NORDIC
LYMPHOMA GROUP NEWSLETTER JUNE 2007
Dear
members of the NLG society,
This early
summer Newsletter will give you some brief information on the present status of
the organization and the study group activities.
NLG Study Centres: Since last Newsletter two more “NLG
Study Centres” have been approved; Aalborg in
101
102 Herlev,
Dept of Hematology
103
Rigshospitalet, Dept of Hematology
104
201
202
203
204
205
301
Haukeland, Dept of Oncology
302
Radiumhopsitalet, Dept of Medical Oncology
304
305
Ullevål, Dept of Oncology
401
Halmstad, Dept of Internal Medicine
402 Karolinska Huddinge, Hematology Center
403 Karolinska Solna, Center of Hematology
404
405
Linköping, Dept of Oncology
406 Malmö,
Depts of Oncology and Hematology
407
Sahlgrenska, Section of Hematology and coagulation
408
409 Umeå,
Dept of Oncology
410
411
Sunderbyn, Dept of Medicine
The activities, as reported on regular forms to the coordinating group,
is fairly good, but there is certainly room for improvement. The
possibility for the centers to apply for some financial support from NLG has so
far not been used! I will remind all center representatives of this option,
which e.g., may be to support some (limited) research nurse assistance if that
has been shown impossible to arrange in respect to a certain study, and that is
crucial for participation in that project.
Economy: For 2007, NLG was awarded 60,000
Euro from the Nordic Cancer Union, which was a 20% increase compared with 2005
and 2006. Based on the applications and stated needs from the working groups,
the NLG coordinating group has decided to divide the money to the following
projects:
CRY -04 9,000 Euro
PET-study 2,000 Euro
NLG T-101 3,000 Euro
NLG T-102 10,000 Euro
MCL 2 and 3 14,000 Euro
Hodgkin,
early stage 2,000
Euro
Indolent,
rituximab ± interferon
13,000 Euro
Nordic CNS
lymphoma protocol 7,000 Euro
The applications process for 2008 is on-going.
The present
sponsor agreement with the industry (a total of 60,000 Euro yearly) is running
through this year. We are now in the process of approaching these and other
potential sponsors for a new agreement for 2008-09. We warmly thank our present
sponsors Roche (main sponsor), Amgen, Schering (now Bayer-Schering),
Schering-Plough, Mundipharma and Wyeth.!
Plenary meeting 2007: This year the plenary meeting will
be held in
Free paper session: This year we also invite all
potential delegates to submit abstracts on any kind of on-going lymphoma
research for a special session on the meeting! Please, send your abstract
before August 31 to any of your national members of the NLG coordinating group.
If your abstract is accepted we will of course also give your participation
highest priority!
Short on on-going activities:
Low grade lymphoma
The work of the group has been
focused on the randomized phase III trial comparing rituximab (4+4 infusions in
standard doses) with the same antibody regimen in combination with interferon
during 5+5 weeks (with start two weeks before rituximab) in patients with CD20+
indolent lymphomas. The accrual of the study on the 1st of April was
262 patients. After a DMBC recommendation more follicular lymphomas (FL) are to
be included and also FL grade IIIa (now considered as an indolent lymphoma) are
now eligible. A total of 313 randomized
patients are to be randomised. Estimated
date of end of accrual: October 31st 2007. Several “spin-off projects” using samples from both the previous Nordic
Phase II and the ongoing phase III trial, have been initiated; as gene
expression profiling of fresh frozen lymphoma tissue and extended immunohistochemical studies and FISH on paraffin sections (also using tissuemicroarray tecniques). Fc-receptorgenotyping using previous
blood samples is performed and the results will be related to the response to
therapy.
A “follicular lymphoma working group” has been initiated including the above members and also pathologist
from the four countries (Jan Delabie, Marja-Liisa Karjalainen-Lindsberg,
Birgitta Sander and Christer Sundström). The focus of
the group is biological markers and translational research. The group is represented in the International
Lunenburg Lymphoma Biomarker Consortium (Eva Kimby +
Birgitta Sander).
Large B-cell
lymphoma
CRY-04 study: A Nordic phase 2 study for
patients below 65 years with diffuse large B-cell lymphoma, IPI score 2-3:
CHOEP-14 + rituximab, 6 courses, followed by high dose methotrexate, 1 course
and high dose cytarabine, 1 course: The study has been open for inclusion in
Norway, Sweden and Finland for more than two years and from
PET in DLBCL: A Nordic phase II study
evaluating the response of treatment using 18-F PET for patients with stage
IIB-IV with special emphasis on the prognostic significance of PET after one cycle
of chemotherapy. Three
centres in
New studies: The working groups have been approached by
both other Lymphoma groups and the Pharmaceutical industry concerning other
studies. So far the Large Cell Group has not joined any of these studies.
