Ofatumumab plus HyperCVAD/HD-MA induction leads to high rates of minimal residual disease negativity in patients with newly diagnosed mantle cell lymphoma: Results of a phase 2 study. Cancer 2022 Apr 15;128(8):1595-1604
Date
02/15/2022Pubmed ID
35157306Pubmed Central ID
PMC10086838DOI
10.1002/cncr.34106Scopus ID
2-s2.0-85124534234 (requires institutional sign-in at Scopus site) 1 CitationAbstract
BACKGROUND: Ofatumumab is a humanized type 1 anti-CD20 monoclonal antibody. Preclinical studies show improved complement-mediated cytotoxicity (CMC) compared to rituximab in mantle cell lymphoma (MCL). This study evaluates the safety and efficacy of combining ofatumumab with HyperCVAD/MA (O-HyperCVAD) in newly diagnosed MCL.
METHODS: In this single-arm phase 2 study, 37 patients were treated with the combination of O-HyperCVAD for 4 or 6 cycles, followed by high dose chemotherapy and autologous stem cell transplant. Primary objectives were overall response rate (ORR) and complete response (CR) rate at the end of therapy. Secondary objectives included minimal residual disease (MRD) negativity, progression-free survival (PFS), and overall survival (OS).
RESULTS: Median age was 60 years; ORR was 86% and 73% achieved a CR by modified Cheson criteria. The MRD negativity rate was 78% after 2 cycles of therapy, increasing to 96% at the end of induction; median PFS and OS were 45.5 months and 56 months, respectively. Achieving a post-induction CR by both imaging and flow cytometry was associated with improved PFS and OS. Early MRD negativity (post-2 cycles) was also associated with an improved PFS but not OS. There were 3 deaths while on therapy, and grades 3 and 4 adverse events (AEs) were observed in 22% and 68% of the patients.
CONCLUSION: The addition of ofatumumab to HyperCVAD/HD-MA led to high rates of MRD negativity by flow cytometry in patients with newly diagnosed MCL. Achieving a CR post-induction by both imaging and flow cytometry is associated with improved overall survival.
Author List
Torka P, Akhtar OS, Reddy NM, Baysal BE, Kader A, Groman A, Nichols J, Mavis C, Tario JD, Block AW, Sait SNJ, Ghione P, Sundaram S, Przespolewski ER, Mohr A, Lund I, Kostrewa J, McWhite K, DeMarco J, Johnson M, Darrall A, Thomas-Talley RN, Wallace PK, Neppalli V, Hutson A, Hernandez-Ilizaliturri FJAuthor
Othman S. Akhtar MBBS Assistant Professor in the Medicine department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
AdultAntibodies, Monoclonal, Humanized
Antineoplastic Combined Chemotherapy Protocols
Humans
Lymphoma, Mantle-Cell
Middle Aged
Neoplasm, Residual
Rituximab
