Monday, June 8, 2015

ASCO: The Future of Revlimid for Follicular Lymphoma

More from ASCO (even though it was over a week ago):

Revlimid (also known as Lenalidomide) made a few appearances at ASCO, though they didn't necessarily present anything that will make a difference at your n ext oncologist appointment. Let's say they said a lot about the future of Revlimid/Lenalidomide for Follicular Lymphoma.

The first presents results from a Phase I clinical trial that focused on dosing -- trying to figure out how much to give to patients. The paper is called "Bendamustine and rituximab and lenalidomide (BRR) in the treatment of relapsed and refractory low grade non-Hodgkin lymphoma (NHL): Final results of phase 1 study NCCTG N1088/ALLIANCE."

As the title suggests, this looks at what happens when researchers give Bendamustine to the "R-Squared" (Revlimid + Rituxan) regiment. It's a pahse I study, so it's small, and its purpose is to figure out how much to give, so there isn't an expectation of great results.

That said, they got great results anyway. They involved 15 patients, 6 of whom have Follicular Lymphomna, and gave them different doses of Bendamustine and Revlimid, and the same standard dose of Rituxan. The study had a 100% response rate -- 9 Partial Responses and 6 Complete Responses. And on top of that, they determined the most effective dosage for the three agents. This shows some great hope for the future.

Two other sessions described phase III clinical trials that have already started enrolling.

The first is the MAGNIFY Trial. (I want a job coming up with names for clinical trials). This one focuses on Maintenance. They hope to enroll 500 patients with indolent lymphomas (including Follicular Lymphoma). All will be given R-Squared (Revlimid + Rituxan) as an initial treatment (none will have received any other treatment). Then half will be given Rituxan Maintenance (every 2 months), and the other half will get R-Squared Maintenance (again, every two months). It will be interesting to see if this alternate way of providing Maintenance proves to be an effective alternative to Rituxan Maintenance. I'm especially interested in what kind of side effects will come from taking Revlimid for that long.

The second trial described at ASCO is the AUGMENT Trial. This one is also a phase III trial, and will also involve several types of indolent lymphoma, including FL. For this one, though, patients have already received some kind of initial treatment, and are Relapsed or Refractory (that is, the disease has come back, or never fully left). This study will involve a direct comparison between Rituxan and R-Squared. Half of the patients will get R-Squared, and the other half will get Rituxan + a placebo. Again, this kind of direct comparison to Rituxan will tell us a lot about whether we have a viable alternative to this common treatment.

So, not much to report from ASCO about how great R-Squared is, but there is lots of reason for excitement about the future.

Still a few more goodies from ASCO to talk about. I'll get to them soon.


Anonymous said...

Thanks Bob for keeping us updated . I log on daily to go to your blog to see what you said as your information is so up to mark on our lives with fnhl. Thanks again.

Anonymous said...

I agree w anonymous .....I'm so hoping for good news on future treatments as I watch n wait. Sept will be my one year diagnosversary.
Thank you for this blog, I too, check in every day.

Lymphomaniac said...

Thank you both for reading. And now that I know you check every day, I feel a little guilty for not posting as often these days.....

Anonymous said...

No guilt do amazing work and I think we are lucky to have you.

Lymphomaniac said...

You're right! No guilt! I always say we have enough negative emotions to deal with as cancer patients. we don't need to add guilt to them. (I may go have some ice cream -- guilt-free.)

Anonymous said...

Thank you Bob.

Jomama said...

I too read your blog at least every other day. Thank you for this incredible blog. It is a true source of comfort as well as education. You rock!

I am currently on watch and wait having been diagnosed last March with FL Stage II.

Question - your link for the Manify Trial did not work. I looked that trial up and it appears to be only for relapsed/refractory patients. Do I have my wires crossed?

Anonymous said...

Thanks for keeping on top of fNHL. My wife has fNHL,currently taking Idelalisib and rituximab, and has been doing great for 6 months. We are looking at R2 should she progress on her current treatment.