Evidence map›Paper›PMID 27382029›Full record

ArticleThe oncologist2016

Lenalidomide in Relapsed or Refractory Diffuse Large B-Cell Lymphoma: Is It a Valid Treatment Option?

Patrizia Mondello, Normann Steiner, Wolfgang Willenbacher, Simone Ferrero, Paola Ghione, Alessandra Marabese, Vincenzo Pitini, Salvatore Cuzzocrea, Michael Mian

Open access · bronzeAbstract readMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in The oncologist, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
16citing papers in PubMed, 2 pooled it
4.2field-weighted citation impact, top 6% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

16 citing papers in PubMed, 2 syntheses or guidelines pooled it, 40 citations in OpenAlex.

  1. Pooled it
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  6. Observational
  7. Article
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  12. Treatment of Aggressive B Cell Lymphomas: Updates in 2019.Current hematologic malignancy reports · 2020
    Review
  13. Observational
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 5 institutions in 3 countries.

Patrizia MondelloDepartment of Human Pathology, University of Messina, Messina, Italy Department of Chemical, Biological, Pharmaceutical, and Environmental Sciences, University of Messina, Messina, Italy Lymphoma Service, Memorial Sloan Kettering Cancer Center, New York, New York, USA patriziamondello@hotmail.it.
Normann SteinerInternal Medicine V, Hematology and Oncology, Medical University of Innsbruck, Innsbruck, Austria.
Wolfgang WillenbacherInternal Medicine V, Hematology and Oncology, Medical University of Innsbruck, Innsbruck, Austria.
Simone FerreroDivision of Hematology, Department of Molecular Biotechnologies and Health Sciences, University of Torino, Torino, Italy.
Paola GhioneDivision of Hematology, Department of Molecular Biotechnologies and Health Sciences, University of Torino, Torino, Italy.
Alessandra MarabeseDepartment of Hematology and Center for Bone Marrow Transplantation, Ospedale di Bolzano, Bolzano, Italy.
Vincenzo PitiniDepartment of Human Pathology, University of Messina, Messina, Italy.
Salvatore CuzzocreaDepartment of Chemical, Biological, Pharmaceutical, and Environmental Sciences, University of Messina, Messina, Italy.
Michael MianInternal Medicine V, Hematology and Oncology, Medical University of Innsbruck, Innsbruck, Austria Department of Hematology and Center for Bone Marrow Transplantation, Ospedale di Bolzano, Bolzano, Italy.
Innsbruck Medical University · ATUniversity of Messina · ITUniversity of Turin · ITMemorial Sloan Kettering Cancer Center · USOspedale di Bolzano · IT

Funding

X-RAY CRYSTALLOGRAPHYP30CA008748 · NCI · SLOAN-KETTERING INSTITUTE FOR CANCER RES · PI Nicholas D Socci · 1985 to 2026
$347.4M
NCI NIH HHS P30 CA008748
6 · The paper itself

Abstract

backgroundDespite the advent of new treatment strategies, many patients with diffuse large B-cell lymphoma (DLBCL) relapse or die of the disease. Prospective clinical trials have demonstrated that lenalidomide is an effective and safe treatment option, especially for non-germinal center B-cell (non-GCB) DLBCL. However, routine clinical data are lacking, which is why we provide the results of the so-far largest relapsed/refractory (R/R) DLBCL real-life analysis.

methodsWe retrospectively assessed 123 R/R DLBCL patients who received either 15 or 25 mg/day of lenalidomide from January 2006 to January 2015.

resultsDuring a median follow-up period of 4.5 years, complete remission was achieved in 32% and a partial remission in 33% non-GCB patients compared with 0% and 3% in the GCB group (p < .001 and .001, respectively), with median response durations of 15 and 5 months, respectively (p < .001). Lenalidomide at 25 mg was superior to 15 mg in terms of response (complete remission 21% and partial remission 23% vs. 0% and 8%; p = .007 and .05) and median response duration (10 vs. 4 months; p = .03). Toxicity was limited and reversible. Median progression-free survival differed between non-GCB and GCB patients (37 vs. 30 months; p < .001) and between the two dosages (24 vs. 34 months; p = .002). However, overall survival was similar between the subgroups (38-42 months).

conclusionWe provide evidence that lenalidomide is a valid treatment option for R/R DLBCL, with limited and reversible toxicity, and is more efficient in non-GCB DLBCL and at higher doses. IMPLICATIONS FOR PRACTICE: Despite the advent of new treatment strategies, many patients with diffuse large B-cell lymphoma (DLBCL) relapse or die of the disease; hence, novel therapeutic approaches are urgently needed. This study confirms that lenalidomide is a valid and well-tolerated treatment option for relapsed/refractory (R/R) DLBCL. Superior outcomes were observed in non-germinal center B-cell (GCB) DLBCL, probably because of inhibition of the nuclear factor-κB pathway. Similarly, high drug doses resulted in greater clinical benefits. Overall, lenalidomide is a suitable therapeutic option for R/R DLBCL, especially in non-GCB DLBCL, and 25 mg/day dosing should be preferred.

Indexed as

AdultAgedAntineoplastic Combined Chemotherapy ProtocolsDisease-Free SurvivalFemaleHumansLenalidomideLymphoma, Large B-Cell, DiffuseMaleMiddle AgedNeoplasm Recurrence, LocalPrognosisRemission InductionSecondary PreventionThalidomideTreatment OutcomeLenalidomideThalidomideDiffuse large B-cell lymphomaImmunomodulatory drugLenalidomideRelapsed/refractory lymphoma

Identifiers

PMID27382029
PMCPMC5016065
OpenAlexW2460073819

What OpenQuestion holds

Textmetadata
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.