New Treatment Combination Poses Potential Way to Combat Chemo-Resistant DLBCL

Each year, roughly 20,000 Americans are diagnosed with diffuse large B-cell lymphoma (DLBCL), an aggressive cancer of abnormal B-cells. Most people with DLBCL are cured with the standard chemotherapy regimen rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP), but 30-40 percent of cases are resistant to chemotherapy for reasons that may be related to the way that genes are regulated within the cancer cells.

Prior WCM laboratory research demonstrated that certain genes within chemotherapy-resistant DLBCL cells are often inappropriately turned off and that long-term exposure to low doses of oral hypomethylating agent azacitidine (also known as CC-486) can turn those genes back on, thereby re-sensitizing the cells to chemotherapy.

Lymphoma Program chief Dr. Peter Martin, Dr. Leandro Cerchietti, Dr. John P. Leonard, Dr. Maria Revuelta and Dr. ldefonso Ismael Rodriguez-Rivera, and colleagues from around the country, set out to test a novel therapeutic alternative for these chemo-resistant cases with a phase I, open-label, multicenter trial of oral azacitidine plus R-CHOP in people with high-risk, previously untreated DLBCL, grade 3B follicular lymphoma (FL), or transformed lymphoma. The trial was conducted in collaboration with Alliance Foundation Trials (AFT), a research organization that develops cancer clinical trials with pharmaceutical companies, scientific investigators and the Alliance for Clinical Trials in Oncology (ACTO) institutional member network.

Patients in the trial received CC-486 for seven days prior to R-CHOP initiation, then for 14 days prior to each of five following R-CHOP cycles. The research team found that the combination of CC-486 plus R-CHOP was safe and well tolerated, and that it produced a higher-than-anticipated complete response (CR) rate, or disappearance of signs of cancer, exceeding 85 percent. Dr. Cerchietti’s lab also identified key changes in genes and gene expression consistent with the anticipated CC-486 effect. Dr. Martin presented the team’s findings at the American Society of Hematology Annual Meeting and Exposition on December 9, 2017, in Atlanta, GA.

Weill Cornell Medicine

“We are at an exciting moment in time: CC-486 is emerging simultaneously with a peak in collaborative efforts between scientists, physicians and patients,” said Dr. Martin. “We are working day and night to move this concept forward, including the possible opening of randomized trials.”

Dr. John Leonard Awarded for Outstanding Patient Care

IMG_6169The Lymphoma Program’s Dr. John Leonard was granted the prestigious 2017 Miriam G. Wallach Award for Excellence in Humanistic Medical Care at Weill Cornell Medicine and NewYork-Presbyterian Hospital’s Physician of the Year event, as presented by the Department of Nursing. The award honors a physician who exemplifies altruistic and humanistic qualities and displays exceptional dedication to providing outstanding, compassionate patient-centered care.

Dr. Cam Patterson, Senior Vice President and Chief Operating Officer for NewYork-Presbyterian Hospital/Weill Cornell Medicine, helped to introduce Dr. Leonard and present the award. He noted that Dr. Leonard is widely acknowledged by his colleagues both locally and nationally for his stature in the field of lymphoma research and care, especially known for his astuteness in taking on challenging cases, such as treating pregnant women with lymphoma. He is also regarded as a great partner to his nursing colleagues.

“Receiving an award that is reflective of the feelings of the nursing staff is about as good as it gets,” said Dr. Leonard.

In his acceptance remarks, Dr. Leonard described interactions with his patients staying in the hospital the previous evening. Throughout the course of his visits, conversation topics spanned serious, difficult discussions, as well as some of a more lighthearted nature, including doubles tennis and the New York Yankees.

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Dr. Leonard explained that making his rounds took only a few minutes, but it was the most fun part of his day, and it made a difference to his patients. He noted that small interactions, such as sitting down to talk and certain intricacies in the way that we connect with one another, have the potential to make a huge difference in our relationships.

“These things that you do on a daily basis and don’t even think of affect patients, colleagues and trainees,” said Dr. Leonard. “If we understand that and deliberately carry it through [to practice], we can make an even greater difference for our patients.”

Dr. John Leonard Discusses Results from the GALLIUM Trial for Patients with Previously Untreated Follicular Lymphoma

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Click on the graphic above to watch this interview from the 2016 annual meeting of the American Society of Hematology, Lymphoma Program Director, Dr. John Leonard discusses results from the recently completed GALLIUM trial. In this trial researchers compared the safety and efficacy of either rituximab or obinutuzumab with chemotherapy followed by maintenance with the same agent as first-line therapy for patients with previously untreated follicular lymphoma.