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The 17th International Conference on Malignant Lymphoma (ICML) was held in the near future.
At the conference, a number of research progresses related to follicular lymphoma (FL) were announced, and the efficacy of FL maintenance programs and the treatment options for relapsed and refractory FL were explored
.
The editor now organizes the main content of the research as follows for the reference of readers
.
Abstract 113: The efficacy and safety of PI3kδ inhibitor Zandelisib intermittently in the treatment of FL.
Background The prognosis of FL patients with disease progression (POD24) within 24 months after first-line immunochemotherapy is poor, but these patients may benefit from new treatment options
.
Zandelisib is an oral selective PI3kδ inhibitor.
The intermittent course of Zandelisib in the treatment of FL showed a high objective response rate (ORR) in the dose escalation/expansion phase Ib study and was well tolerated
.
The efficacy and safety study results of intermittent course of Zandelisib in the treatment of FL patients with POD24 are now reported (NCT02914938)
.
Research methods The study included FL patients with an ECOG score ≤ 2 points, who had previously received ≥ 1 treatment but had not received PI3K inhibitor treatment, and received intermittent courses of Zandelisib treatment
.
The patients first received Zandelisib (60 mg daily) for 8 weeks, and then Zandelisib was discontinued on days 1-7 of each 28-day treatment cycle.
Some patients received rituximab at the same time during the intermittent treatment.
(375mg/m2, cycles 1-6, total of 8 doses)
.
Patients continue to receive Zandelisib treatment until disease progression, intolerance or withdrawal from the study
.
Research Results The study included 37 patients with FL who received Zandelisib monotherapy (n=18) or Zandelisib combined with rituximab (n=19)
.
The median line number of the patient's previous treatment was 2 (range: 1-5)
.
The ORR was 86.
5% (32/37), and the complete remission (CR) rate was 27%
.
Among them, the ORR of the monotherapy group was 77.
8% (14/18), and the CR rate was 27.
8%; the ORR of the rituximab combination therapy group was 94.
7% (18/19), and the CR rate was 26.
3%
.
At a median follow-up of 16.
9 months (range: 1.
2-33.
1+), the median duration of response (DOR) was not reached
.
Twenty-two (59%) patients had POD24, of which 15 (68%) patients had previously received ≥2 line therapy.
Although this part of the disease is more difficult to treat, 81.
8% of POD24 patients still achieved remission by Zandelisib treatment
.
Zandelisib is safe, and 3 patients (8%) in the study discontinued treatment due to adverse events (AE)
.
Grade 3 AEs of particular concern were diarrhea (2 cases, 5.
4%), colitis (2 cases, 5.
4%), rash (3 cases, 8.
1%), elevated transaminase (3 cases, 8.
1%), and elevated aspartate aminotransferase (1 case, 2.
7%), no patient had a lung infection
.
Research conclusions Zandelisib alone or in combination with rituximab can achieve a higher lasting remission rate in both POD24 and non-POD24 FL patients
.
Zandelisib is well tolerated, and the incidence of grade 3 AEs of particular concern and the proportion of patients who discontinue the drug due to AEs are both low
.
Abstract 117: Comparison of the efficacy and safety of rituximab maintenance therapy after induction therapy with BR regimen and R-CHOP regimen.
Research background R-CHOP regimen (rituximab, cyclophosphamide, doxorubicin, vinblastine) After induction therapy with alkali, prednisone), rituximab single-agent maintenance therapy can improve the prognosis of newly treated patients with advanced FL
.
The BR regimen (rituximab, bendamustine) induction therapy also showed good efficacy, but it is not clear whether single-agent maintenance therapy of rituximab is required after induction therapy of this regimen
.
The Spanish Lymphoma Working Group (GELTAMO) conducted a study to compare the efficacy of rituximab maintenance therapy in newly treated patients with advanced FL after two induction regimens based on rituximab
.
Research Methods This retrospective study included 16 centers under GELTAMO, who received induction therapy with BR or R-CHOP as the first line, and subsequently received rituximab monotherapy for maintenance therapy in FL patients, to evaluate the efficacy and safety of the treatment plan Sex
.
Research results The study included 309 patients, of which 93 patients received induction therapy with BR regimen and 216 patients received induction therapy with R-CHOP regimen
.
