Indolent lymphoma - historical
The purpose of this page is to provide references to regimens that are obsolete, outdated, or of historical interest only. Is there a regimen missing from this list? Please go to the main iNHL regimen page to find other regimens.
Last updated on 2024-07-23: 1 regimens on this page
1 variants on this page
|
First-line therapy
COPA
COPA: Cyclophosphamide, Oncovin (Vincristine), Prednisone, Adriamycin (Doxorubicin)
Regimen
Study | Dates of enrollment | Evidence | Comparator | Comparative Efficacy |
---|---|---|---|---|
O'Connell et al. 1987 | 1978-1983 | Phase 3 (C) | 1. COPA-B 2. CAP-BOP |
Did not meet efficacy endpoints |
Smalley et al. 1992 (ECOG E6484) | 1985-1988 | Phase 3 (C) | I-COPA | Inferior TTTF |
Note: this regimen is very similar but distinct from CHOP. To our knowledge, this regimen was not tested as an experimental arm in an RCT prior to becoming a standard comparator arm.
Chemotherapy
- Cyclophosphamide (Cytoxan) 600 mg/m2 IV once on day 1
- Vincristine (Oncovin) 1.2 mg/m2 (maximum dose of 2 mg) IV once on day 1
- Doxorubicin (Adriamycin) 50 mg/m2 IV once on day 1
Glucocorticoid therapy
- Prednisone (Sterapred) 100 mg/m2 PO once per day on days 1 to 5
28-day cycle for 8 cycles
References
- O'Connell MJ, Harrington DP, Earle JD, Johnson GJ, Glick JH, Carbone PP, Creech RH, Neiman RS, Mann RB, Silverstein MN; ECOG. Prospectively randomized clinical trial of three intensive chemotherapy regimens for the treatment of advanced unfavorable histology non-Hodgkin's lymphoma. J Clin Oncol. 1987 Sep;5(9):1329-39. link to original article PubMed
- ECOG E6484: Smalley RV, Andersen JW, Hawkins MJ, Bhide V, O'Connell MJ, Oken MM, Borden EC. Interferon alfa combined with cytotoxic chemotherapy for patients with non-Hodgkin's lymphoma. N Engl J Med. 1992 Nov 5;327(19):1336-41. link to original article dosing details in manuscript have been reviewed by our editors PubMed
CVP
CVP: Cyclophosphamide, Vincristine, Prednisone
COP: Cyclophosphamide, Oncovin (Vincristine), Prednisone
VCP: Vincristine, Cyclophosphamide, Prednisone
Regimen variant #1, 750/1.4/40
Study | Dates of enrollment | Evidence | Comparator | Comparative Efficacy | Comparative Toxicity |
---|---|---|---|---|---|
Hagenbeek et al. 2006 | 1993-1997 | Phase 3 (C) | Fludarabine | Did not meet primary endpoint of PFS48 | Less toxic |
Marcus et al. 2004 (M39021) | 2000-2002 | Phase 3 (C) | R-CVP | Inferior TTP | Similar toxicity |
Chemotherapy
- Cyclophosphamide (Cytoxan) 750 mg/m2 IV once on day 1
- Vincristine (Oncovin) 1.4 mg/m2 (maximum dose of 2 mg) IV once on day 1
Glucocorticoid therapy
- Prednisone (Sterapred) 40 mg/m2 PO once per day on days 1 to 5
21-day cycle for up to 8 cycles
Regimen variant #2, 1000/1.4/100
Study | Dates of enrollment | Evidence | Comparator | Comparative Efficacy |
---|---|---|---|---|
Hochster et al. 2009 (ECOG E1496) | Not reported | Phase 3 (C) | FC | Not reported |
Note: the FC arm was closed prematurely and comparisons between CVP and FC were not conducted.
