Transcript
Hi, I'm Peter Martin. I'm the Chief of the Lymphoma Program at Weill Cornell Medical College in New York. It's my pleasure to be here today to review some of the studies that were presented at ASCO this year, specifically, a few studies that were related to follicular lymphoma.
Follicular lymphoma, as you all know, is a pretty common lymphoma. It's an interesting time in follicular lymphoma, because outcomes are now so good that it's becoming increasingly difficult to come up with treatments that are better than historically available treatments.
Nonetheless, we continue to see movement in that direction and attempts to move in that direction.
One such study that was presented this year was a phase 1 study combining obinutuzumab with venetoclax; venetoclax is the BCL-2 inhibitor.
Obvious rationale for using a BCL-2 inhibitor in follicular lymphoma, a disease with a 1418 translocation that results in constitutive expression of BCL-2. Historically, studies of venetoclax have not been all that impressive in follicular lymphoma, which is curious and interesting.
In this study, there was an attempt to combine venetoclax with obinutuzumab, 2 drugs that are relatively well-tolerated and make sense here.
This was a phase 1 study from the Swiss group SAKK. Essentially, they looked at standard dosing of obinutuzumab that everyone is familiar with at 2 different dose levels of venetoclax, 600 milligrams once a day and 800 milligrams once a day.
Long story short is that both dose levels were well-tolerated without any real unanticipated issues or toxicity profiles. There were obviously some cytopenias, as well as some GI issues and some infections, but no real huge issues that were sometimes seen combining venetoclax with chemotherapy.
Overall, it seemed to be relatively active. There was a decent overall response rate, and in fact, there were some complete responses that maybe we wouldn't necessarily expect to see with obinutuzumab. They did evaluate the responses in 2 different ways, one with PET/CT and one with CT. CT is a little bit more stringent in terms of complete responses based purely on size criteria, not metabolic activity, so it had a slightly lower complete response rate, and interestingly, CT-based CRs had a slightly higher progression-free survival.
So overall, the rate of progression-free survival with the regimen based on PET/CT was 68%. Based on CT, it was 74%, so pretty decent.
Is that necessarily better than obinutuzumab alone? I think it's hard to know. The fact that there are some CRs there may warrant taking the regimen further into a phase 2 trial.
