A phase 2 multicenter study of lenalidomide in relapsed or refractory classical Hodgkin lymphoma

Todd A. Fehniger, Sarah Larson, Kathryn Trinkaus, Marilyn J. Siegel, Amanda F. Cashen, Kristie A. Blum, Timothy S. Fenske, David D. Hurd, Andre Goy, Stephanie E. Schneider, Catherine R. Keppel, Nina Wagner-Johnston, Kenneth R. Carson, Nancy L. Bartlett

Research output: Contribution to journalArticle

Abstract

Relapsed or refractory (rel/ref) classical Hodgkin lymphoma (cHL) remains a clinical challenge, with limited effective treatment options available after stem cell transplantation. In a multicenter phase 2 study, the efficacy of lenalidomide in rel/ref cHL patients was evaluated at a dose of 25 mg/d on days 1-21 of a 28-day cycle. Patients remained on lenalidomide until disease progression or an unacceptable adverse event (AE) occurred. Thirty-eight cHL patients were enrolled with a median of 4 (range, 2-9) prior therapies; 87% had undergone prior stem cell transplantation and 55% of patients did not respond to their last prior therapy. Of 36 evaluable patients, responses were 1 complete remission (CR), 6 partial remissions (PRs), and 5 patients with stable disease (SD) for ≥ 6 months resulting in an InternationalWorking Committee (IWC) objective overall response rate (ORR) of 19% and a cytostatic ORR of 33%. Decreased chemokine (CCL17 and CCL22) plasma levels at 2 weeks were associated with a subsequent response. The treatment was well tolerated, and the most common grade 3/4 AEs were neutropenia (47%), anemia (29%), and thrombocytopenia (18%). Four patients discontinued lenalidomide because of rash, elevated transaminases/bilirubin, and cytopenias. We provide preliminary evidence of lenalidomide's activity in patients with rel/ref cHL, and therefore exploration of lenalidomide in combination with other active agents is warranted. This trial is registered at www.ClinicalTrials.gov as NCT00540007.

Original languageEnglish (US)
Pages (from-to)5119-5125
Number of pages7
JournalBlood
Volume118
Issue number19
DOIs
StatePublished - Nov 10 2011
Externally publishedYes

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Hodgkin Disease
Refractory materials
Multicenter Studies
Stem cells
Chemokine CCL22
Chemokine CCL17
Stem Cell Transplantation
Cytostatic Agents
Transaminases
Bilirubin
lenalidomide
Plasmas
Therapeutics
Exanthema
Neutropenia
Thrombocytopenia
Disease Progression
Anemia

ASJC Scopus subject areas

  • Hematology
  • Biochemistry
  • Cell Biology
  • Immunology

Cite this

Fehniger, T. A., Larson, S., Trinkaus, K., Siegel, M. J., Cashen, A. F., Blum, K. A., ... Bartlett, N. L. (2011). A phase 2 multicenter study of lenalidomide in relapsed or refractory classical Hodgkin lymphoma. Blood, 118(19), 5119-5125. https://doi.org/10.1182/blood-2011-07-362475

A phase 2 multicenter study of lenalidomide in relapsed or refractory classical Hodgkin lymphoma. / Fehniger, Todd A.; Larson, Sarah; Trinkaus, Kathryn; Siegel, Marilyn J.; Cashen, Amanda F.; Blum, Kristie A.; Fenske, Timothy S.; Hurd, David D.; Goy, Andre; Schneider, Stephanie E.; Keppel, Catherine R.; Wagner-Johnston, Nina; Carson, Kenneth R.; Bartlett, Nancy L.

In: Blood, Vol. 118, No. 19, 10.11.2011, p. 5119-5125.

Research output: Contribution to journalArticle

Fehniger, TA, Larson, S, Trinkaus, K, Siegel, MJ, Cashen, AF, Blum, KA, Fenske, TS, Hurd, DD, Goy, A, Schneider, SE, Keppel, CR, Wagner-Johnston, N, Carson, KR & Bartlett, NL 2011, 'A phase 2 multicenter study of lenalidomide in relapsed or refractory classical Hodgkin lymphoma', Blood, vol. 118, no. 19, pp. 5119-5125. https://doi.org/10.1182/blood-2011-07-362475
Fehniger TA, Larson S, Trinkaus K, Siegel MJ, Cashen AF, Blum KA et al. A phase 2 multicenter study of lenalidomide in relapsed or refractory classical Hodgkin lymphoma. Blood. 2011 Nov 10;118(19):5119-5125. https://doi.org/10.1182/blood-2011-07-362475
Fehniger, Todd A. ; Larson, Sarah ; Trinkaus, Kathryn ; Siegel, Marilyn J. ; Cashen, Amanda F. ; Blum, Kristie A. ; Fenske, Timothy S. ; Hurd, David D. ; Goy, Andre ; Schneider, Stephanie E. ; Keppel, Catherine R. ; Wagner-Johnston, Nina ; Carson, Kenneth R. ; Bartlett, Nancy L. / A phase 2 multicenter study of lenalidomide in relapsed or refractory classical Hodgkin lymphoma. In: Blood. 2011 ; Vol. 118, No. 19. pp. 5119-5125.
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abstract = "Relapsed or refractory (rel/ref) classical Hodgkin lymphoma (cHL) remains a clinical challenge, with limited effective treatment options available after stem cell transplantation. In a multicenter phase 2 study, the efficacy of lenalidomide in rel/ref cHL patients was evaluated at a dose of 25 mg/d on days 1-21 of a 28-day cycle. Patients remained on lenalidomide until disease progression or an unacceptable adverse event (AE) occurred. Thirty-eight cHL patients were enrolled with a median of 4 (range, 2-9) prior therapies; 87{\%} had undergone prior stem cell transplantation and 55{\%} of patients did not respond to their last prior therapy. Of 36 evaluable patients, responses were 1 complete remission (CR), 6 partial remissions (PRs), and 5 patients with stable disease (SD) for ≥ 6 months resulting in an InternationalWorking Committee (IWC) objective overall response rate (ORR) of 19{\%} and a cytostatic ORR of 33{\%}. Decreased chemokine (CCL17 and CCL22) plasma levels at 2 weeks were associated with a subsequent response. The treatment was well tolerated, and the most common grade 3/4 AEs were neutropenia (47{\%}), anemia (29{\%}), and thrombocytopenia (18{\%}). Four patients discontinued lenalidomide because of rash, elevated transaminases/bilirubin, and cytopenias. We provide preliminary evidence of lenalidomide's activity in patients with rel/ref cHL, and therefore exploration of lenalidomide in combination with other active agents is warranted. This trial is registered at www.ClinicalTrials.gov as NCT00540007.",
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