cancer Center at HMH, Hackensack Meridian Health School of Medicine, Hackensack, NJ, USA
| | - Anurag K Singh
- Division of Hematologic Malignancies & Cellular Therapeutics, University of Kansas Medical Center, Westwood, KS, USA
| | - Joseph P McGuirk
- Division of Hematologic Malignancies & Cellular Therapeutics, University of Kansas Medical Center, Westwood, KS, USA
| | - Taiga Nishihori
- Department of Blood & Marrow Transplant and Cellular Immunotherapy, Moffitt Cancer Center, Tampa, FL, USA
| | - Julio Chavez
- Department of Blood & Marrow Transplant and Cellular Immunotherapy, Moffitt Cancer Center, Tampa, FL, USA
| | - Anthony V Serritella
- Department of Medicine, Section of Hematology/Oncology, University of Chicago, Chicago, IL, USA
| | - Justin Kline
- Department of Medicine, Section of Hematology/Oncology, University of Chicago, Chicago, IL, USA
| | - Mohamad Mohty
- Service d'Hématologie Clinique et de Thérapie Cellulaire, Hospital Saint Antoine, Sorbonne University, Paris, France
| | - Remy Dulery
- Department of Hematology, Centre Henri Becquerel, Rouen, France
| | | | - Roch Houot
- Department of Hematology, CHU Rennes, University of Rennes, Inserm U1236, Rennes, France
| | - Guillaume Manson
- Department of Hematology, CHU Rennes, University of Rennes, Inserm U1236, Rennes, France
| | | | | | | | - Dipenkumar Modi
- Department of Oncology, Karmanos Cancer Institute/Wayne State University, Detroit, MI, USA
| | | | - Lazaros Lekakis
- Division of Transplantation and Cellular Therapy, University of Miami/Sylvester Cancer Center, Miami, FL, USA
| | - Amer Beitinjaneh
- Division of Transplantation and Cellular Therapy, University of Miami/Sylvester Cancer Center, Miami, FL, USA
| | - Matthew J Frigault
- Blood and Marrow Transplant Program, Massachusetts General Hospital, Boston, MA, USA
| | - Yi-Bin Chen
- Blood and Marrow Transplant Program, Massachusetts General Hospital, Boston, MA, USA
| | - Ryan C Lynch
- University of Washington/Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Stephen D Smith
- University of Washington/Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Uttam Rao
- Department of Medicine, Division of Hematology-Oncology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Michael Byrne
- Department of Medicine, Division of Hematology-Oncology, Vanderbilt University Medical Center, Nashville, TN, USA
| | | | | | - Sunita Nathan
- Section of Bone Marrow Transplant and Cell Therapy, Rush University Medical Center, Chicago, IL, USA
| | - Tycel Phillips
- Division of Hematology and Oncology, University of Michigan, Ann Arbor, MI, USA
| | - Robin M Joyce
- Division of Hematologic Malignancy, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Maryam Rahimian
- Division of Hematologic Malignancy, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Asad Bashey
- Blood and Marrow Transplant Program at Northside Hospital, Atlanta, GA, USA
| | - Hatcher J Ballard
- Division of Hematology-Oncology, Department of Medicine, Hospital of the University of Pennsylvania, Philadelphia, PA, USA
| | - Jakub Svoboda
- Division of Hematology-Oncology, Department of Medicine, Hospital of the University of Pennsylvania, Philadelphia, PA, USA
| | - Valter Torri
- Laboratory of Methodology of Clinical Research, Oncology Department. IRCCS Mario Negri Institute, Milano, Italy
| | - Martina Sollini
- Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italia
| | - Chiara De Philippis
- Department of Oncology and Hematology, Humanitas Clinical and Research Center-IRCCS, Rozzano-Milano, Italy
| | - Massimo Magagnoli
- Department of Oncology and Hematology, Humanitas Clinical and Research Center-IRCCS, Rozzano-Milano, Italy
| | - Armando Santoro
- Department of Oncology and Hematology, Humanitas Clinical and Research Center-IRCCS, Rozzano-Milano, Italy
| | - Philippe Armand
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Pier Luigi Zinzani
- Istituto di Ematologia "Seràgnoli", Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale Università Degli Studi, Bologna, Italia
- Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italia
| | - Carmelo Carlo-Stella
- Department of Oncology and Hematology, Humanitas Clinical and Research Center-IRCCS, Rozzano-Milano, Italy
- Department of Biomedical Sciences, Humanitas University, Rozzano-Milan, Italy
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15
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Landsburg DJ, Barta SK, Ramchandren R, Batlevi C, Iyer S, Kelly K, Micallef IN, Smith SM, Stevens DA, Alvarez M, Califano A, Shen Y, Bosker G, Parker J, Soikes R, Martinez E, von Roemeling R, Martell RE, Oki Y. Fimepinostat (CUDC-907) in patients with relapsed/refractory diffuse large B cell and high-grade B-cell lymphoma: report of a phase 2 trial and exploratory biomarker analyses. Br J Haematol 2021; 195:201-209. [PMID: 34341990 DOI: 10.1111/bjh.17730] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Accepted: 07/13/2021] [Indexed: 12/28/2022]
Abstract
Fimepinostat (CUDC-907), a first-in-class oral small-molecule inhibitor of histone deacetylase and phosphatidylinositol 3-kinase, demonstrated efficacy in a phase 1 study of patients with relapsed/refractory (R/R) diffuse large and high-grade B-cell lymphomas (DLBCL/HGBL), particularly those with increased MYC protein expression and/or MYC gene rearrangement/copy number gain (MYC-altered disease). Therefore, a phase 2 study of fimepinostat was conducted in this patient population with 66 eligible patients treated. The primary end-point of overall response (OR) rate for patients with MYC-IHC ≥40% (n = 46) was 15%. Subsequently, exploratory pooled analyses were performed including patients treated on both the phase 1 and 2 studies based upon the presence of MYC-altered disease as well as a biomarker identified by Virtual Inference of Protein activity by Enriched Regulon analysis (VIPER). For these patients with MYC-altered disease (n = 63), the overall response (OR) rate was 22% with seven responding patients remaining on treatment for approximately two years or longer, and VIPER yielded a three-protein biomarker classification with positive and negative predictive values of ≥85%. Prolonged durations of response were achieved by patients with MYC-altered R/R DLBCL/HGBL treated with single-agent fimepinostat. Combination therapies and/or biomarker-based patient selection strategies may lead to higher response rates in future clinical trials.
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Affiliation(s)
| | - Stefan K Barta
- University of Pennsylvania, Philadelphia, PA, USA.,Fox Chase Cancer Center, Philadelphia, PA, USA
| | | | - Connie Batlevi
- Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Swaminathan Iyer
- MD Anderson Cancer Center, Houston, TX, USA.,Houston Methodist Hospital, Houston, TX, USA
| | - Kevin Kelly
- University of Southern California, Los Angeles, CA, USA
| | | | | | | | | | | | - Yao Shen
- DarwinHealth, Inc, New York, NY, USA
| | | | | | | | | | | | | | - Yasuhiro Oki
- MD Anderson Cancer Center, Houston, TX, USA.,Genentech, San Francisco, CA, USA
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16
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Straus DJ, Długosz-Danecka M, Connors JM, Alekseev S, Illés Á, Picardi M, Lech-Maranda E, Feldman T, Smolewski P, Savage KJ, Bartlett NL, Walewski J, Ramchandren R, Zinzani PL, Hutchings M, Munoz J, Lee HJ, Kim WS, Advani R, Ansell SM, Younes A, Gallamini A, Liu R, Little M, Fenton K, Fanale M, Radford J. Brentuximab vedotin with chemotherapy for stage III or IV classical Hodgkin lymphoma (ECHELON-1): 5-year update of an international, open-label, randomised, phase 3 trial. Lancet Haematol 2021; 8:e410-e421. [PMID: 34048680 DOI: 10.1016/s2352-3026(21)00102-2] [Citation(s) in RCA: 64] [Impact Index Per Article: 21.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Revised: 03/17/2021] [Accepted: 03/18/2021] [Indexed: 12/23/2022]
Abstract
BACKGROUND Despite advances in the treatment of Hodgkin lymphoma with the introduction of PET-adapted regimens, practical challenges prevent more widespread use of these approaches. The ECHELON-1 study assessed the safety and efficacy of front-line A+AVD (brentuximab vedotin, doxorubicin, vinblastine, and dacarbazine) versus ABVD (doxorubicin, bleomycin, vinblastine, and dacarbazine) in patients with stage III or IV classical Hodgkin lymphoma. The primary analysis showed improved modified progression-free survival with A+AVD. We present an updated analysis of ECHELON-1 at 5 years, an important landmark for this patient population. METHODS ECHELON-1 was an international, open-label, randomised, phase 3 trial done at 218 clinical sites, including hospitals, cancer centres, and community clinics, in 21 countries. Previously untreated patients (≥18 years with an Eastern Cooperative Oncology Group performance status of ≤2) with stage III or IV classical Hodgkin lymphoma were randomly assigned (1:1) to receive A+AVD (brentuximab vedotin, 1·2 mg/kg of bodyweight, doxorubicin 25 mg/m2 of body surface area, vinblastine 6 mg/m2, and dacarbazine 375 mg/m2) or ABVD (doxorubicin 25 mg/m2, bleomycin 10 U/m2, vinblastine 6 mg/m2, and dacarbazine 375 mg/m2) intravenously on days 1 and 15 of each 28-day cycle for up to six cycles. Stratification factors included region (Americas vs Europe vs Asia) and International Prognostic Score risk group (low, intermediate, or high risk). The primary endpoint was modified progression-free survival; this 5-year update includes analysis of progression-free survival as per investigator assessment in the intention-to-treat population, which was an exploratory endpoint, although the 5-year analysis was not prespecified in the protocol. This trial is registered with ClinicalTrials.gov (NCT01712490) and EudraCT (2011-005450-60), and is ongoing. FINDINGS Between Nov 19, 2012, and Jan 13, 2016, 1334 patients were randomly assigned to receive A+AVD (n=664) or ABVD (n=670). At a median follow-up of 60·9 months (IQR 52·2-67·3), 5-year progression-free survival was 82·2% (95% CI 79·0-85·0) with A+AVD and 75·3% (71·7-78·5) with ABVD (hazard ratio [HR] 0·68 [95% CI 0·53-0·87]; p=0·0017). Among PET-2-negative patients, 5-year progression-free survival was higher with A+AVD than with ABVD (84·9% [95% CI 81·7-87·6] vs 78·9% [75·2-82·1]; HR 0·66 [95% CI 0·50-0·88]; p=0·0035). 5-year progression-free survival for PET-2-positive patients was 60·6% (95% CI 45·0-73·1) with A+AVD versus 45·9% (32·7-58·2) with ABVD (HR 0·70 [95% CI 0·39-1·26]; p=0·23). Peripheral neuropathy continued to improve or resolve over time with both A+AVD (375 [85%] of 443 patients) and ABVD (245 [86%] of 286 patients); more patients had ongoing peripheral neuropathy in the A+AVD group (127 [19%] of 662) than in the ABVD group (59 [9%] of 659). Fewer secondary malignancies were reported with A+AVD (19 [3%] of 662) than with ABVD (29 [4%] of 659). More livebirths were reported in the A+AVD group (n=75) than in the ABVD group (n=50). INTERPRETATION With 5 years of follow-up, A+AVD showed robust and durable improvement in progression-free survival versus ABVD, regardless of PET-2 status, and a consistent safety profile. On the basis of these findings, A+AVD should be preferred over ABVD for patients with previously untreated stage III or IV classical Hodgkin lymphoma. FUNDING Millennium Pharmaceuticals (a wholly owned subsidiary of Takeda Pharmaceutical Company), and Seagen.
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Affiliation(s)
- David J Straus
- Department of Medicine, Lymphoma Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
| | - Monika Długosz-Danecka
- Department of Clinical Oncology, Maria Skłodowska-Curie National Research Institute of Oncology, Kraków, Poland
| | - Joseph M Connors
- Centre for Lymphoid Cancer and Department of Medical Oncology, BC Cancer, Vancouver, BC, Canada
| | - Sergey Alekseev
- Petrov Research Institute of Oncology, St Petersburg, Russia
| | | | - Marco Picardi
- Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy
| | - Ewa Lech-Maranda
- Department of Hematology, Institute of Hematology and Transfusion Medicine, Warsaw, Poland
| | - Tatyana Feldman
- John Theurer Cancer Center, Hackensack Meridian Health School of Medicine, Hackensack, NJ, USA
| | | | - Kerry J Savage
- Centre for Lymphoid Cancer and Department of Medical Oncology, BC Cancer, Vancouver, BC, Canada
| | - Nancy L Bartlett
- Washington University School of Medicine Siteman Cancer Center, St Louis, MO, USA
| | - Jan Walewski
- Maria Sklodowska-Curie National Research Institute of Oncology, European Reference Network, Warszawa, Poland
| | | | - Pier Luigi Zinzani
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia Seràgnoli, Bologna, Italy; Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale, Università degli Studi, Bologna, Italy
| | - Martin Hutchings
- Department of Haematology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Javier Munoz
- Banner MD Anderson Cancer Center, Gilbert, AZ, USA
| | - Hun Ju Lee
- University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Won Seog Kim
- Division of Hematology-Oncology, Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Ranjana Advani
- Department of Medicine, Division of Oncology, Stanford University, Stanford, CA, USA
| | | | - Anas Younes
- Department of Medicine, Lymphoma Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA; AstraZeneca Pharmaceuticals, LP Wilmington, DE, USA
| | - Andrea Gallamini
- Research Innovation and Statistics, Antoine-Lacassagne Cancer Centre, Nice, France
| | - Rachael Liu
- Millennium Pharmaceuticals, a wholly owned subsidiary of Takeda Pharmaceuticals, Cambridge, MA, USA
| | - Meredith Little
- Millennium Pharmaceuticals, a wholly owned subsidiary of Takeda Pharmaceuticals, Cambridge, MA, USA
| | | | | | - John Radford
- University of Manchester and the Christie NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK
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Joffe E, Ramchandren R, Nowakowski G, Rosenthal A, Tun HW, Lunning M, Mead MD, Martinez E, von Roemeling R, Leslie L. AN OPEN‐LABEL TRIAL OF ORAL CA‐4948 AN IRAK4 INHIBITOR COMBINED WITH IBRUTINIB IN ADULT PATIENTS WITH RELAPSED OR REFRACTORY HEMATOLOGIC MALIGNANCIES. Hematol Oncol 2021. [DOI: 10.1002/hon.169_2880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- E. Joffe
- Memorial Sloan Kettering Cancer Center Hematology Oncology‐ Lymphoma Services NY New York USA
| | - R. Ramchandren
- University of Tennessee Medical Center‐ University Cancer Specialists Hematology Medical Oncology Knoxville Tennessee USA
| | - G. Nowakowski
- Mayo Clinic‐Minnesota Rochester MN, Hematology ‐ Cancer Center Rochester Minnesota USA
| | - A. Rosenthal
- Mayo Clinic‐Arizona, Hematology Phoenix Arizona USA
| | - H. W. Tun
- Mayo Clinic Florida Hematology Oncology‐ Caner Center Jacksonville Florida USA
| | - M. Lunning
- University of Nebraska Division of Oncology & Hematology Omaha Nebraska USA
| | - M. D. Mead
- University of California Los Angeles‐ Santa Monica Medical Center Medicine, Hematology and Oncology Santa Monica California USA
| | - E. Martinez
- Curis, Clinical Development Lexington Massachusetts USA
| | | | - L. Leslie
- John Theurer Cancer Center Hackensack, NJ, Hematology Oncology Hackensack New Jersey USA
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Zinzani PL, Raut M, Saretsky T, Ramchandren R, Santoro A, Paszkiewicz‐Kozik E, Gasiorowski R, Johnson NA, Oliveira JSR, Buccheri V, Perini GF, Dickinson M, McDonald A, Ozcan M, Sekiguchi N, Giezek H, Nahar A, Kuruvilla J. HEALTH‐RELATED QUALITY OF LIFE AMONG PATIENTS WITH RELAPSED/REFRACTORY CLASSICAL HODGKIN LYMPHOMA (R/R CHL) IN A PHASE 3 STUDY OF PEMBROLIZUMAB VERSUS BRENTUXIMAB VEDOTIN. Hematol Oncol 2021. [DOI: 10.1002/hon.105_2880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- P. L. Zinzani
- IRCCS Azienda Ospedaliero–Universitaria di Bologna Istituto di Ematologia “Seràgnoli” Dipartimento di Medicina Specialistica Diagnostica e Sperimentale Università di Bologna Specialized, Diagnostic and Experimental Medicine Bologna Italy
| | - M. Raut
- Merck & Co., Inc. Department of Medical Oncology Kenilworth New Jersey USA
| | - T. Saretsky
- Merck & Co., Inc. Department of Medical Oncology Kenilworth New Jersey USA
| | - R. Ramchandren
- University of Tennessee Department of Mediciine Knoxville Tennessee USA
| | - A. Santoro
- Humanitas University and IRCCS Humanitas Research Center Department of Oncology Milan Italy
| | - E. Paszkiewicz‐Kozik
- Maria Sklodowska–Curie National Institute of Oncology Department of Medical Oncology Warsaw Poland
| | - R. Gasiorowski
- Concord Hospital, University of Sydney Department of Hematology Sydney Australia
| | - N. A. Johnson
- Jewish General Hospital Department of Hematology Montreal Canada
| | - J. S. R. Oliveira
- Casa de Saúde Santa Marcelina Department of Medical Oncology São Paulo Brazil
| | - V. Buccheri
- Hospital das Clinicas da Faculdade de Medicina da Universidade de São Paulo Department of Clinical Medicine São Paulo Brazil
| | - G. F. Perini
- Hospital Israelita Albert Einstein Department of Hematology São Paulo Brazil
| | - M. Dickinson
- Peter MacCallum Cancer Centre and Royal Melbourne Hospital Department of Lymphoma Disease Melbourne Australia
| | - A. McDonald
- Pretoria East Hospital Department of Hematology Pretoria South Africa
| | - M. Ozcan
- Ankara University School of Medicine Department of Internal Medicine Ankara Turkey
| | - N. Sekiguchi
- National Hospital Organization Disaster Medical Center Department of Medical Oncology Tokyo Japan
| | - H. Giezek
- Merck & Co., Inc. Department of Medical Oncology Kenilworth New Jersey USA
| | - A. Nahar
- Merck & Co., Inc. Department of Medical Oncology Kenilworth New Jersey USA
| | - J. Kuruvilla
- Princess Margaret Cancer Centre Department of Medical Oncology and Hematology Toronto Canada
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19
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Kuruvilla J, Ramchandren R, Santoro A, Paszkiewicz-Kozik E, Gasiorowski R, Johnson NA, Fogliatto LM, Goncalves I, de Oliveira JSR, Buccheri V, Perini GF, Goldschmidt N, Kriachok I, Dickinson M, Komarnicki M, McDonald A, Ozcan M, Sekiguchi N, Zhu Y, Nahar A, Marinello P, Zinzani PL. Pembrolizumab versus brentuximab vedotin in relapsed or refractory classical Hodgkin lymphoma (KEYNOTE-204): an interim analysis of a multicentre, randomised, open-label, phase 3 study. Lancet Oncol 2021; 22:512-524. [PMID: 33721562 DOI: 10.1016/s1470-2045(21)00005-x] [Citation(s) in RCA: 123] [Impact Index Per Article: 41.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2020] [Revised: 12/10/2020] [Accepted: 12/22/2020] [Indexed: 12/21/2022]
Abstract
BACKGROUND PD-1 blockade via pembrolizumab monotherapy has shown antitumour activity and toxicity in patients with relapsed or refractory classical Hodgkin lymphoma. Here, we present interim analyses from the KEYNOTE-204 study evaluating pembrolizumab versus brentuximab vedotin for relapsed or refractory classical Hodgkin lymphoma. METHODS In this randomised, open-label, phase 3 study, patients aged 18 years or older with relapsed or refractory classical Hodgkin lymphoma with measurable disease and an Eastern Cooperative Oncology Group performance status of 0 or 1 who were ineligible for or had relapsed after autologous haematopoietic stem-cell transplantation (HSCT) were enrolled at 78 hospitals and cancer centres in 20 countries and territories. Patients were randomly assigned (1:1) with an interactive voice response system to pembrolizumab 200 mg intravenously every 3 weeks or brentuximab vedotin 1·8 mg/kg intravenously every 3 weeks. Randomisation was stratified by previous autologous HSCT and status after front-line therapy. Results from the second interim analysis are presented here, with a database cutoff of Jan 16, 2020. The dual primary endpoints assessed in the intention-to-treat population were progression-free survival as assessed by blinded independent central review, and overall survival (not analysed at this interim analysis). Safety was assessed in all patients who received at least one dose of the study drug. This study is registered with ClinicalTrials.gov, NCT02684292. Recruitment for this trial is closed. FINDINGS Between July 8, 2016, and July 13, 2018, 151 patients were randomly assigned to pembrolizumab and 153 to brentuximab vedotin. After a median time from randomisation to data cutoff of 25·7 months (IQR 23·4-33·0), median progression-free survival was 13·2 months (95% CI 10·9-19·4) for pembrolizumab versus 8·3 months (5·7-8·8) for brentuximab vedotin (hazard ratio 0·65 [95% CI 0·48-0·88]; p=0·0027). The most common grade 3-5 treatment-related adverse events were pneumonitis (six [4%] of 148 patients in the pembrolizumab group vs one [1%] of 152 patients in the brentuximab vedotin group), neutropenia (three [2%] vs 11 [7%]), decreased neutrophil count (one [1%] vs seven [5%]), and peripheral neuropathy (one [1%] vs five [3%]). Serious treatment-related adverse events occurred in 24 (16%) of 148 patients receiving pembrolizumab and 16 (11%) of 152 patients receiving brentuximab vedotin. One treatment-related death due to pneumonia occurred in the pembrolizumab group. INTERPRETATION Pembrolizumab showed statistically significant and clinically meaningful improvement in progression-free survival compared with brentuximab vedotin, with safety consistent with previous reports. These data support pembrolizumab as the preferred treatment option for patients with relapsed or refractory classical Hodgkin lymphoma who have relapsed post-autologous HSCT or are ineligible for autologous HSCT. FUNDING Merck Sharp & Dohme Corp (a subsidiary of Merck & Co, Inc, Kenilworth, NJ, USA).
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Affiliation(s)
| | | | - Armando Santoro
- Humanitas University, Department of Biomedical Sciences, Milan, Italy
| | | | | | | | | | - Iara Goncalves
- Fundação Pio XII-Hospital de Câncer de Barretos, São Paulo, Brazil
| | | | - Valeria Buccheri
- Hospital das Clinicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | | | | | | | - Michael Dickinson
- Peter MacCallum Cancer Centre and Royal Melbourne Hospital, Melbourne, VIC, Australia
| | | | | | - Muhit Ozcan
- Ankara University School of Medicine, Ankara, Turkey
| | - Naohiro Sekiguchi
- Department of Hematology, National Hospital Organization Disaster Medical Center, Tokyo, Japan
| | - Ying Zhu
- Concord Hospital, Merck & Co, Kenilworth, NJ, USA
| | - Akash Nahar
- Concord Hospital, Merck & Co, Kenilworth, NJ, USA
| | | | - Pier Luigi Zinzani
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy; Istituto di Ematologia "Seràgnoli", Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale, Università di Bologna, Bologna, Italy
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20
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Carreau NA, Pail O, Armand P, Merryman R, Advani RH, Spinner MA, Herrera A, Chen R, Tomassetti S, Ramchandren R, Hamid MS, Assouline S, Santiago R, Wagner-Johnston N, Paul S, Svoboda J, Bair S, Barta S, Liu Y, Nathan S, Karmali R, Burkart M, Torka P, David K, Wei C, Lansigan F, Emery L, Persky D, Smith S, Godfrey J, Chavez J, Xia Y, Troxel AB, Diefenbach C. Checkpoint Blockade Treatment May Sensitize Hodgkin Lymphoma to Subsequent Therapy. Oncologist 2020; 25:878-885. [PMID: 32720734 DOI: 10.1634/theoncologist.2020-0167] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Accepted: 07/16/2020] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Targeted therapies and checkpoint blockade therapy (CBT) have shown efficacy for patients with Hodgkin lymphoma (HL) in the relapsed and refractory (R/R) setting, but once discontinued owing to progression or side effects, it is unclear how successful further therapies will be. Moreover, there are no data on optimal sequencing of these treatments with standard therapies and other novel agents. In a multicenter, retrospective analysis, we investigated whether exposure to CBT could sensitize HL to subsequent therapy. MATERIALS AND METHODS Seventeen centers across the U.S. and Canada retrospectively queried medical records for eligible patients. The primary aim was to evaluate the overall response rate (ORR) to post-CBT treatment using the Lugano criteria. Secondary aims included progression-free survival (PFS), duration of response, and overall survival (OS). RESULTS Eighty-one patients were included. Seventy-two percent had stage III-IV disease, and the population was heavily pretreated with a median of four therapies before CBT. Most patients (65%) discontinued CBT owing to progression. The ORR to post-CBT therapy was 62%, with a median PFS of 6.3 months and median OS of 21 months. Post-CBT treatment regimens consisted of chemotherapy (44%), targeted agents (19%), immunotherapy (15%), transplant conditioning (14%), chemotherapy/targeted combination (7%), and clinical trials (1%). No significant difference in OS was found when stratified by post-CBT regimen. CONCLUSION In a heavily pretreated R/R HL population, CBT may sensitize patients to subsequent treatment, even after progression on CBT. Post-CBT regimen category did not impact OS. This may be a novel treatment strategy, which warrants further investigation in prospective clinical trials. IMPLICATIONS FOR PRACTICE Novel, life-prolonging treatment strategies in relapsed and refractory (R/R) Hodgkin lymphoma (HL) are greatly desired. The results of this multicenter analysis concur with a smaller, earlier report that checkpoint blockade therapy (CBT) use in R/R HL may sensitize patients to their subsequent treatment. This approach may potentially enhance therapeutic options or to bridge patients to transplant. Prospective data are warranted prior to practice implementation. As more work is done in this area, we may also be able to optimize sequencing of CBT and novel agents in the treatment paradigm to minimize treatment-related toxicity and thus improve patient quality of life.
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Affiliation(s)
- Nicole A Carreau
- Division of Hematology and Medical Oncology, Perlmutter Cancer Center at NYU Langone Health, New York, New York, USA
| | - Orrin Pail
- Department of Medicine, New York University School of Medicine & Langone Medical Center, New York, New York, USA
| | - Philippe Armand
- Department of Medical Oncology, Dana Farber Cancer Institute, Boston, Massachusetts, USA
| | - Reid Merryman
- Department of Medical Oncology, Dana Farber Cancer Institute, Boston, Massachusetts, USA
| | - Ranjana H Advani
- Department of Medicine, Division of Oncology, Stanford University, Stanford, California, USA
| | - Michael A Spinner
- Department of Medicine, Division of Oncology, Stanford University, Stanford, California, USA
| | - Alex Herrera
- Department of Hematology and Hematopoietic Cell Transplantation, City of Hope, Duarte, California, USA
| | - Robert Chen
- Department of Hematology and Hematopoietic Cell Transplantation, City of Hope, Duarte, California, USA
| | - Sarah Tomassetti
- Department of Hematology and Hematopoietic Cell Transplantation, City of Hope, Duarte, California, USA
| | - Radhakrishnan Ramchandren
- Division of Hematology and Oncology, University of Tennessee Medical Center, Knoxville, Tennessee, USA
| | - Muhammad S Hamid
- Department of Oncology, Karmanos Cancer Institute, Detroit, Michigan, USA
| | | | | | - Nina Wagner-Johnston
- Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University, Baltimore, Maryland, USA
| | - Suman Paul
- Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University, Baltimore, Maryland, USA
| | - Jakub Svoboda
- Abramson Cancer Center, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Steven Bair
- Abramson Cancer Center, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Stefan Barta
- Abramson Cancer Center, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Yang Liu
- Department of Hematology/Oncology, Fox Chase Cancer Center, Philadelphia, Pennsylvania, USA
| | - Sunita Nathan
- Rush University Medical Center, Chicago, Illinois, USA
| | - Reem Karmali
- Division of Hematology, Northwestern University, Chicago, Illinois, USA
| | - Madelyn Burkart
- Division of Hematology, Northwestern University, Chicago, Illinois, USA
| | - Pallawi Torka
- Roswell Park Comprehensive Cancer Center, Buffalo, New York, USA
| | - Kevin David
- Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey, USA
| | - Catherine Wei
- Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey, USA
| | | | - Lukas Emery
- Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire, USA
| | - Daniel Persky
- Division of Hematology/Oncology, University of Arizona Cancer Center, Tucson, Arizona, USA
| | | | | | | | - Yuhe Xia
- New York University School of Medicine, New York, New York, USA
| | - Andrea B Troxel
- New York University School of Medicine, New York, New York, USA
| | - Catherine Diefenbach
- Division of Hematology and Medical Oncology, Perlmutter Cancer Center at NYU Langone Health, New York, New York, USA
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Kuruvilla J, Ramchandren R, Santoro A, Paszkiewicz-Kozik E, Gasiorowski R, Johnson N, Melnichenko V, Fogliatto LM, Goncalves I, de Oliveira J, Buccheri V, Perini GF, Goldschmidt N, Alekseev S, Kryachok I, Sekiguchi N, Zhu Y, Nahar A, Marinello P, Zinzani PL. KEYNOTE-204: Randomized, open-label, phase III study of pembrolizumab (pembro) versus brentuximab vedotin (BV) in relapsed or refractory classic Hodgkin lymphoma (R/R cHL). J Clin Oncol 2020. [DOI: 10.1200/jco.2020.38.15_suppl.8005] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
8005 Background: PD-1 blockade via pembro monotherapy showed antitumor activity in R/R cHL. KEYNOTE-204 (NCT02684292) was a randomized, international, open-label, phase III study of pembro vs BV in R/R cHL. Methods: Patients (pts) were aged ≥18 y, were post−autologous stem cell transplant (auto-SCT) or ineligible for auto-SCT, and had measurable disease and ECOG PS 0 or 1. BV-naive and BV-exposed pts were eligible. Pts were randomized 1:1 to pembro 200 mg IV Q3W or BV 1.8 mg/kg IV Q3W and stratified by prior auto-SCT (yes vs no) and status after 1L therapy (primary refractory vs relapsed <12 mo vs relapsed ≥12 mo after end of 1L therapy). Primary end points: PFS by blinded independent central review (BICR) per International Working Group (IWG) criteria including clinical and imaging data after auto-SCT or allogeneic SCT (allo-SCT) and OS. Key secondary end points: PFS excluding clinical and imaging data after auto-SCT or allo-SCT (PFS-secondary), and ORR by BICR per IWG, PFS by investigator review per IWG, and safety. Exploratory end point: DOR by BICR per IWG. Results: 304 pts were randomized and 300 were treated (148, pembro; 152, BV); 256 discontinued. Median (range) follow-up: 24.7 (0.6-42.3) mo. 15 pts were BV exposed. Median (range) time on treatment was 305.0 (1-814) and 146.5 (1-794) days with pembro and BV, respectively. Statistically significant improvement was observed with pembro vs BV for primary PFS analysis (HR 0.65 [95% CI 0.48-0.88; P =0.00271]; median 13.2 vs 8.3 mo); 12-mo PFS rates were 53.9% vs 35.6%, respectively. Benefit was observed in all subgroups tested, including pts with no auto-SCT (HR=0.61), primary refractory disease (HR=0.52), prior BV (HR=0.34) and BV naive (HR=0.67). Significant improvement in PFS-secondary was observed with pembro vs BV (HR 0.62 [95% CI 0.46-0.85]; median 12.6 vs 8.2 mo). Per investigator assessment, PFS was longer with pembro vs BV (HR 0.49 [95% CI 0.36-0.67]; median 19.2 vs 8.2 mo). ORR was 65.6% for pembro and 54.2% for BV; CR rates were 24.5% and 24.2%, respectively. Median (range) DOR was 20.7 mo (0.0+ to 33.2+) for pembro and 13.8 mo (0.0+ to 33.9+) for BV. Grade 3-5 TRAEs: 19.6% of pts with pembro and 25.0% with BV. One death due to TRAE occurred with pembro (pneumonia). Conclusions: In pts with R/R cHL, pembro was superior to BV and demonstrated statistically significant and clinically meaningful improvement in PFS across all subgroups, with safety consistent with previous reports. Pembro monotherapy should be standard of care for this pt population with R/R/cHL. Clinical trial information: NCT02684292 .
