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cc by-nc-nd (c) Dickinson, Michael et al, 2021
Si us plau utilitzeu sempre aquest identificador per citar o enllaçar aquest document: https://hdl.handle.net/2445/182755

Phase Ib study of BET inhibitor RO6870810 with venetoclax and rituximab in patients with diffuse large B-cell lymphoma

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Bromodomain and extraterminal (BET) proteins are transcriptional activators for multiple oncogenic processes in diffuse large B-cell lymphoma (DLBCL), including MYC, BCL2, E2F, and toll-like receptor signaling. We report results of a phase 1b dose-escalation study of the novel, subcutaneous BET inhibitor RO6870810 (RO) combined with the BCL-2 inhibitor venetoclax, and rituximab, in recurrent/refractory DLBCL. RO was delivered for 14 days of a 21-day cycle, whereas venetoclax was delivered continuously. A 3 + 3 escalation design was used to determine the safety of the RO+venetoclax doublet; rituximab was added in later cohorts. Thirty-nine patients were treated with a median of 2.8 cycles (range, 1-11). Dose-limiting toxicities included grade 3 febrile neutropenia, grade 4 diarrhea, and hypomagnesemia for the doublet; and grade 3 hyperbilirubinemia and grade 4 diarrhea when rituximab was added. The doublet maximum tolerated dose (MTD) was determined to be 0.65 mg/kg RO+600 mg venetoclax; for RO+venetoclax+rituximab, the MTDs were 0.45 mg/kg, 600 mg, and 375 mg/m2, respectively. The most frequent grade 3 and 4 adverse events were neutropenia (28%) and anemia and thrombocytopenia (23% each). Responses were seen in all cohorts and molecular subtypes. Sustained decreases in CD11b on monocytes indicated pharmacodynamic activity of RO. Overall response rate according to modified Lugano criteria was 38.5%; 48% of responses lasted for ≥180 days. Complete response was observed in 8 patients (20.5%). Optimization of the treatment schedule and a better understanding of predictors of response would be needed to support broader clinical use. This trial is registered on www.clinicaltrials.gov as NCT03255096.

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DICKINSON, Michael, BRIONES, Javier, HERRERA, Alex f., GONZÁLEZ BARCA, Eva, GHOSH, Nilanjan, CORDOBA, Raúl, RUTHERFORD, Sarah c., BOURNAZOU, Eirini, LABRIOLA TOMPKINS, Emily, FRANJKOVIC, Izolda, CHESNE, Evelyne, BROUWER-VISSER, Jurriaan, LECHNER, Katharina, BRENNAN, Barbara, NÜESCH, Eveline, DEMARIO, Mark, RÜTTINGER, Dominik, KORNACKER, Martin, HUTCHINGS, Martin. Phase Ib study of BET inhibitor RO6870810 with venetoclax and rituximab in patients with diffuse large B-cell lymphoma. _Blood Advances_. 2021. Vol. 5, núm. 22, pàgs. 4762-4770. [consulta: 14 de gener de 2026]. ISSN: 2473-9537. [Disponible a: https://hdl.handle.net/2445/182755]

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