Diffuse Large B-Cell Lymphoma
EHA 2016. LB705. PILLAR-2: A randomized, double-blind, placebo-controlled, phase III study of adjuvant everolimus (EVE) in patients (pts) with poor-risk diffuse large B-cell lymphoma (DLBCL).
Franco Cavalli et al.
Conclusion: Adjuvant EVE for 1 year did not improve DFS in poor-risk pts with DLBCL who achieved a CR after R-chemo. Trends favoring adjuvant EVE for DFS and OS in selected pt subgroups and for LSS in the overall population suggest that EVE may provide anti-lymphoma activity in poor-risk DLBCL that warrants further investigation. Clinical trial information: NCT00790036
CARE Faculty Perspective: This was another fairly large RCT with no significant advantage for a maintenance strategy in DLBCL. However, it appears that everolimus provided some benefit in terms of OS and lymphoma-specific survival (LSS) in two patient subgroups: males & those with IPI 4+5. We can expect further investigation with everolimus in these patient groups further to determine whether it could positively affect their life span for high-risk DLBCL. In the future, we may see studies with different populations, different therapies, and perhaps no more maintenance trials.