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Affiliation(s)
| | | | - Armando Santoro
- Humanitas Clinical and Research Center, IRCCS, Rozzano, Italy
| | | | - Robin Gasiorowski
- Concord Repatriation General Hospital, University of Sydney, Sydney, Australia
| | | | | | | | | | | | - Valeria Buccheri
- Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | | | | | - Sergey Alekseev
- N.N. Petrov National Medical Research Center of Oncology, St. Petersburg, Russian Federation
| | | | - Naohiro Sekiguchi
- National Hospital Organization Disaster Medical Center, Tokyo, Japan
| | - Ying Zhu
- Merck & Co., Inc., Kenilworth, NJ
| | | | | | - Pier Luigi Zinzani
- Institute of Hematology “L. e A. Seràgnoli”, University of Bologna, Bologna, Italy
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22
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Patel K, Maris MB, Cheson BD, Zonder JA, Lesokhin AM, Von Keudell G, Seymour EK, Lin GH, Catalano T, Shou Y, Iyer SP, Ramchandren R. Ongoing, first-in-human, phase I dose escalation study of the investigational CD47-blocker TTI-622 in patients with advanced relapsed or refractory lymphoma. J Clin Oncol 2020. [DOI: 10.1200/jco.2020.38.15_suppl.3030] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
3030 Background: CD47 is an immune checkpoint that binds signal regulatory protein alpha (SIRPα) and delivers a "do not eat" signal to suppress macrophage phagocytosis. Cancer cells frequently overexpress CD47 to escape immune surveillance. TTI-622 is a fusion protein consisting of the CD47-binding domain of human SIRPα linked to the Fc region of human IgG4. TTI-622 acts as a decoy receptor, preventing CD47 from delivering its inhibitory signal and enabling macrophage activation and anti-cancer activity via pro-phagocytic signals present on cancer cells. Unlike many CD47-blocking antibodies, TTI-622 does not bind to human erythrocytes and thus may not cause anemia in patients. Methods: In phase 1A, patients with advanced relapsed or refractory lymphoma received IV TTI-622 once per week with dose increased based on traditional 3+3 escalation. Dosing was on a mg/kg basis with the third and subsequent weekly doses approximately 2-fold higher than the first 2 doses (e.g., 0.05, 0.05, and 0.1 mg/kg for weeks 1, 2 and 3). Blood samples were obtained for PK analysis and assessment of CD47 receptor occupancy (RO) on peripheral T cells. Results: At data cut-off, 19 patients (11 M, 8 F) of median age 62 years (range, 24-86) with the following lymphomas: DLBCL 10; HL 6; and TCL, MCL and FL, 1 each, with a median of 3 prior therapies (range, 1-8) were enrolled. No DLTs have been observed in 5 dose levels (0.05 to 4.0 mg/kg). Grade ≥3 related neutropenia occurred in 2 patients; other related AEs occurring in 2 patients each included abdominal pain, fatigue, and nausea; no patients experienced a related SAE. Acute, post-dose platelet decreases occurred transiently and generally were Grade 1- 2; no related Grade ≥3 thrombocytopenia or anemia AEs have been observed. Preliminary PK data indicate a dose-proportional increase in exposure and a T1/2 of approximately 4-5 days following repeat infusions (Week 6). Preliminary biomarker data reveal approximately 60% RO at the end of the first infusion of 2 mg/kg and more sustained 24-hour RO at 1 and 2 mg/kg vs ≤ 0.8 mg/kg. To date, 1 patient with stage 4 non-GCB DLBCL (5 prior therapies) initially achieved PR by Wk 8 and CR by Wk 36, with response ongoing. Conclusions: TTI-622 is well tolerated at doses up to 4 mg/kg per week. Preliminary data indicate dose-dependent increases in PK exposure and target engagement with 1 DLBCL patient having achieved a durable, ongoing CR. Dose escalation is ongoing and additional safety, PK, biomarker and response data will be available at the time of meeting presentation. Clinical trial information: NCT03530683 .
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Affiliation(s)
| | | | | | | | - Alexander M. Lesokhin
- Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York, NY
| | - Gottfried Von Keudell
- Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York, NY
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23
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Carreau NA, Armand P, Merryman RW, Advani RH, Spinner MA, Herrera AF, Ramchandren R, Hamid MS, Assouline S, Santiago R, Wagner-Johnston N, Paul S, Svoboda J, Bair SM, Barta SK, Nathan S, Karmali R, Torka P, David K, Lansigan F, Persky D, Godfrey J, Chavez JC, Xia Y, Diefenbach C. Checkpoint blockade treatment sensitises relapsed/refractory non-Hodgkin lymphoma to subsequent therapy. Br J Haematol 2020; 191:44-51. [PMID: 32430944 DOI: 10.1111/bjh.16756] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Accepted: 04/25/2020] [Indexed: 12/13/2022]
Abstract
Patients with relapsed/refractory (R/R) non-Hodgkin lymphoma (NHL) have limited options for salvage, and checkpoint blockade therapy (CBT) has little efficacy. Usage in solid malignancies suggests that CBT sensitises tumours to subsequent chemotherapy. We performed the first analysis of CBT on subsequent NHL treatment. Seventeen North American centres retrospectively queried records. The primary aim was to evaluate the overall response rate (ORR) to post-CBT treatment. Secondary aims included progression-free survival (PFS), duration of response (DOR) and overall survival (OS). Fifty-nine patients (68% aggressive NHL, 69% advanced disease) were included. Patients received a median of three therapies before CBT. Fifty-three (90%) discontinued CBT due to progression. Post-CBT regimens included chemotherapy (49%), targeted therapy (30%), clinical trial (17%), transplant conditioning (2%) and chimeric antigen receptor T cell (CAR-T) therapy (2%). The ORR to post-CBT treatment was 51%, with median PFS of 6·1 months. In patients with at least stable disease (SD) to post-CBT, the median DOR was significantly longer than to pre-CBT (310 vs. 79 days, P = 0·005) suggesting sensitisation. Nineteen patients were transplanted after post-CBT therapy. Median overall survival was not reached, nor affected by regimen. Prospective trials are warranted, as this may offer R/R NHL patients a novel therapeutic approach.
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Affiliation(s)
- Nicole A Carreau
- Division of Hematology and Medical Oncology, Perlmutter Cancer Center at NYU Langone Health, New York University School of Medicine & Langone Medical Center, New York, NY, USA
| | - Philippe Armand
- Department of Medical Oncology, Dana Farber Cancer Institute, Boston, MA, USA
| | - Reid W Merryman
- Department of Medical Oncology, Dana Farber Cancer Institute, Boston, MA, USA
| | - Ranjana H Advani
- Division of Oncology, Department of Medicine, Stanford University, Stanford, CA, USA
| | - Michael A Spinner
- Division of Oncology, Department of Medicine, Stanford University, Stanford, CA, USA
| | - Alex F Herrera
- Department of Hematology and Hematopoietic Cell Transplantation, City of Hope, Duarte, CA, USA
| | | | - Muhammad S Hamid
- Department of Oncology, Karmanos Cancer Institute, Detroit, MI, USA
| | | | | | - Nina Wagner-Johnston
- Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University, Baltimore, MD, USA
| | - Suman Paul
- Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University, Baltimore, MD, USA
| | - Jakub Svoboda
- Abramson Cancer Center, Hospital of the University of Pennsylvania, Philadelphia, PA, USA
| | - Steven M Bair
- Abramson Cancer Center, Hospital of the University of Pennsylvania, Philadelphia, PA, USA
| | - Stefan K Barta
- Abramson Cancer Center, Hospital of the University of Pennsylvania, Philadelphia, PA, USA
| | | | - Reem Karmali
- Division of Hematology, Northwestern University, Chicago, IL, USA
| | - Pallawi Torka
- Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
| | - Kevin David
- Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, USA
| | | | - Daniel Persky
- Division of Hematology/Oncology, University of Arizona Cancer Center, Tucson, AZ, USA
| | | | | | - Yuhe Xia
- New York University School of Medicine, New York, NY, USA
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24
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Timmerman J, Herbaux C, Ribrag V, Zelenetz AD, Houot R, Neelapu SS, Logan T, Lossos IS, Urba W, Salles G, Ramchandren R, Jacobson C, Godwin J, Carpio C, Lathers D, Liu Y, Neely J, Suryawanshi S, Koguchi Y, Levy R. Urelumab alone or in combination with rituximab in patients with relapsed or refractory B-cell lymphoma. Am J Hematol 2020; 95:510-520. [PMID: 32052473 PMCID: PMC7383599 DOI: 10.1002/ajh.25757] [Citation(s) in RCA: 44] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2019] [Revised: 01/30/2020] [Accepted: 02/05/2020] [Indexed: 12/19/2022]
Abstract
Urelumab, a fully human, non-ligand binding, CD137 agonist IgG4 monoclonal antibody, enhances T-cell and natural killer-cell antitumor activity in preclinical models, and may enhance cytotoxic activity of rituximab. Here we report results in patients with relapsed or refractory diffuse large B-cell lymphoma (DLBCL), follicular lymphoma (FL), and other B-cell lymphomas, in phase 1 studies evaluating urelumab alone (NCT01471210) or combined with rituximab (NCT01775631). Sixty patients received urelumab (0.3 mg/kg IV Q3W, 8 mg IV Q3W, or 8 mg IV Q6W); 46 received urelumab (0.1 mg/kg, 0.3 mg/kg, or 8 mg IV Q3W) plus rituximab 375 mg/m2 IV QW. The maximum tolerated dose (MTD) of urelumab was determined to be 0.1 mg/kg or 8 mg Q3W after a single event of potential drug-induced liver injury occurred with urelumab 0.3 mg/kg. Treatment-related AEs were reported in 52% (urelumab: grade 3/4, 15%) and 72% (urelumab + rituximab: grade 3/4, 28%); three led to discontinuation (grade 3 increased AST, grade 4 acute hepatitis [urelumab]; one death from sepsis syndrome [urelumab plus rituximab]). Objective response rates/disease control rates were 6%/19% (DLBCL, n = 31), 12%/35% (FL, n = 17), and 17%/42% (other B-cell lymphomas, n = 12) with urelumab and 10%/24% (DLBCL, n = 29) and 35%/71% (FL, n = 17) with urelumab plus rituximab. Durable remissions in heavily pretreated patients were achieved; however, many were observed at doses exceeding the MTD. These data show that urelumab alone or in combination with rituximab demonstrated manageable safety in B-cell lymphoma, but the combination did not enhance clinical activity relative to rituximab alone or other current standard of care.
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Affiliation(s)
| | - Charles Herbaux
- Centre Hospitalier Régional Universitaire de LilleLilleFrance
| | | | | | - Roch Houot
- CHU Rennes, Service Hématologie CliniqueRennesFrance
- INSERMUnité dʼInvestigation CliniqueRennesFrance
| | | | - Theodore Logan
- Simon Cancer CenterIndiana UniversityIndianapolisIndiana
| | - Izidore S. Lossos
- University of Miami Miller School of MedicineSylvester Comprehensive Cancer CenterMiamiFlorida
| | - Walter Urba
- Earle A. Chiles Research InstituteProvidence Cancer CenterPortlandOregon
| | | | | | - Caron Jacobson
- Dana‐Farber Cancer InstituteHarvard Medical SchoolBostonMassachusetts
| | - John Godwin
- Earle A. Chiles Research InstituteProvidence Cancer CenterPortlandOregon
| | - Cecilia Carpio
- Hospital Universitari Vall dʼHebronUniversitat Autònoma de BarcelonaBarcelonaSpain
| | | | - Yali Liu
- Bristol‐Myers SquibbPrincetonNew Jersey
| | | | | | - Yoshinobu Koguchi
- Earle A. Chiles Research InstituteProvidence Cancer CenterPortlandOregon
| | - Ronald Levy
- Stanford University School of MedicineStanfordCalifornia
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25
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Merryman RW, Carreau NA, Advani RH, Spinner MA, Herrera AF, Chen R, Tomassetti S, Ramchandren R, Hamid M, Assouline S, Santiago R, Wagner-Johnston N, Paul S, Svoboda J, Bair SM, Barta SK, Liu Y, Nathan S, Karmali R, Burkart M, Torka P, David KA, Wei C, Lansigan F, Emery L, Persky D, Smith SM, Godfrey J, Chavez J, Cohen JB, Troxel AB, Diefenbach C, Armand P. Impact of Treatment Beyond Progression with Immune Checkpoint Blockade in Hodgkin Lymphoma. Oncologist 2020; 25:e993-e997. [PMID: 32275786 DOI: 10.1634/theoncologist.2020-0040] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2020] [Accepted: 04/03/2020] [Indexed: 12/30/2022] Open
Abstract
Atypical response patterns following immune checkpoint blockade (ICB) in Hodgkin lymphoma (HL) led to the concept of continuation of treatment beyond progression (TBP); however, the longitudinal benefit of this approach is unclear. We therefore performed a retrospective analysis of 64 patients treated with ICB; 20 who received TBP (TBP cohort) and 44 who stopped ICB at initial progression (non-TBP cohort). The TBP cohort received ICB for a median of 4.7 months after initial progression and delayed subsequent treatment by a median of 6.6 months. Despite receiving more prior lines of therapy, the TBP cohort achieved longer progression-free survival with post-ICB treatment (median, 17.5 months vs. 6.1 months, p = .035) and longer time-to-subsequent treatment failure, defined as time from initial ICB progression to failure of subsequent treatment (median, 34.6 months vs. 9.9 months, p = .003). With the limitations of a retrospective study, these results support the clinical benefit of TBP with ICB for selected patients.
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Affiliation(s)
| | | | - Ranjana H Advani
- Department of Medicine, Division of Oncology, Stanford University, Stanford, California, USA
| | - Michael A Spinner
- Department of Medicine, Division of Oncology, Stanford University, Stanford, California, USA
| | - Alex F Herrera
- Department of Hematology and Hematopoietic Cell Transplantation, City of Hope, Duarte, California, USA
| | - Robert Chen
- Department of Hematology and Hematopoietic Cell Transplantation, City of Hope, Duarte, California, USA
| | - Sarah Tomassetti
- Department of Hematology and Hematopoietic Cell Transplantation, City of Hope, Duarte, California, USA
| | | | - Muhammad Hamid
- Department of Oncology, Karmanos Cancer Institute, Detroit, Michigan, USA
| | - Sarit Assouline
- Jewish General Hospital, McGill University, Montreal, Quebec, Canada
| | - Raoul Santiago
- Jewish General Hospital, McGill University, Montreal, Quebec, Canada
| | - Nina Wagner-Johnston
- Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University, Baltimore, Maryland, USA
| | - Suman Paul
- Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University, Baltimore, Maryland, USA
| | - Jakub Svoboda
- Abramson Cancer Center, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Steven M Bair
- Abramson Cancer Center, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Stefan K Barta
- Department of Hematology/Oncology, Fox Chase Cancer Center, Philadelphia, Pennsylvania, USA
| | - Yang Liu
- Department of Hematology/Oncology, Fox Chase Cancer Center, Philadelphia, Pennsylvania, USA
| | - Sunita Nathan
- Rush University Medical Center, Chicago, Illinois, USA
| | - Reem Karmali
- Division of Hematology, Northwestern University, Chicago, Illinois, USA
| | | | - Pallawi Torka
- Roswell Park Comprehensive Cancer Center, Buffalo, New York, USA
| | - Kevin A David
- Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey, USA
| | - Catherine Wei
- Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey, USA
| | | | - Lukas Emery
- Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire, USA
| | - Daniel Persky
- Division of Hematology/Oncology, University of Arizona Cancer Center, Tucson, Arizona, USA
| | | | | | - Julio Chavez
- H. Lee Moffitt Cancer Center & Research Institute, Tampa, Florida, USA
| | - Jonathan B Cohen
- Emory University Winship Cancer Institute, Atlanta, Georgia, USA
| | - Andrea B Troxel
- Perlmutter Cancer Center, New York University School of Medicine, New York, New York, USA
| | - Catherine Diefenbach
- Perlmutter Cancer Center, New York University School of Medicine, New York, New York, USA
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26
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Herrera AF, Goy A, Mehta A, Ramchandren R, Pagel JM, Svoboda J, Guan S, Hill JS, Kwei K, Liu EA, Phillips T. Safety and activity of ibrutinib in combination with durvalumab in patients with relapsed or refractory follicular lymphoma or diffuse large B-cell lymphoma. Am J Hematol 2020; 95:18-27. [PMID: 31621094 PMCID: PMC6904508 DOI: 10.1002/ajh.25659] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2019] [Revised: 09/12/2019] [Accepted: 10/11/2019] [Indexed: 12/15/2022]
Abstract
This phase 1b/2, multicenter, open-label study evaluated ibrutinib plus durvalumab in relapsed/refractory follicular lymphoma (FL) or diffuse large B-cell lymphoma (DLBCL). Patients were treated with once-daily ibrutinib 560 mg plus durvalumab 10 mg/kg every 2 weeks in 28-day cycles in phase 1b without dose-limiting toxicities, confirming the phase 2 dosing. Sixty-one patients with FL (n = 27), germinal center B-cell (GCB) DLBCL (n = 16), non-GCB DLBCL (n = 16), and unspecified DLBCL (n = 2) were treated. Overall response rate (ORR) was 25% in all patients, 26% in patients with FL, 13% in patients with GCB DLBCL, and 38% in patients with non-GCB DLBCL. Overall, median progression-free survival was 4.6 months and median overall survival was 18.1 months; both were longer in patients with FL than in patients with DLBCL. The most frequent treatment-emergent adverse events (AEs) in patients with FL and DLBCL, respectively, were diarrhea (16 [59%]; 16 [47%]), fatigue (12 [44%]; 16 [47%]), nausea (9 [33%]; 12 [35%]), peripheral edema (7 [26%]; 13 [38%]), decreased appetite (8 [30%]; 11 [32%]), neutropenia (6 [22%]; 11 [32%]), and vomiting (5 [19%]; 12 [35%]). Investigator-defined immune-related AEs were reported in 12/61 (20%) patients. Correlative analyses were conducted but did not identify any conclusive biomarkers of response. In FL, GCB DLBCL, and non-GCB DLBCL, ibrutinib plus durvalumab demonstrated similar activity to single-agent ibrutinib with the added toxicity of the PD-L1 blockade; the combination resulted in a safety profile generally consistent with those known for each individual agent.
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Affiliation(s)
- Alex F. Herrera
- Department of Hematology/Hematopoietic Cell TransplantationCity of Hope National Medical Center Duarte California
| | - Andre Goy
- John Theurer Cancer Center Division of LymphomaHackensack University Medical Center Hackensack New Jersey
| | - Amitkumar Mehta
- Division of Hematology and OncologyUniversity of Alabama Birmingham Alabama
| | | | - John M. Pagel
- Center for Blood Disorders and Stem Cell Transplantation, Division of OncologySwedish Cancer Institute Seattle Washington
| | - Jakub Svoboda
- Department of Medicine, Division of Hematology and OncologyUniversity of Pennsylvania Philadelphia Pennsylvania
| | - Shanhong Guan
- Department of BiostatisticsPharmacyclics LLC, an AbbVie Company Sunnyvale California
| | - John S. Hill
- Department of Translational MedicinePharmacyclics LLC, an AbbVie Company Sunnyvale California
| | - Kevin Kwei
- Department of Translational MedicinePharmacyclics LLC, an AbbVie Company Sunnyvale California
| | - Emily A. Liu
- Department of Clinical SciencePharmacyclics LLC, an AbbVie Company Sunnyvale California
| | - Tycel Phillips
- Rogel Cancer Center, Division of Hematology and OncologyUniversity of Michigan Ann Arbor Michigan
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27
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Landsburg DJ, Ayers EC, Bond DA, Maddocks KJ, Karmali R, Behdad A, Curry M, Wagner‐Johnston ND, Modi D, Ramchandren R, Assouline SE, Faramand R, Chavez JC, Torka P, Mier Hicks A, Medeiros LJ, Li S. Poor outcomes for double‐hit lymphoma patients treated with curative‐intent second‐line immunochemotherapy following failure of intensive front‐line immunochemotherapy. Br J Haematol 2019; 189:313-317. [DOI: 10.1111/bjh.16319] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2019] [Accepted: 09/25/2019] [Indexed: 11/29/2022]
Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | - Pallawi Torka
- Roswell Park Comprehensive Cancer Center Buffalo NY USA
| | | | | | - Shaoying Li
- The University of Texas MD Anderson Cancer Center Houston TX USA
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28
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Mauz-koerholz C, Kelly K, Keller F, Ramchandren R, Nahar A, Giulino-Roth L. Phase II, open-label study of pembrolizumab in children and young adults with newly diagnosed classical Hodgkin lymphoma (cHL) with slow early response (SER) to frontline chemotherapy: KEYNOTE-667. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz427.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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29
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Ayers EC, Li S, Medeiros LJ, Bond DA, Maddocks KJ, Torka P, Mier Hicks A, Curry M, Wagner-Johnston ND, Karmali R, Behdad A, Fakhri B, Kahl BS, Churnetski MC, Cohen JB, Reddy NM, Modi D, Ramchandren R, Howlett C, Leslie LA, Cytryn S, Diefenbach CS, Faramand R, Chavez JC, Olszewski AJ, Liu Y, Barta SK, Mukhija D, Hill BT, Ma H, Amengual JE, Nathan S, Assouline SE, Orellana-Noia VM, Portell CA, Chandar A, David KA, Giri A, Hess BT, Landsburg DJ. Outcomes in patients with aggressive B-cell non-Hodgkin lymphoma after intensive frontline treatment failure. Cancer 2019; 126:293-303. [PMID: 31568564 DOI: 10.1002/cncr.32526] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2019] [Revised: 06/19/2019] [Accepted: 07/12/2019] [Indexed: 11/11/2022]
Abstract
BACKGROUND Salvage immunochemotherapy followed by high-dose chemotherapy and autologous stem cell transplantation is the standard-of-care second-line treatment for patients with relapsed/refractory diffuse large B-cell lymphoma after first-line R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone). Outcomes after receipt of second-line immunochemotherapy in patients with aggressive B-cell lymphomas who relapse or are refractory to intensive first-line immunochemotherapy regimens (etoposide, prednisone, vincristine, cyclophosphamide, doxorubicin, and rituximab [R-EPOCH], rituximab, hyperfractionated cyclophosphamide, vincristine, doxorubicin, and dexamethasone alternating with methotrexate and cytarabine [R-HyperCVAD], rituximab, cyclophosphamide, vincristine, doxorubicin, and high-dose methotrexate alternating with ifosfamide, etoposide, and cytarabine [R-CODOX-M/IVAC]) remain unknown. METHODS Outcomes of patients with non-Burkitt, aggressive B-cell lymphomas and relapsed/refractory disease after first-line treatment with intensive immunochemotherapy regimens who received platinum-based second-line immunochemotherapy were reviewed retrospectively. Analyses were performed to determine progression-free survival (PFS) and overall survival (OS) from the time of receipt of second-line immunochemotherapy. RESULTS In total, 195 patients from 19 academic centers were included in the study. The overall response rate to second-line immunochemotherapy was 44%, with a median PFS of 3 months and a median OS of 8 months. Patients with early treatment failure (primary refractory or relapse <12 months from completion of first-line therapy) experienced inferior median PFS (2.8 vs 23 months; P < .001) and OS (6 months vs not reached; P < .001) compared with patients with late treatment failure. Although the 17% of patients with early failure who achieved a complete response to second-line immunochemotherapy experienced prolonged survival, this outcome could not be predicted by clinicopathologic features at the start of second-line immunochemotherapy. CONCLUSIONS Patients with early treatment failure after intensive first-line immunochemotherapy experience poor outcomes after receiving standard second-line immunochemotherapy. The use of standard-of-care or experimental therapies currently available in the third-line setting and beyond should be investigated in the second-line setting for these patients.
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Affiliation(s)
- Emily C Ayers
- Abramson Cancer Center, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Shaoying Li
- Department of Hematopathology, The University of Texas MD Anderson Cancer, Houston, Texas
| | - L Jeffrey Medeiros
- Department of Hematopathology, The University of Texas MD Anderson Cancer, Houston, Texas
| | - David A Bond
- Department of Internal Medicine, The Ohio State University Cancer Center, Columbus, Ohio
| | - Kami J Maddocks
- Department of Hematology, The Ohio State University Cancer Center, Columbus, Ohio
| | - Pallawi Torka
- Roswell Park Comprehensive Cancer Center, Buffalo, New York
| | | | - Madeira Curry
- Johns Hopkins Sidney Kimmel Comprehensive Cancer Center, Baltimore, Maryland
| | | | - Reem Karmali
- Department of Medicine, Division of Hematology/Oncology, Northwestern University Feinberg.,School of Medicine, Robert H. Lurie Comprehensive Cancer Center, Northwestern University, Chicago, Illinois
| | - Amir Behdad
- Department of Pathology, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Bita Fakhri
- Washington University School of Medicine, St. Louis, Missouri
| | - Brad S Kahl
- Washington University School of Medicine, St. Louis, Missouri
| | - Michael C Churnetski
- Department of Hematology, Winship Cancer Institute, Emory University, Atlanta, Georgia.,Department of Medical Oncology, Winship Cancer Institute, Emory University, Atlanta, Georgia
| | - Jonathon B Cohen
- Department of Hematology, Winship Cancer Institute, Emory University, Atlanta, Georgia
| | - Nishitha M Reddy
- Department of Hematology/Oncology, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Dipenkumar Modi
- Karmanos Cancer Institute/Wayne State University, Detroit, Michigan
| | | | - Christina Howlett
- Deparrment of Pharmacy and Clinical Services, John Theurer Cancer Center, Hackensack Meridian Health, Hackensack, New Jersey
| | - Lori A Leslie
- John Theurer Cancer Center, Hackensack Meridian Health, Hackensack, New Jersey
| | - Samuel Cytryn
- New York University Perlmutter Cancer Center, New York, New York
| | | | - Rawan Faramand
- Department of Malignant Hematology, H. Lee Moffitt Cancer Center, Tampa, Florida
| | - Julio C Chavez
- Department of Malignant Hematology, H. Lee Moffitt Cancer Center, Tampa, Florida
| | - Adam J Olszewski
- The Warren Alpert Medical School of Brown University, Providence, Rhode Island.,Division of Hematology-Oncology, Rhode Island Hospital, Providence, Rhode Island
| | - Yang Liu
- Fox Chase Cancer Center, Philadelphia, Pennsylvania
| | - Stefan K Barta
- Abramson Cancer Center, University of Pennsylvania, Philadelphia, Pennsylvania.,Fox Chase Cancer Center, Philadelphia, Pennsylvania
| | | | - Brian T Hill
- Hematology and Medical Oncology, Taussig Cancer Institute, Cleveland Clinic, Cleveland, Ohio
| | - Helen Ma
- Center for Lymphoid Malignancies, Department of Medicine, and Department of Pathology and Cell Biology, Columbia University Medical Center , New York
| | - Jennifer E Amengual
- Division of Hematology and Oncology, Department of Medicine, Herbert Irving Comprehensive Cancer Center, Columbia University Medical Center, New York
| | | | - Sarit E Assouline
- Medicine and Oncology, Jewish General Hospital, McGill University, Montreal, Quebec, Canada
| | | | - Craig A Portell
- Hematology and Oncology, University of Virginia, Charlottesville, Virginia
| | - Ashwin Chandar
- Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey
| | | | - Anshu Giri
- Hollings Cancer Center, Medical University of South Carolina, Charleston, South Carolina
| | - Brian T Hess
- Hollings Cancer Center, Medical University of South Carolina, Charleston, South Carolina
| | - Daniel J Landsburg
- Abramson Cancer Center, University of Pennsylvania, Philadelphia, Pennsylvania
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Diefenbach C, Kahl B, Banerjee L, McMillan A, Ramchandren R, Miall F, Briones J, Cordoba R, Gonzalez-Barca E, Panizo C, Hirata J, Chang N, Musick L, Abrisqueta P. POLATUZUMAB VEDOTIN (POLA) + OBINUTUZUMAB (G) + LENALIDOMIDE (LEN) IN PATIENTS (PTS) WITH RELAPSED/REFRACTORY (R/R) FOLLICULAR LYMPHOMA (FL): PHASE IB/II INTERIM ANALYSIS. Hematol Oncol 2019. [DOI: 10.1002/hon.132_2629] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- C. Diefenbach
- Department of Hematology/Oncology; Perlmutter Cancer Center at NYU Langone Health; New York NY United States
| | - B. Kahl
- Division of Oncology; Washington University; St. Louis MO United States
| | - L. Banerjee
- Oncology Centre; Maidstone and Tonbridge Wells NHS Trust; Kent United Kingdom
| | - A. McMillan
- Centre for Clinical Haematology; Nottingham University Hospitals NHS Trust; Nottingham United Kingdom
| | - R. Ramchandren
- Division of Oncology; University of Tennessee, Knoxville, TN, United States, Barbara Ann Karmanos Cancer Institute; Detroit MI United States
| | - F. Miall
- Department of Haematology; University Hospitals of Leicester NHS Trust; Leicester United Kingdom
| | - J. Briones
- Department of Hematology; Hospital Santa Creu i Sant Pau; Barcelona Spain
| | - R. Cordoba
- Department of Hematology; Fundacion Jimenez Diaz; Madrid Spain
| | | | - C. Panizo
- Haemotology and Haemotherapy Department; Clínica Universidad de Navarra; Madrid Spain
| | - J. Hirata
- Production Development Oncology; Genentech, Inc.; South San Francisco CA United States
| | - N. Chang
- Oncology; F. Hoffmann-La Roche Ltd; Mississauga Canada
| | - L. Musick
- Clinical Sciences-Hematology; Genentech, Inc.; South San Francisco CA United States
| | - P. Abrisqueta
- Department of Hematology; Vall d'Hebron Institute of Oncology (VHIO), Hospital Universitari Vall d'Hebron; Barcelona Spain
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Ansell S, Ramchandren R, Domingo-Domènech E, Rueda A, Trněný M, Feldman T, Lee H, Provencio M, Sillaber C, Cohen J, Savage K, Willenbacher W, Sumbul A, Sacchi M, Armand P. NIVOLUMAB PLUS DOXORUBICIN, VINBLASTINE AND DACARBAZINE FOR NEWLY DIAGNOSED ADVANCED-STAGE CLASSICAL HODGKIN LYMPHOMA: CHECKMATE 205 COHORT D 2-YEAR FOLLOW-UP. Hematol Oncol 2019. [DOI: 10.1002/hon.104_2629] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- S. Ansell
- Division of Hematology; Mayo Clinic; Rochester United States
| | - R. Ramchandren
- Division of Hematology and Oncology; University of Tennessee; Knoxville United States
| | | | - A. Rueda
- Servicio de Oncología; Hospital Costa del Sol; Marbella Spain
| | - M. Trněný
- Department of Haematology; Charles University in Prague and General University Hospital in Prague; Prague Czech Republic
| | - T. Feldman
- Hematology & Oncology; Hackensack University Medical Center; Hackensack United States
| | - H. Lee
- Department of Lymphoma and Myeloma; Division of Cancer Medicine, University of Texas MD Anderson Cancer Center; Houston United States
| | - M. Provencio
- Medical Oncology Department; Hospital Universitario Puerta de Hierro; Madrid Spain
| | - C. Sillaber
- Clinical Division of Oncology; Medical University of Vienna; Vienna Austria
| | - J. Cohen
- Department of Hematology and Medical Oncology; Winship Cancer Institute, Emory University; Atlanta United States
| | - K. Savage
- Department of Pathology and Laboratory Medicine; British Columbia Cancer Center for Lymphoid Cancer; Vancouver Canada
| | - W. Willenbacher
- Department of Internal Medicine; Innsbruck University Hospital & OncoTyrol - Center for Personalized Cancer Medicine; Innsbruck Austria
| | - A. Sumbul
- Bristol-Myers Squibb; Princeton United States
| | - M. Sacchi
- Bristol-Myers Squibb; Princeton United States
| | - P. Armand
- Department of Medical Oncology; Dana-Farber Cancer Institute; Boston United States
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Wang M, Ramchandren R, Chen R, Karlin L, Chong G, Jurczak W, Wu K, Bishton M, Collins G, Eliadis P, Peyrade F, Freise K, Sukbuntherng J, Lee Y, Dobkowska E, Fedorov V, Neuenburg J, Tam C. RESULTS FROM THE SAFETY RUN-IN PERIOD OF THE SYMPATICO STUDY EVALUATING IBRUTINIB IN COMBINATION WITH VENETOCLAX IN PATIENTS WITH RELAPSED/REFRACTORY MANTLE CELL LYMPHOMA. Hematol Oncol 2019. [DOI: 10.1002/hon.146_2630] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- M. Wang
- Department of Lymphoma/Myeloma; University of Texas MD Anderson Cancer Center; Houston United States
| | - R. Ramchandren
- Department of Oncology; Karmanos Cancer Institute; Detroit United States
| | - R. Chen
- Department of Hematology & Hematopoietic Cell Transplantation; City of Hope; Duarte United States
| | - L. Karlin
- Department of Hematology; Centre Hospitalier Lyon Sud; Pierre-Bénite France
| | - G. Chong
- Department of Medical Oncology and Clinical Haematology; Olivia Newton-John Cancer Centre, and University of Melbourne; Melbourne Australia
| | - W. Jurczak
- Department of Hematology; Jagiellonian University; Kraków Poland
| | - K. Wu
- Department of Hematology; Ziekenhuis Netwerk Antwerpen; Antwerp Belgium
| | - M. Bishton
- Department of Clinical Haematology; Nottingham University Hospitals NHS Trust; Nottingham United Kingdom
| | - G. Collins
- Department of Hematology; Oxford University Hospitals, NHS Foundation Trust; Oxford United Kingdom
| | - P. Eliadis
- Department of Oncology; ICON Cancer Care; South Brisbane Australia
| | - F. Peyrade
- Department of Oncology; Centre Antoine Lacassagne; Nice France
| | - K. Freise
- Department of Clinical Pharmacology and Pharmacometrics; AbbVie Inc; North Chicago United States
| | - J. Sukbuntherng
- Department of Drug Metabolism & Pharmacokinetics; Pharmacyclics LLC, an AbbVie Company; Sunnyvale United States
| | - Y. Lee
- Department of Biostatistics; Pharmacyclics LLC, an AbbVie Company; Sunnyvale United States
| | - E. Dobkowska
- Department of Clinical Science; Pharmacyclics LLC, an AbbVie Company; Sunnyvale United States
| | - V. Fedorov
- Department of Clinical Science; Pharmacyclics LLC, an AbbVie Company; Sunnyvale United States
| | - J. Neuenburg
- Department of Clinical Science; Pharmacyclics LLC, an AbbVie Company; Sunnyvale United States
| | - C. Tam
- Department of Haematology; Peter MacCallum Cancer Centre & St. Vincent's Hospital and the University of Melbourne; Melbourne Australia
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Ramchandren R, Domingo-Domènech E, Rueda A, Trněný M, Feldman TA, Lee HJ, Provencio M, Sillaber C, Cohen JB, Savage KJ, Willenbacher W, Ligon AH, Ouyang J, Redd R, Rodig SJ, Shipp MA, Sacchi M, Sumbul A, Armand P, Ansell SM. Nivolumab for Newly Diagnosed Advanced-Stage Classic Hodgkin Lymphoma: Safety and Efficacy in the Phase II CheckMate 205 Study. J Clin Oncol 2019; 37:1997-2007. [PMID: 31112476 DOI: 10.1200/jco.19.00315] [Citation(s) in RCA: 144] [Impact Index Per Article: 28.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
PURPOSE Nivolumab, an anti-programmed death-1 monoclonal antibody, has demonstrated frequent and durable responses in relapsed/refractory classic Hodgkin lymphoma (cHL). We report results from Cohort D of the CheckMate 205 trial, which assessed nivolumab monotherapy followed by nivolumab plus doxorubicin, vinblastine, and dacarbazine (N-AVD) for newly diagnosed cHL. METHODS Patients 18 years of age or older with untreated, advanced-stage (defined as III to IV and IIB with unfavorable risk factors) cHL were eligible for Cohort D of this multicenter, noncomparative, phase II trial. Patients received nivolumab monotherapy for four doses, followed by 12 doses of N-AVD; all doses were every 2 weeks, and nivolumab was administered at 240 mg intravenously. The primary end point was safety. Efficacy end points included objective response rate and modified progression-free survival, defined as time to disease progression/relapse, death, or next therapy. Chromosome 9p24.1 alterations and programmed death-ligand 1 expression were assessed in Hodgkin Reed-Sternberg cells in evaluable patients. RESULTS A total of 51 patients were enrolled and treated. At diagnosis, 49% of patients had an International Prognostic Score of 3 or greater. Overall, 59% experienced a grade 3 to 4 treatment-related adverse event. Treatment-related febrile neutropenia was reported in 10% of patients. Endocrine immune-mediated adverse events were all grade 1 to 2 and did not require high-dose corticosteroids; all nonendocrine immune-mediated adverse events resolved (most commonly, rash; 5.9%). At the end of therapy, the objective response rate (95% CI) per independent radiology review committee was 84% (71% to 93%), with 67% (52% to 79%), achieving complete remission (five patients [10%] were nonevaluable and counted as nonresponders). With a minimum follow-up of 9.4 months, 9-month modified progression-free survival was 92%. Patients with higher-level Hodgkin Reed-Sternberg programmed death-ligand 1 expression had more favorable responses to N-AVD (P = .041). CONCLUSION Nivolumab followed by N-AVD was associated with promising efficacy and safety profiles for newly diagnosed, advanced-stage cHL.
