The following article features coverage from the American Society of Hematology 2020 meeting. Click here to read more of MPR’s conference coverage.


Older patients with relapsed/refractory indolent non-Hodgkin lymphoma (NHL) benefited from lenalidomide plus rituximab (R2); they saw a benefit that was similar to the benefit seen in the overall population in the phase 3 MAGNIFY trial (ClinicalTrials.gov Identifier: NCT01996865), according to results of a study presented at the virtual 62nd American Society of Hematology (ASH) Annual Meeting and Exposition.

“Because advanced age at diagnosis is a risk factor in patients with indolent lymphoma, we performed post hoc subgroup analyses by age in patients with relapsed/refractory indolent lymphoma from the MAGNIFY study,” Frederick Lansigan, MD, of the Dartmouth-Hitchcock Medical Center in Lebanon, New Hampshire, and presenter of the study, said.

The multicenter, phase 3b MAGNIFY trial treated 393 patients with R2 induction, then randomly assigned patients to receive R2 or rituximab maintenance for 18 months. Patients had relapsed/refractory grade 1 to 3b follicular lymphoma (FL), transformed FL, marginal zone lymphoma (MZL), or mantle cell lymphoma (MCL). The present analysis included patients with grade 1 to 3a FL or MZL and treated with R2 induction. The primary endpoint was progression-free survival (PFS).


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At baseline, the median age of the patients in the entire cohort was 66 years, the median age in the older cohort was 76 years (range, 70-91 years), and it was 60 years in the younger cohort (range, 35-69 years). The majority of patients across cohorts had an Eastern Cooperative Oncology Group performance status of 0 or 1 and an Ann Arbor disease stage of III to IV. Approximately 41% of patients had bulky disease.

In the overall population, the overall response rate (ORR) was 75% with a complete response (CR)/CR unconfirmed (CRu) rate of 44%. The ORR was similar regardless of age, as it was 75% among both the elderly and younger cohorts, with CR/CRu rates of 47% and 44%, respectively.

The median duration of response was not yet reached.

The median PFS was 41.2 months overall during a median follow-up of 32.6 months, which remained similar when stratified by age group. The 1-year PFS of the entire cohort was 77%, and was 72.9% and 79.5% among patients in the elderly and younger cohorts, respectively.  

Overall, the treatment-emergent adverse events (TEAEs) profile was similar among elderly patients as the entire cohort, Dr Lansigan said. The most common TEAEs among older patients was fatigue, neutropenia, diarrhea, constipation, and nausea.

Dr Lansigan concluded that, “R2 therapy showed similar clinical activity in patients ≥70 years of age with relapsed/refractory indolent lymphoma compared to the overall population.”

Disclosures: Some of the presenters disclosed financial relationships with the pharmaceutical industry and/or the medical device industry. For a full list of disclosures, please refer to the presentation abstract.

Read more of MPR’s coverage of the ASH 2020 meeting by visiting the conference page.

Reference

Lansigan F, Andorsky DJ, Coleman M, et al. Subgroup analyses of elderly pateints aged ≥70 years in MAGNIFY: A phase IIIb interim analysis of induction R2 followed by maintenance in relapsed/refractory indolent non-Hodgkin lymphoma. Presented at: the 62nd American Society of Hematology (ASH) Annual Meeting and Exposition; December 5-9, 2020. Abstract 340.

This article originally appeared on Cancer Therapy Advisor