Abstract 833P
Background
Effective salvage chemotherapy is crucial for patients (pts) with relapsed or refractory(R/R) aggressive non-Hodgkin lymphoma (aNHL). A study on the safety and effectiveness of GVM±R regimen for R/R aNHL was presented in the 2023 ASH (abstract 6232), here we updated the latest data.
Methods
This phase I study utilized a 3+3 dose-escalation design with four levels of mitoxantrone hydrochloride liposome (PLM60) (16, 18, 20 and 22 mg/m2) to determine the maximum tolerated dose and recommended Phase II dosage (RP2D) of PLM60 in the GVM regimen (gemcitabine 800 mg/m2and vinorelbine 20 mg/m2 on day 1 and 8, PLM60 on day 1).
Results
As of November 28, 2023, the study enrolled 18 R/R aNHL pts. (Table) Three patients experienced dose-limiting toxicities (DLTs) of grade 4 neutropenia lasting for more than 7 days at doses of 16, 18, and 20 mg/m2, respectively. Hematologic toxicity was the most common adverse event, with grade 3 febrile neutropenia and pneumonia each occurring at a rate of 16.7%. At data cut-off on March 14, 2024, the objective response rate (ORR) was 66.7% (12/18) and the complete response (CR) rate was 50.0% (9/18). The ORR was 71.4% (5/7) and 63.6% (7/11), and the CR rate was 71.4% (5/7) and 36.4% (4/11) for DLBCL and T/NK lymphoma, respectively. Among pts with a history of resistance to anthracyclines, the ORR was 50% (4/8) and the CR rate was 37.5% (3/8). After a median follow-up of 9.1 months (95%CI 6.4-11.8 ), the median progression-free survival was 11.0 months (95%CI 0.0-22.6), median overall survival (OS) has not yet been reached, and the 1-year OS rate was 63.4%. Following evaluation by the Data and Safety Monitoring Board, PLM60 18mg/m2 was established as the RP2D due to the elevated hematologic toxicity observed after multiple treatment cycles and preliminary efficacy data. Table: 833P
Patient characteristics
Characteristics | N=18 |
Median age(range), years | 47.5 (23.0,70.0) |
Male, n(%) | 8 (44.4) |
aNHL subtypes | |
DLBCL | 7 (38.9) |
PTCL | 10 (55.6) |
NKTCL | 1 (5.6) |
Ann Arbor stage, n (%) | |
III-IV | 18 (100.0) |
IPI score, n(%) | |
0-2 | 8 (44.4) |
3-5 | 10 (55.6) |
Medain lines of prior therapy (range) | 1.5 (1.0, 5.0) |
Refractory to last-line therapy, n (%) | 14 (77.8) |
Refractory to anthracycline-based chemotherapy, n (%) | 8 (44.4) |
Type of prior therapy, n (%) | |
Anthracycline-based chemotherapy | 15 (83.3) |
Rituximab in DLBCL | 6/7 (85.7) |
Anti-CD19 CAR T-cell | 2 (11.1) |
Conclusions
The GVM±R regimen exhibited manageable safety and encouraging efficacy in pts with R/R aNHL. The phase II study (NCT06244368) with dose expansion at RP2D is currently ongoing.
Clinical trial identification
NCT05299164.
Editorial acknowledgement
Legal entity responsible for the study
Blood Diseases Hospital, Chinese Academy of Medical Sciences.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.
Resources from the same session
707P - Paclitaxel, ifosfamide and cisplatin (TIP) in patients (pts) with poor prognosis nonseminomatous germ cell tumor (NSGCT) with unfavourable serum tumor markers (STM) decline: A phase II study
Presenter: Edgar Israelyan
Session: Poster session 09
708P - The Empower Pathway: An audit of the first 150 patients. Enhanced personalised care of testicular cancer survivors
Presenter: Penny Champion
Session: Poster session 09
817P - A machine learning algorithm utilizing clinicopathologic parameters for extranodal natural killer/T cell lymphoma
Presenter: Shuo Li
Session: Poster session 09
Resources:
Abstract
818P - The association between hospital volume and overall survival in adult AML patients treated with intensive chemotherapy
Presenter: Z.L.Rana Kaplan
Session: Poster session 09
819P - Efficacy and safety of orelabrutinib plus R-CHOP-like regimens for treatment-naïve diffuse large B-cell lymphoma with double expression
Presenter: Wei Wan
Session: Poster session 09
820P - Second primary malignancies and disease transformation in symptomatic patients with Waldenstrom’s macroglobulinemia: Outcomes of a population-based analysis
Presenter: Vasiliki Spiliopoulou
Session: Poster session 09
821P - Circulating chromosomal alterations in lymphoid malignancies
Presenter: Rosalie Griffin
Session: Poster session 09
822P - Preliminary results from a phase Ib study of amulirafusp alfa (IMM0306) in combination with lenalidomide in patients with relapsed or refractory CD20-positive B-cell non-Hodgkin's lymphoma
Presenter: Lijuan Deng
Session: Poster session 09
823P - The bone marrow immune ecosystem shapes acquired resistance to daratumumab in plasma cell myeloma
Presenter: Yun Wang
Session: Poster session 09
824P - FLT3-ITD induces immune escape in AML via up-regulating CD47 expression and decreased phagpcytic ability of macrophages
Presenter: Shuzhao Chen
Session: Poster session 09