Multicenter phase 2 trial of lenalidomide in combination with R-ESHAP in patients with relapsed or refractory diffuse large B-cell lymphoma

Patients with relapsed or refractory diffuse large B-cell lymphoma (R/R DLBCL) have poor outcomes with current salvage regimens. A multicenter phase 2 trial in Spain evaluated the combination of lenalidomide with R-ESHAP (rituximab, etoposide, solu-medrol., high-dose cytarabine, and cisplatin) for R/R DLBCL. The ORR after three cycles was 67%, with complete remission in 35%. Patients with response underwent autoSCT. At median follow-up of 41 months, the estimated 3-year PFS and OS were 42% and 48%, respectively. The most common grade 3 or 4 adverse events werd thrombocytopenia (70% of patients), neutropenia (67%), and anemia (35%). The authors conclude that among patients with R/R DLBCL, lenalidomide in combination with R-ESHAP is a feasible salvage regimen with promising efficacy.