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Affiliation(s)
| | | | - Antonio Rueda
- 4Costa del Sol Hospital, Marbella, Spain, and Institute of Biomedical Research in Málaga (IBIMA), Málaga, Spain
| | - Marek Trněný
- 5Charles University in Prague and General University Hospital in Prague, Prague, Czech Republic
| | - Tatyana A Feldman
- 6John Theurer Cancer Center at Hackensack Meridian Health, Hackensack, NJ
| | - Hun Ju Lee
- 7University of Texas MD Anderson Cancer Center, Houston, TX
| | | | | | | | - Kerry J Savage
- 11British Columbia Cancer Centre for Lymphoid Cancer, Vancouver, British Columbia, Canada
| | - Wolfgang Willenbacher
- 12Innsbruck University Hospital, Innsbruck, Austria.,13OncoTyrol-Center of Personalized Cancer Medicine, Innsbruck, Austria
| | | | | | | | - Scott J Rodig
- 14Brigham and Women's Hospital, Boston, MA.,15Dana-Farber Cancer Institute, Boston, MA
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Diefenbach C, Kahl B, Banerjee L, McMillan A, Ramchandren R, Miall F, Briones J, Cordoba R, González Barca E, Panizo C, Hirata J, Chang N, Musick L, Abrisqueta Costa P. Polatuzumab vedotin (Pola) + obinutuzumab (G) and lenalidomide (Len) in patients (pts) with relapsed/refractory (R/R) follicular lymphoma (FL): Interim analysis of a phase Ib/II trial. J Clin Oncol 2019. [DOI: 10.1200/jco.2019.37.15_suppl.7505] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
7505 Background: Pola-G-Len may enhance anti-tumor immune response in R/R FL. We report a pre-planned interim analysis of the safety/efficacy of induction and maintenance with Pola-G-Len in pts with R/R FL in a phase Ib/II study. Methods: Pts received induction treatment with 6x 28-D cycles of: G 1000mg IV (C1: D1, D8, D15; C2–6: D1); Pola 1.4mg/kg or 1.8mg/kg (dose escalation [DE]) or RP2D (expansion) IV (D1); and Len 10–20mg (DE) or RP2D (expansion) PO (D1–21). Pts with CR/PR/SD at the end of induction (EOI) received G 1000mg (D1 every 2mo, for 24mo), and Len (10mg, D1–21 monthly, 12mo). Primary endpoints: C1 DLTs, safety/tolerability, CR rate at EOI (modified Lugano criteria). Results: At the interim data cut-off (7/6/2018), 52 pts were enrolled: 9 discontinued the study (adverse events [AE], n=3; death due to PD, n=4; pt withdrawal, n=1; other, n=1). Median pt age was 62 (range 32–87) years; 58% FLIPI 3–5; 79% ≥2 prior therapy lines; 50% refractory to last treatment. Grade ≥3 AEs were experienced by 75% of pts: neutropenia (46%), thrombocytopenia (17%), anemia (12%) and infections (12%) were most common. AEs leading to Len dose reduction/interruption occurred in 31%/52% of pts. One Grade 5 AE was reported (septic shock after PD in pt receiving subsequent therapy). RP2D: Pola 1.4mg/kg + Len 20mg. Preliminary efficacy data suggest high activity (Table). Median PFS not reached (median follow-up duration 8.95mo; efficacy-evaluable population [EEP]). Conclusions: The safety profile of Pola-G-Len is consistent with known profiles of the individual drugs. Response rates at EOI with Pola-G-Len are promising, with high CR compared with available R/R FL treatments. Responses at EOI (EEP; RP2D; N=18). Clinical trial information: NCT02600897. [Table: see text]
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Affiliation(s)
| | - Brad Kahl
- Division of Oncology, Washington University, St Louis, MO
| | - Lalita Banerjee
- Oncology Centre, Maidstone and Tonbridge Wells Hospital, Kent, United Kingdom
| | - Andrew McMillan
- Centre for Clinical Haematology, Nottingham University Hospitals NHS Trust, Nottingham, United Kingdom
| | - Radhakrishnan Ramchandren
- Division of Oncology, University of Tennessee, Knoxville, TN; Barbara Ann Karmanos Cancer Institute, Detroit, MI
| | - Fiona Miall
- Department of Haematology, University Hospitals of Leicester NHS Trust, Leicester, United Kingdom
| | - Javier Briones
- Department of Hematology, Hospital Santa Creu i Sant Pau, Barcelona, Spain
| | | | | | | | | | - Naomi Chang
- F. Hoffmann-La Roche Ltd, Mississauga, ON, Canada
| | | | - Pau Abrisqueta Costa
- Department of Hematology, Vall d'Hebron Institute of Oncology (VHIO), Hospital Universitari Vall d'Hebron, Barcelona, Spain
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Ramchandren R, Ansell SM, Armand P, Engert A, Taylor F, Cocks K, Chen C, Bennett B, Moreno-Koehler A, Roeder A, Sumbul A, Sacchi M, Cella D. HSR19-107: Nivolumab for Newly Diagnosed Classical Hodgkin Lymphoma: Patient-Reported Outcomes From CheckMate 205 Cohort D. J Natl Compr Canc Netw 2019. [DOI: 10.6004/jnccn.2018.7210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Background: Patients (pts) with classical Hodgkin lymphoma (cHL) frequently experience reduced health-related quality of life (HRQoL) (Oerlemans et al, Ann Hematol 2011). Nivolumab, a fully human IgG4 anti-programmed death-1 (PD-1) immune checkpoint inhibitor monoclonal antibody, demonstrated efficacy and clinically meaningful improvement in pt-reported outcomes (PROs) in pts with relapsed/refractory cHL in cohorts A, B, and C of CheckMate 205 (NCT02181738) (Armand et al, J Clin Oncol 2018; Engert et al, ASH 2017). Nivolumab monotherapy followed by nivolumab + doxorubicin, vinblastine and dacarbazine (N-AVD) demonstrated an objective response rate of 84% in newly diagnosed cHL (cohort D of CheckMate 205; Ramchandren et al, EHA 2018). We present PROs in CheckMate 205 cohort D. Methods: Pts ≥18 years of age with untreated, advanced-stage cHL, with ECOG performance status (PS) of 0–1 received 4 doses of nivolumab monotherapy (240 mg IV Q2W) followed by N-AVD for 6 cycles (12 doses). Pts then entered the follow-up (FU) period. PROs were an exploratory endpoint, assessed using the EuroQol 5 Dimensions-3 level (EQ-5D-3L) and associated visual analog scale (EQ-VAS) in all treated pts who had both a baseline (monotherapy cycle 1) and post-baseline assessment. EQ-VAS ranges from 0–100, with higher scores indicating better HRQoL. In EQ-5D-3L, pts can report no, some, or extreme problems in each of 5 dimensions (mobility, self-care, activity, pain, and anxiety). Results: 51 pts were treated. At baseline, median age was 37 years, 63% were male, 59% had ECOG PS of 0. 49 pts (96%) completed baseline EQ-VAS. Mean EQ-VAS scores exceeded the mean baseline score at the end of monotherapy, after 2 combination cycles, at the end of therapy, and during follow-up (Table 1). The proportion of pts reporting some or extreme problems in EQ-5D-3L was numerically lower than or similar to baseline after monotherapy for all dimensions, but was numerically higher than baseline (dimensions of mobility and activity) after 2 combination cycles, and remained close to or numerically below baseline during follow-up (dimensions of self-care, activity, pain, and anxiety). Conclusions: Pt-reported HRQoL, as assessed by observed mean EQ-VAS scores, did not deteriorate from baseline during treatment with nivolumab followed by N-AVD. Proportions of pts reporting problems in individual EQ-5D-3L dimensions were generally similar to baseline during treatment and follow-up.
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Affiliation(s)
| | | | | | | | | | - Kim Cocks
- fAdelphi Values, Bollington, United Kingdom
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Martin P, Goy A, Ramchandren R, Ferrante L, Londhe A, McGowan T, Bartlett NL. To the Editor, A multicenter, open-label, early access treatment protocol for ibrutinib in patients with relapsed or refractory mantle cell lymphoma. J Oncol Pharm Pract 2019; 25:1027-1030. [PMID: 30786822 DOI: 10.1177/1078155219831435] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Peter Martin
- 1 Department of Medicine, Weill Cornell Medicine, New York, NY, USA
| | - Andre Goy
- 2 Hackensack University Medical Center, Hackensack, NJ, USA
| | | | | | - Anil Londhe
- 5 Janssen Research & Development, LLC, Titusville, NJ, USA
| | | | - Nancy L Bartlett
- 6 Washington University of Medicine, Siteman Cancer Center, St. Louis, MO, USA
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Sukari A, Nagasaka M, Alhasan R, Patel D, Wozniak A, Ramchandren R, Vaishampayan U, Weise A, Flaherty L, Jang H, Kim S, Gadgeel S. Cancer Site and Adverse Events Induced by Immune Checkpoint Inhibitors: A Retrospective Analysis of Real-life Experience at a Single Institution. Anticancer Res 2019; 39:781-790. [PMID: 30711957 DOI: 10.21873/anticanres.13175] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2018] [Revised: 12/17/2018] [Accepted: 12/20/2018] [Indexed: 01/05/2023]
Abstract
BACKGROUND Data on the characteristics of patients who are likely to experience adverse events, both immune-related and non-immune-related, from programmed cell death-1 (PD1) inhibitors are limited. PATIENTS AND METHODS Data from patients who received ≥1 dose of single-agent PD1 inhibitor between August 3, 2011 and August 31, 2016 were obtained from our Institution's pharmacy database. AEs were graded using Common Terminology Criteria for Adverse Events version 4. RESULTS One hundred and eighty-two patients received at least one dose of single-agent PD1 inhibitor prior to data cut-off. After excluding 14 patients with uncommon malignancies, the total number of patients were 168. The median age was 63 (range=24-92) years. There were 87 (52%) cases of non-small cell lung cancer (NSCLC), 35 (21%) of renal cell carcinoma (RCC), 12 (7%) of melanoma, 18 (11%) of Hodgkin's lymphomas, eight (5%) of head and neck squamous cell carcinoma (HNSCC) and eight (5%) of small cell lung cancer. Considering grade 2 or more AEs, 30 (18%) patients had kidney injury, 34 (20%) hypothyroidism, 36 (21%) transaminitis, 20 (12%) pneumonitis, and 18 (11%) colitis. Patients with RCC had higher odds of experiencing grade 2 or more kidney injury than patients with other primary tumor types (adjusted p=0.025), whereas patients with Hodgkin's lymphoma and HNSCC had higher odds of grade 2 hypothyroidism (adjusted p=0.005). Patients with NSCLC had higher risk of death with pneumonitis than those whose primary cancer was not NSCLC (adjusted p=0.005). DISCUSSION The increased odds of patients with Hodgkin's lymphoma and HNSCC experiencing grade 2 or more hypothyroidism may be related to previous radiation exposure. Most patients with RCC had undergone nephrectomy, making them more susceptible to acute kidney injury. When pneumonitis occurred in patients with primary NSCLC, the overall survival was significantly worse. The duration of PD1 therapy was significantly associated with onset of pneumonitis (p=0.007). CONCLUSION The site of primary tumor or metastasis may help predict the most common AEs in patients treated with PD1 inhibitors.
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Affiliation(s)
- Ammar Sukari
- Department of Oncology, Barbara Ann Karmanos Cancer Institute, Wayne State University School of Medicine, Detroit, MI, U.S.A.
| | - Misako Nagasaka
- Department of Oncology, Barbara Ann Karmanos Cancer Institute, Wayne State University School of Medicine, Detroit, MI, U.S.A.,Department of Advanced Medical Innovation, St. Marianna University Graduate School of Medicine, Kawasaki, Japan
| | - Roba Alhasan
- Department of Hematology and Oncology, Michigan State University, Lansing, MI, U.S.A
| | - Dhaval Patel
- Department of Oncology, Barbara Ann Karmanos Cancer Institute, Wayne State University School of Medicine, Detroit, MI, U.S.A
| | | | - Radhakrishnan Ramchandren
- Department of Oncology, Barbara Ann Karmanos Cancer Institute, Wayne State University School of Medicine, Detroit, MI, U.S.A
| | - Ulka Vaishampayan
- Department of Oncology, Barbara Ann Karmanos Cancer Institute, Wayne State University School of Medicine, Detroit, MI, U.S.A
| | - Amy Weise
- Department of Oncology, Barbara Ann Karmanos Cancer Institute, Wayne State University School of Medicine, Detroit, MI, U.S.A
| | - Lawrence Flaherty
- Department of Oncology, Barbara Ann Karmanos Cancer Institute, Wayne State University School of Medicine, Detroit, MI, U.S.A
| | - Hyejeong Jang
- Department of Oncology, Barbara Ann Karmanos Cancer Institute, Wayne State University School of Medicine, Detroit, MI, U.S.A
| | - Seongho Kim
- Department of Oncology, Barbara Ann Karmanos Cancer Institute, Wayne State University School of Medicine, Detroit, MI, U.S.A
| | - Shirish Gadgeel
- Department of Internal Medicine, Division of Hematology/Oncology, University of Michigan, Ann Arbor, MI, U.S.A
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O'Connor OA, Özcan M, Jacobsen ED, Roncero JM, Trotman J, Demeter J, Masszi T, Pereira J, Ramchandren R, Beaven A, Caballero D, Horwitz SM, Lennard A, Turgut M, Hamerschlak N, d'Amore FA, Foss F, Kim WS, Leonard JP, Zinzani PL, Chiattone CS, Hsi ED, Trümper L, Liu H, Sheldon-Waniga E, Ullmann CD, Venkatakrishnan K, Leonard EJ, Shustov AR. Randomized Phase III Study of Alisertib or Investigator's Choice (Selected Single Agent) in Patients With Relapsed or Refractory Peripheral T-Cell Lymphoma. J Clin Oncol 2019; 37:613-623. [PMID: 30707661 PMCID: PMC6494247 DOI: 10.1200/jco.18.00899] [Citation(s) in RCA: 78] [Impact Index Per Article: 15.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PURPOSE The aim of this open-label, first-in-setting, randomized phase III trial was to evaluate the efficacy of alisertib, an investigational Aurora A kinase inhibitor, in patients with relapsed/refractory peripheral T-cell lymphoma (PTCL). PATIENTS AND METHODS Adult patients with relapsed/refractory PTCL—one or more prior therapy—were randomly assigned 1:1 to receive oral alisertib 50 mg two times per day (days 1 to 7; 21-day cycle) or investigator-selected single-agent comparator, including intravenous pralatrexate 30 mg/m2 (once per week for 6 weeks; 7-week cycle), or intravenous gemcitabine 1,000 mg/m2 or intravenous romidepsin 14 mg/m2 (days 1, 8, and 15; 28-day cycle). Tumor tissue (disease subtype) and imaging were assessed by independent central review. Primary outcomes were overall response rate and progression-free survival (PFS). Two interim analyses and one final analysis were planned. RESULTS Between May 2012 and October 2014, 271 patients were randomly assigned (alisertib, n = 138; comparator, n = 133). Enrollment was stopped early on the recommendation of the independent data monitoring committee as a result of the low probability of alisertib achieving PFS superiority with full enrollment. Centrally assessed overall response rate was 33% for alisertib and 45% for the comparator arm (odds ratio, 0.60; 95% CI, 0.33 to 1.08). Median PFS was 115 days for alisertib and 104 days for the comparator arm (hazard ratio, 0.87; 95% CI, 0.637 to 1.178). The most common adverse events were anemia (53% of alisertib-treated patients v 34% of comparator-treated patients) and neutropenia (47% v 31%, respectively). A lower percentage of patients who received alisertib (9%) compared with the comparator (14%) experienced events that led to study drug discontinuation. Of 26 on-study deaths, five were considered treatment related (alisertib, n = 3 of 11; comparator, n = 2 of 15). Two-year overall survival was 35% for each arm. CONCLUSION In patients with relapsed/refractory PTCL, alisertib was not statistically significantly superior to the comparator arm.
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Affiliation(s)
| | - Muhit Özcan
- 2 Ankara University Medical School, Ankara, Turkey
| | | | | | - Judith Trotman
- 5 Concord Repatriation General Hospital, Concord, New South Wales, Australia.,6 University of Sydney, New South Wales, Australia
| | - Judit Demeter
- 7 Semmelweis Egyetem Általános Orvostudományi Kar, Budapest, Hungary
| | - Tamás Masszi
- 8 St. István and St. László Hospital, Budapest, Hungary.,9 Semmelweis University, Budapest, Hungary
| | - Juliana Pereira
- 10 Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | | | - Anne Beaven
- 12 Duke University Health System, Durham, NC
| | | | | | - Anne Lennard
- 15 Northern Centre for Cancer Care, Newcastle upon Tyne, United Kingdom
| | | | | | | | - Francine Foss
- 19 Smilow Cancer Hospital at Yale New Haven, New Haven, CT
| | - Won-Seog Kim
- 20 Sungkyunkwan University School of Medicine, Seoul, South Korea
| | | | | | | | | | - Lorenz Trümper
- 25 University Medical Center Göttingen, Göttingen, Germany
| | - Hua Liu
- 26 Millennium Pharmaceuticals, Cambridge, MA
| | | | | | | | | | - Andrei R Shustov
- 27 University of Washington, Seattle Cancer Care Alliance, Seattle, WA
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Ramchandren R, Advani RH, Ansell SM, Bartlett NL, Chen R, Connors JM, Feldman T, Forero-Torres A, Friedberg JW, Gopal AK, Gordon LI, Kuruvilla J, Savage KJ, Younes A, Engley G, Manley TJ, Fenton K, Straus DJ. Brentuximab Vedotin plus Chemotherapy in North American Subjects with Newly Diagnosed Stage III or IV Hodgkin Lymphoma. Clin Cancer Res 2019; 25:1718-1726. [PMID: 30617130 DOI: 10.1158/1078-0432.ccr-18-2435] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2018] [Revised: 11/12/2018] [Accepted: 01/04/2019] [Indexed: 11/16/2022]
Abstract
PURPOSE To evaluate safety and efficacy outcomes for subjects on the ECHELON-1 study treated in North America (NA). PATIENTS AND METHODS ECHELON-1 is a global, open-label, randomized phase III study comparing doxorubicin, vinblastine, and dacarbazine in combination with brentuximab vedotin (A+AVD) versus ABVD (AVD + bleomycin) as first-line therapy in subjects with stage III or IV classical Hodgkin lymphoma (cHL; NCT01712490). Subjects were randomized 1:1 to receive A+AVD or ABVD intravenously on days 1 and 15 of each 28-day cycle for up to 6 cycles. RESULTS The NA subgroup consisted of 497 subjects in the A+AVD (n = 250) and ABVD (n = 247) arms. Similar to the primary analysis based on the intent-to-treat population, the primary endpoint [modified progression-free survival (PFS) per independent review] demonstrated an improvement among subjects who received A+AVD compared with ABVD (HR = 0.60; P = 0.012). For PFS, the risk of progression or death was also reduced (HR = 0.50; P = 0.002). Subsequent anticancer therapies were lower in the A+AVD arm. Grade 3 or 4 adverse events (AEs) were more common, but there were fewer study discontinuations due to AEs in the A+AVD arm as compared with ABVD. Noted differences between arms included higher rates of febrile neutropenia (20% vs. 9%) and peripheral neuropathy (80% vs. 56%), but lower rates of pulmonary toxicity (3% vs. 10%) in subjects treated with A+AVD versus ABVD. CONCLUSIONS The efficacy benefit and manageable toxicity profile observed in the NA subgroup of ECHELON-1 support A+AVD as a frontline treatment option for patients with stage III or IV cHL.
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Affiliation(s)
| | - Ranjana H Advani
- Department of Medicine, Stanford University, Palo Alto, California
| | | | - Nancy L Bartlett
- Division of Oncology, Siteman Cancer Center, Washington University School of Medicine, St. Louis, Missouri
| | - Robert Chen
- Department of Hematology and Hematopoietic Cell Transplantation, City of Hope National Medical Center, Duarte, California
| | - Joseph M Connors
- University of British Columbia and the Department of Medical Oncology, British Columbia Cancer Centre for Lymphoid Cancer, Vancouver, British Columbia, Canada
| | - Tatyana Feldman
- John Theurer Cancer Centre, Hackensack University Medical Center, Hackensack, New Jersey
| | - Andres Forero-Torres
- Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama
| | - Jonathan W Friedberg
- James P Wilmot Cancer Institute, University of Rochester Medical Center, Rochester, New York
| | - Ajay K Gopal
- Fred Hutchinson Cancer Research Center, University of Washington, Seattle, Washington
| | - Leo I Gordon
- Robert H. Lurie Comprehensive Cancer Center, Northwestern University, Chicago, Illinois
| | - John Kuruvilla
- Division of Medical Oncology and Hematology, Princess Margaret Hospital, Toronto, Ontario, Canada
| | - Kerry J Savage
- University of British Columbia and the Department of Medical Oncology, British Columbia Cancer Centre for Lymphoid Cancer, Vancouver, British Columbia, Canada
| | - Anas Younes
- Lymphoma Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
| | | | | | | | - David J Straus
- Lymphoma Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
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41
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Johnston PB, Pinter-Brown LC, Warsi G, White K, Ramchandren R. Phase 2 study of everolimus for relapsed or refractory classical Hodgkin lymphoma. Exp Hematol Oncol 2018; 7:12. [PMID: 29774169 PMCID: PMC5948762 DOI: 10.1186/s40164-018-0103-z] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2018] [Accepted: 04/24/2018] [Indexed: 12/31/2022] Open
Abstract
Background The current standard of care for classical Hodgkin lymphoma (HL) is multiagent chemotherapy with or without radiation. In patients who relapse or fail to respond, additional high-dose chemotherapy with autologous hematopoietic stem cell transplantation (AHSCT) can improve progression-free survival (PFS). Novel therapies are required for patients refractory to chemotherapy and AHSCT. The mammalian target of rapamycin inhibitor everolimus has shown preliminary activity in preclinical models of HL and promising efficacy in patients with relapsed or refractory HL. Methods This was an open-label, two-stage, phase 2 study that enrolled 57 patients aged ≥ 18 years with classic HL that had progressed after standard therapy. Patients received everolimus 10 mg daily until disease progression, intolerable toxicity, withdrawal of consent, or investigator decision. The primary endpoint was overall response rate; secondary endpoints included PFS, overall survival, time to response, duration of response, and safety. Results Overall response rate was 45.6% (95% confidence interval [CI] 32.4–59.3%); five patients (8.8%) experienced a complete response and 21 patients had a partial response (36.8%). Median PFS was 8.0 months (95% CI 5.1–11.0 months). Seven patients (12%) were long-term responders (≥ 12 months). The most common study drug-related adverse events were thrombocytopenia (45.6%), fatigue (31.6%), anemia (26.3%), rash (24.6%), and stomatitis (22.8%). Conclusions Everolimus 10 mg/day demonstrated favorable results in patients with heavily pretreated, relapsed, or refractory classical HL. These findings support the further evaluation of everolimus in this indication. Trial registration ClinicalTrials.gov NCT01022996. Registered November 25, 2009
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Affiliation(s)
- Patrick B Johnston
- 1Division of Hematology, Mayo Clinic, 200 First Street SW, Rochester, MN 55905 USA
| | - Lauren C Pinter-Brown
- 2Department of Hematology/Oncology, David Geffen School of Medicine at UCLA, Los Angeles, CA USA
| | - Ghulam Warsi
- 3Department of Oncology, Novartis Pharmaceuticals Corporation, East Hanover, NJ USA
| | - Kristen White
- 3Department of Oncology, Novartis Pharmaceuticals Corporation, East Hanover, NJ USA
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Armand P, Engert A, Younes A, Fanale M, Santoro A, Zinzani PL, Timmerman JM, Collins GP, Ramchandren R, Cohen JB, De Boer JP, Kuruvilla J, Savage KJ, Trneny M, Shipp MA, Kato K, Sumbul A, Farsaci B, Ansell SM. Nivolumab for Relapsed/Refractory Classic Hodgkin Lymphoma After Failure of Autologous Hematopoietic Cell Transplantation: Extended Follow-Up of the Multicohort Single-Arm Phase II CheckMate 205 Trial. J Clin Oncol 2018; 36:1428-1439. [PMID: 29584546 PMCID: PMC6075855 DOI: 10.1200/jco.2017.76.0793] [Citation(s) in RCA: 471] [Impact Index Per Article: 78.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Purpose Genetic alterations causing overexpression of programmed death-1 ligands are near universal in classic Hodgkin lymphoma (cHL). Nivolumab, a programmed death-1 checkpoint inhibitor, demonstrated efficacy in relapsed/refractory cHL after autologous hematopoietic cell transplantation (auto-HCT) in initial analyses of one of three cohorts from the CheckMate 205 study of nivolumab for cHL. Here, we assess safety and efficacy after extended follow-up of all three cohorts. Methods This multicenter, single-arm, phase II study enrolled patients with relapsed/refractory cHL after auto-HCT treatment failure into cohorts by treatment history: brentuximab vedotin (BV)–naïve (cohort A), BV received after auto-HCT (cohort B), and BV received before and/or after auto-HCT (cohort C). All patients received nivolumab 3 mg/kg every 2 weeks until disease progression/unacceptable toxicity. The primary end point was objective response rate per independent radiology review committee. Results Overall, 243 patients were treated; 63 in cohort A, 80 in cohort B, and 100 in cohort C. After a median follow-up of 18 months, 40% continued to receive treatment. The objective response rate was 69% (95% CI, 63% to 75%) overall and 65% to 73% in each cohort. Overall, the median duration of response was 16.6 months (95% CI, 13.2 to 20.3 months), and median progression-free survival was 14.7 months (95% CI, 11.3 to 18.5 months). Of 70 patients treated past conventional disease progression, 61% of those evaluable had stable or further reduced target tumor burdens. The most common grade 3 to 4 drug-related adverse events were lipase increases (5%), neutropenia (3%), and ALT increases (3%). Twenty-nine deaths occurred; none were considered treatment related. Conclusion With extended follow-up, responses to nivolumab were frequent and durable. Nivolumab seems to be associated with a favorable safety profile and long-term benefits across a broad spectrum of patients with relapsed/refractory cHL.