Chemotherapy
- Cyclophosphamide (Cytoxan) 1000 mg/m2 IV once on day 1
- Vincristine (Oncovin) 1.4 mg/m2 (maximum dose of 2 mg) IV once on day 1
Glucocorticoid therapy
- Prednisone (Sterapred) 100 mg/m2 PO once per day on days 1 to 5
21-day cycle for 6 to 8 cycles
Subsequent treatment
- Rituximab maintenance versus observation
Regimen variant #3, 2000/1.4/100
Study | Dates of enrollment | Evidence | Comparator | Comparative Efficacy |
---|---|---|---|---|
Unterhalt et al. 1996 | 1989-04 to 1996-01 | Phase 3 (C) | PmM | Seems to have inferior EFS |
Chemotherapy
- Cyclophosphamide (Cytoxan) 400 mg/m2 (route not specified) once per day on days 1 to 5
- Vincristine (Oncovin) 1.4 mg/m2 IV once on day 1
Glucocorticoid therapy
- Prednisone (Sterapred) 100 mg/m2 (route not specified) once per day on days 1 to 5
21-day cycle for 6 cycles
Subsequent treatment
- Unterhalt et al. 1996, responders: COP continuation x 2 (8 total), then interferon alfa maintenance versus observation
References
- Unterhalt M, Herrmann R, Tiemann M, Parwaresch R, Stein H, Trümper L, Nahler M, Reuss-Borst M, Tirier C, Neubauer A, Freund M, Kreuser ED, Dietzfelbinger H, Bodenstein H, Engert A, Stauder R, Eimermacher H, Landys K, Hiddemann W; German Low-Grade Lymphoma Study Group. Prednimustine, mitoxantrone (PmM) vs cyclophosphamide, vincristine, prednisone (COP) for the treatment of advanced low-grade non-Hodgkin's lymphoma. Leukemia. 1996 May;10(5):836-43. PubMed
- Update: Hiddemann W, Unterhalt M, Herrmann R, Wöltjen HH, Kreuser ED, Trümper L, Reuss-Borst M, Terhardt-Kasten E, Busch M, Neubauer A, Kaiser U, Hanrath RD, Middeke H, Helm G, Freund M, Stein H, Tiemann M, Parwaresch R. Mantle-cell lymphomas have more widespread disease and a slower response to chemotherapy compared with follicle-center lymphomas: results of a prospective comparative analysis of the German Low-Grade Lymphoma Study Group. J Clin Oncol. 1998 May;16(5):1922-30. link to original article PubMed
- M39021: Marcus R, Imrie K, Belch A, Cunningham D, Flores E, Catalano J, Solal-Celigny P, Offner F, Walewski J, Raposo J, Jack A, Smith P. CVP chemotherapy plus rituximab compared with CVP as first-line treatment for advanced follicular lymphoma. Blood. 2005 Feb 15;105(4):1417-23. Epub 2004 Oct 19.link to original article dosing details in abstract have been reviewed by our editors PubMed
- Update: Marcus R, Imrie K, Solal-Celigny P, Catalano JV, Dmoszynska A, Raposo JC, Offner FC, Gomez-Codina J, Belch A, Cunningham D, Wassner-Fritsch E, Stein G. Phase III study of R-CVP compared with cyclophosphamide, vincristine, and prednisone alone in patients with previously untreated advanced follicular lymphoma. J Clin Oncol. 2008 Oct 1;26(28):4579-86. Epub 2008 Jul 28. link to original article PubMed
- Hagenbeek A, Eghbali H, Monfardini S, Vitolo U, Hoskin PJ, de Wolf-Peeters C, MacLennan K, Staab-Renner E, Kalmus J, Schott A, Teodorovic I, Negrouk A, van Glabbeke M, Marcus R. Phase III intergroup study of fludarabine phosphate compared with cyclophosphamide, vincristine, and prednisone chemotherapy in newly diagnosed patients with stage III and IV low-grade malignant Non-Hodgkin's lymphoma. J Clin Oncol. 2006 Apr 1;24(10):1590-6. link to original article dosing details in abstract have been reviewed by our editors PubMed
- ECOG E1496: Hochster H, Weller E, Gascoyne RD, Habermann TM, Gordon LI, Ryan T, Zhang L, Colocci N, Frankel S, Horning SJ. Maintenance rituximab after cyclophosphamide, vincristine, and prednisone prolongs progression-free survival in advanced indolent lymphoma: results of the randomized phase III ECOG1496 Study. J Clin Oncol. 2009 Apr 1;27(10):1607-14. Epub 2009 Mar 2. link to original article dosing details in manuscript have been reviewed by our editors link to PMC article PubMed NCT00003204
- Update: Barta SK, Li H, Hochster HS, Hong F, Weller E, Gascoyne RD, Habermann TM, Gordon LI, Colocci N, Bengtson EM, Horning SJ, Kahl BS. Randomized phase 3 study in low-grade lymphoma comparing maintenance anti-CD20 antibody with observation after induction therapy: A trial of the ECOG-ACRIN Cancer Research Group (E1496). Cancer. 2016 Oct;122(19):2996-3004. Epub 2016 Jun 28. link to original article link to PMC article PubMed
Fludarabine monotherapy
Regimen
Study | Dates of enrollment | Evidence | Comparator | Comparative Efficacy |
---|---|---|---|---|
Zinzani et al. 2000 | 1995-1998 | Phase 3 (C) | Fludarabine & Idarubicin | Superior CR rate1 |
1The superiority of this arm was only observed in the FL subgroup; overall, there was no statistically significant difference between arms.
