Author: lymphomaprogram

Located on the Upper East Side of New York City, the Lymphoma Program at Weill Cornell Medical College/NewYork Presbyterian Hospital is internationally recognized for our efforts to enable patients with non-Hodgkin lymphoma, Hodgkin disease and related disorders to have the best possible clinical outcome, including cure when possible.

ASCO2015: A phase I/II Trial of the Combination of Romidepsin and Lenalidomide in Patients with Relapsed/Refractory Lymphoma and Myeloma: Activity in T-cell Lymphoma.

Picture2By Dr. Jia Ruan 

Romidepsin, a histone deacetylase inhibitor, and lenalidomide, an immunomodulatory agent, have previously shown efficacy and a lack of cumulative toxicity in the treatment of patients with relapsed/refractory lymphoma and myeloma. Results from phase I of this trial were previously reported in ASCO 2014. The maximum tolerated dose in cycle 1 for romidepsin was 14 mg/m2 IV on days 1, 8, and 15, while lenalidomide was 25 mg oral on days 1-21 of a 28-day cycle. In this trial patients were treated to progression or intolerance.  Results of patients with t-cell lymphoma were reported at the 2015 ASCO meeting.

21 patients (10 CTCL, 11 PTCL) with a median age of 64 were enrolled in this trial. 15 of these patients were treated at the maximum tolerated dose. 19 of these patients were evaluable for efficacy with an overall response rate of 53%. For patients the median time of response was 7.3 weeks, median event free survival was 15.5 weeks, and median overall survival was not reached. 10 out of 21 patients remained on therapy with 7 discontinued for disease progression, 3 for toxicity, and 1 for stem cell transplant. Side effects were generally expected and manageable.

Results from this study confirm that the romidepsin and lenalidomide combination has significant activity in relapsed and refractory T-cell lymphoma. This study demonstrated that novel biologic agent and combinations can be effective and well-tolerated treatment options for patients with T-cell lymphoma, who may be poor candidates for intensive therapy or have chemotherapy-resistant disease.

New Clinical Trial: A Phase II Trial of PET-Directed Therapy for Limited Stage DLBCL

The Weill Cornell Lymphoma Program has recently opened a new clinical trial for men and women with Diffuse Large B-cell Lymphoma (DLBCL). The study sponsor is the Southwest Oncology Group, and the principal investigator at Weill Cornell is Peter Martin, M.D.. For more information about the study, please call Amelyn Rodgriguez, RN at (212) 746-1362 or e-mail Amelyn at amr2017@med.cornell.edu.

Key Eligibility

  • Men and women age 18 years and older
  • Patient must have biopsy proven diffuse large B-cell lymphoma
  • Patient cannot have received prior chemotherapy, radiation, or antibody therapy for lymphoma
  • Detailed eligibility reviewed when you contact the study team

Study Details 

This phase II trial studies how well PET-directed chemotherapy works in treating patients with limited-stage diffuse large B-cell lymphoma. Drugs used in chemotherapy, such as cyclophosphamide, doxorubicin hydrochloride, vincristine sulfate, and prednisone, work in different ways to stop cancer cells, either by killing the cells or by stopping them from dividing. Radiation therapy uses high-energy x-rays to kill cancer cells. Monoclonal antibodies, such as rituximab, can block cancer growth in different ways. Some block the ability of cancer cells to grow and spread. Others find cancer cells and help kill them or carry cancer-killing substances to them. Radiolabeled monoclonal antibodies, such as yttrium Y 90 ibritumomab tiuxetan, can find cancer cells and carry cancer-killing substances to them without harming normal cells. Comparing results of diagnostic procedures, such as PET scan and CT scan, done before, during, and after chemotherapy may help doctors predict a patient’s response to treatment and help plan the best treatment.

Primarily, this study will assess the 5 year progression- free survival (PFS) rate in patients with newly diagnosed limited-stage diffuse, large B-cell lymphoma (DLBCL) using positron emission tomography (PET)/CT scan to direct therapy after 3 courses of rituximab, cyclophosphamide, doxorubicin hydrochloride, vincristine sulfate, and prednisone (R-CHOP).

Patients will be stratified according to whether the patient was upstaged to advanced stage DLBCL, based on local review of the baseline PET/CT (yes vs no).

  • Chemotherapy: Patients receive R-CHOP comprising rituximab IV, cyclophosphamide IV over 30-60 minutes, vincristine sulfate IV, and doxorubicin hydrochloride IV on day 1, and prednisone orally on days 1-5. Treatment repeats every 21 days for 3* courses. NOTE: *Patients found to have advanced stage DLBCL based on local review of the baseline PET scan receive 6 courses of R-CHOP.
  • FDG/PET – Radiotherapy: Patients undergo fludeoxyglucose F 18 positron emission tomography (FDG-PET)/CT scan at baseline, on days 15-18 of course 3, and at 12 weeks after completion of course 3. Patients with complete response (PET scan negative) receive one additional course of R-CHOP as above. Patients with partial response (PET scan positive) undergo involved-field radiotherapy (IFRT) 5 days a week for approximately 4-5 weeks.
  • Monoclonal antibody: Beginning 3-6 weeks after completion of IFRT, patients receive yttrium Y 90 ibritumomab tiuxetan IV over 10 minutes and rituximab IV on day 1 and on day 7, 8, or 9.
  • Patients may undergo blood sample collection at baseline for correlative studies. Bone marrow tissue samples may be also collected for correlative studies.
  • After completion of study therapy, patients are followed up every 6 months for 2 years and then yearly for 5 years.

REDLAMP 5: Rituximab vs. Watch & Wait Approach in Patients with Advanced Follicular Lymphoma

Conventional therapy for patients with advanced stage, low tumor burden follicular lymphoma can include watchful waiting until the disease progresses. In this video Dr. Kelly Trevino explains the findings of a study in Lancet Oncology that assessed the difference in quality of life for patients who used rituximab to delay chemotherapy treatment and those patients who took the watchful wait approach.

Previous #REDLAMP entries can be viewed on our Youtube channel.

We encourage you to follow the Lymphoma Program on Twitter, Youtube, and Facebook where we will highlight new videos are about research publications as they are released. We also welcome your feedback, suggestions and questions about this project. If you have other questions about our lymphoma program or clinical trials or would like to see one of our lymphoma specialists, please contact us at 646-962-2074.