Institute of Hematology, University of Bologna, Bologna, Italy.
Division of Hematology, Fondazione IRCCS Ospedale Maggiore Policlinico, Università degli Studi di Milano, Milan, Italy.
Oncologist. 2018 Sep;23(9):1033-1038. doi: 10.1634/theoncologist.2017-0597. Epub 2018 Apr 19.
Mantle cell lymphoma (MCL) has the worst prognosis of B-cell subtypes owing to its aggressive clinical disease course and incurability with standard chemo-immunotherapy. Options for relapsed MCL are limited, although several single agents have been studied. Lenalidomide is available in Italy for patients with MCL based on a local disposition of the Italian Drug Agency.
SUBJECTS, MATERIALS, AND METHODS: An observational retrospective study was conducted in 24 Italian hematology centers with the aim to improve information on effectiveness and safety of lenalidomide use in real practice.
Seventy patients received lenalidomide for 21/28 days with a median of eight cycles. At the end of therapy, there were 22 complete responses (31.4%), 11 partial responses, 6 stable diseases, and 31 progressions, with an overall response rate of 47.1%. Eighteen patients (22.9%) received lenalidomide in combination with either dexamethasone ( = 13) or rituximab ( = 5). Median overall survival (OS) was reached at 33 months and median disease-free survival (DFS) at 20 months: 14/22 patients are in continuous complete response with a median of 26 months. Patients who received lenalidomide alone were compared with patients who received lenalidomide in combination: OS and DFS did not differ. Progression-free survivals are significantly different: at 56 months, 36% in the combination group versus 13% in patients who received lenalidomide alone. Toxicities were manageable, even if 17 of them led to an early drug discontinuation.
Lenalidomide therapy for relapsed MCL patients is effective and tolerable even in a real-life context.
Several factors influence treatment choice in relapsed/refractory mantle cell lymphoma (rrMCL), and the therapeutic scenario is continuously evolving. In fact, rrMCL became the first lymphoma for which four novel agents have been approved: temsirolimus, lenalidomide, ibrutinib, and bortezomib. The rrMCL therapeutic algorithm is not so well established because data in the everyday clinical practice are still poor. Lenalidomide for rrMCL patients is effective and tolerable even in a real-life context.
套细胞淋巴瘤（MCL）的临床病程具有侵袭性，且标准化疗和免疫治疗无法治愈，因此其预后在 B 细胞亚型中最差。尽管已经研究了几种单药治疗方案，但复发 MCL 的选择有限。利那度胺在意大利可用于 MCL 患者，这基于意大利药品管理局的地方规定。
在 24 家意大利血液学中心进行了一项观察性回顾性研究，旨在提高利那度胺在实际应用中的有效性和安全性信息。
70 例患者接受利那度胺治疗，每 21/28 天 1 个周期，中位数为 8 个周期。治疗结束时，22 例完全缓解（31.4%），11 例部分缓解，6 例疾病稳定，31 例进展，总缓解率为 47.1%。18 例（22.9%）患者接受利那度胺联合地塞米松（13 例）或利妥昔单抗（5 例）治疗。中位总生存期（OS）为 33 个月，中位无进展生存期（DFS）为 20 个月：22 例中有 14 例持续完全缓解，中位时间为 26 个月。单独接受利那度胺治疗的患者与联合接受利那度胺治疗的患者相比：OS 和 DFS 无差异。无进展生存期差异显著：56 个月时，联合组为 36%，单独接受利那度胺治疗的患者为 13%。毒性可控制，尽管其中 17 例导致药物早期停药。
利那度胺治疗复发 MCL 患者有效且耐受良好，即使在真实环境中也是如此。
影响复发/难治性套细胞淋巴瘤（rrMCL）治疗选择的因素有很多，治疗方案也在不断发展。事实上，rrMCL 是第一个有四种新型药物获批的淋巴瘤：替西罗莫司、来那度胺、依鲁替尼和硼替佐米。rrMCL 的治疗方案尚未完全建立，因为在日常临床实践中数据仍然较少。利那度胺治疗 rrMCL 患者有效且耐受良好，即使在真实环境中也是如此。
