refractory non hodgkin's lymphoma survival rate

For all patients, the ORR was 69%, with a CR rate of 16%. Table 1b: Selection of Phase II/III monotherapy studies for relapsed/refractory non-Hodgkin lymphoma or diffuse large B-cell lymphoma ineligible for high-dose therapy.32-39 Previous studies have included only small numbers of patients, indicating a need for a larger analysis of outcomes in patients with refractory DLBCL. Aside from data suggesting that BV retreatment produces responses in patients with relapsed/refractory HL who were previously sensitive to BV,39 there are no available data on which to base decisions about the use of BV post-ASCT consolidation in patients with prior BV exposure. There is no accepted standard of care for third or fourth-line treatment. Patients with prior exposure to BV or who did not achieve at least stable disease to salvage therapy were not eligible. For the randomized study cohorts, covariates were determined at random assignment. Among 53 evaluable patients, the complete response rate to BV-bendamustine was 74%, and among 40 patients who proceeded to ASCT, 2-year PFS was 70%. For patients progressing after frontline treatment, second-line therapy followed by consolidation with autologous stem cell transplant (ASCT) remains the standard of care; … Given the uncertainty regarding the optimal second-line treatment approach, enrollment in a clinical trial should always be considered. Privacy Policy In summary, achievement of a complete response in the setting of R/R lymphoma remains a positive prognostic factor. PIX301 was a multicentre, randomised, active-controlled study evaluating the efficacy and safety of pixantrone as a single-agent therapy in the management of patients with aggressive R/R-NHL (73% with DLBCL) who had received at least two prior therapies and had adequate cardiac function (left ventricular ejection fraction: ≥50%) at time of study entry.14 Patients were randomised 1:1 to either pixantrone (50 mg/m2 on Days 1, 8, and 15, every 28 days, ≤6 cycles) or to available active comparators in the EU and USA (physician’s choice, used at standard therapeutic doses and schedules). Results from clinical trials and retrospective cohort analyses identified by using a similar definition of refractory showed that these patients have consistently poor clinical outcomes.13,15-23  In 6 studies that assessed different chemotherapy regimens for 251 patients who had aggressive lymphoma refractory to first-line therapy, the objective response rate ranged from 0% to 23%, and the median OS was <10 months.15,17-20,22  In an additional 3 studies of 135 patients whose lymphoma was refractory to second-line therapy, the objective response rate ranged from 1% to 14%, and the median OS was 5 months.18,21,24  Finally, in 2 studies of patients who relapsed after ASCT, median OS of 8 months (n = 45) and 10 months (n = 75) were reported.13,23.

Supplemental figures and table (PDF, 384 KB), https://doi.org/10.1182/blood-2017-03-769620. Results from RCTs have demonstrated that the findings of preclinical studies have carried through to clinical practice. Herbrecht R et al. To understand the relatively favorable outcomes of some of the clinically defined subgroups in this data set, biomarkers such as cell of origin or the presence of chromosomal translocations involving BCL-2 and C-MYC (double-hit lymphomas) would be required36 ; such an evaluation of biology of patients in the SCHOLAR-1 study cohorts is planned. Pixantrone dimaleate versus other chemotherapeutic agents as a single-agent salvage treatment in patients with relapsed or refractory aggressive non-Hodgkin lymphoma: a phase 3, multicentre, open-label, randomised trial. Our results confirm our assumptions built on these earlier studies, that patients do indeed have poor outcomes, regardless of refractory subgroup.

For example, the time period of patients’ treatment may influence the applicability of the benchmark to future studies. dexamethasone, cytarabine, cisplatin; DLBCL: diffuse large B-cell lymphoma; EFS: event-free survival; Outcomes in refractory diffuse large B-cell lymphoma: results from the international SCHOLAR-1 study. These results showed that 20% of patients remained alive at 2 years; however, these long-term durable responses were primarily driven by the minority of patients who received ASCT and/or achieved a CR or PR and who represent the tail of the Kaplan-Meier curve of OS.

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