Safety and efficacy of durvalumab with R-CHOP or R2-CHOP in untreated, high-risk DLBCL: a phase 2, open-label trial

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningfagfællebedømt

  • Grzegorz S. Nowakowski
  • Wolfgang Willenbacher
  • Richard Greil
  • Thomas S. Larsen
  • Krish Patel
  • Ulrich Jäger
  • Robert F. Manges
  • Lorenz Trümper
  • Hele Everaus
  • Nagesh Kalakonda
  • Brown, Peter de Nully
  • Judit Meszaros Jørgensen
  • David Cunningham
  • Justine Dell’Aringa
  • Brian Fox
  • Neus Domper Rubio
  • Nurgul Kilavuz
  • Marie Laure Casadebaig
  • Oliver Manzke
  • Javier Munoz

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 (R2-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 R2-CHOP (ABC), then durvalumab consolidation (1500 mg every 28 days). Of 46 patients, 43 received R-CHOP and three R2-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.

TidsskriftInternational Journal of Hematology
Udgave nummer2
Sider (fra-til)222-232
StatusUdgivet - 2022

Bibliografisk note

Funding Information:
This trial (NCT03003520) was sponsored by Celgene, a Bristol Myers Squibb company, and supported by AstraZeneca/MedImmune.

Funding Information:
GSN has received grants from Celgene/Bristol Myers Squibb, Curis, Incyte, MorphoSys, Roche, and Seattle Genetics, and personal fees from Debiopharm, Karyopahrm, Kite, Kymera, Selvita, and TG Therapeutics. WW has served on steering and safety committees for Amgen, Celgene, DSMM, and Morphosys; was employed by Oncotyrol (20%); has served on advisory boards and as a consultant for Amgen, Bristol Myers Squibb/Celgene, Gilead, GSK, Incyte, Janssen, Novartis, Merck, Pfizer, Roche, Sandoz, Sanofi, and Takeda; has presented lectures for Amgen, AbbVie, Bristol Myers Squibb/Celgene, Fujimoto, Gilead, GSK, Janssen, Myelom- und Lymphomselbsthilfe Österreich, Novartis, Pfizer, Roche, Sandoz, Sanofi, and Takeda; and has received research funding from Amgen, Bristol Myers Squibb, Celgene, Janssen, Novartis, Roche, Sanofi, Takeda, oncotyrol, European Commission (FP7—OPTATIO), and Bundesland Tirol Programm “Translational research.” RG has received honoraria, consulting/advisory fees, research funding, and travel fees, accommodations, and/or expenses from AbbVie, Amgen, AstraZeneca, Bristol Myers Squibb, Celgene, Daiichi Sankyo, Gilead, Merck, MSD, Novartis, Roche, Sandoz, and Takeda. TSL has served as a consultant and on advisory boards for Bristol Myers Squibb/Celgene, Novartis, Roche, and Gilead. KP has received grants and/or personal fees from AstraZeneca, Bristol Myers Squibb, Genentech, Kite Pharmaceuticals, Pharmacyclics/Janssen, and TG Therapeutics. UJ has served on the advisory board for Bristol Myers Squibb/Celgene, Roche, Novartis, and Janssen; and has served as a consultant for Miltenyi, Takeda, Merck, Incyte, and AbbVie. RFM, LT, and HE have nothing to disclose. NK has received research funding from Celgene and Roche UK, and has served on the advisory board for Bristol Myers Squibb, Gilead, Karyopharm, and Takeda. PB has served on the advisory board for Celgene, Incyte, Takeda, and Roche. JMJ has received personal fees from Bristol Myers Squibb/Celgene, Gilead/Kite Pharma, Novartis, and Roche. DC has received research funding from Amgen, AstraZeneca, Bayer, Celgene, Clovis, Eli Lilly, Janssen, MedImmune, Merck, Merrimack, Sanofi, and 4SC. BF, NDR, NK, and M-LC are employees of and stockholders in Bristol Myers Squibb. JD, NK, and OM were employees of and stockholders in Bristol Myers Squibb at the time of the study. JM has served as a consultant for Pharmacyclics, Bayer, Gilead/Kite Pharma, Pfizer, Janssen, Juno/Celgene, Bristol Myers Squibb, Kyowa, Alexion, Beigene, Fosunkite, Innovent, Seattle Genetics, and Beigene; has received research funding from Bayer, Gilead/Kite Pharma, Celgene, Merck, Portola, Incyte, Genentech, Pharmacyclics, Seattle Genetics, Janssen, and Millennium; has received honoraria from Kyowa and Seattle Genetics; and has served on the speakers bureau for Gilead/Kite Pharma, Kyowa, Bayer, Pharmacyclics/Janssen, Seattle Genetics, Acrotech/Aurobindo, Beigene, Verastem, AstraZeneca, Celgene/Bristol Myers Squibb, Genentech/Roche, and AbbVie.

Publisher Copyright:
© 2021, Japanese Society of Hematology.

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