Abstract
Therapy for patients with POD24 follicular lymphoma: Treatment patterns and outcomes from the Lymphoma Epidemiology of Outcomes (LEO) Consortium
Journal of clinical oncology, Vol.40(16_suppl), pp.7573-7573
06/01/2022
DOI: 10.1200/JCO.2022.40.16_suppl.7573
Abstract
7573
Background: While most patients (pts) with follicular lymphoma (FL) usually have favorable outcomes, those with refractory disease after first-line anti-CD20 based immunochemotherapy (IC), or progression within 24 months of diagnosis (POD24) have higher risk of premature death. There are no standard approaches for treating this vulnerable group and studies testing novel agents are ongoing in this setting. We sought to investigate clinical practice treatment choices and efficacy for pts with POD24 that align with eligibility criteria for the randomized SWOG1608 which compares IC with novel agents in this population. Methods: This was a multicenter observational cohort study from the LEO Consortium. Eligible pts had grade 1-3a FL diagnosed between 1/1/2002 and 2/1/2019, and initiated therapy after POD24 to first-line bendamustine or CHOP (cyclophosphamide, doxorubicin, vincristine, prednisone) based IC. Observation, radiotherapy, or rituximab monotherapy were permitted prior to IC and pts with transformation prior to the subsequent therapy after IC were excluded as per S1608. Outcomes of interest were overall and complete response rate (ORR/CR), progression-free survival (PFS), and overall survival (OS). Results: We identified 196 eligible pts with early progression to IC (39% antiCD20 Benda; 61% antiCD20 CHOP) who received subsequent therapy. Median age at post IC treatment was 57 years, 78% grade 1-2 FL. Treatments for pts with POD24 included CHOP- or Benda-based in 31%, salvage/hematopoietic stem cell transplant (HSCT) in 27%, novel therapies in 10% (including phosphatidylinositol 3-kinase inhibitors), antiCD20 monotherapy in 9%, and lenalidomide-based treatment in 8% (table); 21% of pts were treated on clinical trials. Across all treatments, ORR (CR) was 63% (37%) (95% CI: 55-70). At a median follow up of 6.2 years, 2 year PFS was 22% (95% CI: 17%-29%) and 5 year OS was 71% (95% CI: 65-79). Outcomes by regimen are shown in the table. Conclusions: Pts with FL experiencing POD24 following first-line IC are treated heterogeneously, with many pts still receiving IC as subsequent therapy. Despite modest CR rates and low 2-year PFS, 5-year OS appear to be improving compared to historical outcomes. This supports the ongoing need to investigate novel treatments in this population. [Table: see text]
Details
- Title: Subtitle
- Therapy for patients with POD24 follicular lymphoma: Treatment patterns and outcomes from the Lymphoma Epidemiology of Outcomes (LEO) Consortium
- Creators
- Carla Casulo - University of Rochester Medical CenterMelissa C. Larson - Mayo ClinicJonathan R Day - University of IowaThomas Matthew Habermann - Mayo ClinicIzidore S. Lossos - University of Miami Health SystemYucai Wang - Mayo ClinicLoretta J. Nastoupil - The University of Texas MD Anderson Cancer CenterChristopher Strouse - University of IowaDai Chihara - The University of Texas MD Anderson Cancer CenterPeter Martin - Weill Cornell MedicineJonathon Brett Cohen - Emory UniversityBrad S. Kahl - University of Wisconsin Carbone Cancer CenterJia Ruan - Weill Cornell MedicineWalter Richard Burack - University of RochesterJean Louise Koff - Emory UniversityJonathan W. Friedberg - University of Rochester Medical CenterJames Robert Cerhan - Mayo ClinicChristopher Flowers - Emory UniversityBrian K. Link - University of IowaMatthew J. Maurer - Mayo Clinic
- Resource Type
- Abstract
- Publication Details
- Journal of clinical oncology, Vol.40(16_suppl), pp.7573-7573
- DOI
- 10.1200/JCO.2022.40.16_suppl.7573
- ISSN
- 0732-183X
- eISSN
- 1527-7755
- Grant note
- DOI: 10.13039/100000002, name: U.S. National Institutes of Health; name: Pharmaceutical/Biotech Company.
- Language
- English
- Date published
- 06/01/2022
- Academic Unit
- Internal Medicine; Epidemiology; Hematology, Oncology, and Blood & Marrow Transplantation
- Record Identifier
- 9984362676902771
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