Article ; Online: Venetoclax plus R- or G-CHOP in non-Hodgkin lymphoma: results from the CAVALLI phase 1b trial.
2019 Volume 133, Issue 18, Page(s) 1964–1976
Abstract: ... with rituximab or obinutuzumab and cyclophosphamide, doxorubicin, vincristine, and prednisone (R-/G-CHOP ... to 800 mg. A further reduction to 5 days per cycle occurred at the 800-mg dose level in the G-CHOP arm ... in the G-CHOP arm; however, safety was manageable. Overall response rates were 87.5% (R-CHOP and G-CHOP ...
Abstract | Novel strategies, such as chemosensitization with targeted agents, that build on the success of standard immunochemotherapy show promise for the treatment of non-Hodgkin lymphoma (NHL). Here, we report a phase 1b study investigating dose escalation of the BCL2 inhibitor, venetoclax, in combination with rituximab or obinutuzumab and cyclophosphamide, doxorubicin, vincristine, and prednisone (R-/G-CHOP) chemotherapy in B-cell NHL. Objectives included safety assessment and determination of a recommended phase 2 dose (RP2D). Fifty-six patients were enrolled, most with follicular lymphoma (43%) or diffuse large B-cell lymphoma (DLBCL; 32%). Dose-limiting toxicities were reported in 3/14 patients at the first venetoclax dose (200 mg/d), after which dosing was changed from daily to 10 days per cycle and escalated to 800 mg. A further reduction to 5 days per cycle occurred at the 800-mg dose level in the G-CHOP arm. Cytopenias were predominant among grade 3/4 events and reported at a higher rate than expected, particularly in the G-CHOP arm; however, safety was manageable. Overall response rates were 87.5% (R-CHOP and G-CHOP combinations); complete response (CR) rates were 79.2% and 78.1%, respectively. Most double-expressor (BCL2 |
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MeSH term(s) | Aged ; Antibodies, Monoclonal, Humanized/therapeutic use ; Antineoplastic Combined Chemotherapy Protocols/therapeutic use ; Bridged Bicyclo Compounds, Heterocyclic/therapeutic use ; Cyclophosphamide/therapeutic use ; Disease-Free Survival ; Doxorubicin/therapeutic use ; Female ; Humans ; Lymphoma, Non-Hodgkin/drug therapy ; Lymphoma, Non-Hodgkin/mortality ; Male ; Maximum Tolerated Dose ; Middle Aged ; Prednisone/therapeutic use ; Rituximab/therapeutic use ; Sulfonamides/therapeutic use ; Vincristine/therapeutic use |
Chemical Substances | Antibodies, Monoclonal, Humanized ; Bridged Bicyclo Compounds, Heterocyclic ; R-CHOP protocol ; Sulfonamides ; Rituximab (4F4X42SYQ6) ; Vincristine (5J49Q6B70F) ; Doxorubicin (80168379AG) ; Cyclophosphamide (8N3DW7272P) ; venetoclax (N54AIC43PW) ; obinutuzumab (O43472U9X8) ; Prednisone (VB0R961HZT) |
Language | English |
Publishing date | 2019-03-08 |
Publishing country | United States |
Document type | Clinical Trial, Phase I ; Clinical Trial, Phase II ; Journal Article ; Multicenter Study ; Research Support, Non-U.S. Gov't |
ZDB-ID | 80069-7 |
ISSN | 1528-0020 ; 0006-4971 |
ISSN (online) | 1528-0020 |
ISSN | 0006-4971 |
DOI | 10.1182/blood-2018-11-880526 |
Database | MEDical Literature Analysis and Retrieval System OnLINE |
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