8 results on '"Ghosh, Nilanjan"'
Search Results
2. Multi-center analysis of practice patterns and outcomes of younger and older patients with mantle cell lymphoma in the rituximab era.
- Author
-
Karmali R, Switchenko JM, Goyal S, Shanmugasundaram K, Churnetski MC, Kolla B, Bachanova V, Gerson JN, Barta SK, Gordon MJ, Danilov AV, Grover NS, Epperla N, Mathews S, Burkart M, Sawalha Y, Hill BT, Ghosh N, Park SI, Bond DA, Maddocks KJ, Badar T, Fenske TS, Hamadani M, Guo J, Malecek M, Kahl BS, Martin P, Blum KA, Flowers CR, and Cohen JB
- Subjects
- Age Factors, Aged, Female, Humans, Lymphoma, Mantle-Cell epidemiology, Male, Middle Aged, Progression-Free Survival, Retrospective Studies, Survival Analysis, Treatment Outcome, Antineoplastic Agents, Immunological therapeutic use, Lymphoma, Mantle-Cell drug therapy, Rituximab therapeutic use
- Abstract
Clinical outcomes and predictors of survival in patients with newly diagnosed mantle cell lymphoma (MCL) treated in the rituximab era (2000-2015) at 12 US academic centers were assessed to identify determinants of survival across age groups. Objectives were to characterize and compare practice patterns, outcomes and prognostic factors for survival in younger patients (age < 65) and older patients (age ≥ 65 years). Among 1162 patients included, 697 were younger and 465 were older. In younger patients, 2-year progression free survival (PFS) and overall survival (OS) rates were 79% and 92% respectively; blastoid histology, ECOG ≥ 2, and lack of maintenance rituximab (MR) remained statistically relevant to poor OS on univariate analysis (UVA) and multivariate analysis (MVA). In older patients, 2-year PFS and OS rates were 67% and 86% respectively; lack of maintenance rituximab remained significantly associated with inferior PFS and OS on UVA and MVA (p < 0.001). Two-year PFS rates were 79%, and 67% and 2-year OS rates were 92% and 86% for ages < 65 and ≥ 65 respectively (p < 0.001). First-line high-dose cytarabine exposure and/or MR lessened the negative impact of age on survival. Taken collectively, survival outcomes for older patients remain inferior to those of younger patients in the rituximab era. However, maintenance rituximab and potentially high-dose cytarabine-based induction can mitigate the negative impact of age on survival., (© 2021 Wiley Periodicals LLC.)
- Published
- 2021
- Full Text
- View/download PDF
3. Ibrutinib plus lenalidomide and rituximab has promising activity in relapsed/refractory non-germinal center B-cell-like DLBCL.
- Author
-
Goy A, Ramchandren R, Ghosh N, Munoz J, Morgan DS, Dang NH, Knapp M, Delioukina M, Kingsley E, Ping J, Beaupre DM, Neuenburg JK, and Ruan J
- Subjects
- Adenine analogs & derivatives, Adult, Aged, Aged, 80 and over, Antineoplastic Agents administration & dosage, Antineoplastic Agents adverse effects, Antineoplastic Combined Chemotherapy Protocols administration & dosage, Antineoplastic Combined Chemotherapy Protocols adverse effects, Drug Administration Schedule, Female, Humans, Lenalidomide administration & dosage, Lenalidomide adverse effects, Lymphoma, Large B-Cell, Diffuse pathology, Male, Maximum Tolerated Dose, Middle Aged, Neoplasm Recurrence, Local drug therapy, Neoplasm Recurrence, Local pathology, Piperidines, Pyrazoles administration & dosage, Pyrazoles adverse effects, Pyrimidines administration & dosage, Pyrimidines adverse effects, Rituximab administration & dosage, Rituximab adverse effects, Treatment Outcome, Antineoplastic Agents therapeutic use, Antineoplastic Combined Chemotherapy Protocols therapeutic use, Lenalidomide therapeutic use, Lymphoma, Large B-Cell, Diffuse drug therapy, Pyrazoles therapeutic use, Pyrimidines therapeutic use, Rituximab therapeutic use
- Abstract
The outcome of patients with relapsed/refractory diffuse large B-cell lymphoma (DLBCL) is poor, particularly in patients ineligible for stem cell transplantation or who fail induction therapy or salvage therapy. The phase 1b portion of this open-label, dose-escalation (3+3+3 design) study examined the maximum tolerated dose (MTD) and preliminary safety and activity of the regimen in transplant-ineligible adults with histologically confirmed relapsed/refractory DLBCL after at least 1 prior therapy. Patients received once-daily 560 mg ibrutinib, 375 mg/m
2 intravenous rituximab day 1 of cycles 1 to 6, and 10, 15, 20, or 25 mg lenalidomide days 1 to 21 of each 28-day cycle. Forty-five patients were treated; median time since diagnosis was 14.1 months, and 51% of the patients had non-germinal center B-cell-like (non-GCB) DLBCL, 33% had transformed DLBCL, 60% were refractory, and 27% were primary refractory. Because of dose-limiting toxicities, a de-escalation cohort (10 mg lenalidomide) was initiated, and with subsequent re-escalation up to 25 mg lenalidomide, the MTD was not reached. In response-evaluable patients, the overall response rate (ORR) was 44% (complete response [CR], 28%); among them, the ORR was 65% (CR, 41%) in non-GCB and 69% and 56% in relapsed (n = 16) and secondary refractory (n = 27) disease, respectively. Overall and for non-GCB, median response duration was 15.9 months, with 2 patients receiving therapy beyond 3 years. Phase 2 was initiated with 20 mg lenalidomide in relapsed/refractory non-GCB, whereas the phase 1b 25-mg lenalidomide cohort was being completed; an additional 25-mg cohort in phase 2 is currently ongoing. This study was registered at www.clinicaltrials.gov as #NCT02077166., (© 2019 by The American Society of Hematology.)- Published
