Tazemetostat for relapsed/refractory B-cell non-Hodgkin lymphoma with EZH2 mutation in Japan: 3-year follow-up for a phase II study

Int J Hematol. 2024 Nov;120(5):621-630. doi: 10.1007/s12185-024-03834-9. Epub 2024 Aug 23.

Abstract

Previously, we reported the efficacy and safety of tazemetostat in Japanese patients with relapsed/refractory follicular lymphoma (FL) and diffuse large B-cell lymphoma (DLBCL) harboring the EZH2 mutation in a multicenter, open-label, phase II study. Here, we present a follow-up analysis of tazemetostat at a long-term median follow-up of 35.0 months. Twenty patients were enrolled: 17 in the FL cohort and three in the DLBCL cohort. In the FL cohort, the objective response rate was 70.6%, consistent with the primary analysis, and the median progression-free survival (PFS) was not reached. The 24-month and 36-month PFS rates were 72.1% (95% confidence interval [CI] 41.5%-88.6%) and 64.1% (95% CI 33.7%-83.4%), respectively. The median duration of treatment was 30.2 months. After the primary analysis at a median follow-up of 12.9 months, grade 1-2 urinary tract infection, peripheral motor neuropathy, and hypogammaglobulinemia newly emerged, but the incidence of adverse events (AEs) did not increase notably during this follow-up period. No unexpected grade ≥ 3 treatment-related AEs were reported. Long-term oral monotherapy with tazemetostat showed favorable efficacy and safety profiles, indicating that it may be a useful third-line or later treatment option for patients with relapsed/refractory FL harboring the EZH2 mutation. Trial registration: ClinicalTrials.gov: NCT03456726.

Keywords: EZH2 mutation; B-cell non-Hodgkin lymphoma; Phase II; Tazemetostat; Trimethylation of lysine 27 in histone 3.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Benzamides / therapeutic use
  • Biphenyl Compounds / therapeutic use
  • Clinical Trials, Phase II as Topic
  • Enhancer of Zeste Homolog 2 Protein* / genetics
  • Female
  • Follow-Up Studies
  • Humans
  • Japan
  • Lymphoma, Follicular / drug therapy
  • Lymphoma, Follicular / genetics
  • Lymphoma, Large B-Cell, Diffuse / drug therapy
  • Lymphoma, Large B-Cell, Diffuse / genetics
  • Lymphoma, Large B-Cell, Diffuse / mortality
  • Male
  • Middle Aged
  • Morpholines* / administration & dosage
  • Morpholines* / adverse effects
  • Morpholines* / therapeutic use
  • Mutation*
  • Pyridones* / administration & dosage
  • Pyridones* / adverse effects
  • Pyridones* / therapeutic use
  • Recurrence
  • Treatment Outcome

Substances

  • Benzamides
  • Biphenyl Compounds
  • Enhancer of Zeste Homolog 2 Protein
  • EZH2 protein, human
  • Morpholines
  • Pyridones
  • tazemetostat

Associated data

  • ClinicalTrials.gov/NCT03456726