Combination treatment boosts lasting remission in B-cell Lymphoma

Before treatment with ViPOR, full-body and cross-sectional PET scans of a patient show large lymphoma tumors (circled in the top two panels). Following treatment, the tumors have disappeared (bottom two panels) Image credit – Center for Cancer Research/National Cancer Institute

CANCER DIGEST – June 23, 2024 – A non-chemotherapy regimen has achieved a significant improvement in long-term remissions in people with certain types of treatment-resistant aggressive B-cell lymphomas, according to researchers at the National Cancer Institute. The findings were published June 20, 2024, in the New England Journal of Medicine.

Lymphoma is a group of cancers of the lymph system identified by the types of lymph cells affected. The patients in this trial had diffuse large B-cell lymphoma, the most common form of non-Hodgkin's lymphoma, that tends to start in the lymph nodes in the upper body, chest, armpits and neck.

“Many of these patients who stopped responding to standard treatments would have otherwise died within a year,” said Christopher J. Melani, M.D., of NCI’s Center for Cancer Research, who co-led the study, "and now we have a good proportion who are still alive past two years, and some past four years. It’s gratifying to see these long-term remissions and potential cures in patients.”

In the trial the researchers used a cocktail of non-chemotherapy drugs called ViPOR, which includes ventoclax, ibrutinib, obinutuzumab, lenalidomide, and prednisone, in 50 patients with the most common form of lymphoma who had stopped responding to, or did not respond to standard therapy.

The ViPOR combination substantially shrank tumors in 26 of 48 (54%) of the patients who could be evaluated. In 18 of those 26 patients (38%) the tumors disappeared, called a complete response. After two years of follow-up 36 percent of all patients were surviving and 34 percent survived without cancer.

Side effects of the regimen were described as mild to moderate with only five patients stopping treatment due to side effects.

The researchers are looking to see if other drugs might be added to the mix to improve effectiveness, and in the meantime are readying a larger clinical trial to further test the regimen at multiple cancer treatment centers.

Source: National Institutes of Health press release