Note: to our knowledge, this regimen was not tested as an experimental arm in an RCT in this context, prior to becoming a standard comparator arm.
Chemotherapy
- Fludarabine (Fludara) 25 mg/m2 IV over 30 minutes once per day on days 1 to 5
28-day cycle for 6 cycles
References
- Zinzani PL, Magagnoli M, Moretti L, De Renzo A, Battista R, Zaccaria A, Guardigni L, Mazza P, Marra R, Ronconi F, Lauta VM, Bendandi M, Gherlinzoni F, Gentilini P, Ciccone F, Cellini C, Stefoni V, Ricciuti F, Gobbi M, Tura S. Randomized trial of fludarabine versus fludarabine and idarubicin as frontline treatment in patients with indolent or mantle-cell lymphoma. J Clin Oncol. 2000 Feb;18(4):773-9. link to original article dosing details in manuscript have been reviewed by our editors PubMed
Cyclophosphamide & Fludarabine (FC)
FC: Fludarabine & Cyclophosphamide
CF: Cyclophosphamide & Fludarabine
Regimen
Study | Dates of enrollment | Evidence | Comparator | Comparative Efficacy |
---|---|---|---|---|
Hochster et al. 2009 (ECOG E1496) | Not reported | Phase 3 (E-switch-ic) | CVP | Not reported |
Note: investigation into this regimen was halted due to excess mortality.
Chemotherapy
- Fludarabine (Fludara) 20 mg/m2 IV once per day on days 1 to 5
- Cyclophosphamide (Cytoxan) 1000 mg/m2 IV once on day 1
28-day cycle for up to 8 cycles
Subsequent treatment
- Rituximab maintenance versus observation
References
- ECOG E1496: Hochster H, Weller E, Gascoyne RD, Habermann TM, Gordon LI, Ryan T, Zhang L, Colocci N, Frankel S, Horning SJ. Maintenance rituximab after cyclophosphamide, vincristine, and prednisone prolongs progression-free survival in advanced indolent lymphoma: results of the randomized phase III ECOG1496 Study. J Clin Oncol. 2009 Apr 1;27(10):1607-14. Epub 2009 Mar 2. link to original article dosing details in manuscript have been reviewed by our editors link to PMC article PubMed NCT00003204
FND
FND: Fludarabine, Novantrone (Mitoxantrone), Dexamethasone
Regimen
Study | Dates of enrollment | Evidence |
---|---|---|
McLaughlin et al. 1996 | 1992-01 to 1993-12 | Phase 2 |
Chemotherapy
- Fludarabine (Fludara) 25 mg/m2 IV once per day on days 1 to 3
- Mitoxantrone (Novantrone) 10 mg/m2 IV once on day 1
Glucocorticoid therapy
- Dexamethasone (Decadron) 20 mg/day IV or PO on days 1 to 5
28-day cycle for up to 8 cycles
References
- McLaughlin P, Hagemeister FB, Romaguera JE, Sarris AH, Pate O, Younes A, Swan F, Keating M, Cabanillas F. Fludarabine, mitoxantrone, and dexamethasone: an effective new regimen for indolent lymphoma. J Clin Oncol. 1996 Apr;14(4):1262-8. link to original article dosing details in manuscript have been reviewed by our editors PubMed
ProMACE-MOPP
ProMACE-MOPP: Prolix (Prednisone), Methotrexate, Adriamycin (Doxorubicin), Cyclophosphamide, Etoposide, Mustargen (Mechlorethamine), Oncovin (Vincristine), Procarbazine, Prednisone
Regimen
Study | Evidence | Comparator |
---|---|---|
Young et al. 1988 | Phase 3 (E-esc) | Watchful waiting |
Note: Treatment details are not available for online review.
