1. Lenalidomide treatment and prognostic markers in relapsed or refractory chronic lymphocytic leukemia: data from the prospective, multicenter phase-II CLL-009 trial.
- Author
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Bühler, A, Wendtner, C-M, Kipps, TJ, Rassenti, L, Fraser, GAM, Michallet, A-S, Hillmen, P, Dürig, J, Gregory, SA, Kalaycio, M, Aurran-Schleinitz, T, Trentin, L, Gribben, JG, Chanan-Khan, A, Purse, B, Zhang, J, De Bedout, S, Mei, J, Hallek, M, and Stilgenbauer, S
- Subjects
Humans ,Recurrence ,Thalidomide ,Antineoplastic Agents ,Immunologic Factors ,Prognosis ,Treatment Outcome ,Retreatment ,Survival Analysis ,Follow-Up Studies ,Drug Resistance ,Neoplasm ,Mutation ,Aged ,Aged ,80 and over ,Middle Aged ,Female ,Immunoglobulin Heavy Chains ,Male ,Tumor Suppressor Protein p53 ,Leukemia ,Lymphocytic ,Chronic ,B-Cell ,Lenalidomide ,Drug Resistance ,Neoplasm ,and over ,Leukemia ,Lymphocytic ,Chronic ,B-Cell ,Cardiorespiratory Medicine and Haematology ,Oncology and Carcinogenesis - Abstract
Efficacy of lenalidomide was investigated in 103 patients with relapsed/refractory chronic lymphocytic leukemia (CLL) treated on the prospective, multicenter randomized phase-II CLL-009 trial. Interphase cytogenetic and mutational analyses identified TP53 mutations, unmutated IGHV, or del(17p) in 36/96 (37.5%), 68/88 (77.3%) or 22/92 (23.9%) patients. The overall response rate (ORR) was 40.4% (42/104). ORRs were similar irrespective of TP53 mutation (36.1% (13/36) vs 43.3% (26/60) for patients with vs without mutation) or IGHV mutation status (45.0% (9/20) vs 39.1% (27/68)); however, patients with del(17p) had lower ORRs than those without del(17p) (21.7% (5/22) vs 47.1% (33/70); P=0.049). No significant differences in progression-free survival and overall survival (OS) were observed when comparing subgroups defined by the presence or absence of high-risk genetic characteristics. In multivariate analyses, only multiple prior therapies (⩾3 lines) significantly impacted outcomes (median OS: 21.2 months vs not reached; P=0.019). This analysis indicates that lenalidomide is active in patients with relapsed/refractory CLL with unfavorable genetic profiles, including TP53 inactivation or unmutated IGHV. (ClinicalTrials.gov identifier: NCT00963105).
- Published
- 2016