Real-World Efficacy and Safety of Rituximab, Lenalidomide and İbrutinib Combination in Patients with Relapsed and/or Refractory Non-Hodgkin Lymphoma

Abstract Background Relapsed or refractory (R/R) Non-Hodgkin Lymphoma (NHL) is associated with poor outcomes and the therapic options are limited. Recently, rituximab, lenalidomide, and ibrutinib (RLI) suggest promising efficacy in some clinical studies. Consequently, we evaluated the RLI in a real-life setting. Methods This retrospective, single-center study analyzed the outcomes of RLI as an off label salvage theraphy in patients with R/R NHL from June 2020-April 2022. Results We analyzed twenty-one patients including diffuse large B-cell lymphoma (DLBCL) (n = 16), primary central nervous system lymphoma (PCNSL) (n = 2), mantle cell lymphoma (MCL) (n = 2), marginal zone lymphoma (MZL) (n = 1). The most common adverse events (AEs) were fatigue (48%), neutropenia (48%), infection (33%). The median TTR (time to response) was 2 months (range, 1.7–3.8). The ORR (overall response rate) was 38% (95% CI 15%-61%) with 29% CR (complete response) and 9% PR (partial response). The median DoR (duration of response) was 12.8 months (range, 4.4–19.5+). The median OS (overall survival) was 7.9 months (95% CI 2.2–13.5) and median PFS (progression free survival) was 3.5 months (95% CI 0.0-8.3). Conclusions Our results suggest that RLI is a viable therapeutic option with promising activity and favorable toxicity profile in patients with R/R NHL.