Recent trial results suggest that adding obinutuzumab to standard salvage chemotherapy appeared to be well tolerated in patients with Burkitt lymphoma. This is according to findings presented at the 2022 American Society of Pediatric Hematology/Oncology Conference by Max Cohen, DO, of New York Medical College, in Valhalla, NY, and colleagues.
The study investigators explained in their report that relapsed/refractory B-cell non-Hodgkin lymphomas, such as diffuse large B-cell lymphoma and Burkitt lymphoma, are linked to a high level of resistance to chemotherapy, which contributes to poor outcomes. Obinutuzumab is a CD20-directed monoclonal antibody that the investigators sought to evaluate as an addition to a chemotherapy regimen in these patients.
The results are from an analysis of a phase 2 trial (ClinicalTrials.gov Identifier: NCT02393157), of patients with relapsed/refractory CD20-positive mature B-cell non-Hodgkin lymphoma and an eligible patient age range of 3 to 31 years. Patients in this study were given 4 doses of obinutuzumab initially, followed by 2 cycles of chemoimmunotherapy, consisting of obinutuzumab with ifosfamide, carboplatin, and etoposide (ICE).
Patients who had achieved a partial response (PR) or complete response (CR) following the first cycle of therapy could then undergo hematopoietic stem cell transplantation (HSCT). In the absence of progressive disease, patients could proceed with cycle 2 of therapy, and patients could receive a third cycle if needed.
At the time of the report, 6 patients had been enrolled with Burkitt lymphoma. Their ages range from 7 to 20 years. One patient had central nervous system-positive disease, and 1 patient was in second relapse.
Patients received a median of 2 cycles of therapy (range, 1-3). The overall response rate was 83.3%. This included 4 patients achieving PR and 1 patient achieving CR. A mixed response was seen in 1 patient, and this patient experienced disease progression and died prior to being eligible for HSCT. The other 5 patients underwent HSCT, with 3 of them (who reached PR) dying due to disease complications afterward.
Of the participants, 2 of the patients are alive after HSCT; 1of these patients had achieved PR, and 1 had achieved CR. These patients continue to be free of disease at 4 or 5 years following therapy. Adverse events considered related to obinutuzumab or ICE have not been reported.
In this analysis, the study investigators considered the combination of obinutuzumab with ICE chemotherapy to be well tolerated in the 6 evaluated patients. They noted that there were no grade 3 or higher adverse events, and 5 patients were able to undergo HSCT. The trial continues to recruit patients.
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Cohen M, Hochberg J, Barth M, et al. Phase II trial of obinutuzumab and ICE chemotherapy in relapsed mature B-cell non-Hodgkin lymphoma. Presented at: 2022 American Society of Pediatric Hematology/Oncology (ASPHO) Conference; May 4-7, 2022. Abstract 219.