Single-center phase 1-2 trial of lenalidomide plus obinutuzumab for relapsed or refractory indolent B cell non-Hodgkin lymphoma

Rituximab and lenalidomide is a preferred option for relapsed or refractory (R/R) indolent B cell non-Hodgkin lymphoma. A phase 1-2 trial at MD Anderson Cancer Center (Houston, TX) evaluated the combination of obinutuzumab and lenalidomide for R/R grade 1-3A follicular lymphoma, marginal zone lymphoma or small lymphocytic lymphoma. Grade 3 or 4 hematologic toxicities included neutropenia (21% of patients) and thrombocytopenia (11%), while grade 3 or 4 non-hematologic toxicities included lung infection (8%), fatigue (8%), and rash (6%). Overall response at six months was seen in 90% (95% CI 79-96) with complete response in 33% (22-47). At 41.7 months median follow-up, median progression-free survival, time to progression, and overall survival have not been reached. The authors conclude that the combination of lenalidomide with obinutuzumab is safe and highly active in patients with R/R indolent B cell non-Hodgkin lymphoma.