Tuesday, May 23, 2017

ASCO: Lenalidomide plus Obinutuzumab in Relapsed FL

Another ASCO preview.

This time, a look at the results from phase I and phase II trials for Lenalidomide plus Obinutuzumab.

This seems like a natural pairing. Lenalidomide is one of the ingredients in  in the R-squared combination that has so many FL experts so excited (Lenalidomide also goes by the name of Revlimid, and combining it with Rituxan gives us R-squared).

Obinutuzumab is a kind of Rituxan substitute. Like Rituxan, it targets the CD20 protein on B cells. Unlike Rituxan, it is humanized -- basically, Rituxan is made from mouse cells, and Obinutuzumab is made from human cells, which may cut down on the allergic reactions that some patients have with Rituxan (including me).

So the Lenalidomide plus Obinutuzumab combination makes sense, given how successful the Lenalidomide plus Rituxan combination works.

This fairly small study (just 36 patients) was divided into two parts. All of them had relapsed Follicualr Lymphoma (a treatment had worked, but the FL had returned).

In phase I, 6 FL patients helped to determine dose escalation -- how much Lenalidomide could be taken and still be both safe and effective. After that was figured out, in phase II, the other 30 patients were given that full amount, along with the Obinutuzumab.

Results were excellent -- 100% of patients showed a response, with 78% of them getting a Complete Response.

Side effects were manageable, and included fatigue, diarrhea, and rash, as well as neutropenia (low white blood cells that can lead to infection).

Longer term, with a median follow up of 14 months, 10 of the 36 patients had progressed. The researchers estimated that the Progression Free Survival rate at 24 month will be 61%. 

So overall, this seems like an effective and safe combination. The researchers are looking at the successful patients to see if there are any biomarkers that will help identify which other patients might have success with this combination. They also say that this combination is being studied as an initial treatment for FL patients, too.

I'll keep looking for more good FL news in the ASCO abstracts.

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