Low dose continuous lenalidomide in heavily pretreated patients with relapsed or refractory classical Hodgkin lymphoma: a retrospective case series.

Patients with relapsed or refractory (R/R) classical Hodgkin lymphoma (cHL) following autologous stem cell transplant (ASCT) remain a management challenge with few reliably effective treatments. Lenalidomide, an immunomodulatory drug approved for patients with myelodysplastic syndrome with del(5q), multiple myeloma, and mantle cell lymphoma, has demonstrated some activity in patients with R/R cHL, though the toxicity of traditional doses and schedules has been a barrier to consistent use. Low dose continuous (LDC) schedules have emerged as promising, with a more favorable safety profile. We report herein that LDC schedules are associated with a far more tolerable toxicity profile, and exhibit at least equivalent efficacy in this patient population. We report that patients diagnosed with R/R cHL who previously underwent, or were not candidates for, ASCT and/or clinical trials, were administered daily LDC lenalidomide (20 mg orally with dose reduction for toxicity). Among the 19 patients included in this analysis, 11% of patients achieved a partial response (PR), with no documented complete responses (CR). A total of 12 (63%) patients maintained stable disease (SD), with 7 patients (37%) remaining in SD for more than 6 months. The clinical benefit rate (comprised of CR, PR, and SD for greater than 6 months) was 47% (7 out of 19 patients). The median progression-free survival and overall survival of all patients were 9.4 months (range, 4.6-14.4 months) and 90 months (range, 63.6-166.8 months), respectively. In general, the treatment was well tolerated, with grade 3 or 4 adverse events consisting of neutropenia (

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© The Author(s), 2020.

Déclaration de conflit d'intérêts

Conflict of interest statement: HM and BC have nothing to report. FM received research funding from Seattle Genetics. JKL received research support and advisory board service from Kymera Therapeutics, research support from Denovo Biopharma, advisory board service from Astex Pharmaceuticals, and Speakers’ Bureau from AstraZeneca. CD received research funding from Bayer, Amgen, TG Therapeutics, Applied Therapeutics. EM received research support from Merck, Celgene, Spectrum, and has a scientific advisory role with Mundipharma, Verastem, Spectrum, Myeloid Therapeutics. OAO received research funding from Affimed, Agensys, Celgene, Merck, Seattle Genetics, Spectrum, TG Therapeutics, and Trillium; and has a scientific advisory role for Celgene (Data Safety Monitoring Committee), Mundipharma, and TG Therapeutics (Travel support only). AS received research support from Affimed and consultancy fees from Seattle Genetics, Gilead, and Daiichi Sanko.