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Affiliation(s)
- Philippe Armand
- Philippe Armand and Margaret A. Shipp, Dana-Farber Cancer Institute, Boston, MA; Andreas Engert, University Hospital of Cologne, Cologne, Germany; Anas Younes, Memorial Sloan Kettering Cancer Center, New York, NY; Michelle Fanale, University of Texas MD Anderson Cancer Center, Houston, TX; Armando Santoro, Humanitas Cancer Center, Humanitas University, Milan; Pier Luigi Zinzani, Institute of Hematology "L. e A. Seràgnoli," University of Bologna, Bologna, Italy; John M. Timmerman, University of California Los Angeles Medical Center, Los Angeles, CA; Graham P. Collins, Oxford Cancer and Haematology Centre, Churchill Hospital, Oxford, United Kingdom; Radhakrishnan Ramchandren, Barbara Ann Karmanos Cancer Institute, Detroit, MI; Jonathon B. Cohen, Winship Cancer Institute, Emory University, Atlanta, GA; Jan Paul De Boer, Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, the Netherlands, on behalf of Lunenburg Lymphoma Phase I/II Consortium; John Kuruvilla, University of Toronto and Princess Margaret Cancer Centre, Toronto, Ontario; Kerry J. Savage, BC Cancer Agency, Vancouver, British Columbia, Canada; Marek Trneny, Charles University, General Hospital in Prague, Prague, Czech Republic; Kazunobu Kato, Anne Sumbul, and Benedetto Farsaci, Bristol-Myers Squibb, Princeton, NJ; and Stephen M. Ansell, Mayo Clinic, Rochester, MN
| | - Andreas Engert
- Philippe Armand and Margaret A. Shipp, Dana-Farber Cancer Institute, Boston, MA; Andreas Engert, University Hospital of Cologne, Cologne, Germany; Anas Younes, Memorial Sloan Kettering Cancer Center, New York, NY; Michelle Fanale, University of Texas MD Anderson Cancer Center, Houston, TX; Armando Santoro, Humanitas Cancer Center, Humanitas University, Milan; Pier Luigi Zinzani, Institute of Hematology "L. e A. Seràgnoli," University of Bologna, Bologna, Italy; John M. Timmerman, University of California Los Angeles Medical Center, Los Angeles, CA; Graham P. Collins, Oxford Cancer and Haematology Centre, Churchill Hospital, Oxford, United Kingdom; Radhakrishnan Ramchandren, Barbara Ann Karmanos Cancer Institute, Detroit, MI; Jonathon B. Cohen, Winship Cancer Institute, Emory University, Atlanta, GA; Jan Paul De Boer, Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, the Netherlands, on behalf of Lunenburg Lymphoma Phase I/II Consortium; John Kuruvilla, University of Toronto and Princess Margaret Cancer Centre, Toronto, Ontario; Kerry J. Savage, BC Cancer Agency, Vancouver, British Columbia, Canada; Marek Trneny, Charles University, General Hospital in Prague, Prague, Czech Republic; Kazunobu Kato, Anne Sumbul, and Benedetto Farsaci, Bristol-Myers Squibb, Princeton, NJ; and Stephen M. Ansell, Mayo Clinic, Rochester, MN
| | - Anas Younes
- Philippe Armand and Margaret A. Shipp, Dana-Farber Cancer Institute, Boston, MA; Andreas Engert, University Hospital of Cologne, Cologne, Germany; Anas Younes, Memorial Sloan Kettering Cancer Center, New York, NY; Michelle Fanale, University of Texas MD Anderson Cancer Center, Houston, TX; Armando Santoro, Humanitas Cancer Center, Humanitas University, Milan; Pier Luigi Zinzani, Institute of Hematology "L. e A. Seràgnoli," University of Bologna, Bologna, Italy; John M. Timmerman, University of California Los Angeles Medical Center, Los Angeles, CA; Graham P. Collins, Oxford Cancer and Haematology Centre, Churchill Hospital, Oxford, United Kingdom; Radhakrishnan Ramchandren, Barbara Ann Karmanos Cancer Institute, Detroit, MI; Jonathon B. Cohen, Winship Cancer Institute, Emory University, Atlanta, GA; Jan Paul De Boer, Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, the Netherlands, on behalf of Lunenburg Lymphoma Phase I/II Consortium; John Kuruvilla, University of Toronto and Princess Margaret Cancer Centre, Toronto, Ontario; Kerry J. Savage, BC Cancer Agency, Vancouver, British Columbia, Canada; Marek Trneny, Charles University, General Hospital in Prague, Prague, Czech Republic; Kazunobu Kato, Anne Sumbul, and Benedetto Farsaci, Bristol-Myers Squibb, Princeton, NJ; and Stephen M. Ansell, Mayo Clinic, Rochester, MN
| | - Michelle Fanale
- Philippe Armand and Margaret A. Shipp, Dana-Farber Cancer Institute, Boston, MA; Andreas Engert, University Hospital of Cologne, Cologne, Germany; Anas Younes, Memorial Sloan Kettering Cancer Center, New York, NY; Michelle Fanale, University of Texas MD Anderson Cancer Center, Houston, TX; Armando Santoro, Humanitas Cancer Center, Humanitas University, Milan; Pier Luigi Zinzani, Institute of Hematology "L. e A. Seràgnoli," University of Bologna, Bologna, Italy; John M. Timmerman, University of California Los Angeles Medical Center, Los Angeles, CA; Graham P. Collins, Oxford Cancer and Haematology Centre, Churchill Hospital, Oxford, United Kingdom; Radhakrishnan Ramchandren, Barbara Ann Karmanos Cancer Institute, Detroit, MI; Jonathon B. Cohen, Winship Cancer Institute, Emory University, Atlanta, GA; Jan Paul De Boer, Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, the Netherlands, on behalf of Lunenburg Lymphoma Phase I/II Consortium; John Kuruvilla, University of Toronto and Princess Margaret Cancer Centre, Toronto, Ontario; Kerry J. Savage, BC Cancer Agency, Vancouver, British Columbia, Canada; Marek Trneny, Charles University, General Hospital in Prague, Prague, Czech Republic; Kazunobu Kato, Anne Sumbul, and Benedetto Farsaci, Bristol-Myers Squibb, Princeton, NJ; and Stephen M. Ansell, Mayo Clinic, Rochester, MN
| | - Armando Santoro
- Philippe Armand and Margaret A. Shipp, Dana-Farber Cancer Institute, Boston, MA; Andreas Engert, University Hospital of Cologne, Cologne, Germany; Anas Younes, Memorial Sloan Kettering Cancer Center, New York, NY; Michelle Fanale, University of Texas MD Anderson Cancer Center, Houston, TX; Armando Santoro, Humanitas Cancer Center, Humanitas University, Milan; Pier Luigi Zinzani, Institute of Hematology "L. e A. Seràgnoli," University of Bologna, Bologna, Italy; John M. Timmerman, University of California Los Angeles Medical Center, Los Angeles, CA; Graham P. Collins, Oxford Cancer and Haematology Centre, Churchill Hospital, Oxford, United Kingdom; Radhakrishnan Ramchandren, Barbara Ann Karmanos Cancer Institute, Detroit, MI; Jonathon B. Cohen, Winship Cancer Institute, Emory University, Atlanta, GA; Jan Paul De Boer, Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, the Netherlands, on behalf of Lunenburg Lymphoma Phase I/II Consortium; John Kuruvilla, University of Toronto and Princess Margaret Cancer Centre, Toronto, Ontario; Kerry J. Savage, BC Cancer Agency, Vancouver, British Columbia, Canada; Marek Trneny, Charles University, General Hospital in Prague, Prague, Czech Republic; Kazunobu Kato, Anne Sumbul, and Benedetto Farsaci, Bristol-Myers Squibb, Princeton, NJ; and Stephen M. Ansell, Mayo Clinic, Rochester, MN
| | - Pier Luigi Zinzani
- Philippe Armand and Margaret A. Shipp, Dana-Farber Cancer Institute, Boston, MA; Andreas Engert, University Hospital of Cologne, Cologne, Germany; Anas Younes, Memorial Sloan Kettering Cancer Center, New York, NY; Michelle Fanale, University of Texas MD Anderson Cancer Center, Houston, TX; Armando Santoro, Humanitas Cancer Center, Humanitas University, Milan; Pier Luigi Zinzani, Institute of Hematology "L. e A. Seràgnoli," University of Bologna, Bologna, Italy; John M. Timmerman, University of California Los Angeles Medical Center, Los Angeles, CA; Graham P. Collins, Oxford Cancer and Haematology Centre, Churchill Hospital, Oxford, United Kingdom; Radhakrishnan Ramchandren, Barbara Ann Karmanos Cancer Institute, Detroit, MI; Jonathon B. Cohen, Winship Cancer Institute, Emory University, Atlanta, GA; Jan Paul De Boer, Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, the Netherlands, on behalf of Lunenburg Lymphoma Phase I/II Consortium; John Kuruvilla, University of Toronto and Princess Margaret Cancer Centre, Toronto, Ontario; Kerry J. Savage, BC Cancer Agency, Vancouver, British Columbia, Canada; Marek Trneny, Charles University, General Hospital in Prague, Prague, Czech Republic; Kazunobu Kato, Anne Sumbul, and Benedetto Farsaci, Bristol-Myers Squibb, Princeton, NJ; and Stephen M. Ansell, Mayo Clinic, Rochester, MN
| | - John M Timmerman
- Philippe Armand and Margaret A. Shipp, Dana-Farber Cancer Institute, Boston, MA; Andreas Engert, University Hospital of Cologne, Cologne, Germany; Anas Younes, Memorial Sloan Kettering Cancer Center, New York, NY; Michelle Fanale, University of Texas MD Anderson Cancer Center, Houston, TX; Armando Santoro, Humanitas Cancer Center, Humanitas University, Milan; Pier Luigi Zinzani, Institute of Hematology "L. e A. Seràgnoli," University of Bologna, Bologna, Italy; John M. Timmerman, University of California Los Angeles Medical Center, Los Angeles, CA; Graham P. Collins, Oxford Cancer and Haematology Centre, Churchill Hospital, Oxford, United Kingdom; Radhakrishnan Ramchandren, Barbara Ann Karmanos Cancer Institute, Detroit, MI; Jonathon B. Cohen, Winship Cancer Institute, Emory University, Atlanta, GA; Jan Paul De Boer, Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, the Netherlands, on behalf of Lunenburg Lymphoma Phase I/II Consortium; John Kuruvilla, University of Toronto and Princess Margaret Cancer Centre, Toronto, Ontario; Kerry J. Savage, BC Cancer Agency, Vancouver, British Columbia, Canada; Marek Trneny, Charles University, General Hospital in Prague, Prague, Czech Republic; Kazunobu Kato, Anne Sumbul, and Benedetto Farsaci, Bristol-Myers Squibb, Princeton, NJ; and Stephen M. Ansell, Mayo Clinic, Rochester, MN
| | - Graham P Collins
- Philippe Armand and Margaret A. Shipp, Dana-Farber Cancer Institute, Boston, MA; Andreas Engert, University Hospital of Cologne, Cologne, Germany; Anas Younes, Memorial Sloan Kettering Cancer Center, New York, NY; Michelle Fanale, University of Texas MD Anderson Cancer Center, Houston, TX; Armando Santoro, Humanitas Cancer Center, Humanitas University, Milan; Pier Luigi Zinzani, Institute of Hematology "L. e A. Seràgnoli," University of Bologna, Bologna, Italy; John M. Timmerman, University of California Los Angeles Medical Center, Los Angeles, CA; Graham P. Collins, Oxford Cancer and Haematology Centre, Churchill Hospital, Oxford, United Kingdom; Radhakrishnan Ramchandren, Barbara Ann Karmanos Cancer Institute, Detroit, MI; Jonathon B. Cohen, Winship Cancer Institute, Emory University, Atlanta, GA; Jan Paul De Boer, Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, the Netherlands, on behalf of Lunenburg Lymphoma Phase I/II Consortium; John Kuruvilla, University of Toronto and Princess Margaret Cancer Centre, Toronto, Ontario; Kerry J. Savage, BC Cancer Agency, Vancouver, British Columbia, Canada; Marek Trneny, Charles University, General Hospital in Prague, Prague, Czech Republic; Kazunobu Kato, Anne Sumbul, and Benedetto Farsaci, Bristol-Myers Squibb, Princeton, NJ; and Stephen M. Ansell, Mayo Clinic, Rochester, MN
| | - Radhakrishnan Ramchandren
- Philippe Armand and Margaret A. Shipp, Dana-Farber Cancer Institute, Boston, MA; Andreas Engert, University Hospital of Cologne, Cologne, Germany; Anas Younes, Memorial Sloan Kettering Cancer Center, New York, NY; Michelle Fanale, University of Texas MD Anderson Cancer Center, Houston, TX; Armando Santoro, Humanitas Cancer Center, Humanitas University, Milan; Pier Luigi Zinzani, Institute of Hematology "L. e A. Seràgnoli," University of Bologna, Bologna, Italy; John M. Timmerman, University of California Los Angeles Medical Center, Los Angeles, CA; Graham P. Collins, Oxford Cancer and Haematology Centre, Churchill Hospital, Oxford, United Kingdom; Radhakrishnan Ramchandren, Barbara Ann Karmanos Cancer Institute, Detroit, MI; Jonathon B. Cohen, Winship Cancer Institute, Emory University, Atlanta, GA; Jan Paul De Boer, Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, the Netherlands, on behalf of Lunenburg Lymphoma Phase I/II Consortium; John Kuruvilla, University of Toronto and Princess Margaret Cancer Centre, Toronto, Ontario; Kerry J. Savage, BC Cancer Agency, Vancouver, British Columbia, Canada; Marek Trneny, Charles University, General Hospital in Prague, Prague, Czech Republic; Kazunobu Kato, Anne Sumbul, and Benedetto Farsaci, Bristol-Myers Squibb, Princeton, NJ; and Stephen M. Ansell, Mayo Clinic, Rochester, MN
| | - Jonathon B Cohen
- Philippe Armand and Margaret A. Shipp, Dana-Farber Cancer Institute, Boston, MA; Andreas Engert, University Hospital of Cologne, Cologne, Germany; Anas Younes, Memorial Sloan Kettering Cancer Center, New York, NY; Michelle Fanale, University of Texas MD Anderson Cancer Center, Houston, TX; Armando Santoro, Humanitas Cancer Center, Humanitas University, Milan; Pier Luigi Zinzani, Institute of Hematology "L. e A. Seràgnoli," University of Bologna, Bologna, Italy; John M. Timmerman, University of California Los Angeles Medical Center, Los Angeles, CA; Graham P. Collins, Oxford Cancer and Haematology Centre, Churchill Hospital, Oxford, United Kingdom; Radhakrishnan Ramchandren, Barbara Ann Karmanos Cancer Institute, Detroit, MI; Jonathon B. Cohen, Winship Cancer Institute, Emory University, Atlanta, GA; Jan Paul De Boer, Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, the Netherlands, on behalf of Lunenburg Lymphoma Phase I/II Consortium; John Kuruvilla, University of Toronto and Princess Margaret Cancer Centre, Toronto, Ontario; Kerry J. Savage, BC Cancer Agency, Vancouver, British Columbia, Canada; Marek Trneny, Charles University, General Hospital in Prague, Prague, Czech Republic; Kazunobu Kato, Anne Sumbul, and Benedetto Farsaci, Bristol-Myers Squibb, Princeton, NJ; and Stephen M. Ansell, Mayo Clinic, Rochester, MN
| | - Jan Paul De Boer
- Philippe Armand and Margaret A. Shipp, Dana-Farber Cancer Institute, Boston, MA; Andreas Engert, University Hospital of Cologne, Cologne, Germany; Anas Younes, Memorial Sloan Kettering Cancer Center, New York, NY; Michelle Fanale, University of Texas MD Anderson Cancer Center, Houston, TX; Armando Santoro, Humanitas Cancer Center, Humanitas University, Milan; Pier Luigi Zinzani, Institute of Hematology "L. e A. Seràgnoli," University of Bologna, Bologna, Italy; John M. Timmerman, University of California Los Angeles Medical Center, Los Angeles, CA; Graham P. Collins, Oxford Cancer and Haematology Centre, Churchill Hospital, Oxford, United Kingdom; Radhakrishnan Ramchandren, Barbara Ann Karmanos Cancer Institute, Detroit, MI; Jonathon B. Cohen, Winship Cancer Institute, Emory University, Atlanta, GA; Jan Paul De Boer, Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, the Netherlands, on behalf of Lunenburg Lymphoma Phase I/II Consortium; John Kuruvilla, University of Toronto and Princess Margaret Cancer Centre, Toronto, Ontario; Kerry J. Savage, BC Cancer Agency, Vancouver, British Columbia, Canada; Marek Trneny, Charles University, General Hospital in Prague, Prague, Czech Republic; Kazunobu Kato, Anne Sumbul, and Benedetto Farsaci, Bristol-Myers Squibb, Princeton, NJ; and Stephen M. Ansell, Mayo Clinic, Rochester, MN
| | - John Kuruvilla
- Philippe Armand and Margaret A. Shipp, Dana-Farber Cancer Institute, Boston, MA; Andreas Engert, University Hospital of Cologne, Cologne, Germany; Anas Younes, Memorial Sloan Kettering Cancer Center, New York, NY; Michelle Fanale, University of Texas MD Anderson Cancer Center, Houston, TX; Armando Santoro, Humanitas Cancer Center, Humanitas University, Milan; Pier Luigi Zinzani, Institute of Hematology "L. e A. Seràgnoli," University of Bologna, Bologna, Italy; John M. Timmerman, University of California Los Angeles Medical Center, Los Angeles, CA; Graham P. Collins, Oxford Cancer and Haematology Centre, Churchill Hospital, Oxford, United Kingdom; Radhakrishnan Ramchandren, Barbara Ann Karmanos Cancer Institute, Detroit, MI; Jonathon B. Cohen, Winship Cancer Institute, Emory University, Atlanta, GA; Jan Paul De Boer, Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, the Netherlands, on behalf of Lunenburg Lymphoma Phase I/II Consortium; John Kuruvilla, University of Toronto and Princess Margaret Cancer Centre, Toronto, Ontario; Kerry J. Savage, BC Cancer Agency, Vancouver, British Columbia, Canada; Marek Trneny, Charles University, General Hospital in Prague, Prague, Czech Republic; Kazunobu Kato, Anne Sumbul, and Benedetto Farsaci, Bristol-Myers Squibb, Princeton, NJ; and Stephen M. Ansell, Mayo Clinic, Rochester, MN
| | - Kerry J Savage
- Philippe Armand and Margaret A. Shipp, Dana-Farber Cancer Institute, Boston, MA; Andreas Engert, University Hospital of Cologne, Cologne, Germany; Anas Younes, Memorial Sloan Kettering Cancer Center, New York, NY; Michelle Fanale, University of Texas MD Anderson Cancer Center, Houston, TX; Armando Santoro, Humanitas Cancer Center, Humanitas University, Milan; Pier Luigi Zinzani, Institute of Hematology "L. e A. Seràgnoli," University of Bologna, Bologna, Italy; John M. Timmerman, University of California Los Angeles Medical Center, Los Angeles, CA; Graham P. Collins, Oxford Cancer and Haematology Centre, Churchill Hospital, Oxford, United Kingdom; Radhakrishnan Ramchandren, Barbara Ann Karmanos Cancer Institute, Detroit, MI; Jonathon B. Cohen, Winship Cancer Institute, Emory University, Atlanta, GA; Jan Paul De Boer, Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, the Netherlands, on behalf of Lunenburg Lymphoma Phase I/II Consortium; John Kuruvilla, University of Toronto and Princess Margaret Cancer Centre, Toronto, Ontario; Kerry J. Savage, BC Cancer Agency, Vancouver, British Columbia, Canada; Marek Trneny, Charles University, General Hospital in Prague, Prague, Czech Republic; Kazunobu Kato, Anne Sumbul, and Benedetto Farsaci, Bristol-Myers Squibb, Princeton, NJ; and Stephen M. Ansell, Mayo Clinic, Rochester, MN
| | - Marek Trneny
- Philippe Armand and Margaret A. Shipp, Dana-Farber Cancer Institute, Boston, MA; Andreas Engert, University Hospital of Cologne, Cologne, Germany; Anas Younes, Memorial Sloan Kettering Cancer Center, New York, NY; Michelle Fanale, University of Texas MD Anderson Cancer Center, Houston, TX; Armando Santoro, Humanitas Cancer Center, Humanitas University, Milan; Pier Luigi Zinzani, Institute of Hematology "L. e A. Seràgnoli," University of Bologna, Bologna, Italy; John M. Timmerman, University of California Los Angeles Medical Center, Los Angeles, CA; Graham P. Collins, Oxford Cancer and Haematology Centre, Churchill Hospital, Oxford, United Kingdom; Radhakrishnan Ramchandren, Barbara Ann Karmanos Cancer Institute, Detroit, MI; Jonathon B. Cohen, Winship Cancer Institute, Emory University, Atlanta, GA; Jan Paul De Boer, Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, the Netherlands, on behalf of Lunenburg Lymphoma Phase I/II Consortium; John Kuruvilla, University of Toronto and Princess Margaret Cancer Centre, Toronto, Ontario; Kerry J. Savage, BC Cancer Agency, Vancouver, British Columbia, Canada; Marek Trneny, Charles University, General Hospital in Prague, Prague, Czech Republic; Kazunobu Kato, Anne Sumbul, and Benedetto Farsaci, Bristol-Myers Squibb, Princeton, NJ; and Stephen M. Ansell, Mayo Clinic, Rochester, MN
| | - Margaret A Shipp
- Philippe Armand and Margaret A. Shipp, Dana-Farber Cancer Institute, Boston, MA; Andreas Engert, University Hospital of Cologne, Cologne, Germany; Anas Younes, Memorial Sloan Kettering Cancer Center, New York, NY; Michelle Fanale, University of Texas MD Anderson Cancer Center, Houston, TX; Armando Santoro, Humanitas Cancer Center, Humanitas University, Milan; Pier Luigi Zinzani, Institute of Hematology "L. e A. Seràgnoli," University of Bologna, Bologna, Italy; John M. Timmerman, University of California Los Angeles Medical Center, Los Angeles, CA; Graham P. Collins, Oxford Cancer and Haematology Centre, Churchill Hospital, Oxford, United Kingdom; Radhakrishnan Ramchandren, Barbara Ann Karmanos Cancer Institute, Detroit, MI; Jonathon B. Cohen, Winship Cancer Institute, Emory University, Atlanta, GA; Jan Paul De Boer, Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, the Netherlands, on behalf of Lunenburg Lymphoma Phase I/II Consortium; John Kuruvilla, University of Toronto and Princess Margaret Cancer Centre, Toronto, Ontario; Kerry J. Savage, BC Cancer Agency, Vancouver, British Columbia, Canada; Marek Trneny, Charles University, General Hospital in Prague, Prague, Czech Republic; Kazunobu Kato, Anne Sumbul, and Benedetto Farsaci, Bristol-Myers Squibb, Princeton, NJ; and Stephen M. Ansell, Mayo Clinic, Rochester, MN
| | - Kazunobu Kato
- Philippe Armand and Margaret A. Shipp, Dana-Farber Cancer Institute, Boston, MA; Andreas Engert, University Hospital of Cologne, Cologne, Germany; Anas Younes, Memorial Sloan Kettering Cancer Center, New York, NY; Michelle Fanale, University of Texas MD Anderson Cancer Center, Houston, TX; Armando Santoro, Humanitas Cancer Center, Humanitas University, Milan; Pier Luigi Zinzani, Institute of Hematology "L. e A. Seràgnoli," University of Bologna, Bologna, Italy; John M. Timmerman, University of California Los Angeles Medical Center, Los Angeles, CA; Graham P. Collins, Oxford Cancer and Haematology Centre, Churchill Hospital, Oxford, United Kingdom; Radhakrishnan Ramchandren, Barbara Ann Karmanos Cancer Institute, Detroit, MI; Jonathon B. Cohen, Winship Cancer Institute, Emory University, Atlanta, GA; Jan Paul De Boer, Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, the Netherlands, on behalf of Lunenburg Lymphoma Phase I/II Consortium; John Kuruvilla, University of Toronto and Princess Margaret Cancer Centre, Toronto, Ontario; Kerry J. Savage, BC Cancer Agency, Vancouver, British Columbia, Canada; Marek Trneny, Charles University, General Hospital in Prague, Prague, Czech Republic; Kazunobu Kato, Anne Sumbul, and Benedetto Farsaci, Bristol-Myers Squibb, Princeton, NJ; and Stephen M. Ansell, Mayo Clinic, Rochester, MN
| | - Anne Sumbul
- Philippe Armand and Margaret A. Shipp, Dana-Farber Cancer Institute, Boston, MA; Andreas Engert, University Hospital of Cologne, Cologne, Germany; Anas Younes, Memorial Sloan Kettering Cancer Center, New York, NY; Michelle Fanale, University of Texas MD Anderson Cancer Center, Houston, TX; Armando Santoro, Humanitas Cancer Center, Humanitas University, Milan; Pier Luigi Zinzani, Institute of Hematology "L. e A. Seràgnoli," University of Bologna, Bologna, Italy; John M. Timmerman, University of California Los Angeles Medical Center, Los Angeles, CA; Graham P. Collins, Oxford Cancer and Haematology Centre, Churchill Hospital, Oxford, United Kingdom; Radhakrishnan Ramchandren, Barbara Ann Karmanos Cancer Institute, Detroit, MI; Jonathon B. Cohen, Winship Cancer Institute, Emory University, Atlanta, GA; Jan Paul De Boer, Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, the Netherlands, on behalf of Lunenburg Lymphoma Phase I/II Consortium; John Kuruvilla, University of Toronto and Princess Margaret Cancer Centre, Toronto, Ontario; Kerry J. Savage, BC Cancer Agency, Vancouver, British Columbia, Canada; Marek Trneny, Charles University, General Hospital in Prague, Prague, Czech Republic; Kazunobu Kato, Anne Sumbul, and Benedetto Farsaci, Bristol-Myers Squibb, Princeton, NJ; and Stephen M. Ansell, Mayo Clinic, Rochester, MN
| | - Benedetto Farsaci
- Philippe Armand and Margaret A. Shipp, Dana-Farber Cancer Institute, Boston, MA; Andreas Engert, University Hospital of Cologne, Cologne, Germany; Anas Younes, Memorial Sloan Kettering Cancer Center, New York, NY; Michelle Fanale, University of Texas MD Anderson Cancer Center, Houston, TX; Armando Santoro, Humanitas Cancer Center, Humanitas University, Milan; Pier Luigi Zinzani, Institute of Hematology "L. e A. Seràgnoli," University of Bologna, Bologna, Italy; John M. Timmerman, University of California Los Angeles Medical Center, Los Angeles, CA; Graham P. Collins, Oxford Cancer and Haematology Centre, Churchill Hospital, Oxford, United Kingdom; Radhakrishnan Ramchandren, Barbara Ann Karmanos Cancer Institute, Detroit, MI; Jonathon B. Cohen, Winship Cancer Institute, Emory University, Atlanta, GA; Jan Paul De Boer, Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, the Netherlands, on behalf of Lunenburg Lymphoma Phase I/II Consortium; John Kuruvilla, University of Toronto and Princess Margaret Cancer Centre, Toronto, Ontario; Kerry J. Savage, BC Cancer Agency, Vancouver, British Columbia, Canada; Marek Trneny, Charles University, General Hospital in Prague, Prague, Czech Republic; Kazunobu Kato, Anne Sumbul, and Benedetto Farsaci, Bristol-Myers Squibb, Princeton, NJ; and Stephen M. Ansell, Mayo Clinic, Rochester, MN
| | - Stephen M Ansell
- Philippe Armand and Margaret A. Shipp, Dana-Farber Cancer Institute, Boston, MA; Andreas Engert, University Hospital of Cologne, Cologne, Germany; Anas Younes, Memorial Sloan Kettering Cancer Center, New York, NY; Michelle Fanale, University of Texas MD Anderson Cancer Center, Houston, TX; Armando Santoro, Humanitas Cancer Center, Humanitas University, Milan; Pier Luigi Zinzani, Institute of Hematology "L. e A. Seràgnoli," University of Bologna, Bologna, Italy; John M. Timmerman, University of California Los Angeles Medical Center, Los Angeles, CA; Graham P. Collins, Oxford Cancer and Haematology Centre, Churchill Hospital, Oxford, United Kingdom; Radhakrishnan Ramchandren, Barbara Ann Karmanos Cancer Institute, Detroit, MI; Jonathon B. Cohen, Winship Cancer Institute, Emory University, Atlanta, GA; Jan Paul De Boer, Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, the Netherlands, on behalf of Lunenburg Lymphoma Phase I/II Consortium; John Kuruvilla, University of Toronto and Princess Margaret Cancer Centre, Toronto, Ontario; Kerry J. Savage, BC Cancer Agency, Vancouver, British Columbia, Canada; Marek Trneny, Charles University, General Hospital in Prague, Prague, Czech Republic; Kazunobu Kato, Anne Sumbul, and Benedetto Farsaci, Bristol-Myers Squibb, Princeton, NJ; and Stephen M. Ansell, Mayo Clinic, Rochester, MN
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Herrera AF, Moskowitz AJ, Bartlett NL, Vose JM, Ramchandren R, Feldman TA, LaCasce AS, Ansell SM, Moskowitz CH, Fenton K, Ogden CA, Taft D, Zhang Q, Kato K, Campbell M, Advani RH. Interim results of brentuximab vedotin in combination with nivolumab in patients with relapsed or refractory Hodgkin lymphoma. Blood 2018; 131:1183-1194. [PMID: 29229594 PMCID: PMC5855021 DOI: 10.1182/blood-2017-10-811224] [Citation(s) in RCA: 236] [Impact Index Per Article: 39.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2017] [Accepted: 11/30/2017] [Indexed: 12/13/2022] Open
Abstract
In this phase 1/2 study, brentuximab vedotin (BV) and nivolumab (Nivo) administered in combination were evaluated as initial salvage therapy in patients with relapsed or refractory (R/R) classical Hodgkin lymphoma (HL). Patients received up to 4 cycles of combination treatment, with BV administered on day 1 and Nivo on day 8 of the first cycle. For cycles 2 to 4, BV and Nivo were both administered on day 1. After study treatment, responses were evaluated by investigators per the 2014 Lugano classification, and patients could proceed to autologous stem cell transplantation (ASCT). Sixty-two patients were enrolled; the complete response rate among all treated patients (n = 61) was 61%, with an objective response rate of 82%. Before ASCT, adverse events (AEs) occurred in 98% of patients, mostly grades 1 and 2. Infusion-related reactions (IRRs) occurred in 44% of patients overall, with 41% of patients experiencing an IRR during at least 1 infusion of BV. Five patients (8%) were treated with systemic steroids for immune-related AEs. A reduction of peripheral T-cell subsets including regulatory T cells was observed after the first dose of BV, and reduced serum levels of thymus- and activation-regulated chemokine concurrent with an increase in proinflammatory cytokines and chemokines were seen after the first BV plus Nivo infusions. The combination of BV plus Nivo was an active and well-tolerated first salvage regimen, potentially providing patients with R/R HL an alternative to traditional chemotherapy. This trial was registered at www.clinicaltrials.gov as #NCT02572167.
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Affiliation(s)
| | | | - Nancy L Bartlett
- Division of Hematology and Oncology, Washington University School of Medicine, St. Louis, MO
| | - Julie M Vose
- University of Nebraska Medical Center, Omaha, NE
| | | | | | | | | | | | | | | | | | - Qu Zhang
- Seattle Genetics, Inc, Bothell, WA
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44
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Roemer MGM, Redd RA, Cader FZ, Pak CJ, Abdelrahman S, Ouyang J, Sasse S, Younes A, Fanale M, Santoro A, Zinzani PL, Timmerman J, Collins GP, Ramchandren R, Cohen JB, De Boer JP, Kuruvilla J, Savage KJ, Trneny M, Ansell S, Kato K, Farsaci B, Sumbul A, Armand P, Neuberg DS, Pinkus GS, Ligon AH, Rodig SJ, Shipp MA. Major Histocompatibility Complex Class II and Programmed Death Ligand 1 Expression Predict Outcome After Programmed Death 1 Blockade in Classic Hodgkin Lymphoma. J Clin Oncol 2018; 36:942-950. [PMID: 29394125 DOI: 10.1200/jco.2017.77.3994] [Citation(s) in RCA: 244] [Impact Index Per Article: 40.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Purpose Hodgkin Reed-Sternberg (HRS) cells evade antitumor immunity by multiple means, including gains of 9p24.1/ CD274(PD-L1)/ PDCD1LG2(PD-L2) and perturbed antigen presentation. Programmed death 1 (PD-1) receptor blockade is active in classic Hodgkin lymphoma (cHL) despite reported deficiencies of major histocompatibility complex (MHC) class I expression on HRS cells. Herein, we assess bases of sensitivity to PD-1 blockade in patients with relapsed/refractory cHL who were treated with nivolumab (anti-PD-1) in the CheckMate 205 trial. Methods HRS cells from archival tumor biopsies were evaluated for 9p24.1 alterations by fluorescence in situ hybridization and for expression of PD ligand 1 (PD-L1) and the antigen presentation pathway components-β2-microglobulin, MHC class I, and MHC class II-by immunohistochemistry. These parameters were correlated with clinical responses and progression-free survival (PFS) after PD-1 blockade. Results Patients with higher-level 9p24.1 copy gain and increased PD-L1 expression on HRS cells had superior PFS. HRS cell expression of β2-microglobulin/MHC class I was not predictive for complete remission or PFS after nivolumab therapy. In contrast, HRS cell expression of MHC class II was predictive for complete remission. In patients with a > 12-month interval between myeloablative autologous stem-cell transplantation and nivolumab therapy, HRS cell expression of MHC class II was associated with prolonged PFS. Conclusion Genetically driven PD-L1 expression and MHC class II positivity on HRS cells are potential predictors of favorable outcome after PD-1 blockade. In cHL, clinical responses to nivolumab were not dependent on HRS cell expression of MHC class I.
