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.
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