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Poster display session: Biomarkers, Gynaecological cancers, Haematological malignancies, Immunotherapy of cancer, New diagnostic tools, NSCLC - early stage, locally advanced & metastatic, SCLC, Thoracic malignancies, Translational research

3021 - Progression of disease within 2 years (POD24) is a clinically significant endpoint to identify follicular lymphoma patients with high risk of death

Date

20 Oct 2018

Session

Poster display session: Biomarkers, Gynaecological cancers, Haematological malignancies, Immunotherapy of cancer, New diagnostic tools, NSCLC - early stage, locally advanced & metastatic, SCLC, Thoracic malignancies, Translational research

Topics

Tumour Site

Lymphomas

Presenters

Clara Sortais

Citation

Annals of Oncology (2018) 29 (suppl_8): viii359-viii371. 10.1093/annonc/mdy286

Authors

C. Sortais1, A. Lok1, T. Gastinne1, B. Mahé1, V. Dubruille1, N. Blin1, S. Howlett2, A. Tabah2, P. Arnaud2, A. Moreau3, P. Moreau1, C. Leux4, S. Le Gouill1

Author affiliations

  • 1 Service D'hématologie Clinique, CHU de Nantes, 44093 - Nantes/FR
  • 2 Lymphoma Department, Celgene medical, 07901 - Summit/US
  • 3 Service D'anatomopathologie, CHU de Nantes, 44093 - Nantes/FR
  • 4 Service D'information Médicale, CHU de Nantes, 44093 - Nantes/FR
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Resources

Abstract 3021

Background

Follicular lymphoma (FL) is an indolent non-Hodgkin’s lymphoma with heterogeneous outcomes among patients. Casulo et al (JCO 2015) showed that progression of disease within 2 years (POD24) after diagnosis for FL patients treated by R-CHOP was associated with poor outcomes, needing further validations before using it as a standard endpoint to evaluate treatment efficacy. We investigated the POD24 predictive value for all patients treated or not with R-CHOP in our institution (Nantes Medical University, France).

Methods

Patients with grade 1, 2 or 3a FL treated from 2007 were registered in our local database (approved by French authorities, CNIL) and included in the present retrospective monocentric study, with up-dating of patient’s outcomes. FL diagnosis was performed by local pathologist experts (members of the national LYSA-pathologist group, France).

Results

Between 2007 and 2016, 317 patients with confirmed FL were included. At diagnosis: 24 did not received any treatment (Wait and watch), 259 were treated with Rituximab (R) (including R alone in 98 cases), 143 received an anthracycline-containing regimen (mainly R-CHOP like), 5 received bendamustine-containing regimen, radiotherapy alone in 11 cases and another chemotherapy regimen in 36 cases (mainly R-COP). Second line treatment (N = 151) consisted of chemotherapy in 91 cases, R alone in 37 cases. After first line therapy, 61 patients relapsed or died within 2y (POD24+), 99 patients after 2y, including 21 transformations, and 154 patients did not progress or die (missing = 3). At the time of the present analysis, the median follow-up is 5y. Median PFS is 58.2 months. OS at 1y, 3y, and 5y are 98.4% [97.0-99.8], 95.1% [92.6-97.6] and 92.5% [89.3-95.9] respectively. The 5y OS was statistically worst for POD24+ patients (82 % [71.9-93.5]) than for POD24- patients (93.3% [88.98-97.8]) (p = 0.00001). Age at diagnosis (≥60), performance status (PS ≥ 1), FLIPI, FLIPI2 scores (high) and transformation are predictive of OS in univariate analysis. PS (≥1) at diagnostic is predictive of POD24+.

Conclusions

POD24 is predictive of a worse OS regardless of first line treatment nature and can be recommended as a relevant endpoint for clinical trials.

Clinical trial identification

Legal entity responsible for the study

CHU de Nantes.

Funding

Has not received any funding.

Editorial Acknowledgement

Disclosure

All authors have declared no conflicts of interest.

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