Remissions Shorter for Patients With R/R FL After Multiple Therapy Lines
It is uncommon for patients with relapsed/refractory (R/R) follicular lymphoma (FL) to achieve a complete response (CR) after ≥2 prior lines of therapy (LOT), according to a meta-analysis presented at the virtual 2021 American Society of Clinical Oncology (ASCO) Annual Meeting.
Patients with FL when treated with early lines of therapy have high response rates, according to Steve Kanters, PhD, President and Lead Analyst, RainCity Analytics, Vancouver, British Columbia, Canada, and colleagues. However, among patients with R/R FL after ≥2 prior LOT, remissions are shorter.
Thus, Dr Kanters et al sought to evaluate the clinical outcomes for R/R FL after ≥2 prior LOT using currently available treatment options.
On June 2, 2021, electronic databases were searched and found 12 studies between 2014 and 2020 focusing on systemic therapies in adults with R/R FL after ≥2 prior LOT, including anti-CD20 monoclonal antibodies and alkylating agents, either combined or not.
The estimated ORR for the ≥2 prior LOT group was 56% (95% CI, 47.2-64.5) and the number of patients with CR was 12.2% (95% CI, 8-17.3). The median OS was 54.4 months (95% CI, 45.8-76) and the median PFS was 10.3 months (95% CI, 9.3-11.1). The OS at 18 months was 71% (95% CI, 68-74) and the PFS at 18 months was 35% (95% CI, 33-38). The 24-month OS decreased from 66% in the ≥2 prior LOT group to 60% in the ≥3 prior LOT group. A similar trend was seen in PFS at 24 months (28% vs 24%).
In all, the study found that few R/R FL patients with ≥2 prior LOT were able to achieve CR.
“Despite some benefit, approximately 1/3 of patients die within 24 months. The shorter median PFS with increasing prior LOT suggest treatment durability is suboptimal in later LOT. These findings indicate that patients are underserved by current treatments, demonstrating a need for new treatments that can achieve high rates of response that are durable in this disease,” concluded Dr Kanters.—Emily Bader
