The American Society of Clinical Oncology (ASCO) held its Annual Meeting from June 2-6, 2023. During the meeting, a variety of stakeholders discussed clinical practices, guidelines, trends, and research related to oncology. As reported by Hematology Advisor, one presentation focused on the six-year safety and efficacy results from the Phase 2 CHRONOS-1 trial. This trial explored the impact of copanlisib, an intravenously-administered PI3K inhibitor, on relapsed or refractory (R/R) follicular lymphoma. 

Patients within the study had two previous lines of therapy that had failed. Researchers wanted to understand how well copanlisib slowed the cancer’s progression and whether it could potentially improve overall survival. 

104 patients enrolled in the study; they were placed onto a 28-day treatment cycle. During this, they received 60mg copanlisib on the first, eighth, and fifteenth days.

The six-year results show that:

• The overall response rate was 57.7%, which means that 60 patients had some response to treatment. 19.2% of patients had a complete response, which means that they no longer had signs of detectable cancer. 
• No patients had their follicular lymphoma transform or progress to diffuse large B-cell lymphoma (DLBCL). 
• Copanlisib significantly improved overall survival rate. At the six year follow-up, 43% (45 patients) were still alive. 
• There were some side effects linked to copanlisib treatment, such as diarrhea, fever, neutropenia (low white blood cell/neutrophil level), high blood pressure, and high blood sugar. 

What is Follicular Lymphoma?

A type of non-Hodgkin’s lymphoma (NHL), follicular lymphoma is a slow-growing cancer of the lymphatic system. It forms from B-lymphocytes, or white blood cells that play a role in immune response. Normally, these lymphocytes attack foreign invaders and keep you healthy. When cancer forms in these lymphocytes, it prevents the body from protecting itself against infection and causes other symptoms. 

Follicular lymphoma is rare in younger individuals and more likely to occur in the sixth decade of life. Symptoms can include:

• Swollen lymph nodes in the neck, groin, abdomen, and/or underarms
• Shortness of breath
• Unintentional weight loss
• Fatigue
• Fever and night sweats 

In some cases, doctors may choose not to treat follicular lymphoma right away; instead, patients would be monitored. Treatment—such as chemotherapy, radiation, or targeted therapy—may be used to manage symptoms. Even though follicular lymphoma responds well to treatment, it can recur.