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Affiliation(s)
- Margaretha G M Roemer
- Margaretha G.M. Roemer, Robert A. Redd, Fathima Zumla Cader, Christine J. Pak, Sara Abdelrahman, Jing Ouyang, Philippe Armand, Donna S. Neuberg, and Margaret A. Shipp, Dana-Farber Cancer Institute; Geraldine S. Pinkus, Azra H. Ligon, and Scott J. Rodig, Brigham and Women's Hospital, Boston, MA; Margaretha G.M. Roemer, VU University Medical Center; Jan Paul De Boer, Antoni van Leeuwenhoek Hospital, Lunenburg Phase I/II Consortium, Amsterdam, the Netherlands; Stephanie Sasse, University Hospital of Cologne, Cologne, Germany; Anas Younes, Memorial Sloan Kettering Cancer Center, New York, NY; Michelle Fanale, University of Texas MD Anderson Cancer Center, Houston, TX; Armando Santoro, Humanitas University, Rozzano, Milan; Pier Luigi Zinzani, University of Bologna, Bologna, Italy; John Timmerman, University of California, Los Angeles Medical Center, Los Angeles, CA; Graham P. Collins, Churchill Hospital, Oxford, United Kingdom; Radhakrishnan Ramchandren, Barbara Ann Karmanos Cancer Institute, Detroit, MI; Jonathon B. Cohen, Emory University, Atlanta, GA; John Kuruvilla, Princess Margaret Cancer Centre, Toronto, Ontario, Canada; Kerry J. Savage, British Columbia Cancer Agency Center for Lymphoid Cancer, Vancouver, British Columbia, Canada; Marek Trneny, Charles University in Prague, General University Hospital in Prague, Prague, Czech Republic; Stephen Ansell, Mayo Clinic, Rochester, MN; and Kazunobu Kato, Benedetto Farsaci, and Anne Sumbul, Bristol-Myers Squibb, Princeton, NJ
| | - Robert A Redd
- Margaretha G.M. Roemer, Robert A. Redd, Fathima Zumla Cader, Christine J. Pak, Sara Abdelrahman, Jing Ouyang, Philippe Armand, Donna S. Neuberg, and Margaret A. Shipp, Dana-Farber Cancer Institute; Geraldine S. Pinkus, Azra H. Ligon, and Scott J. Rodig, Brigham and Women's Hospital, Boston, MA; Margaretha G.M. Roemer, VU University Medical Center; Jan Paul De Boer, Antoni van Leeuwenhoek Hospital, Lunenburg Phase I/II Consortium, Amsterdam, the Netherlands; Stephanie Sasse, University Hospital of Cologne, Cologne, Germany; Anas Younes, Memorial Sloan Kettering Cancer Center, New York, NY; Michelle Fanale, University of Texas MD Anderson Cancer Center, Houston, TX; Armando Santoro, Humanitas University, Rozzano, Milan; Pier Luigi Zinzani, University of Bologna, Bologna, Italy; John Timmerman, University of California, Los Angeles Medical Center, Los Angeles, CA; Graham P. Collins, Churchill Hospital, Oxford, United Kingdom; Radhakrishnan Ramchandren, Barbara Ann Karmanos Cancer Institute, Detroit, MI; Jonathon B. Cohen, Emory University, Atlanta, GA; John Kuruvilla, Princess Margaret Cancer Centre, Toronto, Ontario, Canada; Kerry J. Savage, British Columbia Cancer Agency Center for Lymphoid Cancer, Vancouver, British Columbia, Canada; Marek Trneny, Charles University in Prague, General University Hospital in Prague, Prague, Czech Republic; Stephen Ansell, Mayo Clinic, Rochester, MN; and Kazunobu Kato, Benedetto Farsaci, and Anne Sumbul, Bristol-Myers Squibb, Princeton, NJ
| | - Fathima Zumla Cader
- Margaretha G.M. Roemer, Robert A. Redd, Fathima Zumla Cader, Christine J. Pak, Sara Abdelrahman, Jing Ouyang, Philippe Armand, Donna S. Neuberg, and Margaret A. Shipp, Dana-Farber Cancer Institute; Geraldine S. Pinkus, Azra H. Ligon, and Scott J. Rodig, Brigham and Women's Hospital, Boston, MA; Margaretha G.M. Roemer, VU University Medical Center; Jan Paul De Boer, Antoni van Leeuwenhoek Hospital, Lunenburg Phase I/II Consortium, Amsterdam, the Netherlands; Stephanie Sasse, University Hospital of Cologne, Cologne, Germany; Anas Younes, Memorial Sloan Kettering Cancer Center, New York, NY; Michelle Fanale, University of Texas MD Anderson Cancer Center, Houston, TX; Armando Santoro, Humanitas University, Rozzano, Milan; Pier Luigi Zinzani, University of Bologna, Bologna, Italy; John Timmerman, University of California, Los Angeles Medical Center, Los Angeles, CA; Graham P. Collins, Churchill Hospital, Oxford, United Kingdom; Radhakrishnan Ramchandren, Barbara Ann Karmanos Cancer Institute, Detroit, MI; Jonathon B. Cohen, Emory University, Atlanta, GA; John Kuruvilla, Princess Margaret Cancer Centre, Toronto, Ontario, Canada; Kerry J. Savage, British Columbia Cancer Agency Center for Lymphoid Cancer, Vancouver, British Columbia, Canada; Marek Trneny, Charles University in Prague, General University Hospital in Prague, Prague, Czech Republic; Stephen Ansell, Mayo Clinic, Rochester, MN; and Kazunobu Kato, Benedetto Farsaci, and Anne Sumbul, Bristol-Myers Squibb, Princeton, NJ
| | - Christine J Pak
- Margaretha G.M. Roemer, Robert A. Redd, Fathima Zumla Cader, Christine J. Pak, Sara Abdelrahman, Jing Ouyang, Philippe Armand, Donna S. Neuberg, and Margaret A. Shipp, Dana-Farber Cancer Institute; Geraldine S. Pinkus, Azra H. Ligon, and Scott J. Rodig, Brigham and Women's Hospital, Boston, MA; Margaretha G.M. Roemer, VU University Medical Center; Jan Paul De Boer, Antoni van Leeuwenhoek Hospital, Lunenburg Phase I/II Consortium, Amsterdam, the Netherlands; Stephanie Sasse, University Hospital of Cologne, Cologne, Germany; Anas Younes, Memorial Sloan Kettering Cancer Center, New York, NY; Michelle Fanale, University of Texas MD Anderson Cancer Center, Houston, TX; Armando Santoro, Humanitas University, Rozzano, Milan; Pier Luigi Zinzani, University of Bologna, Bologna, Italy; John Timmerman, University of California, Los Angeles Medical Center, Los Angeles, CA; Graham P. Collins, Churchill Hospital, Oxford, United Kingdom; Radhakrishnan Ramchandren, Barbara Ann Karmanos Cancer Institute, Detroit, MI; Jonathon B. Cohen, Emory University, Atlanta, GA; John Kuruvilla, Princess Margaret Cancer Centre, Toronto, Ontario, Canada; Kerry J. Savage, British Columbia Cancer Agency Center for Lymphoid Cancer, Vancouver, British Columbia, Canada; Marek Trneny, Charles University in Prague, General University Hospital in Prague, Prague, Czech Republic; Stephen Ansell, Mayo Clinic, Rochester, MN; and Kazunobu Kato, Benedetto Farsaci, and Anne Sumbul, Bristol-Myers Squibb, Princeton, NJ
| | - Sara Abdelrahman
- Margaretha G.M. Roemer, Robert A. Redd, Fathima Zumla Cader, Christine J. Pak, Sara Abdelrahman, Jing Ouyang, Philippe Armand, Donna S. Neuberg, and Margaret A. Shipp, Dana-Farber Cancer Institute; Geraldine S. Pinkus, Azra H. Ligon, and Scott J. Rodig, Brigham and Women's Hospital, Boston, MA; Margaretha G.M. Roemer, VU University Medical Center; Jan Paul De Boer, Antoni van Leeuwenhoek Hospital, Lunenburg Phase I/II Consortium, Amsterdam, the Netherlands; Stephanie Sasse, University Hospital of Cologne, Cologne, Germany; Anas Younes, Memorial Sloan Kettering Cancer Center, New York, NY; Michelle Fanale, University of Texas MD Anderson Cancer Center, Houston, TX; Armando Santoro, Humanitas University, Rozzano, Milan; Pier Luigi Zinzani, University of Bologna, Bologna, Italy; John Timmerman, University of California, Los Angeles Medical Center, Los Angeles, CA; Graham P. Collins, Churchill Hospital, Oxford, United Kingdom; Radhakrishnan Ramchandren, Barbara Ann Karmanos Cancer Institute, Detroit, MI; Jonathon B. Cohen, Emory University, Atlanta, GA; John Kuruvilla, Princess Margaret Cancer Centre, Toronto, Ontario, Canada; Kerry J. Savage, British Columbia Cancer Agency Center for Lymphoid Cancer, Vancouver, British Columbia, Canada; Marek Trneny, Charles University in Prague, General University Hospital in Prague, Prague, Czech Republic; Stephen Ansell, Mayo Clinic, Rochester, MN; and Kazunobu Kato, Benedetto Farsaci, and Anne Sumbul, Bristol-Myers Squibb, Princeton, NJ
| | - Jing Ouyang
- Margaretha G.M. Roemer, Robert A. Redd, Fathima Zumla Cader, Christine J. Pak, Sara Abdelrahman, Jing Ouyang, Philippe Armand, Donna S. Neuberg, and Margaret A. Shipp, Dana-Farber Cancer Institute; Geraldine S. Pinkus, Azra H. Ligon, and Scott J. Rodig, Brigham and Women's Hospital, Boston, MA; Margaretha G.M. Roemer, VU University Medical Center; Jan Paul De Boer, Antoni van Leeuwenhoek Hospital, Lunenburg Phase I/II Consortium, Amsterdam, the Netherlands; Stephanie Sasse, University Hospital of Cologne, Cologne, Germany; Anas Younes, Memorial Sloan Kettering Cancer Center, New York, NY; Michelle Fanale, University of Texas MD Anderson Cancer Center, Houston, TX; Armando Santoro, Humanitas University, Rozzano, Milan; Pier Luigi Zinzani, University of Bologna, Bologna, Italy; John Timmerman, University of California, Los Angeles Medical Center, Los Angeles, CA; Graham P. Collins, Churchill Hospital, Oxford, United Kingdom; Radhakrishnan Ramchandren, Barbara Ann Karmanos Cancer Institute, Detroit, MI; Jonathon B. Cohen, Emory University, Atlanta, GA; John Kuruvilla, Princess Margaret Cancer Centre, Toronto, Ontario, Canada; Kerry J. Savage, British Columbia Cancer Agency Center for Lymphoid Cancer, Vancouver, British Columbia, Canada; Marek Trneny, Charles University in Prague, General University Hospital in Prague, Prague, Czech Republic; Stephen Ansell, Mayo Clinic, Rochester, MN; and Kazunobu Kato, Benedetto Farsaci, and Anne Sumbul, Bristol-Myers Squibb, Princeton, NJ
| | - Stephanie Sasse
- Margaretha G.M. Roemer, Robert A. Redd, Fathima Zumla Cader, Christine J. Pak, Sara Abdelrahman, Jing Ouyang, Philippe Armand, Donna S. Neuberg, and Margaret A. Shipp, Dana-Farber Cancer Institute; Geraldine S. Pinkus, Azra H. Ligon, and Scott J. Rodig, Brigham and Women's Hospital, Boston, MA; Margaretha G.M. Roemer, VU University Medical Center; Jan Paul De Boer, Antoni van Leeuwenhoek Hospital, Lunenburg Phase I/II Consortium, Amsterdam, the Netherlands; Stephanie Sasse, University Hospital of Cologne, Cologne, Germany; Anas Younes, Memorial Sloan Kettering Cancer Center, New York, NY; Michelle Fanale, University of Texas MD Anderson Cancer Center, Houston, TX; Armando Santoro, Humanitas University, Rozzano, Milan; Pier Luigi Zinzani, University of Bologna, Bologna, Italy; John Timmerman, University of California, Los Angeles Medical Center, Los Angeles, CA; Graham P. Collins, Churchill Hospital, Oxford, United Kingdom; Radhakrishnan Ramchandren, Barbara Ann Karmanos Cancer Institute, Detroit, MI; Jonathon B. Cohen, Emory University, Atlanta, GA; John Kuruvilla, Princess Margaret Cancer Centre, Toronto, Ontario, Canada; Kerry J. Savage, British Columbia Cancer Agency Center for Lymphoid Cancer, Vancouver, British Columbia, Canada; Marek Trneny, Charles University in Prague, General University Hospital in Prague, Prague, Czech Republic; Stephen Ansell, Mayo Clinic, Rochester, MN; and Kazunobu Kato, Benedetto Farsaci, and Anne Sumbul, Bristol-Myers Squibb, Princeton, NJ
| | - Anas Younes
- Margaretha G.M. Roemer, Robert A. Redd, Fathima Zumla Cader, Christine J. Pak, Sara Abdelrahman, Jing Ouyang, Philippe Armand, Donna S. Neuberg, and Margaret A. Shipp, Dana-Farber Cancer Institute; Geraldine S. Pinkus, Azra H. Ligon, and Scott J. Rodig, Brigham and Women's Hospital, Boston, MA; Margaretha G.M. Roemer, VU University Medical Center; Jan Paul De Boer, Antoni van Leeuwenhoek Hospital, Lunenburg Phase I/II Consortium, Amsterdam, the Netherlands; Stephanie Sasse, University Hospital of Cologne, Cologne, Germany; Anas Younes, Memorial Sloan Kettering Cancer Center, New York, NY; Michelle Fanale, University of Texas MD Anderson Cancer Center, Houston, TX; Armando Santoro, Humanitas University, Rozzano, Milan; Pier Luigi Zinzani, University of Bologna, Bologna, Italy; John Timmerman, University of California, Los Angeles Medical Center, Los Angeles, CA; Graham P. Collins, Churchill Hospital, Oxford, United Kingdom; Radhakrishnan Ramchandren, Barbara Ann Karmanos Cancer Institute, Detroit, MI; Jonathon B. Cohen, Emory University, Atlanta, GA; John Kuruvilla, Princess Margaret Cancer Centre, Toronto, Ontario, Canada; Kerry J. Savage, British Columbia Cancer Agency Center for Lymphoid Cancer, Vancouver, British Columbia, Canada; Marek Trneny, Charles University in Prague, General University Hospital in Prague, Prague, Czech Republic; Stephen Ansell, Mayo Clinic, Rochester, MN; and Kazunobu Kato, Benedetto Farsaci, and Anne Sumbul, Bristol-Myers Squibb, Princeton, NJ
| | - Michelle Fanale
- Margaretha G.M. Roemer, Robert A. Redd, Fathima Zumla Cader, Christine J. Pak, Sara Abdelrahman, Jing Ouyang, Philippe Armand, Donna S. Neuberg, and Margaret A. Shipp, Dana-Farber Cancer Institute; Geraldine S. Pinkus, Azra H. Ligon, and Scott J. Rodig, Brigham and Women's Hospital, Boston, MA; Margaretha G.M. Roemer, VU University Medical Center; Jan Paul De Boer, Antoni van Leeuwenhoek Hospital, Lunenburg Phase I/II Consortium, Amsterdam, the Netherlands; Stephanie Sasse, University Hospital of Cologne, Cologne, Germany; Anas Younes, Memorial Sloan Kettering Cancer Center, New York, NY; Michelle Fanale, University of Texas MD Anderson Cancer Center, Houston, TX; Armando Santoro, Humanitas University, Rozzano, Milan; Pier Luigi Zinzani, University of Bologna, Bologna, Italy; John Timmerman, University of California, Los Angeles Medical Center, Los Angeles, CA; Graham P. Collins, Churchill Hospital, Oxford, United Kingdom; Radhakrishnan Ramchandren, Barbara Ann Karmanos Cancer Institute, Detroit, MI; Jonathon B. Cohen, Emory University, Atlanta, GA; John Kuruvilla, Princess Margaret Cancer Centre, Toronto, Ontario, Canada; Kerry J. Savage, British Columbia Cancer Agency Center for Lymphoid Cancer, Vancouver, British Columbia, Canada; Marek Trneny, Charles University in Prague, General University Hospital in Prague, Prague, Czech Republic; Stephen Ansell, Mayo Clinic, Rochester, MN; and Kazunobu Kato, Benedetto Farsaci, and Anne Sumbul, Bristol-Myers Squibb, Princeton, NJ
| | - Armando Santoro
- Margaretha G.M. Roemer, Robert A. Redd, Fathima Zumla Cader, Christine J. Pak, Sara Abdelrahman, Jing Ouyang, Philippe Armand, Donna S. Neuberg, and Margaret A. Shipp, Dana-Farber Cancer Institute; Geraldine S. Pinkus, Azra H. Ligon, and Scott J. Rodig, Brigham and Women's Hospital, Boston, MA; Margaretha G.M. Roemer, VU University Medical Center; Jan Paul De Boer, Antoni van Leeuwenhoek Hospital, Lunenburg Phase I/II Consortium, Amsterdam, the Netherlands; Stephanie Sasse, University Hospital of Cologne, Cologne, Germany; Anas Younes, Memorial Sloan Kettering Cancer Center, New York, NY; Michelle Fanale, University of Texas MD Anderson Cancer Center, Houston, TX; Armando Santoro, Humanitas University, Rozzano, Milan; Pier Luigi Zinzani, University of Bologna, Bologna, Italy; John Timmerman, University of California, Los Angeles Medical Center, Los Angeles, CA; Graham P. Collins, Churchill Hospital, Oxford, United Kingdom; Radhakrishnan Ramchandren, Barbara Ann Karmanos Cancer Institute, Detroit, MI; Jonathon B. Cohen, Emory University, Atlanta, GA; John Kuruvilla, Princess Margaret Cancer Centre, Toronto, Ontario, Canada; Kerry J. Savage, British Columbia Cancer Agency Center for Lymphoid Cancer, Vancouver, British Columbia, Canada; Marek Trneny, Charles University in Prague, General University Hospital in Prague, Prague, Czech Republic; Stephen Ansell, Mayo Clinic, Rochester, MN; and Kazunobu Kato, Benedetto Farsaci, and Anne Sumbul, Bristol-Myers Squibb, Princeton, NJ
| | - Pier Luigi Zinzani
- Margaretha G.M. Roemer, Robert A. Redd, Fathima Zumla Cader, Christine J. Pak, Sara Abdelrahman, Jing Ouyang, Philippe Armand, Donna S. Neuberg, and Margaret A. Shipp, Dana-Farber Cancer Institute; Geraldine S. Pinkus, Azra H. Ligon, and Scott J. Rodig, Brigham and Women's Hospital, Boston, MA; Margaretha G.M. Roemer, VU University Medical Center; Jan Paul De Boer, Antoni van Leeuwenhoek Hospital, Lunenburg Phase I/II Consortium, Amsterdam, the Netherlands; Stephanie Sasse, University Hospital of Cologne, Cologne, Germany; Anas Younes, Memorial Sloan Kettering Cancer Center, New York, NY; Michelle Fanale, University of Texas MD Anderson Cancer Center, Houston, TX; Armando Santoro, Humanitas University, Rozzano, Milan; Pier Luigi Zinzani, University of Bologna, Bologna, Italy; John Timmerman, University of California, Los Angeles Medical Center, Los Angeles, CA; Graham P. Collins, Churchill Hospital, Oxford, United Kingdom; Radhakrishnan Ramchandren, Barbara Ann Karmanos Cancer Institute, Detroit, MI; Jonathon B. Cohen, Emory University, Atlanta, GA; John Kuruvilla, Princess Margaret Cancer Centre, Toronto, Ontario, Canada; Kerry J. Savage, British Columbia Cancer Agency Center for Lymphoid Cancer, Vancouver, British Columbia, Canada; Marek Trneny, Charles University in Prague, General University Hospital in Prague, Prague, Czech Republic; Stephen Ansell, Mayo Clinic, Rochester, MN; and Kazunobu Kato, Benedetto Farsaci, and Anne Sumbul, Bristol-Myers Squibb, Princeton, NJ
| | - John Timmerman
- Margaretha G.M. Roemer, Robert A. Redd, Fathima Zumla Cader, Christine J. Pak, Sara Abdelrahman, Jing Ouyang, Philippe Armand, Donna S. Neuberg, and Margaret A. Shipp, Dana-Farber Cancer Institute; Geraldine S. Pinkus, Azra H. Ligon, and Scott J. Rodig, Brigham and Women's Hospital, Boston, MA; Margaretha G.M. Roemer, VU University Medical Center; Jan Paul De Boer, Antoni van Leeuwenhoek Hospital, Lunenburg Phase I/II Consortium, Amsterdam, the Netherlands; Stephanie Sasse, University Hospital of Cologne, Cologne, Germany; Anas Younes, Memorial Sloan Kettering Cancer Center, New York, NY; Michelle Fanale, University of Texas MD Anderson Cancer Center, Houston, TX; Armando Santoro, Humanitas University, Rozzano, Milan; Pier Luigi Zinzani, University of Bologna, Bologna, Italy; John Timmerman, University of California, Los Angeles Medical Center, Los Angeles, CA; Graham P. Collins, Churchill Hospital, Oxford, United Kingdom; Radhakrishnan Ramchandren, Barbara Ann Karmanos Cancer Institute, Detroit, MI; Jonathon B. Cohen, Emory University, Atlanta, GA; John Kuruvilla, Princess Margaret Cancer Centre, Toronto, Ontario, Canada; Kerry J. Savage, British Columbia Cancer Agency Center for Lymphoid Cancer, Vancouver, British Columbia, Canada; Marek Trneny, Charles University in Prague, General University Hospital in Prague, Prague, Czech Republic; Stephen Ansell, Mayo Clinic, Rochester, MN; and Kazunobu Kato, Benedetto Farsaci, and Anne Sumbul, Bristol-Myers Squibb, Princeton, NJ
| | - Graham P Collins
- Margaretha G.M. Roemer, Robert A. Redd, Fathima Zumla Cader, Christine J. Pak, Sara Abdelrahman, Jing Ouyang, Philippe Armand, Donna S. Neuberg, and Margaret A. Shipp, Dana-Farber Cancer Institute; Geraldine S. Pinkus, Azra H. Ligon, and Scott J. Rodig, Brigham and Women's Hospital, Boston, MA; Margaretha G.M. Roemer, VU University Medical Center; Jan Paul De Boer, Antoni van Leeuwenhoek Hospital, Lunenburg Phase I/II Consortium, Amsterdam, the Netherlands; Stephanie Sasse, University Hospital of Cologne, Cologne, Germany; Anas Younes, Memorial Sloan Kettering Cancer Center, New York, NY; Michelle Fanale, University of Texas MD Anderson Cancer Center, Houston, TX; Armando Santoro, Humanitas University, Rozzano, Milan; Pier Luigi Zinzani, University of Bologna, Bologna, Italy; John Timmerman, University of California, Los Angeles Medical Center, Los Angeles, CA; Graham P. Collins, Churchill Hospital, Oxford, United Kingdom; Radhakrishnan Ramchandren, Barbara Ann Karmanos Cancer Institute, Detroit, MI; Jonathon B. Cohen, Emory University, Atlanta, GA; John Kuruvilla, Princess Margaret Cancer Centre, Toronto, Ontario, Canada; Kerry J. Savage, British Columbia Cancer Agency Center for Lymphoid Cancer, Vancouver, British Columbia, Canada; Marek Trneny, Charles University in Prague, General University Hospital in Prague, Prague, Czech Republic; Stephen Ansell, Mayo Clinic, Rochester, MN; and Kazunobu Kato, Benedetto Farsaci, and Anne Sumbul, Bristol-Myers Squibb, Princeton, NJ
| | - Radhakrishnan Ramchandren
- Margaretha G.M. Roemer, Robert A. Redd, Fathima Zumla Cader, Christine J. Pak, Sara Abdelrahman, Jing Ouyang, Philippe Armand, Donna S. Neuberg, and Margaret A. Shipp, Dana-Farber Cancer Institute; Geraldine S. Pinkus, Azra H. Ligon, and Scott J. Rodig, Brigham and Women's Hospital, Boston, MA; Margaretha G.M. Roemer, VU University Medical Center; Jan Paul De Boer, Antoni van Leeuwenhoek Hospital, Lunenburg Phase I/II Consortium, Amsterdam, the Netherlands; Stephanie Sasse, University Hospital of Cologne, Cologne, Germany; Anas Younes, Memorial Sloan Kettering Cancer Center, New York, NY; Michelle Fanale, University of Texas MD Anderson Cancer Center, Houston, TX; Armando Santoro, Humanitas University, Rozzano, Milan; Pier Luigi Zinzani, University of Bologna, Bologna, Italy; John Timmerman, University of California, Los Angeles Medical Center, Los Angeles, CA; Graham P. Collins, Churchill Hospital, Oxford, United Kingdom; Radhakrishnan Ramchandren, Barbara Ann Karmanos Cancer Institute, Detroit, MI; Jonathon B. Cohen, Emory University, Atlanta, GA; John Kuruvilla, Princess Margaret Cancer Centre, Toronto, Ontario, Canada; Kerry J. Savage, British Columbia Cancer Agency Center for Lymphoid Cancer, Vancouver, British Columbia, Canada; Marek Trneny, Charles University in Prague, General University Hospital in Prague, Prague, Czech Republic; Stephen Ansell, Mayo Clinic, Rochester, MN; and Kazunobu Kato, Benedetto Farsaci, and Anne Sumbul, Bristol-Myers Squibb, Princeton, NJ
| | - Jonathon B Cohen
- Margaretha G.M. Roemer, Robert A. Redd, Fathima Zumla Cader, Christine J. Pak, Sara Abdelrahman, Jing Ouyang, Philippe Armand, Donna S. Neuberg, and Margaret A. Shipp, Dana-Farber Cancer Institute; Geraldine S. Pinkus, Azra H. Ligon, and Scott J. Rodig, Brigham and Women's Hospital, Boston, MA; Margaretha G.M. Roemer, VU University Medical Center; Jan Paul De Boer, Antoni van Leeuwenhoek Hospital, Lunenburg Phase I/II Consortium, Amsterdam, the Netherlands; Stephanie Sasse, University Hospital of Cologne, Cologne, Germany; Anas Younes, Memorial Sloan Kettering Cancer Center, New York, NY; Michelle Fanale, University of Texas MD Anderson Cancer Center, Houston, TX; Armando Santoro, Humanitas University, Rozzano, Milan; Pier Luigi Zinzani, University of Bologna, Bologna, Italy; John Timmerman, University of California, Los Angeles Medical Center, Los Angeles, CA; Graham P. Collins, Churchill Hospital, Oxford, United Kingdom; Radhakrishnan Ramchandren, Barbara Ann Karmanos Cancer Institute, Detroit, MI; Jonathon B. Cohen, Emory University, Atlanta, GA; John Kuruvilla, Princess Margaret Cancer Centre, Toronto, Ontario, Canada; Kerry J. Savage, British Columbia Cancer Agency Center for Lymphoid Cancer, Vancouver, British Columbia, Canada; Marek Trneny, Charles University in Prague, General University Hospital in Prague, Prague, Czech Republic; Stephen Ansell, Mayo Clinic, Rochester, MN; and Kazunobu Kato, Benedetto Farsaci, and Anne Sumbul, Bristol-Myers Squibb, Princeton, NJ
| | - Jan Paul De Boer
- Margaretha G.M. Roemer, Robert A. Redd, Fathima Zumla Cader, Christine J. Pak, Sara Abdelrahman, Jing Ouyang, Philippe Armand, Donna S. Neuberg, and Margaret A. Shipp, Dana-Farber Cancer Institute; Geraldine S. Pinkus, Azra H. Ligon, and Scott J. Rodig, Brigham and Women's Hospital, Boston, MA; Margaretha G.M. Roemer, VU University Medical Center; Jan Paul De Boer, Antoni van Leeuwenhoek Hospital, Lunenburg Phase I/II Consortium, Amsterdam, the Netherlands; Stephanie Sasse, University Hospital of Cologne, Cologne, Germany; Anas Younes, Memorial Sloan Kettering Cancer Center, New York, NY; Michelle Fanale, University of Texas MD Anderson Cancer Center, Houston, TX; Armando Santoro, Humanitas University, Rozzano, Milan; Pier Luigi Zinzani, University of Bologna, Bologna, Italy; John Timmerman, University of California, Los Angeles Medical Center, Los Angeles, CA; Graham P. Collins, Churchill Hospital, Oxford, United Kingdom; Radhakrishnan Ramchandren, Barbara Ann Karmanos Cancer Institute, Detroit, MI; Jonathon B. Cohen, Emory University, Atlanta, GA; John Kuruvilla, Princess Margaret Cancer Centre, Toronto, Ontario, Canada; Kerry J. Savage, British Columbia Cancer Agency Center for Lymphoid Cancer, Vancouver, British Columbia, Canada; Marek Trneny, Charles University in Prague, General University Hospital in Prague, Prague, Czech Republic; Stephen Ansell, Mayo Clinic, Rochester, MN; and Kazunobu Kato, Benedetto Farsaci, and Anne Sumbul, Bristol-Myers Squibb, Princeton, NJ
| | - John Kuruvilla
- Margaretha G.M. Roemer, Robert A. Redd, Fathima Zumla Cader, Christine J. Pak, Sara Abdelrahman, Jing Ouyang, Philippe Armand, Donna S. Neuberg, and Margaret A. Shipp, Dana-Farber Cancer Institute; Geraldine S. Pinkus, Azra H. Ligon, and Scott J. Rodig, Brigham and Women's Hospital, Boston, MA; Margaretha G.M. Roemer, VU University Medical Center; Jan Paul De Boer, Antoni van Leeuwenhoek Hospital, Lunenburg Phase I/II Consortium, Amsterdam, the Netherlands; Stephanie Sasse, University Hospital of Cologne, Cologne, Germany; Anas Younes, Memorial Sloan Kettering Cancer Center, New York, NY; Michelle Fanale, University of Texas MD Anderson Cancer Center, Houston, TX; Armando Santoro, Humanitas University, Rozzano, Milan; Pier Luigi Zinzani, University of Bologna, Bologna, Italy; John Timmerman, University of California, Los Angeles Medical Center, Los Angeles, CA; Graham P. Collins, Churchill Hospital, Oxford, United Kingdom; Radhakrishnan Ramchandren, Barbara Ann Karmanos Cancer Institute, Detroit, MI; Jonathon B. Cohen, Emory University, Atlanta, GA; John Kuruvilla, Princess Margaret Cancer Centre, Toronto, Ontario, Canada; Kerry J. Savage, British Columbia Cancer Agency Center for Lymphoid Cancer, Vancouver, British Columbia, Canada; Marek Trneny, Charles University in Prague, General University Hospital in Prague, Prague, Czech Republic; Stephen Ansell, Mayo Clinic, Rochester, MN; and Kazunobu Kato, Benedetto Farsaci, and Anne Sumbul, Bristol-Myers Squibb, Princeton, NJ
| | - Kerry J Savage
- Margaretha G.M. Roemer, Robert A. Redd, Fathima Zumla Cader, Christine J. Pak, Sara Abdelrahman, Jing Ouyang, Philippe Armand, Donna S. Neuberg, and Margaret A. Shipp, Dana-Farber Cancer Institute; Geraldine S. Pinkus, Azra H. Ligon, and Scott J. Rodig, Brigham and Women's Hospital, Boston, MA; Margaretha G.M. Roemer, VU University Medical Center; Jan Paul De Boer, Antoni van Leeuwenhoek Hospital, Lunenburg Phase I/II Consortium, Amsterdam, the Netherlands; Stephanie Sasse, University Hospital of Cologne, Cologne, Germany; Anas Younes, Memorial Sloan Kettering Cancer Center, New York, NY; Michelle Fanale, University of Texas MD Anderson Cancer Center, Houston, TX; Armando Santoro, Humanitas University, Rozzano, Milan; Pier Luigi Zinzani, University of Bologna, Bologna, Italy; John Timmerman, University of California, Los Angeles Medical Center, Los Angeles, CA; Graham P. Collins, Churchill Hospital, Oxford, United Kingdom; Radhakrishnan Ramchandren, Barbara Ann Karmanos Cancer Institute, Detroit, MI; Jonathon B. Cohen, Emory University, Atlanta, GA; John Kuruvilla, Princess Margaret Cancer Centre, Toronto, Ontario, Canada; Kerry J. Savage, British Columbia Cancer Agency Center for Lymphoid Cancer, Vancouver, British Columbia, Canada; Marek Trneny, Charles University in Prague, General University Hospital in Prague, Prague, Czech Republic; Stephen Ansell, Mayo Clinic, Rochester, MN; and Kazunobu Kato, Benedetto Farsaci, and Anne Sumbul, Bristol-Myers Squibb, Princeton, NJ
| | - Marek Trneny
- Margaretha G.M. Roemer, Robert A. Redd, Fathima Zumla Cader, Christine J. Pak, Sara Abdelrahman, Jing Ouyang, Philippe Armand, Donna S. Neuberg, and Margaret A. Shipp, Dana-Farber Cancer Institute; Geraldine S. Pinkus, Azra H. Ligon, and Scott J. Rodig, Brigham and Women's Hospital, Boston, MA; Margaretha G.M. Roemer, VU University Medical Center; Jan Paul De Boer, Antoni van Leeuwenhoek Hospital, Lunenburg Phase I/II Consortium, Amsterdam, the Netherlands; Stephanie Sasse, University Hospital of Cologne, Cologne, Germany; Anas Younes, Memorial Sloan Kettering Cancer Center, New York, NY; Michelle Fanale, University of Texas MD Anderson Cancer Center, Houston, TX; Armando Santoro, Humanitas University, Rozzano, Milan; Pier Luigi Zinzani, University of Bologna, Bologna, Italy; John Timmerman, University of California, Los Angeles Medical Center, Los Angeles, CA; Graham P. Collins, Churchill Hospital, Oxford, United Kingdom; Radhakrishnan Ramchandren, Barbara Ann Karmanos Cancer Institute, Detroit, MI; Jonathon B. Cohen, Emory University, Atlanta, GA; John Kuruvilla, Princess Margaret Cancer Centre, Toronto, Ontario, Canada; Kerry J. Savage, British Columbia Cancer Agency Center for Lymphoid Cancer, Vancouver, British Columbia, Canada; Marek Trneny, Charles University in Prague, General University Hospital in Prague, Prague, Czech Republic; Stephen Ansell, Mayo Clinic, Rochester, MN; and Kazunobu Kato, Benedetto Farsaci, and Anne Sumbul, Bristol-Myers Squibb, Princeton, NJ
| | - Stephen Ansell
- Margaretha G.M. Roemer, Robert A. Redd, Fathima Zumla Cader, Christine J. Pak, Sara Abdelrahman, Jing Ouyang, Philippe Armand, Donna S. Neuberg, and Margaret A. Shipp, Dana-Farber Cancer Institute; Geraldine S. Pinkus, Azra H. Ligon, and Scott J. Rodig, Brigham and Women's Hospital, Boston, MA; Margaretha G.M. Roemer, VU University Medical Center; Jan Paul De Boer, Antoni van Leeuwenhoek Hospital, Lunenburg Phase I/II Consortium, Amsterdam, the Netherlands; Stephanie Sasse, University Hospital of Cologne, Cologne, Germany; Anas Younes, Memorial Sloan Kettering Cancer Center, New York, NY; Michelle Fanale, University of Texas MD Anderson Cancer Center, Houston, TX; Armando Santoro, Humanitas University, Rozzano, Milan; Pier Luigi Zinzani, University of Bologna, Bologna, Italy; John Timmerman, University of California, Los Angeles Medical Center, Los Angeles, CA; Graham P. Collins, Churchill Hospital, Oxford, United Kingdom; Radhakrishnan Ramchandren, Barbara Ann Karmanos Cancer Institute, Detroit, MI; Jonathon B. Cohen, Emory University, Atlanta, GA; John Kuruvilla, Princess Margaret Cancer Centre, Toronto, Ontario, Canada; Kerry J. Savage, British Columbia Cancer Agency Center for Lymphoid Cancer, Vancouver, British Columbia, Canada; Marek Trneny, Charles University in Prague, General University Hospital in Prague, Prague, Czech Republic; Stephen Ansell, Mayo Clinic, Rochester, MN; and Kazunobu Kato, Benedetto Farsaci, and Anne Sumbul, Bristol-Myers Squibb, Princeton, NJ
| | - Kazunobu Kato
- Margaretha G.M. Roemer, Robert A. Redd, Fathima Zumla Cader, Christine J. Pak, Sara Abdelrahman, Jing Ouyang, Philippe Armand, Donna S. Neuberg, and Margaret A. Shipp, Dana-Farber Cancer Institute; Geraldine S. Pinkus, Azra H. Ligon, and Scott J. Rodig, Brigham and Women's Hospital, Boston, MA; Margaretha G.M. Roemer, VU University Medical Center; Jan Paul De Boer, Antoni van Leeuwenhoek Hospital, Lunenburg Phase I/II Consortium, Amsterdam, the Netherlands; Stephanie Sasse, University Hospital of Cologne, Cologne, Germany; Anas Younes, Memorial Sloan Kettering Cancer Center, New York, NY; Michelle Fanale, University of Texas MD Anderson Cancer Center, Houston, TX; Armando Santoro, Humanitas University, Rozzano, Milan; Pier Luigi Zinzani, University of Bologna, Bologna, Italy; John Timmerman, University of California, Los Angeles Medical Center, Los Angeles, CA; Graham P. Collins, Churchill Hospital, Oxford, United Kingdom; Radhakrishnan Ramchandren, Barbara Ann Karmanos Cancer Institute, Detroit, MI; Jonathon B. Cohen, Emory University, Atlanta, GA; John Kuruvilla, Princess Margaret Cancer Centre, Toronto, Ontario, Canada; Kerry J. Savage, British Columbia Cancer Agency Center for Lymphoid Cancer, Vancouver, British Columbia, Canada; Marek Trneny, Charles University in Prague, General University Hospital in Prague, Prague, Czech Republic; Stephen Ansell, Mayo Clinic, Rochester, MN; and Kazunobu Kato, Benedetto Farsaci, and Anne Sumbul, Bristol-Myers Squibb, Princeton, NJ
| | - Benedetto Farsaci
- Margaretha G.M. Roemer, Robert A. Redd, Fathima Zumla Cader, Christine J. Pak, Sara Abdelrahman, Jing Ouyang, Philippe Armand, Donna S. Neuberg, and Margaret A. Shipp, Dana-Farber Cancer Institute; Geraldine S. Pinkus, Azra H. Ligon, and Scott J. Rodig, Brigham and Women's Hospital, Boston, MA; Margaretha G.M. Roemer, VU University Medical Center; Jan Paul De Boer, Antoni van Leeuwenhoek Hospital, Lunenburg Phase I/II Consortium, Amsterdam, the Netherlands; Stephanie Sasse, University Hospital of Cologne, Cologne, Germany; Anas Younes, Memorial Sloan Kettering Cancer Center, New York, NY; Michelle Fanale, University of Texas MD Anderson Cancer Center, Houston, TX; Armando Santoro, Humanitas University, Rozzano, Milan; Pier Luigi Zinzani, University of Bologna, Bologna, Italy; John Timmerman, University of California, Los Angeles Medical Center, Los Angeles, CA; Graham P. Collins, Churchill Hospital, Oxford, United Kingdom; Radhakrishnan Ramchandren, Barbara Ann Karmanos Cancer Institute, Detroit, MI; Jonathon B. Cohen, Emory University, Atlanta, GA; John Kuruvilla, Princess Margaret Cancer Centre, Toronto, Ontario, Canada; Kerry J. Savage, British Columbia Cancer Agency Center for Lymphoid Cancer, Vancouver, British Columbia, Canada; Marek Trneny, Charles University in Prague, General University Hospital in Prague, Prague, Czech Republic; Stephen Ansell, Mayo Clinic, Rochester, MN; and Kazunobu Kato, Benedetto Farsaci, and Anne Sumbul, Bristol-Myers Squibb, Princeton, NJ