- 2019
- Full Text
- View/download PDF
4. Maintenance rituximab or observation after frontline treatment with bendamustine-rituximab for follicular lymphoma.
- Author
-
Hill BT, Nastoupil L, Winter AM, Becnel MR, Cerhan JR, Habermann TM, Link BK, Maurer MJ, Fakhri B, Reddy P, Smith SD, Mukhija D, Jagadeesh D, Desai A, Alderuccio JP, Lossos IS, Mehra P, Portell CA, Goldman ML, Calzada O, Cohen JB, Hussain MJ, Ghosh N, Caimi P, Tiutan T, Martin P, Kodali A, Evens AM, and Kahl BS
- Subjects
- Adult, Aged, Aged, 80 and over, Antineoplastic Combined Chemotherapy Protocols adverse effects, Bendamustine Hydrochloride adverse effects, Cyclophosphamide adverse effects, Disease-Free Survival, Doxorubicin administration & dosage, Doxorubicin adverse effects, Female, Humans, Lymphoma, Follicular mortality, Male, Middle Aged, Prednisone adverse effects, Retrospective Studies, Rituximab adverse effects, Survival Rate, Vincristine adverse effects, Antineoplastic Combined Chemotherapy Protocols administration & dosage, Bendamustine Hydrochloride administration & dosage, Cyclophosphamide administration & dosage, Lymphoma, Follicular drug therapy, Maintenance Chemotherapy, Prednisone administration & dosage, Rituximab administration & dosage, Vincristine administration & dosage
- Abstract
Bendamustine (B) with rituximab (R) is a standard frontline treatment for medically fit follicular lymphoma (FL) patients. The safety and efficacy of maintenance rituximab (MR) after BR induction has not been formally compared to observation for FL, resulting in disparate practice patterns. Prospective trials have shown benefit of MR after R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, prednisone) or R-CVP (rituximab, cyclophosphamide, vincristine, prednisone), yet recent data from the GALLIUM study comparing outcomes of patients treated with chemotherapy with R or obinutuzumab (G) showed higher than anticipated fatal adverse events with BR/BG. In order to assess the efficacy and tolerability of MR after BR, we retrospectively collected data on 640 newly diagnosed patients treated with FL. We found that patients who achieved partial remission (PR) after ≥4 cycles of BR had improved duration of response (DOR) with MR vs. no maintenance, whereas those in complete remission did not. These findings were confirmed in a validation cohort. In the entire study population, the known fatal adverse event rate after BR was 2·5% and did not significantly differ in those receiving MR versus no maintenance. [Correction added on 14 January 2019, after online publication: The preceding sentence has been corrected in this current version.] Within the limitations inherent to retrospective analysis, these data suggest that FL patients with a PR to BR experience prolongation of remission with MR with an acceptable safety profile., (© 2018 British Society for Haematology and John Wiley & Sons Ltd.)
