Long-term responses to thalidomide and rituximab in Waldenstrom's macroglobulinemia.

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Abstracts

2007 ASCO Annual Meeting

Long-term responses to thalidomide and rituximab in Waldenstrom's macroglobulinemia.

Sub-category:

Lymphoma

Category:

Lymphoma and Plasma Cell Disorders

Meeting:

2007 ASCO Annual Meeting

Session Type and Session Title:

Oral Presentation, Myeloma

Abstract No:

8017

Citation:

Journal of Clinical Oncology, 2007 ASCO Annual Meeting Proceedings Part I. Vol 25, No. 18S (June 20 Supplement), 2007: 8017

Author(s):

J. D. Soumerai, A. R. Branagan, C. J. Patterson, Z. R. Hunter, S. P. Treon

Abstract:

Background: Rituximab is active in Waldenstrom's macroglobulinemia (WM), producing response rates of 40-50%. Lower response rates are observed among patients with the Fc?RIIIA-158 FF polymorphism; high B₂M (>3.0 mg/dL), and high serum IgM levels (>6,000 mg/dL). Thalidomide enhances rituximab-mediated ADCC of lymphoplasmacytic cells and produces response rates of 25% in WM. As such, we conducted this phase II study using thalidomide and rituximab in patients naïve to either agent. Methods: Intended therapy was: Weeks 1-52: Thalidomide (200 mg po qHS for 2 wks, then 400 mg po qHS) Weeks 2-5, 13- 16: Rituximab (375 mg/m²/wk) Twenty-five patients were enrolled, 20 of whom were previously untreated, with a baseline median age of 62 (range 44-86 yrs), BM involvement of 40 (range 5-80%), serum IgM of 3,670 (range 924-8,610 mg/dL), B₂M of 2.6 (range 1.4-8.3 mg/L), Hct of 34.1 (range 23.6-42.6%). Results: Grade >2 toxicities to thalidomide included neuroparesthesias (n=11); somnolence (n=3); confusion (n=3); rash (n=2); tremors (n=2); bradycardia (n=2) and palpitations (n=1). Among patients experiencing neuroparesthesias, 10 demonstrated resolution to grade 1 (n=3) or complete resolution (n=7) at a median of 6.7 (range 0.4- 22.5 months). Dose reduction of thalidomide occurred in all patients and led to discontinuation in 11 patients. Twenty-three patients were evaluable. Responses among evaluable patients: CR (n=1); PR (n=15); MR (n=2); SD (n=1) for an overall and a major response rate of 78% and 70%, respectively. Median serum IgM decreased from 3,670 (924-8,610 mg/dL) to 1,590 (36-5,230 mg/dL) (p<0.001), while median hematocrit rose from 33.0 (23.6-42.6%) to 37.6 (29.3-44.3%) (p=0.004) at best response. With a median follow-up of 42+ months, the median TTP for all evaluable patients on study was 35 months, and 38+ months for responders. Overall response was associated with median cumulative thalidomide dose: CR/PR/MR (29,275 mg) vs. SD/NR (7,400 mg); p=0.004. Overall responses were unaffected by Fc?RIIIA-158 polymorphism status (81% vs. 71% for VV/FV vs. FF); serum IgM (78% vs. 80% for <6,000 vs. >6,000 mg/dL); and B₂M levels (71% vs. 89% for <3 vs. >3 g/dL); p=NS. Conclusions: Thalidomide in combination with rituximab is highly active and produces long- term responses in patients with WM.

Abstract Disclosures

Abstracts that were granted an exception in accordance with ASCO's Conflict of Interest Policy and are designated with a caret symbol (^) here and in the print version.

Associated Presentation(s):

1. Long-term responses to thalidomide and rituximab in Waldenstrom's macroglobulinemia.

Meeting: 2007 ASCO Annual Meeting
Presenter: Jacob Drobnyk Soumerai
Session: Myeloma (Oral Presentation)

Other Abstracts in this Sub-Category:

		1. A phase II study of a novel oral isotype-selective histone deacetylase (HDAC) inhibitor in patients with relapsed or refractory Hodgkin lymphoma. Meeting: 2007 ASCO Annual Meeting Abstract No: 8000 First Author: A. Younes Category: Lymphoma and Plasma Cell Disorders - Lymphoma
		2. Cyclophosphamide and fludarabine (CF) in advanced indolent lymphoma: Results from the ECOG/CALGB intergroup E1496 trial. Meeting: 2007 ASCO Annual Meeting Abstract No: 8004 First Author: H. S. Hochster Category: Lymphoma and Plasma Cell Disorders - Lymphoma
		3. Phase II study of short course CHOP-rituximab (R) followed by ibritumomab tiuxetan (IT) as first-line treatment for follicular lymphoma (FL). Meeting: 2007 ASCO Annual Meeting Abstract No: 8005 First Author: R. C. Jankowitz Category: Lymphoma and Plasma Cell Disorders - Lymphoma
		More...

Abstracts by J. D. Soumerai:

		1. Association of maintenance rituximab with clinical outcome in rituximab-naïve patients with Waldenstrom's macroglobulinemia (WM) who respond to a rituximab-containing regimen. Meeting: 2010 ASCO Annual Meeting Abstract No: 8107 First Author: L. I. Ioakimidis Category: Lymphoma and Plasma Cell Disorders - Plasma Cell Disorders
		2. Long-term follow-up of patients with lymphoplasmacytic lymphoma (Waldenstrom's macroglobulinemia) who were treated with alemtuzumab. Meeting: 2010 ASCO Annual Meeting Abstract No: 8109 First Author: J. D. Soumerai Category: Lymphoma and Plasma Cell Disorders - Plasma Cell Disorders
		3. Increased prevalence of monoclonal gammopathy, abnormal immunoglobulin levels, and recurrent infections in family members of patients with familial Waldenstrom's macroglobulinemia. Meeting: 2008 ASCO Annual Meeting Abstract No: 8540 First Author: Z. R. Hunter Category: Lymphoma and Plasma Cell Disorders - Lymphoma
		More...

Presentations by J. D. Soumerai:

1. Long-term follow-up of patients with lymphoplasmacytic lymphoma (Waldenstrom's macroglobulinemia) who were treated with alemtuzumab.

Meeting: 2010 ASCO Annual Meeting
Presenter: Jacob D Soumerai
Session: Lymphoma and Plasma Cell Disorders (General Poster Session)

2. Long-term responses to thalidomide and rituximab in Waldenstrom's macroglobulinemia.

Meeting: 2007 ASCO Annual Meeting
Presenter: Jacob Drobnyk Soumerai
Session: Myeloma (Oral Presentation)

More...

Educational Book Manuscripts by J. D. Soumerai:

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