| | - Anne Sumbul
- Margaretha G.M. Roemer, Robert A. Redd, Fathima Zumla Cader, Christine J. Pak, Sara Abdelrahman, Jing Ouyang, Philippe Armand, Donna S. Neuberg, and Margaret A. Shipp, Dana-Farber Cancer Institute; Geraldine S. Pinkus, Azra H. Ligon, and Scott J. Rodig, Brigham and Women's Hospital, Boston, MA; Margaretha G.M. Roemer, VU University Medical Center; Jan Paul De Boer, Antoni van Leeuwenhoek Hospital, Lunenburg Phase I/II Consortium, Amsterdam, the Netherlands; Stephanie Sasse, University Hospital of Cologne, Cologne, Germany; Anas Younes, Memorial Sloan Kettering Cancer Center, New York, NY; Michelle Fanale, University of Texas MD Anderson Cancer Center, Houston, TX; Armando Santoro, Humanitas University, Rozzano, Milan; Pier Luigi Zinzani, University of Bologna, Bologna, Italy; John Timmerman, University of California, Los Angeles Medical Center, Los Angeles, CA; Graham P. Collins, Churchill Hospital, Oxford, United Kingdom; Radhakrishnan Ramchandren, Barbara Ann Karmanos Cancer Institute, Detroit, MI; Jonathon B. Cohen, Emory University, Atlanta, GA; John Kuruvilla, Princess Margaret Cancer Centre, Toronto, Ontario, Canada; Kerry J. Savage, British Columbia Cancer Agency Center for Lymphoid Cancer, Vancouver, British Columbia, Canada; Marek Trneny, Charles University in Prague, General University Hospital in Prague, Prague, Czech Republic; Stephen Ansell, Mayo Clinic, Rochester, MN; and Kazunobu Kato, Benedetto Farsaci, and Anne Sumbul, Bristol-Myers Squibb, Princeton, NJ
| | - Philippe Armand
- Margaretha G.M. Roemer, Robert A. Redd, Fathima Zumla Cader, Christine J. Pak, Sara Abdelrahman, Jing Ouyang, Philippe Armand, Donna S. Neuberg, and Margaret A. Shipp, Dana-Farber Cancer Institute; Geraldine S. Pinkus, Azra H. Ligon, and Scott J. Rodig, Brigham and Women's Hospital, Boston, MA; Margaretha G.M. Roemer, VU University Medical Center; Jan Paul De Boer, Antoni van Leeuwenhoek Hospital, Lunenburg Phase I/II Consortium, Amsterdam, the Netherlands; Stephanie Sasse, University Hospital of Cologne, Cologne, Germany; Anas Younes, Memorial Sloan Kettering Cancer Center, New York, NY; Michelle Fanale, University of Texas MD Anderson Cancer Center, Houston, TX; Armando Santoro, Humanitas University, Rozzano, Milan; Pier Luigi Zinzani, University of Bologna, Bologna, Italy; John Timmerman, University of California, Los Angeles Medical Center, Los Angeles, CA; Graham P. Collins, Churchill Hospital, Oxford, United Kingdom; Radhakrishnan Ramchandren, Barbara Ann Karmanos Cancer Institute, Detroit, MI; Jonathon B. Cohen, Emory University, Atlanta, GA; John Kuruvilla, Princess Margaret Cancer Centre, Toronto, Ontario, Canada; Kerry J. Savage, British Columbia Cancer Agency Center for Lymphoid Cancer, Vancouver, British Columbia, Canada; Marek Trneny, Charles University in Prague, General University Hospital in Prague, Prague, Czech Republic; Stephen Ansell, Mayo Clinic, Rochester, MN; and Kazunobu Kato, Benedetto Farsaci, and Anne Sumbul, Bristol-Myers Squibb, Princeton, NJ
| | - Donna S Neuberg
- Margaretha G.M. Roemer, Robert A. Redd, Fathima Zumla Cader, Christine J. Pak, Sara Abdelrahman, Jing Ouyang, Philippe Armand, Donna S. Neuberg, and Margaret A. Shipp, Dana-Farber Cancer Institute; Geraldine S. Pinkus, Azra H. Ligon, and Scott J. Rodig, Brigham and Women's Hospital, Boston, MA; Margaretha G.M. Roemer, VU University Medical Center; Jan Paul De Boer, Antoni van Leeuwenhoek Hospital, Lunenburg Phase I/II Consortium, Amsterdam, the Netherlands; Stephanie Sasse, University Hospital of Cologne, Cologne, Germany; Anas Younes, Memorial Sloan Kettering Cancer Center, New York, NY; Michelle Fanale, University of Texas MD Anderson Cancer Center, Houston, TX; Armando Santoro, Humanitas University, Rozzano, Milan; Pier Luigi Zinzani, University of Bologna, Bologna, Italy; John Timmerman, University of California, Los Angeles Medical Center, Los Angeles, CA; Graham P. Collins, Churchill Hospital, Oxford, United Kingdom; Radhakrishnan Ramchandren, Barbara Ann Karmanos Cancer Institute, Detroit, MI; Jonathon B. Cohen, Emory University, Atlanta, GA; John Kuruvilla, Princess Margaret Cancer Centre, Toronto, Ontario, Canada; Kerry J. Savage, British Columbia Cancer Agency Center for Lymphoid Cancer, Vancouver, British Columbia, Canada; Marek Trneny, Charles University in Prague, General University Hospital in Prague, Prague, Czech Republic; Stephen Ansell, Mayo Clinic, Rochester, MN; and Kazunobu Kato, Benedetto Farsaci, and Anne Sumbul, Bristol-Myers Squibb, Princeton, NJ
| | - Geraldine S Pinkus
- Margaretha G.M. Roemer, Robert A. Redd, Fathima Zumla Cader, Christine J. Pak, Sara Abdelrahman, Jing Ouyang, Philippe Armand, Donna S. Neuberg, and Margaret A. Shipp, Dana-Farber Cancer Institute; Geraldine S. Pinkus, Azra H. Ligon, and Scott J. Rodig, Brigham and Women's Hospital, Boston, MA; Margaretha G.M. Roemer, VU University Medical Center; Jan Paul De Boer, Antoni van Leeuwenhoek Hospital, Lunenburg Phase I/II Consortium, Amsterdam, the Netherlands; Stephanie Sasse, University Hospital of Cologne, Cologne, Germany; Anas Younes, Memorial Sloan Kettering Cancer Center, New York, NY; Michelle Fanale, University of Texas MD Anderson Cancer Center, Houston, TX; Armando Santoro, Humanitas University, Rozzano, Milan; Pier Luigi Zinzani, University of Bologna, Bologna, Italy; John Timmerman, University of California, Los Angeles Medical Center, Los Angeles, CA; Graham P. Collins, Churchill Hospital, Oxford, United Kingdom; Radhakrishnan Ramchandren, Barbara Ann Karmanos Cancer Institute, Detroit, MI; Jonathon B. Cohen, Emory University, Atlanta, GA; John Kuruvilla, Princess Margaret Cancer Centre, Toronto, Ontario, Canada; Kerry J. Savage, British Columbia Cancer Agency Center for Lymphoid Cancer, Vancouver, British Columbia, Canada; Marek Trneny, Charles University in Prague, General University Hospital in Prague, Prague, Czech Republic; Stephen Ansell, Mayo Clinic, Rochester, MN; and Kazunobu Kato, Benedetto Farsaci, and Anne Sumbul, Bristol-Myers Squibb, Princeton, NJ
| | - Azra H Ligon
- Margaretha G.M. Roemer, Robert A. Redd, Fathima Zumla Cader, Christine J. Pak, Sara Abdelrahman, Jing Ouyang, Philippe Armand, Donna S. Neuberg, and Margaret A. Shipp, Dana-Farber Cancer Institute; Geraldine S. Pinkus, Azra H. Ligon, and Scott J. Rodig, Brigham and Women's Hospital, Boston, MA; Margaretha G.M. Roemer, VU University Medical Center; Jan Paul De Boer, Antoni van Leeuwenhoek Hospital, Lunenburg Phase I/II Consortium, Amsterdam, the Netherlands; Stephanie Sasse, University Hospital of Cologne, Cologne, Germany; Anas Younes, Memorial Sloan Kettering Cancer Center, New York, NY; Michelle Fanale, University of Texas MD Anderson Cancer Center, Houston, TX; Armando Santoro, Humanitas University, Rozzano, Milan; Pier Luigi Zinzani, University of Bologna, Bologna, Italy; John Timmerman, University of California, Los Angeles Medical Center, Los Angeles, CA; Graham P. Collins, Churchill Hospital, Oxford, United Kingdom; Radhakrishnan Ramchandren, Barbara Ann Karmanos Cancer Institute, Detroit, MI; Jonathon B. Cohen, Emory University, Atlanta, GA; John Kuruvilla, Princess Margaret Cancer Centre, Toronto, Ontario, Canada; Kerry J. Savage, British Columbia Cancer Agency Center for Lymphoid Cancer, Vancouver, British Columbia, Canada; Marek Trneny, Charles University in Prague, General University Hospital in Prague, Prague, Czech Republic; Stephen Ansell, Mayo Clinic, Rochester, MN; and Kazunobu Kato, Benedetto Farsaci, and Anne Sumbul, Bristol-Myers Squibb, Princeton, NJ
| | - Scott J Rodig
- Margaretha G.M. Roemer, Robert A. Redd, Fathima Zumla Cader, Christine J. Pak, Sara Abdelrahman, Jing Ouyang, Philippe Armand, Donna S. Neuberg, and Margaret A. Shipp, Dana-Farber Cancer Institute; Geraldine S. Pinkus, Azra H. Ligon, and Scott J. Rodig, Brigham and Women's Hospital, Boston, MA; Margaretha G.M. Roemer, VU University Medical Center; Jan Paul De Boer, Antoni van Leeuwenhoek Hospital, Lunenburg Phase I/II Consortium, Amsterdam, the Netherlands; Stephanie Sasse, University Hospital of Cologne, Cologne, Germany; Anas Younes, Memorial Sloan Kettering Cancer Center, New York, NY; Michelle Fanale, University of Texas MD Anderson Cancer Center, Houston, TX; Armando Santoro, Humanitas University, Rozzano, Milan; Pier Luigi Zinzani, University of Bologna, Bologna, Italy; John Timmerman, University of California, Los Angeles Medical Center, Los Angeles, CA; Graham P. Collins, Churchill Hospital, Oxford, United Kingdom; Radhakrishnan Ramchandren, Barbara Ann Karmanos Cancer Institute, Detroit, MI; Jonathon B. Cohen, Emory University, Atlanta, GA; John Kuruvilla, Princess Margaret Cancer Centre, Toronto, Ontario, Canada; Kerry J. Savage, British Columbia Cancer Agency Center for Lymphoid Cancer, Vancouver, British Columbia, Canada; Marek Trneny, Charles University in Prague, General University Hospital in Prague, Prague, Czech Republic; Stephen Ansell, Mayo Clinic, Rochester, MN; and Kazunobu Kato, Benedetto Farsaci, and Anne Sumbul, Bristol-Myers Squibb, Princeton, NJ
| | - Margaret A Shipp
- Margaretha G.M. Roemer, Robert A. Redd, Fathima Zumla Cader, Christine J. Pak, Sara Abdelrahman, Jing Ouyang, Philippe Armand, Donna S. Neuberg, and Margaret A. Shipp, Dana-Farber Cancer Institute; Geraldine S. Pinkus, Azra H. Ligon, and Scott J. Rodig, Brigham and Women's Hospital, Boston, MA; Margaretha G.M. Roemer, VU University Medical Center; Jan Paul De Boer, Antoni van Leeuwenhoek Hospital, Lunenburg Phase I/II Consortium, Amsterdam, the Netherlands; Stephanie Sasse, University Hospital of Cologne, Cologne, Germany; Anas Younes, Memorial Sloan Kettering Cancer Center, New York, NY; Michelle Fanale, University of Texas MD Anderson Cancer Center, Houston, TX; Armando Santoro, Humanitas University, Rozzano, Milan; Pier Luigi Zinzani, University of Bologna, Bologna, Italy; John Timmerman, University of California, Los Angeles Medical Center, Los Angeles, CA; Graham P. Collins, Churchill Hospital, Oxford, United Kingdom; Radhakrishnan Ramchandren, Barbara Ann Karmanos Cancer Institute, Detroit, MI; Jonathon B. Cohen, Emory University, Atlanta, GA; John Kuruvilla, Princess Margaret Cancer Centre, Toronto, Ontario, Canada; Kerry J. Savage, British Columbia Cancer Agency Center for Lymphoid Cancer, Vancouver, British Columbia, Canada; Marek Trneny, Charles University in Prague, General University Hospital in Prague, Prague, Czech Republic; Stephen Ansell, Mayo Clinic, Rochester, MN; and Kazunobu Kato, Benedetto Farsaci, and Anne Sumbul, Bristol-Myers Squibb, Princeton, NJ
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Connors JM, Jurczak W, Straus DJ, Ansell SM, Kim WS, Gallamini A, Younes A, Alekseev S, Illés Á, Picardi M, Lech-Maranda E, Oki Y, Feldman T, Smolewski P, Savage KJ, Bartlett NL, Walewski J, Chen R, Ramchandren R, Zinzani PL, Cunningham D, Rosta A, Josephson NC, Song E, Sachs J, Liu R, Jolin HA, Huebner D, Radford J. Brentuximab Vedotin with Chemotherapy for Stage III or IV Hodgkin's Lymphoma. N Engl J Med 2018; 378:331-344. [PMID: 29224502 PMCID: PMC5819601 DOI: 10.1056/nejmoa1708984] [Citation(s) in RCA: 464] [Impact Index Per Article: 77.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
BACKGROUND Brentuximab vedotin is an anti-CD30 antibody-drug conjugate that has been approved for relapsed and refractory Hodgkin's lymphoma. METHODS We conducted an open-label, multicenter, randomized phase 3 trial involving patients with previously untreated stage III or IV classic Hodgkin's lymphoma, in which 664 were assigned to receive brentuximab vedotin, doxorubicin, vinblastine, and dacarbazine (A+AVD) and 670 were assigned to receive doxorubicin, bleomycin, vinblastine, and dacarbazine (ABVD). The primary end point was modified progression-free survival (the time to progression, death, or noncomplete response and use of subsequent anticancer therapy) as adjudicated by an independent review committee. The key secondary end point was overall survival. RESULTS At a median follow-up of 24.6 months, 2-year modified progression-free survival rates in the A+AVD and ABVD groups were 82.1% (95% confidence interval [CI], 78.8 to 85.0) and 77.2% (95% CI, 73.7 to 80.4), respectively, a difference of 4.9 percentage points (hazard ratio for an event of progression, death, or modified progression, 0.77; 95% CI, 0.60 to 0.98; P=0.04). There were 28 deaths with A+AVD and 39 with ABVD (hazard ratio for interim overall survival, 0.73 [95% CI, 0.45 to 1.18]; P=0.20) [corrected]. All secondary efficacy end points trended in favor of A+AVD. Neutropenia occurred in 58% of the patients receiving A+AVD and in 45% of those receiving ABVD; in the A+AVD group, the rate of febrile neutropenia was lower among the 83 patients who received primary prophylaxis with granulocyte colony-stimulating factor than among those who did not (11% vs. 21%). Peripheral neuropathy occurred in 67% of patients in the A+AVD group and in 43% of patients in the ABVD group; 67% of patients in the A+AVD group who had peripheral neuropathy had resolution or improvement at the last follow-up visit. Pulmonary toxicity of grade 3 or higher was reported in less than 1% of patients receiving A+AVD and in 3% of those receiving ABVD. Among the deaths that occurred during treatment, 7 of 9 in the A+AVD group were associated with neutropenia and 11 of 13 in the ABVD group were associated with pulmonary-related toxicity. CONCLUSIONS A+AVD had superior efficacy to ABVD in the treatment of patients with advanced-stage Hodgkin's lymphoma, with a 4.9 percentage-point lower combined risk of progression, death, or noncomplete response and use of subsequent anticancer therapy at 2 years. (Funded by Millennium Pharmaceuticals and Seattle Genetics; ECHELON-1 ClinicalTrials.gov number, NCT01712490 ; EudraCT number, 2011-005450-60 .).
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Affiliation(s)
- Joseph M Connors
- From the University of British Columbia and the Department of Medical Oncology, British Columbia Cancer Agency Centre for Lymphoid Cancer, Vancouver, Canada (J.M.C., K.J.S.); the Department of Hematology, Jagiellonian University, Krakow (W.J.), the Department of Hematology, Institute of Hematology and Transfusion Medicine, Warsaw (E.L.-M.), the Department of Hematology and Transfusion Medicine, Center of Postgraduate Medical Education, Warsaw (E.L.-M.), the Department of Experimental Hematology, Medical University of Lodz, Lodz (P.S.), and the Department of Lymphoid Malignancy, the Maria Sklodowska-Curie Memorial Institute and Oncology Center, Warsaw (J.W.) - all in Poland; Lymphoma Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York (D.J.S., A.Y.); the Department of Internal Medicine, Division of Hematology, Mayo Clinic, Rochester, MN (S.M.A.); the Division of Hematology and Oncology, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, South Korea (W.S.K.); Research Innovation and Statistics, Antoine-Lacassagne Cancer Center, Nice, France (A.G.); Petrov Research Institute of Oncology, St. Petersburg, Russia (S.A.); the Department of Hematology, Faculty of Medicine, University of Debrecen, Debrecen (Á.I.), and the Department of Hematology, National Institute of Oncology, Budapest (A.R.) - both in Hungary; the Department of Advanced Biomedical Science, Federico II University Hospital, Naples (M.P.), and the Institute of Hematology Seràgnoli, University of Bologna, Bologna (P.L.Z.) - both in Italy; the Department of Lymphoma and Myeloma, M.D. Anderson Cancer Center, Houston (Y.O.); John Theurer Cancer Center, Hackensack University Medical Center, Hackensack, NJ (T.F.); the Department of Medicine, Division of Oncology, Washington University School of Medicine, St. Louis (N.L.B.); the Department of Hematology and Hematopoietic Cell Transplantation, City of Hope National Medical Center, Duarte, CA (R.C.); the Department of Hematology-Oncology, Barbara Ann Karmanos Cancer Center, Detroit (R.R.); Gastrointestinal and Lymphoma Unit, The Royal Marsden NHS Foundation Trust, Sutton (D.C.), and the Department of Medical Oncology, University of Manchester and the Christie NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester (J.R.) - both in the United Kingdom; the Department of Clinical Development, Seattle Genetics, Bothell, WA (N.C.J., E.S.); and Oncology Clinical Research (J.S., H.A.J., D.H.) and Global Biostatistics (R.L.), Millennium Pharmaceuticals, Cambridge, MA
| | - Wojciech Jurczak
- From the University of British Columbia and the Department of Medical Oncology, British Columbia Cancer Agency Centre for Lymphoid Cancer, Vancouver, Canada (J.M.C., K.J.S.); the Department of Hematology, Jagiellonian University, Krakow (W.J.), the Department of Hematology, Institute of Hematology and Transfusion Medicine, Warsaw (E.L.-M.), the Department of Hematology and Transfusion Medicine, Center of Postgraduate Medical Education, Warsaw (E.L.-M.), the Department of Experimental Hematology, Medical University of Lodz, Lodz (P.S.), and the Department of Lymphoid Malignancy, the Maria Sklodowska-Curie Memorial Institute and Oncology Center, Warsaw (J.W.) - all in Poland; Lymphoma Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York (D.J.S., A.Y.); the Department of Internal Medicine, Division of Hematology, Mayo Clinic, Rochester, MN (S.M.A.); the Division of Hematology and Oncology, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, South Korea (W.S.K.); Research Innovation and Statistics, Antoine-Lacassagne Cancer Center, Nice, France (A.G.); Petrov Research Institute of Oncology, St. Petersburg, Russia (S.A.); the Department of Hematology, Faculty of Medicine, University of Debrecen, Debrecen (Á.I.), and the Department of Hematology, National Institute of Oncology, Budapest (A.R.) - both in Hungary; the Department of Advanced Biomedical Science, Federico II University Hospital, Naples (M.P.), and the Institute of Hematology Seràgnoli, University of Bologna, Bologna (P.L.Z.) - both in Italy; the Department of Lymphoma and Myeloma, M.D. Anderson Cancer Center, Houston (Y.O.); John Theurer Cancer Center, Hackensack University Medical Center, Hackensack, NJ (T.F.); the Department of Medicine, Division of Oncology, Washington University School of Medicine, St. Louis (N.L.B.); the Department of Hematology and Hematopoietic Cell Transplantation, City of Hope National Medical Center, Duarte, CA (R.C.); the Department of Hematology-Oncology, Barbara Ann Karmanos Cancer Center, Detroit (R.R.); Gastrointestinal and Lymphoma Unit, The Royal Marsden NHS Foundation Trust, Sutton (D.C.), and the Department of Medical Oncology, University of Manchester and the Christie NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester (J.R.) - both in the United Kingdom; the Department of Clinical Development, Seattle Genetics, Bothell, WA (N.C.J., E.S.); and Oncology Clinical Research (J.S., H.A.J., D.H.) and Global Biostatistics (R.L.), Millennium Pharmaceuticals, Cambridge, MA
| | - David J Straus
- From the University of British Columbia and the Department of Medical Oncology, British Columbia Cancer Agency Centre for Lymphoid Cancer, Vancouver, Canada (J.M.C., K.J.S.); the Department of Hematology, Jagiellonian University, Krakow (W.J.), the Department of Hematology, Institute of Hematology and Transfusion Medicine, Warsaw (E.L.-M.), the Department of Hematology and Transfusion Medicine, Center of Postgraduate Medical Education, Warsaw (E.L.-M.), the Department of Experimental Hematology, Medical University of Lodz, Lodz (P.S.), and the Department of Lymphoid Malignancy, the Maria Sklodowska-Curie Memorial Institute and Oncology Center, Warsaw (J.W.) - all in Poland; Lymphoma Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York (D.J.S., A.Y.); the Department of Internal Medicine, Division of Hematology, Mayo Clinic, Rochester, MN (S.M.A.); the Division of Hematology and Oncology, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, South Korea (W.S.K.); Research Innovation and Statistics, Antoine-Lacassagne Cancer Center, Nice, France (A.G.); Petrov Research Institute of Oncology, St. Petersburg, Russia (S.A.); the Department of Hematology, Faculty of Medicine, University of Debrecen, Debrecen (Á.I.), and the Department of Hematology, National Institute of Oncology, Budapest (A.R.) - both in Hungary; the Department of Advanced Biomedical Science, Federico II University Hospital, Naples (M.P.), and the Institute of Hematology Seràgnoli, University of Bologna, Bologna (P.L.Z.) - both in Italy; the Department of Lymphoma and Myeloma, M.D. Anderson Cancer Center, Houston (Y.O.); John Theurer Cancer Center, Hackensack University Medical Center, Hackensack, NJ (T.F.); the Department of Medicine, Division of Oncology, Washington University School of Medicine, St. Louis (N.L.B.); the Department of Hematology and Hematopoietic Cell Transplantation, City of Hope National Medical Center, Duarte, CA (R.C.); the Department of Hematology-Oncology, Barbara Ann Karmanos Cancer Center, Detroit (R.R.); Gastrointestinal and Lymphoma Unit, The Royal Marsden NHS Foundation Trust, Sutton (D.C.), and the Department of Medical Oncology, University of Manchester and the Christie NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester (J.R.) - both in the United Kingdom; the Department of Clinical Development, Seattle Genetics, Bothell, WA (N.C.J., E.S.); and Oncology Clinical Research (J.S., H.A.J., D.H.) and Global Biostatistics (R.L.), Millennium Pharmaceuticals, Cambridge, MA
| | - Stephen M Ansell
- From the University of British Columbia and the Department of Medical Oncology, British Columbia Cancer Agency Centre for Lymphoid Cancer, Vancouver, Canada (J.M.C., K.J.S.); the Department of Hematology, Jagiellonian University, Krakow (W.J.), the Department of Hematology, Institute of Hematology and Transfusion Medicine, Warsaw (E.L.-M.), the Department of Hematology and Transfusion Medicine, Center of Postgraduate Medical Education, Warsaw (E.L.-M.), the Department of Experimental Hematology, Medical University of Lodz, Lodz (P.S.), and the Department of Lymphoid Malignancy, the Maria Sklodowska-Curie Memorial Institute and Oncology Center, Warsaw (J.W.) - all in Poland; Lymphoma Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York (D.J.S., A.Y.); the Department of Internal Medicine, Division of Hematology, Mayo Clinic, Rochester, MN (S.M.A.); the Division of Hematology and Oncology, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, South Korea (W.S.K.); Research Innovation and Statistics, Antoine-Lacassagne Cancer Center, Nice, France (A.G.); Petrov Research Institute of Oncology, St. Petersburg, Russia (S.A.); the Department of Hematology, Faculty of Medicine, University of Debrecen, Debrecen (Á.I.), and the Department of Hematology, National Institute of Oncology, Budapest (A.R.) - both in Hungary; the Department of Advanced Biomedical Science, Federico II University Hospital, Naples (M.P.), and the Institute of Hematology Seràgnoli, University of Bologna, Bologna (P.L.Z.) - both in Italy; the Department of Lymphoma and Myeloma, M.D. Anderson Cancer Center, Houston (Y.O.); John Theurer Cancer Center, Hackensack University Medical Center, Hackensack, NJ (T.F.); the Department of Medicine, Division of Oncology, Washington University School of Medicine, St. Louis (N.L.B.); the Department of Hematology and Hematopoietic Cell Transplantation, City of Hope National Medical Center, Duarte, CA (R.C.); the Department of Hematology-Oncology, Barbara Ann Karmanos Cancer Center, Detroit (R.R.); Gastrointestinal and Lymphoma Unit, The Royal Marsden NHS Foundation Trust, Sutton (D.C.), and the Department of Medical Oncology, University of Manchester and the Christie NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester (J.R.) - both in the United Kingdom; the Department of Clinical Development, Seattle Genetics, Bothell, WA (N.C.J., E.S.); and Oncology Clinical Research (J.S., H.A.J., D.H.) and Global Biostatistics (R.L.), Millennium Pharmaceuticals, Cambridge, MA
| | - Won S Kim
- From the University of British Columbia and the Department of Medical Oncology, British Columbia Cancer Agency Centre for Lymphoid Cancer, Vancouver, Canada (J.M.C., K.J.S.); the Department of Hematology, Jagiellonian University, Krakow (W.J.), the Department of Hematology, Institute of Hematology and Transfusion Medicine, Warsaw (E.L.-M.), the Department of Hematology and Transfusion Medicine, Center of Postgraduate Medical Education, Warsaw (E.L.-M.), the Department of Experimental Hematology, Medical University of Lodz, Lodz (P.S.), and the Department of Lymphoid Malignancy, the Maria Sklodowska-Curie Memorial Institute and Oncology Center, Warsaw (J.W.) - all in Poland; Lymphoma Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York (D.J.S., A.Y.); the Department of Internal Medicine, Division of Hematology, Mayo Clinic, Rochester, MN (S.M.A.); the Division of Hematology and Oncology, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, South Korea (W.S.K.); Research Innovation and Statistics, Antoine-Lacassagne Cancer Center, Nice, France (A.G.); Petrov Research Institute of Oncology, St. Petersburg, Russia (S.A.); the Department of Hematology, Faculty of Medicine, University of Debrecen, Debrecen (Á.I.), and the Department of Hematology, National Institute of Oncology, Budapest (A.R.) - both in Hungary; the Department of Advanced Biomedical Science, Federico II University Hospital, Naples (M.P.), and the Institute of Hematology Seràgnoli, University of Bologna, Bologna (P.L.Z.) - both in Italy; the Department of Lymphoma and Myeloma, M.D. Anderson Cancer Center, Houston (Y.O.); John Theurer Cancer Center, Hackensack University Medical Center, Hackensack, NJ (T.F.); the Department of Medicine, Division of Oncology, Washington University School of Medicine, St. Louis (N.L.B.); the Department of Hematology and Hematopoietic Cell Transplantation, City of Hope National Medical Center, Duarte, CA (R.C.); the Department of Hematology-Oncology, Barbara Ann Karmanos Cancer Center, Detroit (R.R.); Gastrointestinal and Lymphoma Unit, The Royal Marsden NHS Foundation Trust, Sutton (D.C.), and the Department of Medical Oncology, University of Manchester and the Christie NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester (J.R.) - both in the United Kingdom; the Department of Clinical Development, Seattle Genetics, Bothell, WA (N.C.J., E.S.); and Oncology Clinical Research (J.S., H.A.J., D.H.) and Global Biostatistics (R.L.), Millennium Pharmaceuticals, Cambridge, MA
| | - Andrea Gallamini
- From the University of British Columbia and the Department of Medical Oncology, British Columbia Cancer Agency Centre for Lymphoid Cancer, Vancouver, Canada (J.M.C., K.J.S.); the Department of Hematology, Jagiellonian University, Krakow (W.J.), the Department of Hematology, Institute of Hematology and Transfusion Medicine, Warsaw (E.L.-M.), the Department of Hematology and Transfusion Medicine, Center of Postgraduate Medical Education, Warsaw (E.L.-M.), the Department of Experimental Hematology, Medical University of Lodz, Lodz (P.S.), and the Department of Lymphoid Malignancy, the Maria Sklodowska-Curie Memorial Institute and Oncology Center, Warsaw (J.W.) - all in Poland; Lymphoma Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York (D.J.S., A.Y.); the Department of Internal Medicine, Division of Hematology, Mayo Clinic, Rochester, MN (S.M.A.); the Division of Hematology and Oncology, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, South Korea (W.S.K.); Research Innovation and Statistics, Antoine-Lacassagne Cancer Center, Nice, France (A.G.); Petrov Research Institute of Oncology, St. Petersburg, Russia (S.A.); the Department of Hematology, Faculty of Medicine, University of Debrecen, Debrecen (Á.I.), and the Department of Hematology, National Institute of Oncology, Budapest (A.R.) - both in Hungary; the Department of Advanced Biomedical Science, Federico II University Hospital, Naples (M.P.), and the Institute of Hematology Seràgnoli, University of Bologna, Bologna (P.L.Z.) - both in Italy; the Department of Lymphoma and Myeloma, M.D. Anderson Cancer Center, Houston (Y.O.); John Theurer Cancer Center, Hackensack University Medical Center, Hackensack, NJ (T.F.); the Department of Medicine, Division of Oncology, Washington University School of Medicine, St. Louis (N.L.B.); the Department of Hematology and Hematopoietic Cell Transplantation, City of Hope National Medical Center, Duarte, CA (R.C.); the Department of Hematology-Oncology, Barbara Ann Karmanos Cancer Center, Detroit (R.R.); Gastrointestinal and Lymphoma Unit, The Royal Marsden NHS Foundation Trust, Sutton (D.C.), and the Department of Medical Oncology, University of Manchester and the Christie NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester (J.R.) - both in the United Kingdom; the Department of Clinical Development, Seattle Genetics, Bothell, WA (N.C.J., E.S.); and Oncology Clinical Research (J.S., H.A.J., D.H.) and Global Biostatistics (R.L.), Millennium Pharmaceuticals, Cambridge, MA
| | - Anas Younes
- From the University of British Columbia and the Department of Medical Oncology, British Columbia Cancer Agency Centre for Lymphoid Cancer, Vancouver, Canada (J.M.C., K.J.S.); the Department of Hematology, Jagiellonian University, Krakow (W.J.), the Department of Hematology, Institute of Hematology and Transfusion Medicine, Warsaw (E.L.-M.), the Department of Hematology and Transfusion Medicine, Center of Postgraduate Medical Education, Warsaw (E.L.-M.), the Department of Experimental Hematology, Medical University of Lodz, Lodz (P.S.), and the Department of Lymphoid Malignancy, the Maria Sklodowska-Curie Memorial Institute and Oncology Center, Warsaw (J.W.) - all in Poland; Lymphoma Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York (D.J.S., A.Y.); the Department of Internal Medicine, Division of Hematology, Mayo Clinic, Rochester, MN (S.M.A.); the Division of Hematology and Oncology, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, South Korea (W.S.K.); Research Innovation and Statistics, Antoine-Lacassagne Cancer Center, Nice, France (A.G.); Petrov Research Institute of Oncology, St. Petersburg, Russia (S.A.); the Department of Hematology, Faculty of Medicine, University of Debrecen, Debrecen (Á.I.), and the Department of Hematology, National Institute of Oncology, Budapest (A.R.) - both in Hungary; the Department of Advanced Biomedical Science, Federico II University Hospital, Naples (M.P.), and the Institute of Hematology Seràgnoli, University of Bologna, Bologna (P.L.Z.) - both in Italy; the Department of Lymphoma and Myeloma, M.D. Anderson Cancer Center, Houston (Y.O.); John Theurer Cancer Center, Hackensack University Medical Center, Hackensack, NJ (T.F.); the Department of Medicine, Division of Oncology, Washington University School of Medicine, St. Louis (N.L.B.); the Department of Hematology and Hematopoietic Cell Transplantation, City of Hope National Medical Center, Duarte, CA (R.C.); the Department of Hematology-Oncology, Barbara Ann Karmanos Cancer Center, Detroit (R.R.); Gastrointestinal and Lymphoma Unit, The Royal Marsden NHS Foundation Trust, Sutton (D.C.), and the Department of Medical Oncology, University of Manchester and the Christie NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester (J.R.) - both in the United Kingdom; the Department of Clinical Development, Seattle Genetics, Bothell, WA (N.C.J., E.S.); and Oncology Clinical Research (J.S., H.A.J., D.H.) and Global Biostatistics (R.L.), Millennium Pharmaceuticals, Cambridge, MA
| | - Sergey Alekseev
