Summary
At the last ASH (American Society of Hematology) meeting a new prognostic tool for follicular lymphoma (FL), based on the patient cohort of the PRIMA trial (PRIMA-PI, Primary Rituximab and Maintenance-Prognostic Index), was presented. The 10-year update of the PRIMA trial confirms the continuous advantage in progression-free survival of rituximab maintenance after R‑CHOP induction without new safety signals. Similarly rituximab maintenance is beneficial in FL after first-line chemoimmunotherapy with rituximab–bendamustine. Currently checkpoint inhibitors are under investigation in different treatment lines of FL. The earlier ibrutinib is administered in relapsed mantle cell lymphoma, the more effective the long-term efficacy is. New, more selective inhibitors of the Bruton’s tyrosine kinase (BTK) may be an option for patients in whom ibrutinib may be contraindicated.
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References
Solal-Céligny P, Roy P, Colombat P, et al. Follicular lymphoma international prognostic index. Blood. 2004;104(5):1258–65.
Federico M, Bellei M, Marcheselli L, et al. Follicular lymphoma international prognostic index 2: a new prognostic index for follicular lymphoma developed by the international follicular lymphoma prognostic factor project. J Clin Oncol. 2009;27(27):4555–62.
Pastore A, Jurinovic V, Kridel R, et al. Integration of gene mutations in risk prognostication for patients receiving first-line immunochemotherapy for follicular lymphoma: a retrospective analysis of a prospective clinical trial and validation in a population-based registry. Lancet Oncol. 2015;16(9):1111–22.
Jurinovic V, Kridel R, Staiger AM, et al. Clinicogenetic risk models predict early progression of follicular lymphoma after first-line immunochemotherapy. Blood. 2016;128(8):1112–20.
Salles G, Seymour JF, Offner F, et al. Rituximab maintenance for 2 years in patients with high tumour burden follicular lymphoma responding to rituximab plus chemotherapy (PRIMA): a phase 3, randomised controlled trial. Lancet. 2011;377(9759):42–51.
Bachy E, Maurer M, Habermann TM, et al. Discovery and validation of a simplified scoring system (the PRIMA-prognostic index) in de novo follicular lymphoma treated initially with Immunochemotherapy. Blood. 2017;130:413.
Salles G, Seymour JF, Feugier P, et al. Long term follow-up of the PRIMA study: half of patients receiving rituximab maintenance remain progression free at 10 years. Blood. 2017;130:486.
Flinn IW, van der Jagt R, Kahl BS, et al. Randomized trial of bendamustine-rituximab or R‑CHOP/R-CVP in first-line treatment of indolent NHL or MCL: the BRIGHT study. Blood. 2014;123(19):2944–52.
Kahl BS, Burke JM, van der Jagt R, et al. Assessment of maintenance rituximab after first-line bendamustine-rituximab in patients with follicular lymphoma: an analysis from the BRIGHT trial. Blood. 2017;130:484.
Rummel MJ, Buske C, Hertenstein B, et al. Four versus two years of Rituximab maintenance (R-maintenance) following Bendamustine plus Rituximab (B-R): initial results of a prospective, randomized Multicenter phase 3 study in first-line follicular Lymphoma (the StiL NHL7-2008 MAINTAIN study). Blood. 2017;130:483.
Rummel MJ, Niederle N, Maschmeyer G, et al. Bendamustine plus rituximab versus CHOP plus rituximab as first-line treatment for patients with indolent and mantle-cell lymphomas: an open-label, multicentre, randomised, phase 3 non-inferiority trial. Lancet. 2013;381(9873):1203–10.
Younes A, John BM, Diefenbach CS, et al. Safety and efficacy of atezolizumab in combination with obinutuzumab and bendamustine in patients with previously untreated follicular lymphoma: an interim analysis. Blood. 2017;130:481.
Nastoupil L, Westin JR, Fowler NH, et al. High complete response rates with pembrolizumab in combination with rituximab in patients with relapsed follicular lymphoma: results of an open-label, phase II study. Blood. 2017;130:414.
Kluin-Nelemans HC, Hoster E, Hermine O, et al. Treatment of older patients with mantle-cell lymphoma. N Engl J Med. 2012;367(6):520–31.
Hoster E, Kluin-Nelemans HC, Hermine O, et al. Rituximab maintenance after first-line immunochemotherapy in mantle cell lymphoma: long-term follow-up of the randomized European MCL elderly trial. Blood. 2017;130:153.
Wang ML, Rule S, Martin P, et al. Targeting BTK with ibrutinib in relapsed or refractory mantle-cell lymphoma. N Engl J Med. 2013;369(6):507–16.
Dreyling M, Jurczak W, Jerkeman M, et al. Ibrutinib versus temsirolimus in patients with relapsed or refractory mantle-cell lymphoma: an international, randomised, open-label, phase 3 study. Lancet. 2016;387(10020):770–8.
Rule S, Dreyling M, Goy A, et al. Median 3.5-year follow-up of Ibrutinib treatment in patients with relapsed/refractory mantle cell lymphoma: a pooled analysis. Blood. 2017;130:151.
Wang M, Rule S, Zinzani PL, et al. Efficacy and safety of acalabrutinib monotherapy in patients with relapsed/refractory mantle cell lymphoma in the phase 2 ACE-LY-004 study. Blood. 2017;130:155.
Tam CS, Simpson D, Opat S, et al. Safety and activity of the highly specific BTK inhibitor BGB-3111 in patients with indolent and aggressive non Hodgkin’s lymphoma. Blood. 2017;130:152.
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T. Nösslinger declares that he has no competing interests.
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Nösslinger, T. Indolent lymphoma at ASH (American Society of Hematology) 2017: maintenance revisited. memo 11, 101–104 (2018). https://doi.org/10.1007/s12254-018-0398-9
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DOI: https://doi.org/10.1007/s12254-018-0398-9