The addition of CD20 monoclonal antibodies to lenalidomide improves response rates and survival in relapsed/refractory patients with chronic lymphocytic leukaemia relative to lenalidomide monotherapy - the MD Anderson Cancer Center experience

We analysed 137 R/R patients treated on sequential lenalidomide-based protocols at MD Anderson Cancer Center from 2005 to 2011 (Ferrajoli et al, 2008, 2012; Badoux et al, 2013): 44 patients received lenalidomide monotherapy, commencing at 10 mg/d and escalating by 5 mg each month to a maximum of 25 mg; 59 received rituximab 375 mg/m2 weekly for four doses commencing on day 1, then monthly from months 2 to 12 and lenalidomide 10 mg/d commencing on day 9. Thirtyfour patients received ofatumumab weekly for four doses (first dose 300 mg, subsequent doses 1000 mg), then monthly (months 2–6), then every other month from month 7 to 24 and lenalidomide 10 mg/d daily, commencing on day 9. In all the studies lenalidomide was given daily, continuously, until progression or excessive toxicity. The relative benefit and toxicityof adding a CD20 mAb and response rates, time-to-treatment failure (TTF) and overall survival (OS) according to baseline characteristics were assessed.