- From the University of British Columbia and the Department of Medical Oncology, British Columbia Cancer Agency Centre for Lymphoid Cancer, Vancouver, Canada (J.M.C., K.J.S.); the Department of Hematology, Jagiellonian University, Krakow (W.J.), the Department of Hematology, Institute of Hematology and Transfusion Medicine, Warsaw (E.L.-M.), the Department of Hematology and Transfusion Medicine, Center of Postgraduate Medical Education, Warsaw (E.L.-M.), the Department of Experimental Hematology, Medical University of Lodz, Lodz (P.S.), and the Department of Lymphoid Malignancy, the Maria Sklodowska-Curie Memorial Institute and Oncology Center, Warsaw (J.W.) - all in Poland; Lymphoma Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York (D.J.S., A.Y.); the Department of Internal Medicine, Division of Hematology, Mayo Clinic, Rochester, MN (S.M.A.); the Division of Hematology and Oncology, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, South Korea (W.S.K.); Research Innovation and Statistics, Antoine-Lacassagne Cancer Center, Nice, France (A.G.); Petrov Research Institute of Oncology, St. Petersburg, Russia (S.A.); the Department of Hematology, Faculty of Medicine, University of Debrecen, Debrecen (Á.I.), and the Department of Hematology, National Institute of Oncology, Budapest (A.R.) - both in Hungary; the Department of Advanced Biomedical Science, Federico II University Hospital, Naples (M.P.), and the Institute of Hematology Seràgnoli, University of Bologna, Bologna (P.L.Z.) - both in Italy; the Department of Lymphoma and Myeloma, M.D. Anderson Cancer Center, Houston (Y.O.); John Theurer Cancer Center, Hackensack University Medical Center, Hackensack, NJ (T.F.); the Department of Medicine, Division of Oncology, Washington University School of Medicine, St. Louis (N.L.B.); the Department of Hematology and Hematopoietic Cell Transplantation, City of Hope National Medical Center, Duarte, CA (R.C.); the Department of Hematology-Oncology, Barbara Ann Karmanos Cancer Center, Detroit (R.R.); Gastrointestinal and Lymphoma Unit, The Royal Marsden NHS Foundation Trust, Sutton (D.C.), and the Department of Medical Oncology, University of Manchester and the Christie NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester (J.R.) - both in the United Kingdom; the Department of Clinical Development, Seattle Genetics, Bothell, WA (N.C.J., E.S.); and Oncology Clinical Research (J.S., H.A.J., D.H.) and Global Biostatistics (R.L.), Millennium Pharmaceuticals, Cambridge, MA
| | - Árpád Illés
- From the University of British Columbia and the Department of Medical Oncology, British Columbia Cancer Agency Centre for Lymphoid Cancer, Vancouver, Canada (J.M.C., K.J.S.); the Department of Hematology, Jagiellonian University, Krakow (W.J.), the Department of Hematology, Institute of Hematology and Transfusion Medicine, Warsaw (E.L.-M.), the Department of Hematology and Transfusion Medicine, Center of Postgraduate Medical Education, Warsaw (E.L.-M.), the Department of Experimental Hematology, Medical University of Lodz, Lodz (P.S.), and the Department of Lymphoid Malignancy, the Maria Sklodowska-Curie Memorial Institute and Oncology Center, Warsaw (J.W.) - all in Poland; Lymphoma Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York (D.J.S., A.Y.); the Department of Internal Medicine, Division of Hematology, Mayo Clinic, Rochester, MN (S.M.A.); the Division of Hematology and Oncology, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, South Korea (W.S.K.); Research Innovation and Statistics, Antoine-Lacassagne Cancer Center, Nice, France (A.G.); Petrov Research Institute of Oncology, St. Petersburg, Russia (S.A.); the Department of Hematology, Faculty of Medicine, University of Debrecen, Debrecen (Á.I.), and the Department of Hematology, National Institute of Oncology, Budapest (A.R.) - both in Hungary; the Department of Advanced Biomedical Science, Federico II University Hospital, Naples (M.P.), and the Institute of Hematology Seràgnoli, University of Bologna, Bologna (P.L.Z.) - both in Italy; the Department of Lymphoma and Myeloma, M.D. Anderson Cancer Center, Houston (Y.O.); John Theurer Cancer Center, Hackensack University Medical Center, Hackensack, NJ (T.F.); the Department of Medicine, Division of Oncology, Washington University School of Medicine, St. Louis (N.L.B.); the Department of Hematology and Hematopoietic Cell Transplantation, City of Hope National Medical Center, Duarte, CA (R.C.); the Department of Hematology-Oncology, Barbara Ann Karmanos Cancer Center, Detroit (R.R.); Gastrointestinal and Lymphoma Unit, The Royal Marsden NHS Foundation Trust, Sutton (D.C.), and the Department of Medical Oncology, University of Manchester and the Christie NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester (J.R.) - both in the United Kingdom; the Department of Clinical Development, Seattle Genetics, Bothell, WA (N.C.J., E.S.); and Oncology Clinical Research (J.S., H.A.J., D.H.) and Global Biostatistics (R.L.), Millennium Pharmaceuticals, Cambridge, MA
| | - Marco Picardi
- From the University of British Columbia and the Department of Medical Oncology, British Columbia Cancer Agency Centre for Lymphoid Cancer, Vancouver, Canada (J.M.C., K.J.S.); the Department of Hematology, Jagiellonian University, Krakow (W.J.), the Department of Hematology, Institute of Hematology and Transfusion Medicine, Warsaw (E.L.-M.), the Department of Hematology and Transfusion Medicine, Center of Postgraduate Medical Education, Warsaw (E.L.-M.), the Department of Experimental Hematology, Medical University of Lodz, Lodz (P.S.), and the Department of Lymphoid Malignancy, the Maria Sklodowska-Curie Memorial Institute and Oncology Center, Warsaw (J.W.) - all in Poland; Lymphoma Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York (D.J.S., A.Y.); the Department of Internal Medicine, Division of Hematology, Mayo Clinic, Rochester, MN (S.M.A.); the Division of Hematology and Oncology, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, South Korea (W.S.K.); Research Innovation and Statistics, Antoine-Lacassagne Cancer Center, Nice, France (A.G.); Petrov Research Institute of Oncology, St. Petersburg, Russia (S.A.); the Department of Hematology, Faculty of Medicine, University of Debrecen, Debrecen (Á.I.), and the Department of Hematology, National Institute of Oncology, Budapest (A.R.) - both in Hungary; the Department of Advanced Biomedical Science, Federico II University Hospital, Naples (M.P.), and the Institute of Hematology Seràgnoli, University of Bologna, Bologna (P.L.Z.) - both in Italy; the Department of Lymphoma and Myeloma, M.D. Anderson Cancer Center, Houston (Y.O.); John Theurer Cancer Center, Hackensack University Medical Center, Hackensack, NJ (T.F.); the Department of Medicine, Division of Oncology, Washington University School of Medicine, St. Louis (N.L.B.); the Department of Hematology and Hematopoietic Cell Transplantation, City of Hope National Medical Center, Duarte, CA (R.C.); the Department of Hematology-Oncology, Barbara Ann Karmanos Cancer Center, Detroit (R.R.); Gastrointestinal and Lymphoma Unit, The Royal Marsden NHS Foundation Trust, Sutton (D.C.), and the Department of Medical Oncology, University of Manchester and the Christie NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester (J.R.) - both in the United Kingdom; the Department of Clinical Development, Seattle Genetics, Bothell, WA (N.C.J., E.S.); and Oncology Clinical Research (J.S., H.A.J., D.H.) and Global Biostatistics (R.L.), Millennium Pharmaceuticals, Cambridge, MA
| | - Ewa Lech-Maranda
- From the University of British Columbia and the Department of Medical Oncology, British Columbia Cancer Agency Centre for Lymphoid Cancer, Vancouver, Canada (J.M.C., K.J.S.); the Department of Hematology, Jagiellonian University, Krakow (W.J.), the Department of Hematology, Institute of Hematology and Transfusion Medicine, Warsaw (E.L.-M.), the Department of Hematology and Transfusion Medicine, Center of Postgraduate Medical Education, Warsaw (E.L.-M.), the Department of Experimental Hematology, Medical University of Lodz, Lodz (P.S.), and the Department of Lymphoid Malignancy, the Maria Sklodowska-Curie Memorial Institute and Oncology Center, Warsaw (J.W.) - all in Poland; Lymphoma Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York (D.J.S., A.Y.); the Department of Internal Medicine, Division of Hematology, Mayo Clinic, Rochester, MN (S.M.A.); the Division of Hematology and Oncology, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, South Korea (W.S.K.); Research Innovation and Statistics, Antoine-Lacassagne Cancer Center, Nice, France (A.G.); Petrov Research Institute of Oncology, St. Petersburg, Russia (S.A.); the Department of Hematology, Faculty of Medicine, University of Debrecen, Debrecen (Á.I.), and the Department of Hematology, National Institute of Oncology, Budapest (A.R.) - both in Hungary; the Department of Advanced Biomedical Science, Federico II University Hospital, Naples (M.P.), and the Institute of Hematology Seràgnoli, University of Bologna, Bologna (P.L.Z.) - both in Italy; the Department of Lymphoma and Myeloma, M.D. Anderson Cancer Center, Houston (Y.O.); John Theurer Cancer Center, Hackensack University Medical Center, Hackensack, NJ (T.F.); the Department of Medicine, Division of Oncology, Washington University School of Medicine, St. Louis (N.L.B.); the Department of Hematology and Hematopoietic Cell Transplantation, City of Hope National Medical Center, Duarte, CA (R.C.); the Department of Hematology-Oncology, Barbara Ann Karmanos Cancer Center, Detroit (R.R.); Gastrointestinal and Lymphoma Unit, The Royal Marsden NHS Foundation Trust, Sutton (D.C.), and the Department of Medical Oncology, University of Manchester and the Christie NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester (J.R.) - both in the United Kingdom; the Department of Clinical Development, Seattle Genetics, Bothell, WA (N.C.J., E.S.); and Oncology Clinical Research (J.S., H.A.J., D.H.) and Global Biostatistics (R.L.), Millennium Pharmaceuticals, Cambridge, MA
| | - Yasuhiro Oki
- From the University of British Columbia and the Department of Medical Oncology, British Columbia Cancer Agency Centre for Lymphoid Cancer, Vancouver, Canada (J.M.C., K.J.S.); the Department of Hematology, Jagiellonian University, Krakow (W.J.), the Department of Hematology, Institute of Hematology and Transfusion Medicine, Warsaw (E.L.-M.), the Department of Hematology and Transfusion Medicine, Center of Postgraduate Medical Education, Warsaw (E.L.-M.), the Department of Experimental Hematology, Medical University of Lodz, Lodz (P.S.), and the Department of Lymphoid Malignancy, the Maria Sklodowska-Curie Memorial Institute and Oncology Center, Warsaw (J.W.) - all in Poland; Lymphoma Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York (D.J.S., A.Y.); the Department of Internal Medicine, Division of Hematology, Mayo Clinic, Rochester, MN (S.M.A.); the Division of Hematology and Oncology, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, South Korea (W.S.K.); Research Innovation and Statistics, Antoine-Lacassagne Cancer Center, Nice, France (A.G.); Petrov Research Institute of Oncology, St. Petersburg, Russia (S.A.); the Department of Hematology, Faculty of Medicine, University of Debrecen, Debrecen (Á.I.), and the Department of Hematology, National Institute of Oncology, Budapest (A.R.) - both in Hungary; the Department of Advanced Biomedical Science, Federico II University Hospital, Naples (M.P.), and the Institute of Hematology Seràgnoli, University of Bologna, Bologna (P.L.Z.) - both in Italy; the Department of Lymphoma and Myeloma, M.D. Anderson Cancer Center, Houston (Y.O.); John Theurer Cancer Center, Hackensack University Medical Center, Hackensack, NJ (T.F.); the Department of Medicine, Division of Oncology, Washington University School of Medicine, St. Louis (N.L.B.); the Department of Hematology and Hematopoietic Cell Transplantation, City of Hope National Medical Center, Duarte, CA (R.C.); the Department of Hematology-Oncology, Barbara Ann Karmanos Cancer Center, Detroit (R.R.); Gastrointestinal and Lymphoma Unit, The Royal Marsden NHS Foundation Trust, Sutton (D.C.), and the Department of Medical Oncology, University of Manchester and the Christie NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester (J.R.) - both in the United Kingdom; the Department of Clinical Development, Seattle Genetics, Bothell, WA (N.C.J., E.S.); and Oncology Clinical Research (J.S., H.A.J., D.H.) and Global Biostatistics (R.L.), Millennium Pharmaceuticals, Cambridge, MA
| | - Tatyana Feldman
- From the University of British Columbia and the Department of Medical Oncology, British Columbia Cancer Agency Centre for Lymphoid Cancer, Vancouver, Canada (J.M.C., K.J.S.); the Department of Hematology, Jagiellonian University, Krakow (W.J.), the Department of Hematology, Institute of Hematology and Transfusion Medicine, Warsaw (E.L.-M.), the Department of Hematology and Transfusion Medicine, Center of Postgraduate Medical Education, Warsaw (E.L.-M.), the Department of Experimental Hematology, Medical University of Lodz, Lodz (P.S.), and the Department of Lymphoid Malignancy, the Maria Sklodowska-Curie Memorial Institute and Oncology Center, Warsaw (J.W.) - all in Poland; Lymphoma Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York (D.J.S., A.Y.); the Department of Internal Medicine, Division of Hematology, Mayo Clinic, Rochester, MN (S.M.A.); the Division of Hematology and Oncology, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, South Korea (W.S.K.); Research Innovation and Statistics, Antoine-Lacassagne Cancer Center, Nice, France (A.G.); Petrov Research Institute of Oncology, St. Petersburg, Russia (S.A.); the Department of Hematology, Faculty of Medicine, University of Debrecen, Debrecen (Á.I.), and the Department of Hematology, National Institute of Oncology, Budapest (A.R.) - both in Hungary; the Department of Advanced Biomedical Science, Federico II University Hospital, Naples (M.P.), and the Institute of Hematology Seràgnoli, University of Bologna, Bologna (P.L.Z.) - both in Italy; the Department of Lymphoma and Myeloma, M.D. Anderson Cancer Center, Houston (Y.O.); John Theurer Cancer Center, Hackensack University Medical Center, Hackensack, NJ (T.F.); the Department of Medicine, Division of Oncology, Washington University School of Medicine, St. Louis (N.L.B.); the Department of Hematology and Hematopoietic Cell Transplantation, City of Hope National Medical Center, Duarte, CA (R.C.); the Department of Hematology-Oncology, Barbara Ann Karmanos Cancer Center, Detroit (R.R.); Gastrointestinal and Lymphoma Unit, The Royal Marsden NHS Foundation Trust, Sutton (D.C.), and the Department of Medical Oncology, University of Manchester and the Christie NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester (J.R.) - both in the United Kingdom; the Department of Clinical Development, Seattle Genetics, Bothell, WA (N.C.J., E.S.); and Oncology Clinical Research (J.S., H.A.J., D.H.) and Global Biostatistics (R.L.), Millennium Pharmaceuticals, Cambridge, MA
| | - Piotr Smolewski
- From the University of British Columbia and the Department of Medical Oncology, British Columbia Cancer Agency Centre for Lymphoid Cancer, Vancouver, Canada (J.M.C., K.J.S.); the Department of Hematology, Jagiellonian University, Krakow (W.J.), the Department of Hematology, Institute of Hematology and Transfusion Medicine, Warsaw (E.L.-M.), the Department of Hematology and Transfusion Medicine, Center of Postgraduate Medical Education, Warsaw (E.L.-M.), the Department of Experimental Hematology, Medical University of Lodz, Lodz (P.S.), and the Department of Lymphoid Malignancy, the Maria Sklodowska-Curie Memorial Institute and Oncology Center, Warsaw (J.W.) - all in Poland; Lymphoma Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York (D.J.S., A.Y.); the Department of Internal Medicine, Division of Hematology, Mayo Clinic, Rochester, MN (S.M.A.); the Division of Hematology and Oncology, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, South Korea (W.S.K.); Research Innovation and Statistics, Antoine-Lacassagne Cancer Center, Nice, France (A.G.); Petrov Research Institute of Oncology, St. Petersburg, Russia (S.A.); the Department of Hematology, Faculty of Medicine, University of Debrecen, Debrecen (Á.I.), and the Department of Hematology, National Institute of Oncology, Budapest (A.R.) - both in Hungary; the Department of Advanced Biomedical Science, Federico II University Hospital, Naples (M.P.), and the Institute of Hematology Seràgnoli, University of Bologna, Bologna (P.L.Z.) - both in Italy; the Department of Lymphoma and Myeloma, M.D. Anderson Cancer Center, Houston (Y.O.); John Theurer Cancer Center, Hackensack University Medical Center, Hackensack, NJ (T.F.); the Department of Medicine, Division of Oncology, Washington University School of Medicine, St. Louis (N.L.B.); the Department of Hematology and Hematopoietic Cell Transplantation, City of Hope National Medical Center, Duarte, CA (R.C.); the Department of Hematology-Oncology, Barbara Ann Karmanos Cancer Center, Detroit (R.R.); Gastrointestinal and Lymphoma Unit, The Royal Marsden NHS Foundation Trust, Sutton (D.C.), and the Department of Medical Oncology, University of Manchester and the Christie NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester (J.R.) - both in the United Kingdom; the Department of Clinical Development, Seattle Genetics, Bothell, WA (N.C.J., E.S.); and Oncology Clinical Research (J.S., H.A.J., D.H.) and Global Biostatistics (R.L.), Millennium Pharmaceuticals, Cambridge, MA
| | - Kerry J Savage
- From the University of British Columbia and the Department of Medical Oncology, British Columbia Cancer Agency Centre for Lymphoid Cancer, Vancouver, Canada (J.M.C., K.J.S.); the Department of Hematology, Jagiellonian University, Krakow (W.J.), the Department of Hematology, Institute of Hematology and Transfusion Medicine, Warsaw (E.L.-M.), the Department of Hematology and Transfusion Medicine, Center of Postgraduate Medical Education, Warsaw (E.L.-M.), the Department of Experimental Hematology, Medical University of Lodz, Lodz (P.S.), and the Department of Lymphoid Malignancy, the Maria Sklodowska-Curie Memorial Institute and Oncology Center, Warsaw (J.W.) - all in Poland; Lymphoma Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York (D.J.S., A.Y.); the Department of Internal Medicine, Division of Hematology, Mayo Clinic, Rochester, MN (S.M.A.); the Division of Hematology and Oncology, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, South Korea (W.S.K.); Research Innovation and Statistics, Antoine-Lacassagne Cancer Center, Nice, France (A.G.); Petrov Research Institute of Oncology, St. Petersburg, Russia (S.A.); the Department of Hematology, Faculty of Medicine, University of Debrecen, Debrecen (Á.I.), and the Department of Hematology, National Institute of Oncology, Budapest (A.R.) - both in Hungary; the Department of Advanced Biomedical Science, Federico II University Hospital, Naples (M.P.), and the Institute of Hematology Seràgnoli, University of Bologna, Bologna (P.L.Z.) - both in Italy; the Department of Lymphoma and Myeloma, M.D. Anderson Cancer Center, Houston (Y.O.); John Theurer Cancer Center, Hackensack University Medical Center, Hackensack, NJ (T.F.); the Department of Medicine, Division of Oncology, Washington University School of Medicine, St. Louis (N.L.B.); the Department of Hematology and Hematopoietic Cell Transplantation, City of Hope National Medical Center, Duarte, CA (R.C.); the Department of Hematology-Oncology, Barbara Ann Karmanos Cancer Center, Detroit (R.R.); Gastrointestinal and Lymphoma Unit, The Royal Marsden NHS Foundation Trust, Sutton (D.C.), and the Department of Medical Oncology, University of Manchester and the Christie NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester (J.R.) - both in the United Kingdom; the Department of Clinical Development, Seattle Genetics, Bothell, WA (N.C.J., E.S.); and Oncology Clinical Research (J.S., H.A.J., D.H.) and Global Biostatistics (R.L.), Millennium Pharmaceuticals, Cambridge, MA
| | - Nancy L Bartlett
- From the University of British Columbia and the Department of Medical Oncology, British Columbia Cancer Agency Centre for Lymphoid Cancer, Vancouver, Canada (J.M.C., K.J.S.); the Department of Hematology, Jagiellonian University, Krakow (W.J.), the Department of Hematology, Institute of Hematology and Transfusion Medicine, Warsaw (E.L.-M.), the Department of Hematology and Transfusion Medicine, Center of Postgraduate Medical Education, Warsaw (E.L.-M.), the Department of Experimental Hematology, Medical University of Lodz, Lodz (P.S.), and the Department of Lymphoid Malignancy, the Maria Sklodowska-Curie Memorial Institute and Oncology Center, Warsaw (J.W.) - all in Poland; Lymphoma Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York (D.J.S., A.Y.); the Department of Internal Medicine, Division of Hematology, Mayo Clinic, Rochester, MN (S.M.A.); the Division of Hematology and Oncology, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, South Korea (W.S.K.); Research Innovation and Statistics, Antoine-Lacassagne Cancer Center, Nice, France (A.G.); Petrov Research Institute of Oncology, St. Petersburg, Russia (S.A.); the Department of Hematology, Faculty of Medicine, University of Debrecen, Debrecen (Á.I.), and the Department of Hematology, National Institute of Oncology, Budapest (A.R.) - both in Hungary; the Department of Advanced Biomedical Science, Federico II University Hospital, Naples (M.P.), and the Institute of Hematology Seràgnoli, University of Bologna, Bologna (P.L.Z.) - both in Italy; the Department of Lymphoma and Myeloma, M.D. Anderson Cancer Center, Houston (Y.O.); John Theurer Cancer Center, Hackensack University Medical Center, Hackensack, NJ (T.F.); the Department of Medicine, Division of Oncology, Washington University School of Medicine, St. Louis (N.L.B.); the Department of Hematology and Hematopoietic Cell Transplantation, City of Hope National Medical Center, Duarte, CA (R.C.); the Department of Hematology-Oncology, Barbara Ann Karmanos Cancer Center, Detroit (R.R.); Gastrointestinal and Lymphoma Unit, The Royal Marsden NHS Foundation Trust, Sutton (D.C.), and the Department of Medical Oncology, University of Manchester and the Christie NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester (J.R.) - both in the United Kingdom; the Department of Clinical Development, Seattle Genetics, Bothell, WA (N.C.J., E.S.); and Oncology Clinical Research (J.S., H.A.J., D.H.) and Global Biostatistics (R.L.), Millennium Pharmaceuticals, Cambridge, MA
| | - Jan Walewski
- From the University of British Columbia and the Department of Medical Oncology, British Columbia Cancer Agency Centre for Lymphoid Cancer, Vancouver, Canada (J.M.C., K.J.S.); the Department of Hematology, Jagiellonian University, Krakow (W.J.), the Department of Hematology, Institute of Hematology and Transfusion Medicine, Warsaw (E.L.-M.), the Department of Hematology and Transfusion Medicine, Center of Postgraduate Medical Education, Warsaw (E.L.-M.), the Department of Experimental Hematology, Medical University of Lodz, Lodz (P.S.), and the Department of Lymphoid Malignancy, the Maria Sklodowska-Curie Memorial Institute and Oncology Center, Warsaw (J.W.) - all in Poland; Lymphoma Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York (D.J.S., A.Y.); the Department of Internal Medicine, Division of Hematology, Mayo Clinic, Rochester, MN (S.M.A.); the Division of Hematology and Oncology, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, South Korea (W.S.K.); Research Innovation and Statistics, Antoine-Lacassagne Cancer Center, Nice, France (A.G.); Petrov Research Institute of Oncology, St. Petersburg, Russia (S.A.); the Department of Hematology, Faculty of Medicine, University of Debrecen, Debrecen (Á.I.), and the Department of Hematology, National Institute of Oncology, Budapest (A.R.) - both in Hungary; the Department of Advanced Biomedical Science, Federico II University Hospital, Naples (M.P.), and the Institute of Hematology Seràgnoli, University of Bologna, Bologna (P.L.Z.) - both in Italy; the Department of Lymphoma and Myeloma, M.D. Anderson Cancer Center, Houston (Y.O.); John Theurer Cancer Center, Hackensack University Medical Center, Hackensack, NJ (T.F.); the Department of Medicine, Division of Oncology, Washington University School of Medicine, St. Louis (N.L.B.); the Department of Hematology and Hematopoietic Cell Transplantation, City of Hope National Medical Center, Duarte, CA (R.C.); the Department of Hematology-Oncology, Barbara Ann Karmanos Cancer Center, Detroit (R.R.); Gastrointestinal and Lymphoma Unit, The Royal Marsden NHS Foundation Trust, Sutton (D.C.), and the Department of Medical Oncology, University of Manchester and the Christie NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester (J.R.) - both in the United Kingdom; the Department of Clinical Development, Seattle Genetics, Bothell, WA (N.C.J., E.S.); and Oncology Clinical Research (J.S., H.A.J., D.H.) and Global Biostatistics (R.L.), Millennium Pharmaceuticals, Cambridge, MA
| | - Robert Chen
- From the University of British Columbia and the Department of Medical Oncology, British Columbia Cancer Agency Centre for Lymphoid Cancer, Vancouver, Canada (J.M.C., K.J.S.); the Department of Hematology, Jagiellonian University, Krakow (W.J.), the Department of Hematology, Institute of Hematology and Transfusion Medicine, Warsaw (E.L.-M.), the Department of Hematology and Transfusion Medicine, Center of Postgraduate Medical Education, Warsaw (E.L.-M.), the Department of Experimental Hematology, Medical University of Lodz, Lodz (P.S.), and the Department of Lymphoid Malignancy, the Maria Sklodowska-Curie Memorial Institute and Oncology Center, Warsaw (J.W.) - all in Poland; Lymphoma Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York (D.J.S., A.Y.); the Department of Internal Medicine, Division of Hematology, Mayo Clinic, Rochester, MN (S.M.A.); the Division of Hematology and Oncology, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, South Korea (W.S.K.); Research Innovation and Statistics, Antoine-Lacassagne Cancer Center, Nice, France (A.G.); Petrov Research Institute of Oncology, St. Petersburg, Russia (S.A.); the Department of Hematology, Faculty of Medicine, University of Debrecen, Debrecen (Á.I.), and the Department of Hematology, National Institute of Oncology, Budapest (A.R.) - both in Hungary; the Department of Advanced Biomedical Science, Federico II University Hospital, Naples (M.P.), and the Institute of Hematology Seràgnoli, University of Bologna, Bologna (P.L.Z.) - both in Italy; the Department of Lymphoma and Myeloma, M.D. Anderson Cancer Center, Houston (Y.O.); John Theurer Cancer Center, Hackensack University Medical Center, Hackensack, NJ (T.F.); the Department of Medicine, Division of Oncology, Washington University School of Medicine, St. Louis (N.L.B.); the Department of Hematology and Hematopoietic Cell Transplantation, City of Hope National Medical Center, Duarte, CA (R.C.); the Department of Hematology-Oncology, Barbara Ann Karmanos Cancer Center, Detroit (R.R.); Gastrointestinal and Lymphoma Unit, The Royal Marsden NHS Foundation Trust, Sutton (D.C.), and the Department of Medical Oncology, University of Manchester and the Christie NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester (J.R.) - both in the United Kingdom; the Department of Clinical Development, Seattle Genetics, Bothell, WA (N.C.J., E.S.); and Oncology Clinical Research (J.S., H.A.J., D.H.) and Global Biostatistics (R.L.), Millennium Pharmaceuticals, Cambridge, MA
| | - Radhakrishnan Ramchandren
- From the University of British Columbia and the Department of Medical Oncology, British Columbia Cancer Agency Centre for Lymphoid Cancer, Vancouver, Canada (J.M.C., K.J.S.); the Department of Hematology, Jagiellonian University, Krakow (W.J.), the Department of Hematology, Institute of Hematology and Transfusion Medicine, Warsaw (E.L.-M.), the Department of Hematology and Transfusion Medicine, Center of Postgraduate Medical Education, Warsaw (E.L.-M.), the Department of Experimental Hematology, Medical University of Lodz, Lodz (P.S.), and the Department of Lymphoid Malignancy, the Maria Sklodowska-Curie Memorial Institute and Oncology Center, Warsaw (J.W.) - all in Poland; Lymphoma Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York (D.J.S., A.Y.); the Department of Internal Medicine, Division of Hematology, Mayo Clinic, Rochester, MN (S.M.A.); the Division of Hematology and Oncology, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, South Korea (W.S.K.); Research Innovation and Statistics, Antoine-Lacassagne Cancer Center, Nice, France (A.G.); Petrov Research Institute of Oncology, St. Petersburg, Russia (S.A.); the Department of Hematology, Faculty of Medicine, University of Debrecen, Debrecen (Á.I.), and the Department of Hematology, National Institute of Oncology, Budapest (A.R.) - both in Hungary; the Department of Advanced Biomedical Science, Federico II University Hospital, Naples (M.P.), and the Institute of Hematology Seràgnoli, University of Bologna, Bologna (P.L.Z.) - both in Italy; the Department of Lymphoma and Myeloma, M.D. Anderson Cancer Center, Houston (Y.O.); John Theurer Cancer Center, Hackensack University Medical Center, Hackensack, NJ (T.F.); the Department of Medicine, Division of Oncology, Washington University School of Medicine, St. Louis (N.L.B.); the Department of Hematology and Hematopoietic Cell Transplantation, City of Hope National Medical Center, Duarte, CA (R.C.); the Department of Hematology-Oncology, Barbara Ann Karmanos Cancer Center, Detroit (R.R.); Gastrointestinal and Lymphoma Unit, The Royal Marsden NHS Foundation Trust, Sutton (D.C.), and the Department of Medical Oncology, University of Manchester and the Christie NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester (J.R.) - both in the United Kingdom; the Department of Clinical Development, Seattle Genetics, Bothell, WA (N.C.J., E.S.); and Oncology Clinical Research (J.S., H.A.J., D.H.) and Global Biostatistics (R.L.), Millennium Pharmaceuticals, Cambridge, MA
| | - Pier L Zinzani
- From the University of British Columbia and the Department of Medical Oncology, British Columbia Cancer Agency Centre for Lymphoid Cancer, Vancouver, Canada (J.M.C., K.J.S.); the Department of Hematology, Jagiellonian University, Krakow (W.J.), the Department of Hematology, Institute of Hematology and Transfusion Medicine, Warsaw (E.L.-M.), the Department of Hematology and Transfusion Medicine, Center of Postgraduate Medical Education, Warsaw (E.L.-M.), the Department of Experimental Hematology, Medical University of Lodz, Lodz (P.S.), and the Department of Lymphoid Malignancy, the Maria Sklodowska-Curie Memorial Institute and Oncology Center, Warsaw (J.W.) - all in Poland; Lymphoma Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York (D.J.S., A.Y.); the Department of Internal Medicine, Division of Hematology, Mayo Clinic, Rochester, MN (S.M.A.); the Division of Hematology and Oncology, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, South Korea (W.S.K.); Research Innovation and Statistics, Antoine-Lacassagne Cancer Center, Nice, France (A.G.); Petrov Research Institute of Oncology, St. Petersburg, Russia (S.A.); the Department of Hematology, Faculty of Medicine, University of Debrecen, Debrecen (Á.I.), and the Department of Hematology, National Institute of Oncology, Budapest (A.R.) - both in Hungary; the Department of Advanced Biomedical Science, Federico II University Hospital, Naples (M.P.), and the Institute of Hematology Seràgnoli, University of Bologna, Bologna (P.L.Z.) - both in Italy; the Department of Lymphoma and Myeloma, M.D. Anderson Cancer Center, Houston (Y.O.); John Theurer Cancer Center, Hackensack University Medical Center, Hackensack, NJ (T.F.); the Department of Medicine, Division of Oncology, Washington University School of Medicine, St. Louis (N.L.B.); the Department of Hematology and Hematopoietic Cell Transplantation, City of Hope National Medical Center, Duarte, CA (R.C.); the Department of Hematology-Oncology, Barbara Ann Karmanos Cancer Center, Detroit (R.R.); Gastrointestinal and Lymphoma Unit, The Royal Marsden NHS Foundation Trust, Sutton (D.C.), and the Department of Medical Oncology, University of Manchester and the Christie NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester (J.R.) - both in the United Kingdom; the Department of Clinical Development, Seattle Genetics, Bothell, WA (N.C.J., E.S.); and Oncology Clinical Research (J.S., H.A.J., D.H.) and Global Biostatistics (R.L.), Millennium Pharmaceuticals, Cambridge, MA
| | - David Cunningham
