1. Blinatumomab after R-CHOP bridging therapy for patients with Richter transformation: a phase 2 multicentre trial.
- Author
-
Guièze R, Ysebaert L, Roos-Weil D, Fornecker LM, Ferrant E, Molina L, Aurran T, Clavert A, de Guibert S, Michallet AS, Saad A, Drénou B, Quittet P, Hivert B, Laribi K, Gay J, Quinquenel A, Broseus J, Rouille V, Schwartz D, Magnin B, Lazarian G, Véronèse L, de Antonio M, Laurent C, Tournilhac O, Pereira B, and Feugier P
- Subjects
- Humans, Male, Female, Middle Aged, Aged, Adult, Aged, 80 and over, Leukemia, Lymphocytic, Chronic, B-Cell drug therapy, Treatment Outcome, Antibodies, Bispecific administration & dosage, Antibodies, Bispecific adverse effects, Antibodies, Bispecific therapeutic use, Antineoplastic Combined Chemotherapy Protocols therapeutic use, Antineoplastic Combined Chemotherapy Protocols adverse effects, Cyclophosphamide therapeutic use, Cyclophosphamide administration & dosage, Cyclophosphamide adverse effects, Rituximab administration & dosage, Rituximab therapeutic use, Rituximab adverse effects, Doxorubicin therapeutic use, Doxorubicin administration & dosage, Doxorubicin adverse effects, Prednisone therapeutic use, Prednisone administration & dosage, Prednisone adverse effects, Vincristine therapeutic use, Vincristine adverse effects, Vincristine administration & dosage, Lymphoma, Large B-Cell, Diffuse drug therapy
- Abstract
Richter transformation (RT) is an aggressive lymphoma occurring in patients with chronic lymphocytic leukaemia. Here we investigated the anti-CD3/anti-CD19 T-cell-engager blinatumomab after R-CHOP (i.e. rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone) in patients with untreated RT of diffuse large B-cell lymphoma histology (NCT03931642). In this multicentre phase 2 study, patients without complete response (CR) after two cycles of R-CHOP were eligible to receive an 8-week blinatumomab induction via continuous vein infusion with stepwise dosing until 112 μg/day. The primary endpoint was the CR rate after blinatumomab induction and secondary endpoint included safety, response duration, progression-free and overall survival. Thirty-nine patients started the first cycle of R-CHOP, 25 of whom received blinatumomab. After blinatumomab induction, five (20%) patients achieved CR, four (16%) achieved partial response, and six (24%) were stable. Considering the entire strategy, the overall response rate in the full-analysis-set was 46% (n = 18), with CR in 14 (36%) patients. The most common treatment-emergent adverse events of all grades in the blinatumomab-safety-set included fever (36%), anaemia (24%), and lymphopaenia (24%). Cytokine release syndrome (grade 1/2) was observed in 16% and neurotoxicity in 20% of patients. Blinatumomab demonstrated encouraging anti-tumour activity (the trial met its primary endpoint) and acceptable toxicity in patients with RT., (© 2024. The Author(s).)
- Published
- 2024
- Full Text
- View/download PDF