1. Lenalidomide, rituximab (R 2 ), and ixazomib for frontline treatment of high risk follicular and indolent non-Hodgkin lymphoma.
- Author
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Hill BT, Chen Y, Jagadeesh D, Dean R, Koc O, Boughan K, Cooper B, Pohlman B, Caimi P, and Smith MR
- Subjects
- Humans, Male, Female, Middle Aged, Aged, Adult, Treatment Outcome, Lymphoma, Non-Hodgkin drug therapy, Lymphoma, Non-Hodgkin mortality, Lymphoma, Non-Hodgkin pathology, Aged, 80 and over, Boron Compounds therapeutic use, Boron Compounds administration & dosage, Boron Compounds adverse effects, Glycine analogs & derivatives, Glycine therapeutic use, Glycine adverse effects, Glycine administration & dosage, Rituximab adverse effects, Rituximab therapeutic use, Rituximab administration & dosage, Antineoplastic Combined Chemotherapy Protocols therapeutic use, Antineoplastic Combined Chemotherapy Protocols adverse effects, Lenalidomide administration & dosage, Lenalidomide therapeutic use, Lenalidomide adverse effects, Lymphoma, Follicular drug therapy, Lymphoma, Follicular mortality
- Abstract
Lenalidomide and rituximab (R
2 ) is an effective frontline treatment for patients with indolent B-cell non-Hodgkin lymphoma (iNHL). We investigated the safety and efficacy of addition of the proteasome inhibitor ixazomib to R2 for treatment of iNHL through a phase I/II clinical trial for high-risk patients. Twenty patients were enrolled, 18 were treated. The target dose of ixazomib 4 mg weekly was achieved during dose escalation. The most common treatment-related adverse events (AEs) were low grade gastrointestinal, rash, neuropathy, and myalgia/arthralgia. There were 33% grade 2 and 17% grade 3 infections. With median follow-up of 5.2 years, four patients discontinued treatment due to lymphoma progression. Best overall response rate (ORR) was 61.2% [55.6% CR, 5.6% PR): 22.2% had stable disease and 16.7% had disease progression. Kaplan-Meier estimates of progression free and overall survival (OS) were 73% and 87% at 36 months, respectively. R2 can safely be combined with ixazomib for treatment-naïve iNHL patients.- Published
- 2024
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