Presently, two follow up studies to the MInT study from the German Large Cell
Lymphoma Group (FLYER, UNFOLDER) are being considered as well as a study for
the elderly population with diffuse large B-cell lymphomas with adverse
prognosis. The National Lymphoma Groups and study centres will be informed. A
protocol meeting after summer vacation is proposed. In addition, a follow up
study for the CRY-04 study and the PET study is being discussed.
Mantle-cell
lymphoma
MCL2-Protocol: Only a
few pathology reviews are missing. The data base is being finalised, and a
paper is in preparation. Submission to ASH and publication
August 2007. Final results to be presented at the
Plenary Meeting.
MCL3: High-dose therapy with autologous stem cell support in first line treatment of mantle cell lymphoma – 90y-ibritumomab tiuxetan in combination with BEAM or BEAC to improve outcome for patients not in CR after induction treatment.
Ongoing, with a very good accrual (~5 patients per month, presently 60 patients). The goal (150 patients) will be reached in less than two years.
T-cell lymphoma
NLG-T-01: Ongoing, almost
Updated feasibility, efficacy and time-related
end-point results were presented as oral paper at ASH 2006 (Orlando). The
toxicity profile was manageable and the cumulative response rate was high.
Three-year survival 67% (95% CI: 56-75%):
The NLG-T-01 will continue in
Scandinavian countries until the international phase III trial (ACT-1 and ACT-2
trials, see below) will be activated, i.e. until Q3-4
ACT-trial (ACT-1 and ACT-2): To be
launched 2007:
The international phase III trial,
ACT-trial, is a result of a collaboration between the NLG and the German Study
Group on Aggressive Non-Hodgkin Lymphomas (DSHNHL). The protocol has been
finalized and is now at the main sponsors’ national medical authorities for
approval. The ACT-1 trial is coordinated by the NLG and the ACT-2 trial by the
DSHNHL. The ACT-1 trial randomizes pts up to 65 yrs between CHOP-14x6 +
autotransplant and CHOP-14 + alemtuzumab x6 +
autotransplant. The antibody alemtuzumab is given at each CHOP course as 30 mg
Auto=
autologous transplant
Obs=
observation without further therapy
CNS lymphoma
Status of
the Nordic PCNSL study
(EudraCT No. 2006-004772-12): A Norwegian patient has been included
in the study as the first patient
Present
activities in the working group: treatment strategies in progressive/relapsed
PCNSL. HD chemotherapy with stem cell rescue might be an option in younger
patients.
Hodgkin´s lymphoma
The Hodgkin
group is currently evaluating the Nordic phase II study on early stage HL. Data
has been reported from
The next
“Newsletter” will be the programme for the plenary meeting in
With best regards from the coordinating group
Mikael Eriksson
chairman,
NLG
NLG Plenary meeting Lillehammer 2007:
Time: October 25 – 27, Place: Radisson SAS Lillehammer
Hotel (www.lillehammerhotel.no)
Preliminary agenda:
Thursday October 25
Morning Working Group meetings (may be started at
Wednesday afternoon/evening)
11.00-12.00
Registration, check in
12.00-13.00
Lunch
13.00-13.15
Meeting opens (
13.15-13.45
Working group: Large B-cell lymphoma
13.45-14.15
Working group: Indolent lymphoma
14.15-14.45
Working group: Mantle cell lymphoma
14.45-15.15
Working group: T-cell lymphoma
15.15-15.45
Coffee/Tea
15.45-16.15
Working group: CNS lymphoma
16.15-16.45
Working group: Hodgkin’s lymphoma
16.45-17.00
Leg stretch-brake
17.00-18.00
Business meeting (closed for industry)
18.30 Refreshments
19.00 Dinner
Friday October 26
08.00-09.00
Breakfast
09.00-10.00
National lymphoma registries – how far have we reached?
Presentation by the
Staging/Epidemiology working group
10.00-10.30
Working group: Pathology
10.30-11.00
Coffee/Tea
11.00-12.30
Guest lecturer, to be announced
12.30-13.30
Lunch
13.30-16.30
Excursion in the surroundings; coffee/tea included
16.30-18.00
Free paper presentation on on-going lymphoma research
18.30 Refreshments
19.00 Dinner; social evening with
music/dance??
Saturday October 27
08.00-09.00
Breakfast
09.00-10.30
“Interesting cases”-session
10.30-11.00
Coffee/Tea
11.00-11.45
Educational lecture: Role of radiotherapy in lymphoma today, Lena Specht
11.45-12.30
Summing-up session, change of chairman, and closing of the meeting