Patients receiving BR regimen are older, and patients with grade 3a FL receive more induction therapy with R-CHOP regimen
.
All patients completed induction therapy.
Among them, patients in the R-CHOP group had a higher incidence of cytopenia during maintenance treatment, and the proportion of patients receiving G-SCF treatment was also higher.
The incidence of infection in the two groups was similar (BR group: 22 cases [ 24.
2%] vs R-CHOP group: 51 cases [25.
4%])
.
Seventy patients (73%) in the BR group and 193 (88%) patients in the R-CHOP group completed maintenance treatment.
The proportion of patients in the BR group was more discontinued.
The most common reasons for discontinuation were hemocytopenia and infection
.
The incidence of infection-related deaths was higher in the BR group (40% vs 7%; P=0.
051), and there was no difference in the incidence of second tumors between the two groups
.
The CR rate (BR group: 87%; R-CHOP group: 90%) and disease progression rate (BR group: 7.
8%; R-CHOP group: 6.
3%) at the end of maintenance treatment in the two groups were similar.
In POD24 patients The same was true (BR group: 9 cases, 10%; R-CHOP group: 21 cases, 10%), and the recurrence rate of patients in the R-CHOP group was significantly higher (21.
8% vs 8%; P=0.
019)
.
At a median follow-up of 6.
2 years (BR group: 5.
1 years; R-CHOP group: 6.
5 years), the 5-year progression-free survival (PFS) rate of BR group was 84%, and that of R-CHOP group was 75% (95%CI: 0.
79-2.
6,; P=0.
2), the 5-year overall survival (OS) rate of the BR group was 87%, and the R-CHOP group was 91% (95%CI: 0.
21-1.
52; P=0.
3) Research conclusions R-CHOP The regimen and the BR regimen showed similar efficacy in the initial treatment of advanced FL, but the BR regimen followed by rituximab maintenance treatment had a higher incidence of adverse events, especially neutropenia and infection
.
Reference source: 1.
J.
Pagel, et al.
2021 ICML.
E-Poster No.
113.
2.
M.
Bastos-Oreiro, et al.
2021 ICML.
E-Poster No.
117.
Stamp "read the original text", we will make progress together
At the conference, a number of research progresses related to follicular lymphoma (FL) were announced, and the efficacy of FL maintenance programs and the treatment options for relapsed and refractory FL were explored
.
The editor now organizes the main content of the research as follows for the reference of readers
.
Abstract 113: The efficacy and safety of PI3kδ inhibitor Zandelisib intermittently in the treatment of FL.
Background The prognosis of FL patients with disease progression (POD24) within 24 months after first-line immunochemotherapy is poor, but these patients may benefit from new treatment options
.
Zandelisib is an oral selective PI3kδ inhibitor.
The intermittent course of Zandelisib in the treatment of FL showed a high objective response rate (ORR) in the dose escalation/expansion phase Ib study and was well tolerated
.
The efficacy and safety study results of intermittent course of Zandelisib in the treatment of FL patients with POD24 are now reported (NCT02914938)
.
Research methods The study included FL patients with an ECOG score ≤ 2 points, who had previously received ≥ 1 treatment but had not received PI3K inhibitor treatment, and received intermittent courses of Zandelisib treatment
.
The patients first received Zandelisib (60 mg daily) for 8 weeks, and then Zandelisib was discontinued on days 1-7 of each 28-day treatment cycle.
Some patients received rituximab at the same time during the intermittent treatment.
(375mg/m2, cycles 1-6, total of 8 doses)
.
Patients continue to receive Zandelisib treatment until disease progression, intolerance or withdrawal from the study
.
Research Results The study included 37 patients with FL who received Zandelisib monotherapy (n=18) or Zandelisib combined with rituximab (n=19)
.
The median line number of the patient's previous treatment was 2 (range: 1-5)
.
The ORR was 86.
5% (32/37), and the complete remission (CR) rate was 27%
.
Among them, the ORR of the monotherapy group was 77.
8% (14/18), and the CR rate was 27.
8%; the ORR of the rituximab combination therapy group was 94.
7% (18/19), and the CR rate was 26.
3%
.
At a median follow-up of 16.
9 months (range: 1.
2-33.
1+), the median duration of response (DOR) was not reached
.
