Checking in on Lenalidomide in Diffuse Large B Cell Lymphoma

Mendel Goldfinger, Mina Xu, Joseph R. Bertino, Dennis L. Cooper

Research output: Contribution to journalComment/debate

1 Scopus citations

Abstract

Lenalidomide has modest single-agent activity comparable with other newer drugs in recurrent diffuse large B cell lymphoma with response rates between 19% and 28%. Retrospective series and 1 prospective study suggest that clinically significant responses were predominantly limited to patients with activated B cell (ABC) lymphoma, a finding in agreement with lenalidomide's potent inhibition of nuclear factor κB, the key driver of ABC lymphomas. Recently completed trials will determine whether the additional use of lenalidomide with R/CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone) enhances survival compared with R/CHOP alone and whether this activity is limited to ABC lymphomas. Lenalidomide also appears to have activity in the maintenance setting regardless of cell of origin and might play an important role in patients with recurrent disease who are not transplantation candidates. Similarly, because of the ability of lenalidomide to cross the blood–brain barrier, it needs to be further explored in patients with high risk for central nervous system spread. The results of lenalidomide combination studies with chemotherapy and with checkpoint inhibitors are eagerly awaited.

Original languageEnglish (US)
Pages (from-to)e307-e311
JournalClinical Lymphoma, Myeloma and Leukemia
Volume19
Issue number6
DOIs
StatePublished - Jun 2019
Externally publishedYes

Keywords

  • Activated B-cell
  • Cell of origin
  • Germinal center
  • PDL-1
  • Revlimid

ASJC Scopus subject areas

  • Hematology
  • Oncology
  • Cancer Research

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