References
- Young RC, Longo DL, Glatstein E, Ihde DC, Jaffe ES, DeVita VT Jr. The treatment of indolent lymphomas: watchful waiting v aggressive combined modality treatment. Semin Hematol. 1988 Apr;25(2 Suppl 2):11-6. does not contain dosing details in abstract PubMed
Relapsed or refractory
Fludarabine monotherapy
Regimen
Study | Dates of enrollment | Evidence | Comparator | Comparative Efficacy |
---|---|---|---|---|
Klasa et al. 2002 | 1993-1996 | Phase 3 (E-switch-ic) | CVP | Seems to have superior PFS |
References
- Klasa RJ, Meyer RM, Shustik C, Sawka CA, Smith A, Guévin R, Maksymiuk A, Rubinger M, Samosh M, Laplante S, Grenier JF. Randomized phase III study of fludarabine phosphate versus cyclophosphamide, vincristine, and prednisone in patients with recurrent low-grade non-Hodgkin's lymphoma previously treated with an alkylating agent or alkylator-containing regimen. J Clin Oncol. 2002 Dec 15;20(24):4649-54. link to original article dosing details in manuscript have been reviewed by our editors PubMed
Fludarabine & Rituximab (FR)
FR: Fludarabine & Rituximab
Regimen
Study | Dates of enrollment | Evidence | Comparator | Comparative Efficacy |
---|---|---|---|---|
Rummel et al. 2015 (StiL NHL 2-2003) | 2003-2010 | Phase 3 (C) | BR | Inferior PFS |
Chemotherapy
- Fludarabine (Fludara) 25 mg/m2 (route not specified) once per day on days 1 to 3
Targeted therapy
- Rituximab (Rituxan) 375 mg/m2 IV once on day 1
28-day cycle for up to 6 cycles
References
- StiL NHL 2-2003: Rummel M, Kaiser U, Balser C, Stauch M, Brugger W, Welslau M, Niederle N, Losem C, Boeck HP, Weidmann E, von Gruenhagen U, Mueller L, Sandherr M, Hahn L, Vereshchagina J, Kauff F, Blau W, Hinke A, Barth J; Study group indolent Lymphomas (StiL). Bendamustine plus rituximab versus fludarabine plus rituximab for patients with relapsed indolent and mantle-cell lymphomas: a multicentre, randomised, open-label, non-inferiority phase 3 trial. Lancet Oncol. 2016 Jan;17(1):57-66. Epub 2015 Dec 5. link to original article dosing details in abstract have been reviewed by our editors PubMed NCT01456351
FMP
FMP: Fludarabine, Mitoxantrone, Prednisone
Regimen
Study | Dates of enrollment | Evidence |
---|---|---|
Zinzani et al. 1995a | 1993-11 to 1994-06 | Phase 2 |
Chemotherapy
- Fludarabine (Fludara) 25 mg/m2 IV once per day on days 1 to 3
- Mitoxantrone (Novantrone) 10 mg/m2 IV once on day 1
Glucocorticoid therapy
- Prednisone (Sterapred) 40 mg IV once per day on days 1 to 5
21-day cycle for up to 6 cycles
References
- Zinzani PL, Bendandi M, Tura S. FMP regimen (fludarabine, mitoxantrone, prednisone) as therapy in recurrent low-grade non-Hodgkin's lymphoma. Eur J Haematol. 1995 Oct;55(4):262-6. link to original article dosing details in manuscript have been reviewed by our editors PubMed
Idelalisib monotherapy
Regimen
Study | Dates of enrollment | Evidence |
---|---|---|
Gopal et al. 2014 (DELTA) | 2011-2012 | Phase 2 (RT) |
References
- DELTA: Gopal AK, Kahl BS, de Vos S, Wagner-Johnston ND, Schuster SJ, Jurczak WJ, Flinn IW, Flowers CR, Martin P, Viardot A, Blum KA, Goy AH, Davies AJ, Zinzani PL, Dreyling M, Johnson D, Miller LL, Holes L, Li D, Dansey RD, Godfrey WR, Salles GA. PI3Kd inhibition by idelalisib in patients with relapsed indolent lymphoma. N Engl J Med. 2014 Mar 13;370(11):1008-18. Epub 2014 Jan 22. link to original article dosing details in manuscript have been reviewed by our editors link to PMC article PubMed NCT01282424
