High survival rates following atezolizumab consolidation in DLBCL

Participants with high-risk diffuse large B-cell lymphoma (DLBCL) and a complete metabolic response (CMR) after R-CHOP benefitted from atezolizumab consolidation therapy. The final analysis of the HOVON 151 study showed improved disease-free survival (DFS) and overall survival.

“The 5-year progression-free survival (PFS) rate for patients with high-risk DLBCL is around 60%,” opened Dr Marcel Nijland (University Medical Center Groningen, the Netherlands) [1]. He shared that the incidence of relapse is around 25% for high-risk patients in clinical remission after R-CHOP and that lenalidomide maintenance and polatuzumab vedotin added to R-CHOP improve PFS but not overall survival [2,3].

The phase 2 HOVON 151 study (NL6335204217) investigated the efficacy of consolidation therapy with the PD-L1 inhibitor atezolizumab in participants with high-risk DLBCL who had a CMR after R-CHOP therapy (n=109). The participants received 1,200 mg of atezolizumab, intravenously administered every 3 weeks, for up to 18 cycles. The primary endpoint was DFS and Dr Nijland presented the study's final analysis [1].

The 2-year DFS rate was 87.9% (90% CI 81.5–92.1), meeting the primary endpoint (see Figure) and surpassing the 2-year DFS rate from a historical cohort (≤79%) [4]. Moreover, the 2-year overall survival rate was 96.3% [1]. Dr Nijland added that 13 of the 15 relapsing participants received salvage chemotherapy, of whom 77% experienced a second CMR.

Figure: Kaplan-Meier curve of disease-free survival in HOVON 151 [1]



Adverse events were reported in 79% of the participants, most commonly being infections (25%), musculoskeletal and connective tissue disorders (9%), and nervous system disorders (9%). The research team noted 10 cases of endocrinopathy and 3 ocular toxicities during the study.

Atezolizumab consolidation therapy after R-CHOP yielded excellent results in participants with high-risk DLBCL who achieved a CMR on R-CHOP. The remarkable 2-year overall survival outcomes and the fact that most participants were chemo-sensitive at relapse support atezolizumab as a consolidation therapy for this population.

1. Nijland M, et al. Feasibility and clinical efficacy of atezolizumab consolidation in high risk diffuse large B-cell lymphoma: final analysis of the HOVON 151. S236, EHA congress 2024, 13–16 June, Madrid, Spain.
2. Thieblemont C, et al. J Clin Oncol. 2017;35(22):2473–2481.
3. Tilly H, et al. N Engl J Med. 2022;386(4):351–363.
4. El-Galaly TC, et al. J Clin Oncol. 2015;33(34):3993–3998.

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Posted on 12 August 20245 September 2024