Romidepsin and lenalidomide-based regimens have efficacy in relapsed/refractory lymphoma: Combined analysis of two phase I studies with expansion cohorts Journal Article


Authors: Mehta-Shah, N.; Lunning, M. A.; Moskowitz, A. J.; Boruchov, A. M.; Ruan, J.; Lynch, P.; Hamlin, P. A.; Leonard, J.; Matasar, M. J.; Myskowski, P. L.; Marzouk, E.; Nair, S.; Sholklapper, T.; Minnal, V.; Palomba, M. L.; Vredenburgh, J.; Kumar, A.; Noy, A.; Straus, D. J.; Zelenetz, A. D.; Schoder, H.; Rademaker, J.; Schaffer, W.; Galasso, N.; Ganesan, N.; Horwitz, S. M.
Article Title: Romidepsin and lenalidomide-based regimens have efficacy in relapsed/refractory lymphoma: Combined analysis of two phase I studies with expansion cohorts
Abstract: Romidepsin (histone deacetylase inhibitor), lenalidomide (immunomodulatory agent), and carfilzomib (proteasome inhibitor), have efficacy and lack cumulative toxicity in relapsed/refractory lymphoma. We performed two investigator initiated sequential phase I studies to evaluate the maximum tolerated dose (MTD) of romidepsin and lenalidomide (regimen A) and romidepsin, lenalidomide, and carfilzomib (regimen B) in relapsed/refractory lymphoma. Cohorts in T-cell lymphoma (TCL), B-cell lymphoma (BCL) were enrolled at the MTD. Forty-nine patients were treated in study A (27 TCL, 17 BCL, 5 Hodgkin lymphoma (HL)) and 27 (16 TCL, 11 BCL) in study B. The MTD of regimen A was romidepsin 14 mg/m2 IV on days 1, 8, and 15 and lenalidomide 25 mg oral on days 1–21 of a 28-day cycle. The MTD of regimen B was romidepsin 8 mg/m2 on days 1 and 8, lenalidomide 10 mg oral on days 1–14 and carfilzomib 36 mg/m2 IV on days 1 and 8 of a 21-day cycle. In study A, 94% had AEs ≥Grade 3, most commonly neutropenia (49%), thrombocytopenia (53%), and electrolyte abnormalities (49%). In study B 59% had AEs ≥Grade 3, including thrombocytopenia (30%) and neutropenia (26%). In study A the ORR was 49% (50% TCL, 47% BCL, 50% HL). In study B the ORR was 48% (50% TCL, 50% BCL). For study A and B the median progression free survival (PFS) was 5.7 months and 3.4 months respectively with 11 patients proceeding to allogeneic transplant. The combinations of romidepsin and lenalidomide and of romidepsin, lenalidomide and carfilzomib showed activity in relapsed/refractory lymphoma with an acceptable safety profile. © 2021 Wiley Periodicals LLC.
Journal Title: American Journal of Hematology
Volume: 96
Issue: 10
ISSN: 0361-8609
Publisher: John Wiley & Sons, Inc.  
Date Published: 2021-10-01
Start Page: 1211
End Page: 1222
Language: English
DOI: 10.1002/ajh.26288
PUBMED: 34251048
PROVIDER: scopus
PMCID: PMC8811706
DOI/URL:
Notes: Article -- Export Date: 1 October 2021 -- Source: Scopus
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MSK Authors
  1. Ariela Noy
    351 Noy
  2. Maria Lia Palomba
    415 Palomba
  3. Matthew Alexander Lunning
    31 Lunning
  4. Steven M Horwitz
    644 Horwitz
  5. Heiko Schoder
    542 Schoder
  6. Andrew D Zelenetz
    767 Zelenetz
  7. Alison Moskowitz
    339 Moskowitz
  8. Paul Hamlin
    276 Hamlin
  9. Matthew J Matasar
    289 Matasar
  10. Peggy Lynch
    5 Lynch
  11. David J Straus
    356 Straus
  12. Patricia Myskowski
    216 Myskowski
  13. Anita Kumar
    180 Kumar
  14. Sumithra Suresh Nair
    3 Nair
  15. Neha Mehta Shah
    23 Shah
  16. Natasha   Galasso
    40 Galasso
  17. Nivetha Ganesan
    48 Ganesan
  18. Veenna Minnal
    2 Minnal