- Published
- 2019
- Full Text
- View/download PDF
5. CD47 Blockade by Hu5F9-G4 and Rituximab in Non-Hodgkin's Lymphoma.
- Author
-
Advani R, Flinn I, Popplewell L, Forero A, Bartlett NL, Ghosh N, Kline J, Roschewski M, LaCasce A, Collins GP, Tran T, Lynn J, Chen JY, Volkmer JP, Agoram B, Huang J, Majeti R, Weissman IL, Takimoto CH, Chao MP, and Smith SM
- Subjects
- Adult, Aged, Aged, 80 and over, Anemia chemically induced, Antibodies, Monoclonal adverse effects, Antibodies, Monoclonal, Humanized, Antineoplastic Combined Chemotherapy Protocols adverse effects, Cell Cycle Checkpoints drug effects, Drug Resistance, Neoplasm, Female, Follow-Up Studies, Humans, Macrophages drug effects, Male, Middle Aged, Phagocytosis drug effects, Rituximab adverse effects, Antibodies, Monoclonal therapeutic use, Antineoplastic Combined Chemotherapy Protocols therapeutic use, CD47 Antigen antagonists & inhibitors, Lymphoma, Follicular drug therapy, Lymphoma, Large B-Cell, Diffuse drug therapy, Macrophages physiology, Rituximab therapeutic use
- Abstract
Background: The Hu5F9-G4 (hereafter, 5F9) antibody is a macrophage immune checkpoint inhibitor blocking CD47 that induces tumor-cell phagocytosis. 5F9 synergizes with rituximab to eliminate B-cell non-Hodgkin's lymphoma cells by enhancing macrophage-mediated antibody-dependent cellular phagocytosis. This combination was evaluated clinically., Methods: We conducted a phase 1b study involving patients with relapsed or refractory non-Hodgkin's lymphoma. Patients may have had diffuse large B-cell lymphoma (DLBCL) or follicular lymphoma. 5F9 (at a priming dose of 1 mg per kilogram of body weight, administered intravenously, with weekly maintenance doses of 10 to 30 mg per kilogram) was given with rituximab to determine safety and efficacy and to suggest a phase 2 dose., Results: A total of 22 patients (15 with DLBCL and 7 with follicular lymphoma) were enrolled. Patients had received a median of 4 (range, 2 to 10) previous therapies, and 95% of the patients had disease that was refractory to rituximab. Adverse events were predominantly of grade 1 or 2. The most common adverse events were anemia and infusion-related reactions. Anemia (an expected on-target effect) was mitigated by the strategy of 5F9 prime and maintenance dosing. Dose-limiting side effects were rare. A selected phase 2 dose of 30 mg of 5F9 per kilogram led to an approximate 100% CD47-receptor occupancy on circulating white and red cells. A total of 50% of the patients had an objective (i.e., complete or partial) response, with 36% having a complete response. The rates of objective response and complete response were 40% and 33%, respectively, among patients with DLBCL and 71% and 43%, respectively, among those with follicular lymphoma. At a median follow-up of 6.2 months among patients with DLBCL and 8.1 months among those with follicular lymphoma, 91% of the responses were ongoing., Conclusions: The macrophage checkpoint inhibitor 5F9 combined with rituximab showed promising activity in patients with aggressive and indolent lymphoma. No clinically significant safety events were observed in this initial study. (Funded by Forty Seven and the Leukemia and Lymphoma Society; ClinicalTrials.gov number, NCT02953509 .).
- Published
- 2018
- Full Text
- View/download PDF
6. R‐CHOP <italic>versus</italic> dose‐adjusted R‐EPOCH in frontline management of primary mediastinal B‐cell lymphoma: a multi‐centre analysis.
- Author
-
Shah, Nirav N., Szabo, Aniko, Huntington, Scott F., Epperla, Narendranath, Reddy, Nishitha, Ganguly, Siddhartha, Vose, Julie, Obiozor, Cynthia, Faruqi, Fahad, Kovach, Alexandra E., Costa, Luciano J., Xaiver, Ana C., Okal, Ryan, Kanate, Abraham S., Ghosh, Nilanjan, Kharfan‐Dabaja, Mohamed A., Strelec, Lauren, Hamadani, Mehdi, Fenske, Timothy S., and Calzada, Oscar
- Subjects
LYMPHOMAS ,DRUG therapy ,MEDIASTINAL tumors ,B cells ,RITUXIMAB ,CYCLOPHOSPHAMIDE ,DOXORUBICIN ,VINCRISTINE ,DISEASES - Abstract
Summary: Primary mediastinal (thymic) large B‐cell lymphoma (PMBCL) is an uncommon subtype of non‐Hodgkin lymphoma (NHL) that presents with a mediastinal mass and has unique clinicopathological features. Historically, patients with PMBCL were treated with R‐CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, prednisone) chemotherapy ± involved field radiation. Since a phase II trial, published in April 2013, demonstrated excellent results using dose‐adjusted (DA) R‐EPOCH (rituximab, etoposide, prednisone, vincristine, cyclophosphamide, doxorubicin), this treatment has gained popularity. We performed a retrospective, multicentre analysis of patients aged ≥18 years with PMBCL since January 2011. Patients were stratified by frontline regimen, R‐CHOP
versus DA‐R‐EPOCH. 132 patients were identified from 11 contributing centres (56 R‐CHOP and 76 DA‐R‐EPOCH). The primary outcome was overall survival. Secondary outcomes included progression‐free survival, complete response (CR) rate, and rates of treatment‐related complications. Demographic characteristics were similar in both groups. DA‐R‐EPOCH use increased after April 2013 (79% vs. 45%,P < 0·001), and there was less radiation use after DA‐R‐EPOCH (13% vs. 59%,P < 0·001). While CR rates were higher with DA‐R‐EPOCH (84% vs. 70%,P = 0·046), these patients were more likely to experience treatment‐related toxicities. At 2 years, 89% of R‐CHOP patients and 91% of DA‐R‐EPOCH patients were alive. To our knowledge, this represents the largest series comparing outcomes of R‐CHOP to DA‐R‐EPOCH for PMBCL. [ABSTRACT FROM AUTHOR]- Published
- 2018
- Full Text
- View/download PDF
7. Observational study of lenalidomide in patients with mantle cell lymphoma who relapsed/progressed after or were refractory/intolerant to ibrutinib (MCL-004).
