Application of the mantle international prognostic index (MIPI) to patients with mantle cell lymphoma treated with fludarabine/cyclophosphamide: Results from a UK NCRI Lymphoma Group study.

Author(s): S. Rule, P. Smith, W. Qian, J. Gambell, N. Curtis, P. Johnson, D. Linch; Derriford Hospital, Plymouth, United Kingdom; Cancer Research UK & UCL Cancer Trials Centre, London, United Kingdom; Southampton General Hospital, Southampton, United Kingdom; University College Hospital London, London, United Kingdom

Study investigators used data from a randomized phase II NCRI trial designed to assess the effect of adding rituximab to fludarabine and cyclophosphamide to validate the Mantle International Prognostic Index (MIPI)—a new prognostic index based on age, performance status, lactate dehydrogenase and leukocyte count for patients with advanced stage MCL. The study confirmed that the MIPI can be used to predict overall survival. However, the test does not discriminate for progression free survival.

Evaluation of the potential of histone deacetylase inhibitors to synergize the antineoplastic effects of the proteasome inhibitor bortezomib in mantle cell lymphoma (MCL).

Author(s): L. Paoluzzi, L. Scotto, V. E. Seshan, O. A. O'Connor; Columbia University , New York, NY; Columbia University, New York, NY

The study investigators examined how effective romidepsin and belinostat (alone and in combination with bortezomib) were at killing various MCL cell lines in the laboratory.  It was discovered that romidepsin, as a single agent, was approximately 100 times more potent than belinostat. The combination of belinostat or romidepsin with bortezomib showed synergism in all cell lines at different concentrations.

Safety analysis of radioimmunotherapy (RIT) in patients with relapsed or refractory low grade, follicular or transformed non-Hodgkin's lymphoma and mantle cell lymphoma based on age at time of therapy.

Author(s): E. Braun, D. Katz, P. Venugopal, M. Larson, J. Shammo, H. Fung, S. Gregory; Rush University Medical Center, Chicago, IL

Study investigators analyzed the safety of radioimmunotherapy (RIT) in patients with relapsed or refractory low grade, follicular or transformed non-Hodgkin lymphoma (NHL) and mantle cell lymphoma (MCL) based on age at time of therapy. Utilizing the Rush University Medical Center database, 61 subjects who received RIT between November 2003 and June 2008, either with iodine I 131 tositumomab (TOSI) or yttrium 90 ibritumomab tiuxetan (IBRI), were divided in 2 groups according to age at time of therapy. Group 1 included patients between 33 and 60 years of age and group 2 included patients 61 years old or older. There was no significant statistical difference between groups in terms of neutrophil, hemoglobin and platelet counts after therapy, indicating that RIT should be considered a safe therapeutic modality in patients with refractory or relapsed indolent, follicular, NHL, transformed and MCL regardless of age.

Durable responses with the antiangiogenic metronomic regimen RT-PEPC in elderly patients with recurrent mantle cell lymphoma (MCL).

Author(s): J. Ruan, P. Martin, M. Coleman, R. Furman, P. Glynn, M. Joyce, K. Cheung, T. Shore, M. Schuster, J. Leonard; Weill Cornell Medical College, New York, NY; Columbia University, New York, NY

Study investigators conducted a phase II study of RT-PEPC (rituximab and thalidomide combined with prednisone, etoposide, procarbazine and cyclophosphamide) in elderly patients with recurrent MCL. At a median follow-up of 30 months, the overall response rate of the 22 evaluable patients was 73 percent. The average length of progression free survival (PFS) was 12 months and the average length of overall survival (OS) was 22 months. Investigators concluded that RT-PEPC has significant and durable clinical activity in MCL with manageable toxicity. It was also determined that quality of life was maintained or improved for those receiving the treatment.

Efficacy and safety of lenalidomide oral monotherapy in patients with relapsed or refractory mantle-cell lymphoma: Results from an international study (NHL-003).

Author(s): C. B. Reeder, T. E. Witzig, P. L. Zinzani, J. M. Vose, R. Buckstein, C. Haioun, R. Bouabdallah, J. Polikoff, D. Pietronigro, M. S. Czuczman; Mayo Clinic Arizona, Scottsdale, AZ; Mayo Clinic, Rochester, MN; Institute of Hematology and Medical Oncology , Bologna, Italy; University of Nebraska, Omaha, NE; Toronto Sunnybrook , Toronto, ON, Canada; Henri Mondor Hospital, Créteil, France; Cancer Center Institute Paoli-Calmettes, Marseille, France; Kaiser Permanente Medical Group, Southern California, CA; Celgene Corporation, Summit, NJ; Roswell Park Cancer Institute, Buffalo, NY

Study investigators analyzed results of 54 MCL patients enrolled in an international phase II trial (NHL-003) examining the use of lenalidomide in patients with relapsed or refractory aggressive non-Hodgkin lymphoma (NHL). They study demonstrated that lenalidomide oral monotherapy is effective in the treatment of patients with relapsed or refractory MCL, with manageable side effects. See response rates listed in the table below: