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ICML 2025 | Durvalumab plus lenalidomide versus single-agent durvalumab for refractory/advanced CTCL
Christiane Querfeld, MD, PhD, City of Hope, Duarte, CA, shares insights into a Phase II trial (NCT03011814) exploring durvalumab plus lenalidomide versus single-agent durvalumab for refractory/advanced cutaneous T-cell lymphoma (CTCL). Dr Querfeld highlights that the combination arm shows superior response rates and predictable toxicities. This interview took place during the 18th International Conference on Malignant Lymphoma (18-ICML) in Lugano, Switzerland.
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Transcript
I’m happy to. Just as a background, so the study is in cutaneous T-cell lymphoma, which is in advanced stages a devastating, disfiguring disease. Patients have lots of symptoms and then the current standard treatment options only achieve about 30 to 40 percent response rates, which usually are short in duration. So we designed a study that compares single-agent durvalumab to the combination durvalumab plus lenalidomide...
I’m happy to. Just as a background, so the study is in cutaneous T-cell lymphoma, which is in advanced stages a devastating, disfiguring disease. Patients have lots of symptoms and then the current standard treatment options only achieve about 30 to 40 percent response rates, which usually are short in duration. So we designed a study that compares single-agent durvalumab to the combination durvalumab plus lenalidomide. And what I’m presenting is actually very exciting data that the combination is superior to the single agent. Disease-free survival or progression-free survival has not been reached in the combination. We have response rates that are 75% in the combination arm compared to a single agent arm which is around 40% and responses are ongoing. So I think what we see is actually that durvalumab plus lenalidomide has a two-pronged effect not only targeting the tumor cells but also the tumor microenvironment. So what we see actually because we analyze the microenvironment besides the clinical responses because all the lesions go away, we see that you’re enhancing really an immune response in T-cells particularly in the CD8 positive tumor-infiltrating cells while we are decreasing really immunosuppressive cells particularly the tumor-associated macrophages and doing this sophisticated computational analysis on cell-cell interactions, we also see that the interactions decrease between the tumor cells and those immunosuppressive cells, which is very exciting. So the toxicities or the adverse events are very actually predictable, and this has been reported in durvalumab, which is mainly thyroid issues, and skin flares, which we think it’s contributed to both durvalumab plus lenalidomide. I think otherwise well tolerated, the infusion is once a month and you give lenalidomide basically three weeks out of four weeks daily.
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