Temsirolimus with BERT for the treatment of relapsed mantle cell and follicular lymphoma

Georg Hess, MD, from the Johannes Gutenberg University, Mainz, Germany, discusses the final results of a Phase I/II trial of temsirolimus in combination with the established chemotherapy bendamustine and rituximab (BERT) in patients with relapsed follicular lymphoma (FL) and mantle cell lymphoma (MCL) at the American Society of Hematology (ASH) Congress 2016 in San Diego, CA. He explains that temsirolimus has been established as a single agent in mantle cell lymphoma, however the duration of response is short when it is used as a single agent. Therefore, its combination with a chemotherapy was investigated in a Phase I/II trial (NCT01078142) to firstly establish the dosing, either 25, 50 or 75 mg, given three times in a four-week cycle. Results showed that 50 mg temsirolimus could safely be combined with BERT on days 1, 8 and 15 of a standard 28-day regimen. The Phase II trial further assessed this dosage, and a response rate of around 85% was demonstrated in patients with both mantle cell and follicular lymphoma. More importantly, long-lasting responses were seen, with a median progression-free survival (PFS) of around 18 months and overall survival (OS) of around 3 years. However, he points out that the scope of mantle cell lymphoma has changed with the use of ibrutinib to treat the disease, and that the current clinical trial has not included patients who were previously treated with ibrutinib.

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