Polatuzumab vedotin (Pola) + rituximab (R) + lenalidomide (Len) in patients (pts) with relapsed/refractory (R/R) diffuse large B-cell lymphoma (DLBCL): Primary analysis of a phase 1b/2 trial.

Authors

null

Catherine S. Magid Diefenbach

Perlmutter Cancer Center at NYU Langone Health, New York, NY

Catherine S. Magid Diefenbach , Pau Abrisqueta , Eva Gonzalez-Barca , Carlos Panizo , Jose Maria Arguinano Perez , Fiona Miall , Mariana Bastos-Oreiro , Armando Lopez-Guillermo , Lalita Banerjee , Andrew McMillan , Jamie Hirata , Lisa Musick , Sourish Saha , Brandon Croft , Erlene Kuizon Seymour

Organizations

Perlmutter Cancer Center at NYU Langone Health, New York, NY, Hospital Vall Hebron, Barcelona, Spain, Instititut Catala D'Oncologia, IDIBELL, Universitat de Barcelona, Barcelona, Spain, University Clinic of Navarra and Healthcare Research Institute of Navarra (IdiSNA), Pamplona, Spain, Complejo Hospitalario de Navarra, Pamplona, Spain, Department of Haematology, University Hospitals of Leicester NHS Trust, Leicester, United Kingdom, Hospital General Universitario Gregorio Marañón, Madrid, Spain, Hospital Clínic de Barcelona, Barcelona, Spain, Oncology Centre, Maidstone and Tunbridge Wells NHS Trust, Kent, United Kingdom, Centre for Clinical Haematology, Nottingham University Hospitals NHS Trust, Nottingham, United Kingdom, Genentech, Inc., South San Francisco, CA, F. Hoffmann-La Roche Ltd., Welwyn Garden City, United Kingdom, Karmanos Cancer Institute/Wayne State University, Detroit, MI

Research Funding

Pharmaceutical/Biotech Company
Study sponsored by F. Hoffmann-La Roche Ltd/Genentech, Inc. Third-party editorial assistance, under direction of authors, was provided by Angela Rogers, PhD, of Ashfield MedComms, an Ashfield Health company, and funded by F. Hoffmann-La Roche Ltd

Background: The combination of Pola-R-Len may enhance anti-tumor response in R/R DLBCL. We report the primary analysis of the R/R DLBCL cohort in a Phase 1b/2 study (GO29834; NCT02600897). Methods: Pts received induction with 6 x 28-Day (D) cycles (C) of: Pola 1.8mg/kg intravenous (IV; C1−6: D1); R 375mg/m2 IV (C1−6: D1) and oral Len 10–20mg (dose escalation) or recommended Phase 2 dose (RP2D) daily on D1–21. Pts with a response at end of induction (EOI) received 6 months (mo) consolidation with R 375mg/m2 (D1 every 2 mo) and Len 10mg (D1–21 monthly). Primary endpoints were safety/tolerability and positron emission tomography (PET)-complete response (CR) rate at EOI by independent review committee (IRC) by modified Lugano criteria. Results: At primary analysis (Sep 08, 2020), 57 pts were enrolled. Median age was 71 years (range 28–92); male (67%); Ann Arbor Stage III–IV (86%); International Prognostic Index 3–5 (60%); median 2 prior therapies; prior bone marrow transplant (11%); prior CAR-T therapy (5%); primary refractory (49%) and refractory to last therapy (65%). Grade 3–4 adverse events (AEs) were experienced by 75% of pts, most commonly, neutropenia (58%), thrombocytopenia (14%), infections (14%) and anemia (11%). AEs led to Len dose reduction in 25% and interruption in 63% of pts. One Grade 5 treatment-related AE (neutropenic sepsis) was reported. In total, 49 pts were treated at RP2D (Pola 1.8mg/kg + Len 20mg). IRC PET-CR rate at EOI was 29% (Table). A best overall response (BOR) assessed by investigator (INV) was seen in 36/49 (74%) pts with 17/49 (35%) pts achieving a CR; of these, 14/17 (82%) remain in remission at the cutoff date. Median duration of response (DOR) was 8.1 mo (95% confidence interval [CI]: 4.7–not evaluable [NE]). After a median follow-up of 9.7 mo, median progression-free survival (PFS) and overall survival (OS) were 6.3 mo (95% CI: 4.5–9.7) and 10.9 mo (95% CI: 7.4–NE), respectively. Conclusions: Our study of the novel triplet combination, Pola-R-Len, demonstrates a tolerable safety profile. This first efficacy report of Pola-R-Len shows promising activity in a difficult-to-treat R/R DLBCL population, particularly in pts achieving CR, a large proportion of whom remain in remission at the cutoff date. Further evaluation of Pola-R-Len and the impact of consolidation therapy is warranted to address the significant unmet need in this patient population. Clinical trial information: NCT02600897

Efficacy results (RP2D).

Outcome
Pola-R-Len

(N=49)
PET-ORR (IRC) at EOI, n (%)
17 (35)
PET-CR (IRC) at EOI*, n (%)
14 (29)
PET-CR (INV) at EOI, n (%)
13 (27)
BOR (INV), n (%)
36 (74)
Best CR (INV), n (%)
17 (35)
Median DOR (INV), mo (95% CI)
8.1 (4.7–NE)
Median PFS (INV), mo (95% CI)
6.3 (4.5–9.7)
Median OS (INV), mo (95% CI)
10.9 (7.4–NE)

*Primary efficacy endpoint; Defined as best response of CR or partial response during the study. ORR, overall response rate.

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Abstract Details

Meeting

2021 ASCO Annual Meeting

Session Type

Poster Discussion Session

Session Title

Hematologic Malignancies—Lymphoma and Chronic Lymphocytic Leukemia

Track

Hematologic Malignancies

Sub Track

Non-Hodgkin Lymphoma

Clinical Trial Registration Number

NCT02600897

Citation

J Clin Oncol 39, 2021 (suppl 15; abstr 7512)

DOI

10.1200/JCO.2021.39.15_suppl.7512

Abstract #

7512

Abstract Disclosures