- Update: Abstract: Ajay K. Gopal, MD, Brad S. Kahl, MD, Sven de Vos, MD, PhD, Nina D. Wagner-Johnston, MD, Stephen J. Schuster, MD, Wojciech Jurczak, MD, PhD, Ian W. Flinn, MD, PhD, Christopher R. Flowers, MD, Peter Martin, MD, Andreas Viardot, MD, Kristie A. Blum, MD, Andre Goy, MD, Andrew Davies, BM PhD, Pier Luigi Zinzani, MD, Martin H. Dreyling, MD, PhD, Leanne M. Holes, Bess Sorensen, PhD, Wayne R. Godfrey, MD and Gilles Andre Salles, MD, PhD. Mature Follow up from a Phase 2 Study of PI3K-Delta Inhibitor Idelalisib in Patients with Double (Rituximab and Alkylating agent)-Refractory Indolent B-Cell Non-Hodgkin Lymphoma (iNHL). Blood 2014 124:1708. link to abstract
Interferon alfa monotherapy
References
- Foon KA, Sherwin SA, Abrams PG, Longo DL, Fer MF, Stevenson HC, Ochs JJ, Bottino GC, Schoenberger CS, Zeffren J, Jaffe ES, Oldham RK. Treatment of advanced non-Hodgkin's lymphoma with recombinant leukocyte A interferon. N Engl J Med. 1984 Nov 1;311(18):1148-52. link to original article PubMed
131Iodine-Tositumomab monotherapy
Regimen
Study | Dates of enrollment | Evidence |
---|---|---|
Kaminski et al. 1993 | Not reported | Non-randomized, fewer than 20 pts |
Press et al. 1995 | Not reported | Phase 2 |
Kaminski et al. 2001 (RIT-II-004) | 1996-1998 | Phase 2 (RT) |
Horning et al. 2004 (CP-97-012) | 1998-1999 | Phase 2 (RT) |
Olney et al. 2014 (SB-393229/032) | 2004-2007 | Phase 2 |
Note: Kiminski et al. 1993 and Press et al. 1995 are included here for historic context but had different treatment details.
Radioconjugate therapy, dosimetric step
- On Day 0, infusions of:
- Tositumomab 450 mg IV over 1 hour
- Tositumomab 35 mg labeled with 5 mCi of Iodine-131 IV over 20 minutes
- First scan of whole body dosimetry & redistribution
- Day 2, 3, or 4: Second scan of whole body dosimetry & redistribution
- Day 6 or 7: Third scan of whole body dosimetry & redistribution
Radioconjugate therapy, therapeutic step
- Any day from day 7 to 15, infusions of:
- Tositumomab 450 mg IV over 1 hour
- Tositumomab 35 mg labeled with an individually calculated dose of Iodine-131 that will provide 75 cGy of radiation to the total body IV over 20 minutes
- 65 cGy total body dose used for patients with platelet counts of 100 to 150,000/mm3
Calculated dose of I-131 is based on information from serial total-body gamma-camera counts
Supportive therapy, therapeutic step
- Acetaminophen (Tylenol) 650 mg PO as premedication for Tositumomab and I-131 (Bexxar)
- Diphenhydramine (Benadryl) 50 mg PO as premedication for Tositumomab and I-131 (Bexxar)
- Potassium iodide (SSKI, saturated solution of potassium iodide) 2 drops PO three times per day starting at least 24 hours before the dosimetric step and continuing for 14 days after the therapeutic infusion; may also use Lugol’s solution or potassium iodide tablets
References
- Kaminski MS, Zasadny KR, Francis IR, Milik AW, Ross CW, Moon SD, Crawford SM, Burgess JM, Petry NA, Butchko GM, Glenn SD, Wahl RL. Radioimmunotherapy of B-cell lymphoma with [131I]anti-B1 (anti-CD20) antibody. N Engl J Med. 1993 Aug 12;329(7):459-65. link to original article PubMed
- Press OW, Eary JF, Appelbaum FR, Martin PJ, Nelp WB, Glenn S, Fisher DR, Porter B, Matthews DC, Gooley T, Bernstein ID. Phase II trial of 131I-B1 (anti-CD20) antibody therapy with autologous stem cell transplantation for relapsed B cell lymphomas. Lancet. 1995 Aug 5;346(8971):336-40. link to original article PubMed