- Author
-
Wang, Michael, Schuster, Stephen J., Phillips, Tycel, Lossos, Izidore S., Goy, Andre, Rule, Simon, Hamadani, Mehdi, Ghosh, Nilanjan, Reeder, Craig B., Barnett, Evelyn, Bravo, Marie-Laure Casadebaig, and Martin, Peter
- Subjects
MANTLE cell lymphoma ,DISEASE relapse ,DRUG side effects ,RITUXIMAB ,DIZZINESS - Abstract
Background: The observational MCL-004 study evaluated outcomes in patients with relapsed/refractory mantle cell lymphoma who received lenalidomide-based therapy after ibrutinib failure or intolerance. Methods: The primary endpoint was investigator-assessed overall response rate based on the 2007 International Working Group criteria. Results: Of 58 enrolled patients (median age, 71 years; range, 50-89), 13 received lenalidomide monotherapy, 11 lenalidomide plus rituximab, and 34 lenalidomide plus other treatment. Most patients (88%) had received ≥ 3 prior therapies (median 4; range, 1-13). Median time from last dose of ibrutinib to the start of lenalidomide was 1. 3 weeks (range, 0.1-21.7); 45% of patients had partial responses or better to prior ibrutinib. Primary reasons for ibrutinib discontinuation were lack of efficacy (88%) and ibrutinib toxicity (9%). After a median of two cycles (range, 0-11) of lenalidomide-based treatment, 17 patients responded (8 complete responses, 9 partial responses), for a 29% overall response rate (95% confidence interval, 18-43%) and a median duration of response of 20 weeks (95% confidence interval, 2.9 to not available). Overall response rate to lenalidomide-based therapy was similar for patients with relapsed/progressive disease after previous response to ibrutinib (i.e., ≥PR) versus ibrutinib-refractory (i. e., ≤SD) patients (30 versus 32%, respectively). The most common all-grade treatment-emergent adverse events after lenalidomide-containing therapy (n = 58) were fatigue (38%) and cough, dizziness, dyspnea, nausea, and peripheral edema (19% each). At data cutoff, 28 patients have died, primarily due to mantle cell lymphoma. Conclusion: Lenalidomide-based treatment showed clinical activity, with no unexpected toxicities, in patients with relapsed/refractory mantle cell lymphoma who previously failed ibrutinib therapy. [ABSTRACT FROM AUTHOR]
- Published
- 2017
- Full Text
- View/download PDF
8. Conditioning Prior to Allogeneic Hematopoietic Stem Cell Transplants for Relapsed/Refractory Diffuse Large B Cell Lymphoma: Is More Actually Less?
- Author
-
Jacobs, Ryan and Ghosh, Nilanjan
- Subjects
- *
HEMATOPOIETIC stem cells , *STEM cell transplantation , *RITUXIMAB , *B cells , *ALEMTUZUMAB , *T cell receptors , *LYMPHOMAS , *HEMATOPOIETIC stem cell transplantation - Abstract
A proportion of patients with diffuse large B cell lymphoma (DLBCL) will fail to achieve durable remission to standard chemoimmunotherapy treatment with R-CHOP or dose- adjusted R-EPOCH regimens [1]. This benefit may be offset by an increased rate of relapse, however, leading to no significant differences in overall survival (OS) between patients receiving myeloablative conditioning (MAC) regimens and those receiving RIC regimens. 333, 1995, 1540-1545 3 E. Van Den Neste, N. Schmitz, N. Mounier, Outcomes of diffuse large B-cell lymphoma patients relapsing after autologous stem cell transplantation: an analysis of patients included in the CORAL study. [Extracted from the article]
- Published
- 2020
- Full Text
- View/download PDF
Catalog
Discovery Service for Jio Institute Digital Library
For full access to our library's resources, please sign in.