Dr Amengual on the Efficacy of Tazemetostat Plus Lenalidomide/Rituximab in Follicular Lymphoma

"I was encouraged by the real-world data [regarding] the use of glofitamab for DLBCL in the relapsed setting. There was a slight reduction in overall response rate and overall survival [compared with clinical trial populations,] but [these outcomes] still closely mirrored what we see in the clinical trials for those who are less sick and receiving glofitamab in earlier lines of treatment"

Jennifer Amengual, MD, Herbert Irving Assistant Professor of Medicine, Division of Hematology and Oncology, Herbert Irving Comprehensive Cancer Center, Columbia University Irving Medical Center, discusses the efficacy of tazemetostat (Tazverik) vs placebo in combination with lenalidomide (Revlimid) and rituximab (Rituxan) for patients with relapsed/refractory follicular lymphoma (FL), according to data from the phase 3 SYMPHONY-1 study (NCT04224493).

In this dose-finding study, patients received rituximab for the first 5 cycles, lenalidomide for the first 12 cycles, and continuous tazemetostat, Amengual begins. The regimen demonstrated no unexpected toxicities, and response rates were notable across molecular subgroups, she states.

The overall response rate (ORR) was 90.9% across the intention-to-treat population (n = 44), including 88.9% in EZH2 wild-type disease, despite prior assumptions that tazemetostat would have enhanced activity in EZH2-mutated tumors, Amengual reports. Among patients refractory to rituximab, the ORR was 93.3%, and those with POD24 follicular lymphoma—historically associated with poor outcomes—had an ORR of 92%, she notes. At a median follow-up of 22.5 months, median progression-free survival and duration of response were not reached, Amengual adds.

These findings were contextualized alongside data from the phase 2 TRANSCEND FL study (NCT04245839) evaluating lisocabtagene maraleucel (liso-cel; Breyanzi) in relapsed/refractory follicular lymphoma, Amengual continues. Liso-cel demonstrated an ORR of 96%, all of which were complete responses, she details. Notably, the CAR T-cell therapy cohort included younger patients, whereas SYMPHONY-1 enrolled an older population, she says.

The results underscore the expanding treatment landscape for follicular lymphoma, highlighting the potential for durable responses with an effective, predominantly oral regimen, as an alternative to intensive cellular therapies, Amengual concludes.