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Bühler, A.; Wendtner, C.-M.; Kipps, T. J.; Rassenti, L.; Fraser, G. A. M.; Michallet, A.-S.; Hillmen, P.; Duerig, J.; Gregory, S. A.; Kalaycio, M.; Aurran-Schleinitz, T.; Trentin, L.; Gribben, J. G.; Chanan-Khan, A.; Purse, B.; Zhang, J.; Bedout, S. de; Mei, J.; Hallek, M.; Stilgenbauer, S. (2016): Lenalidomide treatment and prognostic markers in relapsed or refractory chronic lymphocytic leukemia: data from the prospective, multicenter phase-II CLL-009 trial. In: Blood Cancer Journal, Vol. 6, e404
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Abstract

Efficacy of lenalidomide was investigated in 103 patients with relapsed/refractory chronic lymphocytic leukemia (CLL) treated on the prospective, multicenter randomized phase-II CLL-009 trial. Interphase cytogenetic and mutational analyses identified TP53 mutations, unmutated IGHV, or del(17p) in 36/96 (37.5%), 68/88 (77.3%) or 22/92 (23.9%) patients. The overall response rate (ORR) was 40.4% (42/104). ORRs were similar irrespective of TP53 mutation (36.1% (13/36) vs 43.3% (26/60) for patients with vs without mutation) or IGHV mutation status (45.0% (9/20) vs 39.1% (27/68));however, patients with del(17p) had lower ORRs than those without del(17p) (21.7% (5/22) vs 47.1% (33/70);P = 0.049). No significant differences in progression-free survival and overall survival (OS) were observed when comparing subgroups defined by the presence or absence of high-risk genetic characteristics. In multivariate analyses, only multiple prior therapies (>= 3 lines) significantly impacted outcomes (median OS: 21.2 months vs not reached;P = 0.019). This analysis indicates that lenalidomide is active in patients with relapsed/refractory CLL with unfavorable genetic profiles, including TP53 inactivation or unmutated IGHV.