Journal
INTERNATIONAL JOURNAL OF HEMATOLOGY
Volume 115, Issue 2, Pages 222-232Publisher
SPRINGER JAPAN KK
DOI: 10.1007/s12185-021-03241-4
Keywords
Durvalumab; Diffuse large B-cell lymphoma; High risk; R-CHOP
Categories
Funding
- Celgene
- Bristol Myers Squibb Company
- AstraZeneca/ MedImmune
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The study investigated the efficacy of combining durvalumab with traditional R-CHOP therapy or R-2-CHOP therapy in high-risk diffuse large B-cell lymphoma patients. The results showed that while some patients achieved remission with durvalumab + R-CHOP, overall there was no greater benefit compared to traditional therapy, with consistent adverse events.
Patients with high-risk diffuse large B-cell lymphoma (DLBCL) have poor outcomes following first-line cyclophosphamide, doxorubicin, vincristine, prednisone, and rituximab (R-CHOP). Evidence shows chemotherapy and immune checkpoint blockade can increase antitumor efficacy. This study investigated durvalumab, a programmed death-ligand 1 inhibitor, combined with R-CHOP or lenalidomide + R-CHOP (R-2-CHOP) in newly diagnosed high-risk DLBCL. Patients received durvalumab 1125 mg every 21 days for 2-8 cycles + R-CHOP (non-activated B-cell [ABC] subtype) or R-2-CHOP (ABC), then durvalumab consolidation (1500 mg every 28 days). Of 46 patients, 43 received R-CHOP and three R-2-CHOP. All patients had the high-risk disease; 14 (30.4%) and eight (17.4%) had double- or triple-hit DLBCL, respectively. Following induction, 20/37 (54.1%) patients receiving durvalumab + R-CHOP achieved complete response (CR), and seven (18.9%) partial response (PR); 25 (67.6% [95% CI 50.2-82.0]) continued to consolidation and were progression-free at 12 months. Among efficacy-evaluable patients with double- or triple-hit DLBCL (n = 12), five achieved CR and five PR. Adverse events were generally consistent with R-CHOP. Correlative analyses did not identify conclusive biomarkers of response. Durvalumab + R-CHOP is feasible in DLBCL with no new safety signals, but the combination provided no greater benefit than R-CHOP.
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