- RIT-II-004: Kaminski MS, Zelenetz AD, Press OW, Saleh M, Leonard J, Fehrenbacher L, Lister TA, Stagg RJ, Tidmarsh GF, Kroll S, Wahl RL, Knox SJ, Vose JM. Pivotal study of iodine I 131 tositumomab for chemotherapy-refractory low-grade or transformed low-grade B-cell non-Hodgkin's lymphomas. J Clin Oncol. 2001 Oct 1;19(19):3918-28. link to original article dosing details in manuscript have been reviewed by our editors PubMed
- CP-97-012: Horning SJ, Younes A, Jain V, Kroll S, Lucas J, Podoloff D, Goris M. Efficacy and safety of tositumomab and iodine-131 tositumomab (Bexxar) in B-cell lymphoma, progressive after rituximab. J Clin Oncol. 2005 Feb 1;23(4):712-9. Epub 2004 Dec 21. link to original article PubMed
- Meta-analysis: Fisher RI, Kaminski MS, Wahl RL, Knox SJ, Zelenetz AD, Vose JM, Leonard JP, Kroll S, Goldsmith SJ, Coleman M. Tositumomab and iodine-131 tositumomab produces durable complete remissions in a subset of heavily pretreated patients with low-grade and transformed non-Hodgkin's lymphomas. J Clin Oncol. 2005 Oct 20;23(30):7565-73. Epub 2005 Sep 26. link to original article PubMed
- SB-393229/032: Olney HJ, Freeman MA, Stewart DA, Mangel JE, White DJ, Elia-Pacitti JO. Prolonged progression-free survival and preserved quality of life in the Canadian prospective study of tositumomab and iodine(131)-tositumomab for previously treated, rituximab-exposed, indolent non-Hodgkin lymphoma. Leuk Lymphoma. 2014 Dec;55(12):2754-60. Epub 2014 Apr 3. link to original article PubMed NCT00240565
Ofatumumab monotherapy
Regimen
Study | Dates of enrollment | Evidence | Comparator | Comparative Efficacy |
---|---|---|---|---|
Maloney et al. 2020 (HOMER) | 2010-2016 | Phase 3 (E-switch-ic) | Rituximab | Did not meet primary endpoint of PFS |
Note: there was no MTD determined in Hx-CD20-001.
Targeted therapy
- Ofatumumab (Arzerra) as follows:
- Cycle 1: 300 mg IV once on day 1, then 1000 mg IV once per day on days 8, 15, 22
- Cycle 2: 1000 mg IV once per day on days 1, 8, 15, 22
Supportive therapy
- Acetaminophen (Tylenol) 1000 mg (no route specified) before each dose of ofatumumab
- Cetirizine (Zyrtec) 10 mg (or equivalent) PO before each dose of ofatumumab
- Prednisolone (Millipred) (or equivalent) 100 mg before dose 1 and 2 of ofatumumab
28-day cycle for 2 cycles
References
- HOMER: Maloney DG, Ogura M, Fukuhara N, Davis J, Lasher J, Izquierdo M, Banerjee H, Tobinai K. A phase 3 randomized study (HOMER) of ofatumumab vs rituximab in iNHL relapsed after rituximab-containing therapy. Blood Adv. 2020 Aug 25;4(16):3886-3893. link to original article link to PMC article PubMed NCT01200589
Umbralisib monotherapy
Regimen
Study | Dates of enrollment | Evidence |
---|---|---|
Fowler et al. 2021 (UNITY-NHL) | 2017-2018 | Phase 2b (RT) |
Targeted therapy
- Umbralisib (Ukoniq) 800 mg PO once per day on days 1 to 28, taken with food
28-day cycles
References
- UNITY-NHL: Fowler NH, Samaniego F, Jurczak W, Ghosh N, Derenzini E, Reeves JA, Knopińska-Posłuszny W, Cheah CY, Phillips T, Lech-Maranda E, Cheson BD, Caimi PF, Grosicki S, Leslie LA, Chavez JC, Fonseca G, Babu S, Hodson DJ, Shao SH, Burke JM, Sharman JP, Law JY, Pagel JM, Miskin HP, Sportelli P, O'Connor OA, Weiss MS, Zinzani PL. Umbralisib, a Dual PI3Kδ/CK1ε Inhibitor in Patients With Relapsed or Refractory Indolent Lymphoma. J Clin Oncol. 2021 May 20;39(15):1609-1618. Epub 2021 Mar 8. link to original article link to PMC article dosing details in manuscript have been reviewed by our editors PubMed NCT02793583