Checking in on Lenalidomide in Diffuse Large B Cell Lymphoma |
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| Institution: | 1. Department of Hematology and Medical Oncology, Rutgers Cancer Institute of New Jersey, Rutgers, Robert Wood Johnson Medical School, New Brunswick, NJ;2. Department of Pathology, Yale School of Medicine, New Haven, CT;1. Ophthalmology Department, DHU SightRestore, Pitie-Salpetriere Hospital, Paris, France;2. APHP, Sorbonne Universités, Department of Neurology, Paris, France;3. LOC Network, Pitie-Salpetriere Hospital, Paris, France;4. Clinical Hematology Department, Pitie-Salpetriere Hospital, Paris, France;5. Ophthalmologic Oncology Department, Institut Curie, Paris, France;6. Haematology Department, Institut René Huguenin, Saint Cloud, France;7. Biostatistics, Medical Informatic Department, Pitie-Salpetriere Hospital, Paris, France;8. Biological Hematology Department, Pitie Salpetriere Hospital, Paris, France;9. University Pierre et Marie Curie, Paris, France;1. Department of Hematology, Institute of Hematology and Transfusion Medicine, Warsaw, Poland;2. Department of Hematology, Jagiellonian University Hospital, Krakow, Poland;3. Department of Hematology, Oncology and Internal Medicine, Medical University of Warsaw, Warsaw, Poland;4. Department of Hematology, Medical University of Lodz, Copernicus Memorial Hospital, Lodz, Poland;5. Department of Hematology, Blood Neoplasm and Bone Marrow Transplantation, Medical University, Wrocław, Poland;6. Department of Hematology and Stem Cell Transplantation, University of Medical Sciences, Poznan, Poland;7. Department of Hematology, Teaching Hospital No 1, Chopina, Poland;8. Department of Hematology, Holy Cross Oncology Center, Kielce, Poland;9. Department of Hematooncology and Bone Marrow Transplantation, Medical University of Lublin, Staszica, Poland;10. Department of Hematology, Medical University of Białystok, Białystok, Poland;1. Departments of Oncology and Medicine, University of Calgary, Tom Baker Cancer Centre, Calgary, AB, Canada;2. Department of Medical Oncology, University of Alberta, Cross Cancer Institute, Edmonton, AB, Canada;3. Division of Hematology, Department of Medicine, University of Alberta, Edmonton, AB, Canada;1. Division of Pulmonary, Critical Care and Sleep Medicine, Mount Sinai School of Medicine, New York, NY 10029, USA;2. Departments of Microbiology and Immunology, Mount Sinai School of Medicine, New York, NY 10029, USA;3. Mount Sinai School of Medicine, New York, NY 10029, USA;4. Department of Radiology, Mount Sinai School of Medicine, New York, NY 10029, USA;1. Division of Hematology, Oncology and Stem Cell Transplant, Rush University Medical Center, Chicago, IL;2. Division of Nephrology, Rush University Medical Center, Chicago, IL;3. Department of Pathology, Rush University Medical Center, Chicago, IL;4. Division of Hematology/Oncology, Department of Medicine and UI Cancer Center, University of Illinois at Chicago, Chicago, IL;5. Division of Hematology and Oncology, Department of Medicine, Loyola University Medical Center, Maywood, IL;6. Bone Marrow Transplant and Cellular Therapy Program, Advocate Lutheran General Hospital, Park Ridge, IL;7. Division of Hematology / Oncology, John H. Stroger Hospital of Cook County, Chicago, IL;8. Division of Hematology/Oncology, University of Chicago, Chicago, IL;9. Department of Medicine and Center for International Blood and Marrow Transplant Research, Medical College of Wisconsin, Milwaukee, WI;1. Hematology Department, University Hospital Dubrava, Zagreb, Croatia;2. Pharmacy Department, General Hospital Sibenik, Sibenik, Croatia |
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| Abstract: | Lenalidomide has modest single-agent activity comparable with other newer drugs in recurrent diffuse large B cell lymphoma with response rates between 19% and 28%. Retrospective series and 1 prospective study suggest that clinically significant responses were predominantly limited to patients with activated B cell (ABC) lymphoma, a finding in agreement with lenalidomide's potent inhibition of nuclear factor κB, the key driver of ABC lymphomas. Recently completed trials will determine whether the additional use of lenalidomide with R/CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone) enhances survival compared with R/CHOP alone and whether this activity is limited to ABC lymphomas. Lenalidomide also appears to have activity in the maintenance setting regardless of cell of origin and might play an important role in patients with recurrent disease who are not transplantation candidates. Similarly, because of the ability of lenalidomide to cross the blood–brain barrier, it needs to be further explored in patients with high risk for central nervous system spread. The results of lenalidomide combination studies with chemotherapy and with checkpoint inhibitors are eagerly awaited. |
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| Keywords: | Activated B-cell Cell of origin Germinal center PDL-1 Revlimid |
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