- From the University of British Columbia and the Department of Medical Oncology, British Columbia Cancer Agency Centre for Lymphoid Cancer, Vancouver, Canada (J.M.C., K.J.S.); the Department of Hematology, Jagiellonian University, Krakow (W.J.), the Department of Hematology, Institute of Hematology and Transfusion Medicine, Warsaw (E.L.-M.), the Department of Hematology and Transfusion Medicine, Center of Postgraduate Medical Education, Warsaw (E.L.-M.), the Department of Experimental Hematology, Medical University of Lodz, Lodz (P.S.), and the Department of Lymphoid Malignancy, the Maria Sklodowska-Curie Memorial Institute and Oncology Center, Warsaw (J.W.) - all in Poland; Lymphoma Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York (D.J.S., A.Y.); the Department of Internal Medicine, Division of Hematology, Mayo Clinic, Rochester, MN (S.M.A.); the Division of Hematology and Oncology, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, South Korea (W.S.K.); Research Innovation and Statistics, Antoine-Lacassagne Cancer Center, Nice, France (A.G.); Petrov Research Institute of Oncology, St. Petersburg, Russia (S.A.); the Department of Hematology, Faculty of Medicine, University of Debrecen, Debrecen (Á.I.), and the Department of Hematology, National Institute of Oncology, Budapest (A.R.) - both in Hungary; the Department of Advanced Biomedical Science, Federico II University Hospital, Naples (M.P.), and the Institute of Hematology Seràgnoli, University of Bologna, Bologna (P.L.Z.) - both in Italy; the Department of Lymphoma and Myeloma, M.D. Anderson Cancer Center, Houston (Y.O.); John Theurer Cancer Center, Hackensack University Medical Center, Hackensack, NJ (T.F.); the Department of Medicine, Division of Oncology, Washington University School of Medicine, St. Louis (N.L.B.); the Department of Hematology and Hematopoietic Cell Transplantation, City of Hope National Medical Center, Duarte, CA (R.C.); the Department of Hematology-Oncology, Barbara Ann Karmanos Cancer Center, Detroit (R.R.); Gastrointestinal and Lymphoma Unit, The Royal Marsden NHS Foundation Trust, Sutton (D.C.), and the Department of Medical Oncology, University of Manchester and the Christie NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester (J.R.) - both in the United Kingdom; the Department of Clinical Development, Seattle Genetics, Bothell, WA (N.C.J., E.S.); and Oncology Clinical Research (J.S., H.A.J., D.H.) and Global Biostatistics (R.L.), Millennium Pharmaceuticals, Cambridge, MA
| | - Andras Rosta
- From the University of British Columbia and the Department of Medical Oncology, British Columbia Cancer Agency Centre for Lymphoid Cancer, Vancouver, Canada (J.M.C., K.J.S.); the Department of Hematology, Jagiellonian University, Krakow (W.J.), the Department of Hematology, Institute of Hematology and Transfusion Medicine, Warsaw (E.L.-M.), the Department of Hematology and Transfusion Medicine, Center of Postgraduate Medical Education, Warsaw (E.L.-M.), the Department of Experimental Hematology, Medical University of Lodz, Lodz (P.S.), and the Department of Lymphoid Malignancy, the Maria Sklodowska-Curie Memorial Institute and Oncology Center, Warsaw (J.W.) - all in Poland; Lymphoma Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York (D.J.S., A.Y.); the Department of Internal Medicine, Division of Hematology, Mayo Clinic, Rochester, MN (S.M.A.); the Division of Hematology and Oncology, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, South Korea (W.S.K.); Research Innovation and Statistics, Antoine-Lacassagne Cancer Center, Nice, France (A.G.); Petrov Research Institute of Oncology, St. Petersburg, Russia (S.A.); the Department of Hematology, Faculty of Medicine, University of Debrecen, Debrecen (Á.I.), and the Department of Hematology, National Institute of Oncology, Budapest (A.R.) - both in Hungary; the Department of Advanced Biomedical Science, Federico II University Hospital, Naples (M.P.), and the Institute of Hematology Seràgnoli, University of Bologna, Bologna (P.L.Z.) - both in Italy; the Department of Lymphoma and Myeloma, M.D. Anderson Cancer Center, Houston (Y.O.); John Theurer Cancer Center, Hackensack University Medical Center, Hackensack, NJ (T.F.); the Department of Medicine, Division of Oncology, Washington University School of Medicine, St. Louis (N.L.B.); the Department of Hematology and Hematopoietic Cell Transplantation, City of Hope National Medical Center, Duarte, CA (R.C.); the Department of Hematology-Oncology, Barbara Ann Karmanos Cancer Center, Detroit (R.R.); Gastrointestinal and Lymphoma Unit, The Royal Marsden NHS Foundation Trust, Sutton (D.C.), and the Department of Medical Oncology, University of Manchester and the Christie NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester (J.R.) - both in the United Kingdom; the Department of Clinical Development, Seattle Genetics, Bothell, WA (N.C.J., E.S.); and Oncology Clinical Research (J.S., H.A.J., D.H.) and Global Biostatistics (R.L.), Millennium Pharmaceuticals, Cambridge, MA
| | - Neil C Josephson
- From the University of British Columbia and the Department of Medical Oncology, British Columbia Cancer Agency Centre for Lymphoid Cancer, Vancouver, Canada (J.M.C., K.J.S.); the Department of Hematology, Jagiellonian University, Krakow (W.J.), the Department of Hematology, Institute of Hematology and Transfusion Medicine, Warsaw (E.L.-M.), the Department of Hematology and Transfusion Medicine, Center of Postgraduate Medical Education, Warsaw (E.L.-M.), the Department of Experimental Hematology, Medical University of Lodz, Lodz (P.S.), and the Department of Lymphoid Malignancy, the Maria Sklodowska-Curie Memorial Institute and Oncology Center, Warsaw (J.W.) - all in Poland; Lymphoma Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York (D.J.S., A.Y.); the Department of Internal Medicine, Division of Hematology, Mayo Clinic, Rochester, MN (S.M.A.); the Division of Hematology and Oncology, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, South Korea (W.S.K.); Research Innovation and Statistics, Antoine-Lacassagne Cancer Center, Nice, France (A.G.); Petrov Research Institute of Oncology, St. Petersburg, Russia (S.A.); the Department of Hematology, Faculty of Medicine, University of Debrecen, Debrecen (Á.I.), and the Department of Hematology, National Institute of Oncology, Budapest (A.R.) - both in Hungary; the Department of Advanced Biomedical Science, Federico II University Hospital, Naples (M.P.), and the Institute of Hematology Seràgnoli, University of Bologna, Bologna (P.L.Z.) - both in Italy; the Department of Lymphoma and Myeloma, M.D. Anderson Cancer Center, Houston (Y.O.); John Theurer Cancer Center, Hackensack University Medical Center, Hackensack, NJ (T.F.); the Department of Medicine, Division of Oncology, Washington University School of Medicine, St. Louis (N.L.B.); the Department of Hematology and Hematopoietic Cell Transplantation, City of Hope National Medical Center, Duarte, CA (R.C.); the Department of Hematology-Oncology, Barbara Ann Karmanos Cancer Center, Detroit (R.R.); Gastrointestinal and Lymphoma Unit, The Royal Marsden NHS Foundation Trust, Sutton (D.C.), and the Department of Medical Oncology, University of Manchester and the Christie NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester (J.R.) - both in the United Kingdom; the Department of Clinical Development, Seattle Genetics, Bothell, WA (N.C.J., E.S.); and Oncology Clinical Research (J.S., H.A.J., D.H.) and Global Biostatistics (R.L.), Millennium Pharmaceuticals, Cambridge, MA
| | - Eric Song
- From the University of British Columbia and the Department of Medical Oncology, British Columbia Cancer Agency Centre for Lymphoid Cancer, Vancouver, Canada (J.M.C., K.J.S.); the Department of Hematology, Jagiellonian University, Krakow (W.J.), the Department of Hematology, Institute of Hematology and Transfusion Medicine, Warsaw (E.L.-M.), the Department of Hematology and Transfusion Medicine, Center of Postgraduate Medical Education, Warsaw (E.L.-M.), the Department of Experimental Hematology, Medical University of Lodz, Lodz (P.S.), and the Department of Lymphoid Malignancy, the Maria Sklodowska-Curie Memorial Institute and Oncology Center, Warsaw (J.W.) - all in Poland; Lymphoma Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York (D.J.S., A.Y.); the Department of Internal Medicine, Division of Hematology, Mayo Clinic, Rochester, MN (S.M.A.); the Division of Hematology and Oncology, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, South Korea (W.S.K.); Research Innovation and Statistics, Antoine-Lacassagne Cancer Center, Nice, France (A.G.); Petrov Research Institute of Oncology, St. Petersburg, Russia (S.A.); the Department of Hematology, Faculty of Medicine, University of Debrecen, Debrecen (Á.I.), and the Department of Hematology, National Institute of Oncology, Budapest (A.R.) - both in Hungary; the Department of Advanced Biomedical Science, Federico II University Hospital, Naples (M.P.), and the Institute of Hematology Seràgnoli, University of Bologna, Bologna (P.L.Z.) - both in Italy; the Department of Lymphoma and Myeloma, M.D. Anderson Cancer Center, Houston (Y.O.); John Theurer Cancer Center, Hackensack University Medical Center, Hackensack, NJ (T.F.); the Department of Medicine, Division of Oncology, Washington University School of Medicine, St. Louis (N.L.B.); the Department of Hematology and Hematopoietic Cell Transplantation, City of Hope National Medical Center, Duarte, CA (R.C.); the Department of Hematology-Oncology, Barbara Ann Karmanos Cancer Center, Detroit (R.R.); Gastrointestinal and Lymphoma Unit, The Royal Marsden NHS Foundation Trust, Sutton (D.C.), and the Department of Medical Oncology, University of Manchester and the Christie NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester (J.R.) - both in the United Kingdom; the Department of Clinical Development, Seattle Genetics, Bothell, WA (N.C.J., E.S.); and Oncology Clinical Research (J.S., H.A.J., D.H.) and Global Biostatistics (R.L.), Millennium Pharmaceuticals, Cambridge, MA
| | - Jessica Sachs
- From the University of British Columbia and the Department of Medical Oncology, British Columbia Cancer Agency Centre for Lymphoid Cancer, Vancouver, Canada (J.M.C., K.J.S.); the Department of Hematology, Jagiellonian University, Krakow (W.J.), the Department of Hematology, Institute of Hematology and Transfusion Medicine, Warsaw (E.L.-M.), the Department of Hematology and Transfusion Medicine, Center of Postgraduate Medical Education, Warsaw (E.L.-M.), the Department of Experimental Hematology, Medical University of Lodz, Lodz (P.S.), and the Department of Lymphoid Malignancy, the Maria Sklodowska-Curie Memorial Institute and Oncology Center, Warsaw (J.W.) - all in Poland; Lymphoma Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York (D.J.S., A.Y.); the Department of Internal Medicine, Division of Hematology, Mayo Clinic, Rochester, MN (S.M.A.); the Division of Hematology and Oncology, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, South Korea (W.S.K.); Research Innovation and Statistics, Antoine-Lacassagne Cancer Center, Nice, France (A.G.); Petrov Research Institute of Oncology, St. Petersburg, Russia (S.A.); the Department of Hematology, Faculty of Medicine, University of Debrecen, Debrecen (Á.I.), and the Department of Hematology, National Institute of Oncology, Budapest (A.R.) - both in Hungary; the Department of Advanced Biomedical Science, Federico II University Hospital, Naples (M.P.), and the Institute of Hematology Seràgnoli, University of Bologna, Bologna (P.L.Z.) - both in Italy; the Department of Lymphoma and Myeloma, M.D. Anderson Cancer Center, Houston (Y.O.); John Theurer Cancer Center, Hackensack University Medical Center, Hackensack, NJ (T.F.); the Department of Medicine, Division of Oncology, Washington University School of Medicine, St. Louis (N.L.B.); the Department of Hematology and Hematopoietic Cell Transplantation, City of Hope National Medical Center, Duarte, CA (R.C.); the Department of Hematology-Oncology, Barbara Ann Karmanos Cancer Center, Detroit (R.R.); Gastrointestinal and Lymphoma Unit, The Royal Marsden NHS Foundation Trust, Sutton (D.C.), and the Department of Medical Oncology, University of Manchester and the Christie NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester (J.R.) - both in the United Kingdom; the Department of Clinical Development, Seattle Genetics, Bothell, WA (N.C.J., E.S.); and Oncology Clinical Research (J.S., H.A.J., D.H.) and Global Biostatistics (R.L.), Millennium Pharmaceuticals, Cambridge, MA
| | - Rachael Liu
- From the University of British Columbia and the Department of Medical Oncology, British Columbia Cancer Agency Centre for Lymphoid Cancer, Vancouver, Canada (J.M.C., K.J.S.); the Department of Hematology, Jagiellonian University, Krakow (W.J.), the Department of Hematology, Institute of Hematology and Transfusion Medicine, Warsaw (E.L.-M.), the Department of Hematology and Transfusion Medicine, Center of Postgraduate Medical Education, Warsaw (E.L.-M.), the Department of Experimental Hematology, Medical University of Lodz, Lodz (P.S.), and the Department of Lymphoid Malignancy, the Maria Sklodowska-Curie Memorial Institute and Oncology Center, Warsaw (J.W.) - all in Poland; Lymphoma Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York (D.J.S., A.Y.); the Department of Internal Medicine, Division of Hematology, Mayo Clinic, Rochester, MN (S.M.A.); the Division of Hematology and Oncology, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, South Korea (W.S.K.); Research Innovation and Statistics, Antoine-Lacassagne Cancer Center, Nice, France (A.G.); Petrov Research Institute of Oncology, St. Petersburg, Russia (S.A.); the Department of Hematology, Faculty of Medicine, University of Debrecen, Debrecen (Á.I.), and the Department of Hematology, National Institute of Oncology, Budapest (A.R.) - both in Hungary; the Department of Advanced Biomedical Science, Federico II University Hospital, Naples (M.P.), and the Institute of Hematology Seràgnoli, University of Bologna, Bologna (P.L.Z.) - both in Italy; the Department of Lymphoma and Myeloma, M.D. Anderson Cancer Center, Houston (Y.O.); John Theurer Cancer Center, Hackensack University Medical Center, Hackensack, NJ (T.F.); the Department of Medicine, Division of Oncology, Washington University School of Medicine, St. Louis (N.L.B.); the Department of Hematology and Hematopoietic Cell Transplantation, City of Hope National Medical Center, Duarte, CA (R.C.); the Department of Hematology-Oncology, Barbara Ann Karmanos Cancer Center, Detroit (R.R.); Gastrointestinal and Lymphoma Unit, The Royal Marsden NHS Foundation Trust, Sutton (D.C.), and the Department of Medical Oncology, University of Manchester and the Christie NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester (J.R.) - both in the United Kingdom; the Department of Clinical Development, Seattle Genetics, Bothell, WA (N.C.J., E.S.); and Oncology Clinical Research (J.S., H.A.J., D.H.) and Global Biostatistics (R.L.), Millennium Pharmaceuticals, Cambridge, MA
| | - Hina A Jolin
- From the University of British Columbia and the Department of Medical Oncology, British Columbia Cancer Agency Centre for Lymphoid Cancer, Vancouver, Canada (J.M.C., K.J.S.); the Department of Hematology, Jagiellonian University, Krakow (W.J.), the Department of Hematology, Institute of Hematology and Transfusion Medicine, Warsaw (E.L.-M.), the Department of Hematology and Transfusion Medicine, Center of Postgraduate Medical Education, Warsaw (E.L.-M.), the Department of Experimental Hematology, Medical University of Lodz, Lodz (P.S.), and the Department of Lymphoid Malignancy, the Maria Sklodowska-Curie Memorial Institute and Oncology Center, Warsaw (J.W.) - all in Poland; Lymphoma Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York (D.J.S., A.Y.); the Department of Internal Medicine, Division of Hematology, Mayo Clinic, Rochester, MN (S.M.A.); the Division of Hematology and Oncology, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, South Korea (W.S.K.); Research Innovation and Statistics, Antoine-Lacassagne Cancer Center, Nice, France (A.G.); Petrov Research Institute of Oncology, St. Petersburg, Russia (S.A.); the Department of Hematology, Faculty of Medicine, University of Debrecen, Debrecen (Á.I.), and the Department of Hematology, National Institute of Oncology, Budapest (A.R.) - both in Hungary; the Department of Advanced Biomedical Science, Federico II University Hospital, Naples (M.P.), and the Institute of Hematology Seràgnoli, University of Bologna, Bologna (P.L.Z.) - both in Italy; the Department of Lymphoma and Myeloma, M.D. Anderson Cancer Center, Houston (Y.O.); John Theurer Cancer Center, Hackensack University Medical Center, Hackensack, NJ (T.F.); the Department of Medicine, Division of Oncology, Washington University School of Medicine, St. Louis (N.L.B.); the Department of Hematology and Hematopoietic Cell Transplantation, City of Hope National Medical Center, Duarte, CA (R.C.); the Department of Hematology-Oncology, Barbara Ann Karmanos Cancer Center, Detroit (R.R.); Gastrointestinal and Lymphoma Unit, The Royal Marsden NHS Foundation Trust, Sutton (D.C.), and the Department of Medical Oncology, University of Manchester and the Christie NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester (J.R.) - both in the United Kingdom; the Department of Clinical Development, Seattle Genetics, Bothell, WA (N.C.J., E.S.); and Oncology Clinical Research (J.S., H.A.J., D.H.) and Global Biostatistics (R.L.), Millennium Pharmaceuticals, Cambridge, MA
| | - Dirk Huebner
- From the University of British Columbia and the Department of Medical Oncology, British Columbia Cancer Agency Centre for Lymphoid Cancer, Vancouver, Canada (J.M.C., K.J.S.); the Department of Hematology, Jagiellonian University, Krakow (W.J.), the Department of Hematology, Institute of Hematology and Transfusion Medicine, Warsaw (E.L.-M.), the Department of Hematology and Transfusion Medicine, Center of Postgraduate Medical Education, Warsaw (E.L.-M.), the Department of Experimental Hematology, Medical University of Lodz, Lodz (P.S.), and the Department of Lymphoid Malignancy, the Maria Sklodowska-Curie Memorial Institute and Oncology Center, Warsaw (J.W.) - all in Poland; Lymphoma Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York (D.J.S., A.Y.); the Department of Internal Medicine, Division of Hematology, Mayo Clinic, Rochester, MN (S.M.A.); the Division of Hematology and Oncology, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, South Korea (W.S.K.); Research Innovation and Statistics, Antoine-Lacassagne Cancer Center, Nice, France (A.G.); Petrov Research Institute of Oncology, St. Petersburg, Russia (S.A.); the Department of Hematology, Faculty of Medicine, University of Debrecen, Debrecen (Á.I.), and the Department of Hematology, National Institute of Oncology, Budapest (A.R.) - both in Hungary; the Department of Advanced Biomedical Science, Federico II University Hospital, Naples (M.P.), and the Institute of Hematology Seràgnoli, University of Bologna, Bologna (P.L.Z.) - both in Italy; the Department of Lymphoma and Myeloma, M.D. Anderson Cancer Center, Houston (Y.O.); John Theurer Cancer Center, Hackensack University Medical Center, Hackensack, NJ (T.F.); the Department of Medicine, Division of Oncology, Washington University School of Medicine, St. Louis (N.L.B.); the Department of Hematology and Hematopoietic Cell Transplantation, City of Hope National Medical Center, Duarte, CA (R.C.); the Department of Hematology-Oncology, Barbara Ann Karmanos Cancer Center, Detroit (R.R.); Gastrointestinal and Lymphoma Unit, The Royal Marsden NHS Foundation Trust, Sutton (D.C.), and the Department of Medical Oncology, University of Manchester and the Christie NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester (J.R.) - both in the United Kingdom; the Department of Clinical Development, Seattle Genetics, Bothell, WA (N.C.J., E.S.); and Oncology Clinical Research (J.S., H.A.J., D.H.) and Global Biostatistics (R.L.), Millennium Pharmaceuticals, Cambridge, MA
| | - John Radford
- From the University of British Columbia and the Department of Medical Oncology, British Columbia Cancer Agency Centre for Lymphoid Cancer, Vancouver, Canada (J.M.C., K.J.S.); the Department of Hematology, Jagiellonian University, Krakow (W.J.), the Department of Hematology, Institute of Hematology and Transfusion Medicine, Warsaw (E.L.-M.), the Department of Hematology and Transfusion Medicine, Center of Postgraduate Medical Education, Warsaw (E.L.-M.), the Department of Experimental Hematology, Medical University of Lodz, Lodz (P.S.), and the Department of Lymphoid Malignancy, the Maria Sklodowska-Curie Memorial Institute and Oncology Center, Warsaw (J.W.) - all in Poland; Lymphoma Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York (D.J.S., A.Y.); the Department of Internal Medicine, Division of Hematology, Mayo Clinic, Rochester, MN (S.M.A.); the Division of Hematology and Oncology, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, South Korea (W.S.K.); Research Innovation and Statistics, Antoine-Lacassagne Cancer Center, Nice, France (A.G.); Petrov Research Institute of Oncology, St. Petersburg, Russia (S.A.); the Department of Hematology, Faculty of Medicine, University of Debrecen, Debrecen (Á.I.), and the Department of Hematology, National Institute of Oncology, Budapest (A.R.) - both in Hungary; the Department of Advanced Biomedical Science, Federico II University Hospital, Naples (M.P.), and the Institute of Hematology Seràgnoli, University of Bologna, Bologna (P.L.Z.) - both in Italy; the Department of Lymphoma and Myeloma, M.D. Anderson Cancer Center, Houston (Y.O.); John Theurer Cancer Center, Hackensack University Medical Center, Hackensack, NJ (T.F.); the Department of Medicine, Division of Oncology, Washington University School of Medicine, St. Louis (N.L.B.); the Department of Hematology and Hematopoietic Cell Transplantation, City of Hope National Medical Center, Duarte, CA (R.C.); the Department of Hematology-Oncology, Barbara Ann Karmanos Cancer Center, Detroit (R.R.); Gastrointestinal and Lymphoma Unit, The Royal Marsden NHS Foundation Trust, Sutton (D.C.), and the Department of Medical Oncology, University of Manchester and the Christie NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester (J.R.) - both in the United Kingdom; the Department of Clinical Development, Seattle Genetics, Bothell, WA (N.C.J., E.S.); and Oncology Clinical Research (J.S., H.A.J., D.H.) and Global Biostatistics (R.L.), Millennium Pharmaceuticals, Cambridge, MA
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Witzig TE, Luigi Zinzani P, Habermann TM, Tuscano JM, Drach J, Ramchandren R, Kalayoglu Besisik S, Takeshita K, Casadebaig Bravo ML, Zhang L, Fu T, Goy A. Long-term analysis of phase II studies of single-agent lenalidomide in relapsed/refractory mantle cell lymphoma. Am J Hematol 2017; 92:E575-E583. [PMID: 28699256 DOI: 10.1002/ajh.24854] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2017] [Revised: 07/05/2017] [Accepted: 07/06/2017] [Indexed: 12/27/2022]
Abstract
Mantle cell lymphoma (MCL) is a type of non-Hodgkin lymphoma (NHL) with aggressive disease characteristics resulting in multiple relapses after initial treatment. Lenalidomide is an immunomodulatory agent approved in the US for patients with relapsed/refractory MCL following bortezomib based on results from 3 multicenter phase II studies (2 including relapsed/refractory aggressive NHL and 1 focusing on MCL post-bortezomib). The purpose of this report is to provide longer follow-up on the MCL-001 study (follow-ups were 6.8 [NHL-002], 7.6 [NHL-003], and 52.2 [MCL-001] months). The 206 relapsed MCL patients treated with single-agent lenalidomide (25 mg/day PO, days 1 to 21 every 28-days) had a median age of 67 years (63% ≥65 years), 91% with stage III/IV disease, and 50% with ≥4 previous treatment regimens. With a median follow-up of X, the combined best overall response rate (ORR) was 33% (including 11% with complete remission [CR]/CR unconfirmed CRu). Lenalidomide produced rapid and durable responses with a median time to response of 2.2 months and median duration of response (DOR) of 16.6 months (95% CI: 11.1%-29.8%). The safety profile was consistent and manageable; myelosuppression was the most common adverse event (AE). Overall, single-agent lenalidomide showed consistent efficacy and safety in multiple phase II studies of heavily pretreated patients with relapsed/refractory MCL, including those previously treated with bortezomib.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | - Lei Zhang
- Celgene Corporation; Summit New Jersey
| | - Tommy Fu
- Celgene Corporation; Summit New Jersey
| | - Andre Goy
- John Theurer Cancer Center at HUMC; Hackensack New Jersey
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47
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Dang NH, Ogura M, Castaigne S, Fayad LE, Jerkeman M, Radford J, Pezzutto A, Bondarenko I, Stewart DA, Shnaidman M, Sullivan S, Vandendries E, Tobinai K, Ramchandren R, Hamlin PA, Giné E, Ando K. Randomized, phase 3 trial of inotuzumab ozogamicin plus rituximab versus chemotherapy plus rituximab for relapsed/refractory aggressive B-cell non-Hodgkin lymphoma. Br J Haematol 2017; 182:583-586. [PMID: 28677896 DOI: 10.1111/bjh.14820] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Nam H Dang
- University of Florida, Gainesville, FL, USA
| | - Michinori Ogura
- Nagoya Daini Red Cross Hospital, Nagoya, Japan.,Tokai Central Hospital, Kakamigahara, Japan
| | | | - Luis E Fayad
- University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | | | - John Radford
- University of Manchester and the Christie NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK
| | | | | | | | | | | | | | | | | | - Paul A Hamlin
- Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Eva Giné
- Hospital Clínic, Barcelona, Spain
| | - Kiyoshi Ando
- School Medicine, Tokai University, Isehara, Kanagawa, Japan
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48
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Herrera A, Moskowitz A, Bartlett N, Vose J, Ramchandren R, Feldman T, Lacasce A, Ansell S, Moskowitz C, Fenton K, Ogden C, Taft D, Zhang Q, Kato K, Campbell M, Advani R. INTERIM RESULTS FROM a PHASE 1/2 STUDY OF BRENTUXIMAB VEDOTIN IN COMBINATION WITH NIVOLUMAB IN PATIENTS WITH RELAPSED OR REFRACTORY HODGKIN LYMPHOMA. Hematol Oncol 2017. [DOI: 10.1002/hon.2437_73] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- A.F. Herrera
- Department of Hematology/HCT; City of Hope National Medical Center; Duarte USA
| | - A.J. Moskowitz
- Hematology and Oncology; Memorial Sloan Kettering Cancer Center; New York USA
| | - N.L. Bartlett
- Hematology and Oncology; Washington University School of Medicine; Saint Louis USA
| | - J.M. Vose
- Hematology and Oncology; University of Nebraska Medical Center; Omaha USA
| | - R. Ramchandren
- Hematology and Oncology; Karmanos Cancer Institute; Detroit USA
| | - T.A. Feldman
- Hematology and Oncology; Hackensack University Medical Center; Hackensack USA
| | - A.S. Lacasce
- Medical Oncology; Dana-Farber Cancer Institute; Boston USA
| | - S.M. Ansell
- Hematology and Oncology; Mayo Clinic; Rochester USA
| | - C.H. Moskowitz
- Medical Oncology; Memorial Sloan Kettering Cancer Center; New York USA
| | - K. Fenton
- Biostatistics; Seattle Genetics; Bothell USA
| | - C. Ogden
- Diagnostics and Biomarkers; Seattle Genetics; Bothell USA
| | - D. Taft
- Diagnostics and Biomarkers; Seattle Genetics; Bothell USA
| | - Q. Zhang
- Bioinformatics; Seattle Genetics; Bothell USA
| | - K. Kato
- Oncology; Bristol-Myers Squibb; Princeton USA
| | - M. Campbell
- Clinical Development; Seattle Genetics; Bothell USA
| | - R.H. Advani
- Medical Oncology; Stanford University Medical Center; Palo Alto USA
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49
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Nayak L, Iwamoto F, Ferreri A, Santoro A, Singer S, Batlevi C, Batchelor T, Rubenstein J, Johnston P, Ramchandren R, Soussain C, Drappatz J, Becker K, Witzens-Harig M, Illerhaus G, Herrera A, Masood A, Shipp M. CHECKMATE 647: A PHASE 2, OPEN-LABEL STUDY OF NIVOLUMAB IN RELAPSED/REFRACTORY PRIMARY CENTRAL NERVOUS SYSTEM LYMPHOMA OR RELAPSED/REFRACTORY PRIMARY TESTICULAR LYMPHOMA. Hematol Oncol 2017. [DOI: 10.1002/hon.2440_2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- L. Nayak
- Center for Neuro-oncology; Dana-Farber Cancer Institute; Boston USA
| | - F.M. Iwamoto
- Division of Neuro-Oncology; Columbia University Medical Center; New York USA
| | - A.J. Ferreri
- Unit of Lymphoid Malignancies, Department of Onco-Hematology; IRCCS San Raffaele Scientific Institute; Milan Italy
| | - A. Santoro
- Department of Medical Oncology and Hematology, Humanitas Cancer Center; Humanitas University; Milan Italy
| | - S. Singer
- Neurological Oncology Division; Hackensack University Medical Center; Hackensack USA
| | - C. Batlevi
- Division of Hematologic Oncology; Memorial Sloan Kettering Cancer Center; New York USA
| | - T. Batchelor
- Department of Neurology; Massachusetts General Hospital; Boston USA
| | - J. Rubenstein
- Hematology and Blood and Marrow Transplant; University of California San Francisco Medical Center; San Francisco USA
| | - P. Johnston
- Hematology and Blood and Marrow Transplant; Mayo Clinic; Rochester USA
| | - R. Ramchandren
- Department of Hematology/Oncology; Barbara Ann Karmanos Cancer Institute; Detroit USA
| | - C. Soussain
- Department of Hematology; Institut Curie, Hôpital René-Huguenin; Saint-Cloud France
| | - J. Drappatz
- Division of Hematology/Oncology, Hillman Cancer Center; University of Pittsburgh Medical Center; Pittsburgh USA
| | - K. Becker
- Cancer Immunology; Yale Cancer Center; New Haven USA
| | - M. Witzens-Harig
- Department of Internal Medicine; University Hospital Heidelberg; Heidelberg Germany
| | - G. Illerhaus
- Department of Haematology/Oncology and Palliative Care; Klinikum Stuttgart; Stuttgart Germany
| | - A. Herrera
- Department of Hematology/Hematopoietic Cell Transplantation; City of Hope, Duarte USA
| | - A. Masood
- Global Clinical Research; Bristol-Myers Squibb; Lawrenceville USA
| | - M. Shipp
- Center for Hematologic Oncology; Dana-Farber Cancer Institute; Boston USA
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50
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Fanale M, Engert A, Younes A, Armand P, Ansell S, Zinzani P, Timmerman J, Collins G, Ramchandren R, Cohen J, De Boer J, Kuruvilla J, Savage K, Trneny M, Rodig S, Shipp M, Kato K, Sumbul A, Farsaci B, Santoro A. NIVOLUMAB FOR RELAPSED/REFRACTORY CLASSICAL HODGKIN LYMPHOMA AFTER AUTOLOGOUS TRANSPLANT: FULL RESULTS AFTER EXTENDED FOLLOW-UP OF THE PHASE 2 CHECKMATE 205 TRIAL. Hematol Oncol 2017. [DOI: 10.1002/hon.2437_124] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- M. Fanale
- Department of Lymphoma/Myeloma; University of Texas MD Anderson Cancer Center; Houston USA
| | - A. Engert
- Department of Internal Medicine I; University Hospital of Cologne; Cologne Germany
| | - A. Younes
- Lymphoma Service; Memorial Sloan Kettering Cancer Center; New York USA
| | - P. Armand
- Medical Oncology; Dana-Farber Cancer Institute; Boston USA
| | - S. Ansell
- Division of Hematology; Mayo Clinic; Rochester USA
| | - P.L. Zinzani
- Institute of Hematology “L. e A. Seràgnoli; University of Bologna; Bologna Italy
| | - J.M. Timmerman
- Division of Hematology and Oncology; University of California, Los Angeles; Los Angeles USA
| | - G.P. Collins
- Oxford Cancer and Haematology Center; Churchill Hospital; Headington Oxford UK
| | - R. Ramchandren
- Department of Hematology/Oncology; Barbara Ann Karmanos Cancer Institute; Detroit USA
| | - J.B. Cohen
- Department of Hematology and Medical Oncology, Winship Cancer Institute; Emory University; Atlanta USA
| | - J.P. De Boer
- Department of Medical Oncology, Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital; Amsterdam Netherlands
| | - J. Kuruvilla
- Department of Medical Oncology and Hematology; University of Toronto and Princess Margaret Cancer Centre; Toronto Canada
| | - K.J. Savage
- Department of Medical Oncology; British Columbia Cancer Agency; Vancouver Canada
| | - M. Trneny
- Department of Hematology; Charles University in Prague and General University Hospital in Prague; Prague Czech Republic
| | - S. Rodig
- Department of Pathology; Brigham and Women's Hospital; Boston USA
| | - M. Shipp
- Center for Hematologic Oncology; Dana-Farber Cancer Institute; Boston USA
| | - K. Kato
- Global Clinical Research; Bristol-Myers Squibb; Lawrenceville USA
| | - A. Sumbul
- Global Biostatistics; Bristol-Myers Squibb; Lawrenceville USA
| | - B. Farsaci
- Oncology Biomarkers; Bristol-Myers Squibb; Lawrenceville USA
| | - A. Santoro
- Department of Medical Oncology and Hematology, Humanitas Cancer Center; Humanitas University; Rozzano Milan Italy
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