2021 EHA indolent non-Hodgkin's lymphoma treatment new method exploration

Indolent non-Hodgkin's lymphoma (iNHL) is a type of lymphoma with relatively slow clinical progression.
Although this type of disease usually progresses slowly, it is difficult to cure and prone to repeated recurrence
.

The 26th European Hematology Annual Conference (2021 EHA) will be held soon.
The editor compiled the research and exploration of 2 iNHL treatment options at this EHA conference for the reference of readers
.

Abstract Number: S211 Title: CHRONOS-3 Study: Copanlisib + Rituximab vs.
Placebo + Rituximab for the Treatment of Patients with Relapsed iNHL Randomized Phase III Study Copanlisib (C) is a PI3K inhibitor and has been approved Monotherapy in patients with recurrent follicular lymphoma (FL) who have previously received ≥2 lines of treatment
.

Patients with recurrent iNHL who had no progression of disease after the last treatment with a treatment program containing rituximab (R) and stopped treatment for ≥12 months or were unwilling/unsuitable to receive chemotherapy were included in the study.
FL was the most common, accounting for 60.
0% , Marginal zone lymphoma (MZL) accounted for 20.
7%, small lymphocytic lymphoma (SLL) accounted for 10.
9%, lymphoplasmacytic lymphoma/Wahrenheit macroglobulinemia (LPL/WM) accounted for 8.
3%; median age was 63 Years old (range: 28-91 years old)
.

There were 307 patients in the C+R group and 151 patients in the placebo (P)+R group
.

Inject C 60mg/P intravenously on days 1, 8 and 15 (28 days as a cycle); on days 1, 8, 15, and 22 of cycle 1, and on day 1 of cycles 3, 5, 7 and 9 Intravenous injection of R 375mg/m2
.

The primary endpoint is progression-free survival (PFS), and the secondary endpoints are objective response rate (ORR), duration of response, complete response rate (CRR), overall survival (OS), and adverse events during treatment (TEAE)
.

The deadline for statistics is August 31, 2020
.

With a median follow-up of 19.
2 months, the primary endpoint of the study was reached: the C+R regimen significantly reduced the risk of disease progression/death compared with the P+R regimen (HR: 0.
52; 95% CI: 0.
39-0.
69; unilateral p=0.
000002); the median PFS was 21.
5 months (95% CI: 17.
8-33.
0) and 13.
8 months (95% CI: 10.
2-17.
5), respectively
.

All histological subtypes (HR [95%CI]) have a reduced risk of disease progression/death: FL: 0.
580[0.
404-0.
833]; MZL: 0.
475[0.
245-0.
923]; SLL: 0.
243[0.
111-0.
530]; LPL /WM: 0.
443[0.
160-1.
231]
.

The ORR of the C+R group was 80.
8% (CRR: 33.
9%), and the ORR of the P+R group was 47.
7% (CRR: 14.
6%)
.

All patients with iNHL subtype who received C+R regimen had higher ORR and CRR
.

The median OS cannot be assessed
.

The most common TEAEs (all grades/≥3 grades) in the C+R group were hyperglycemia (69.
4%/56.
4%), hypertension (49.
2%/39.
7% [all grade 3]) and diarrhea (33.
6%/4.
9 %[All are level 3])
.

The most common TEAEs in the P+R group were hyperglycemia (23.
3%/8.
2% [all grade 3]), hypertension (19.
2%/8.
9% [all grade 3]), and neutropenia (16.
4% /12.
3%) and upper respiratory tract infection (16.
4%/0%)
.

The C+R group (47.
2%) had more severe AEs than the P+R group (18.
5%)
.

Grade 5 TEAEs occurred in 6 patients (2.
0%) receiving C+R treatment (1 case [0.
3%] pneumonia considered to be treatment-related) and 1 patient receiving P+R treatment (0.
7%)
.

The study showed that, compared with the P+R regimen, the C+R regimen showed better efficacy in patients with recurrent iNHL
.

The safety of C+R is controllable and consistent with C and R monotherapy
.

The C+R regimen is a potential treatment option for all patients with recurrent iNHL subtypes
.

Abstract Number: S212 Title: Application of Atelizumab+Otuzumab+Venecla in R/R iNHL patients: Initial analysis of the LYSA Phase 2 study.
This study evaluated atilizumab ( The efficacy of Atezolizumab (ATE), Obinutuzumab (OBI) and Venetoclax (Venetoclax, VEN) in the treatment of relapsed/refractory (R/R) B-cell lymphoma, here, researchers report The preliminary efficacy and safety data of the iNHL cohort (n=78) including FL and MZL are presented
.

R/R FL and MZL patients ≥18 years of age were included in the study
.

1g OBI was administered intravenously on Day 1, 8 and 15 (D) of Cycle 1 (C) and D1 of C2-C8, every 3 weeks as a cycle; ATE intravenous administration of 1.
2g every 3 weeks, from C1 D2 Start, and then administer on D2 of each cycle for a total of 24 cycles; VEN is taken orally in full at 800 mg/D, starting from D8 C1, for a total of 24 cycles
.

The primary endpoint is the overall response rate (ORR) after the end of induction (EOI) for 8 cycles of ATE, OBI, and VEN or when treatment is stopped prematurely
.

FL cohort (n=58): The median follow-up time was 14.
5 months
.

The main baseline characteristics include: Ann Arbor Stage III/IV accounted for 85.
7%; FLIPI HR accounted for 47.
3%; >2 previous treatments accounted for 32.
1%; ASCT treatment history accounted for 30.
4%
.

The ORR at EOI was 53.
6%, and the complete metabolic remission (CMR) rate was 30.
4%
.

Thirty-seven patients (63%) received complete induction therapy
.

MZL cohort (n=20): The median follow-up time was 11.
9 months
.

The main baseline characteristics include: Ann Arbor stage IV accounted for 100%; bone marrow involvement accounted for 38.
9%; ≥2 extranodal sites accounted for 50%; and >2 previous treatments accounted for 22.
2%
.

At EOI, the ORR was 66.
76%, the CR rate was 16.
7%, and the PR rate was 50.
0%
.

Eleven patients (55%) received complete induction therapy
.

The remission of the two cohorts was durable, with only 21.
4% of patients experiencing relapse/progress
.

Among 78 patients, a total of 55 (70.
5%) patients had Grade 3-4 AEs, and 1 patient stopped all drugs due to AEs
.

AE level ≥3 was cytopenia, and only 1 patient had febrile neutropenia (1.
3%)
.

Three patients had immune-related AEs (1 case of grade 2 myositis and 2 cases of grade 3 colitis), and no tumor lysis syndrome was observed
.

The study showed that the three-drug combination of ATE, OBI and VEN seemed to be well tolerated, and the regimen did not bring new toxicity
.

Reference source: 1.
Pier Luigi Zinzani, et al.
CHRONOS-3: RANDOMIZED PHASE III STUDY OF COPANLISIB PLUS RITUXIMAB VS RITUXIMAB/PLACEBO IN RELAPSED INDOLENT NON-HODGKIN LYMPHOMA.
2021 EHA Annual Meeting.
Abstract S211.
2.
Charles Herbaux, ATEZOLIZUMAB + OBINUTUZUMAB + VENETOCLAX IN PATIENTS WITH RELAPSED OR REFRACTORY INDOLENT NON-HODGKIN'S LYMPHOMA (R/R INHL): PRIMARY ANALYSIS OF A PHASE 2 TRIAL FROM LYSA.
2021 EHA Annual Meeting.
Abstract S212.
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