Twenty-two (59%) patients had POD24, of which 15 (68%) patients had previously received ≥2 line therapy.
Although this part of the disease is more difficult to treat, 81.
8% of POD24 patients still achieved remission by Zandelisib treatment
.
Zandelisib is safe, and 3 patients (8%) in the study discontinued treatment due to adverse events (AE)
.
Grade 3 AEs of particular concern were diarrhea (2 cases, 5.
4%), colitis (2 cases, 5.
4%), rash (3 cases, 8.
1%), elevated transaminase (3 cases, 8.
1%), and elevated aspartate aminotransferase (1 case, 2.
7%), no patient had a lung infection
.
Research conclusions Zandelisib alone or in combination with rituximab can achieve a higher lasting remission rate in both POD24 and non-POD24 FL patients
.
Zandelisib is well tolerated, and the incidence of grade 3 AEs of particular concern and the proportion of patients who discontinue the drug due to AEs are both low
.
Abstract 117: Comparison of the efficacy and safety of rituximab maintenance therapy after induction therapy with BR regimen and R-CHOP regimen.
Research background R-CHOP regimen (rituximab, cyclophosphamide, doxorubicin, vinblastine) After induction therapy with alkali, prednisone), rituximab single-agent maintenance therapy can improve the prognosis of newly treated patients with advanced FL
.
The BR regimen (rituximab, bendamustine) induction therapy also showed good efficacy, but it is not clear whether single-agent maintenance therapy of rituximab is required after induction therapy of this regimen
.
The Spanish Lymphoma Working Group (GELTAMO) conducted a study to compare the efficacy of rituximab maintenance therapy in newly treated patients with advanced FL after two induction regimens based on rituximab
.
Research Methods This retrospective study included 16 centers under GELTAMO, who received induction therapy with BR or R-CHOP as the first line, and subsequently received rituximab monotherapy for maintenance therapy in FL patients, to evaluate the efficacy and safety of the treatment plan Sex
.
Research results The study included 309 patients, of which 93 patients received induction therapy with BR regimen and 216 patients received induction therapy with R-CHOP regimen
.
Patients receiving BR regimen are older, and patients with grade 3a FL receive more induction therapy with R-CHOP regimen
.
All patients completed induction therapy.
Among them, patients in the R-CHOP group had a higher incidence of cytopenia during maintenance treatment, and the proportion of patients receiving G-SCF treatment was also higher.
The incidence of infection in the two groups was similar (BR group: 22 cases [ 24.
2%] vs R-CHOP group: 51 cases [25.
4%])
.
Seventy patients (73%) in the BR group and 193 (88%) patients in the R-CHOP group completed maintenance treatment.
The proportion of patients in the BR group was more discontinued.
The most common reasons for discontinuation were hemocytopenia and infection
.
The incidence of infection-related deaths was higher in the BR group (40% vs 7%; P=0.
051), and there was no difference in the incidence of second tumors between the two groups
.
The CR rate (BR group: 87%; R-CHOP group: 90%) and disease progression rate (BR group: 7.
8%; R-CHOP group: 6.
3%) at the end of maintenance treatment in the two groups were similar.
In POD24 patients The same was true (BR group: 9 cases, 10%; R-CHOP group: 21 cases, 10%), and the recurrence rate of patients in the R-CHOP group was significantly higher (21.
8% vs 8%; P=0.
019)
.
At a median follow-up of 6.
2 years (BR group: 5.
1 years; R-CHOP group: 6.
5 years), the 5-year progression-free survival (PFS) rate of BR group was 84%, and that of R-CHOP group was 75% (95%CI: 0.
79-2.
6,; P=0.
2), the 5-year overall survival (OS) rate of the BR group was 87%, and the R-CHOP group was 91% (95%CI: 0.
21-1.
52; P=0.
3) Research conclusions R-CHOP The regimen and the BR regimen showed similar efficacy in the initial treatment of advanced FL, but the BR regimen followed by rituximab maintenance treatment had a higher incidence of adverse events, especially neutropenia and infection
.
Reference source: 1.
J.
Pagel, et al.
2021 ICML.
E-Poster No.
113.
2.
M.
Bastos-Oreiro, et al.
2021 ICML.
E-Poster No.
117.
Stamp "read the original text", we will make progress together
