Rituximab Plus Short-Duration Chemotherapy As First-Line Treatment for Follicular Non-Hodgkin’s Lymphoma: A Phase II Trial of the Minnie Pearl Cancer Research Network
| Autor: | F. Anthony Greco, Lisa H. Morrissey, Matthew J. McCarty, Sharlene Litchy, Michael B. Andrews, John D. Hainsworth, Manuel Grimaldi |
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| Rok vydání: | 2005 |
| Předmět: |
Adult
Male Cancer Research medicine.medical_specialty Vincristine Cyclophosphamide medicine.medical_treatment Follicular lymphoma Antineoplastic Agents CHOP Gastroenterology Antibodies Monoclonal Murine-Derived Prednisone hemic and lymphatic diseases Internal medicine Antineoplastic Combined Chemotherapy Protocols medicine Humans Lymphoma Follicular Aged Aged 80 and over Chemotherapy business.industry Antibodies Monoclonal Combination chemotherapy Middle Aged medicine.disease Surgery Survival Rate Treatment Outcome Oncology Doxorubicin Injections Intravenous Rituximab business Follow-Up Studies medicine.drug |
| Zdroj: | Journal of Clinical Oncology. 23:1500-1506 |
| ISSN: | 1527-7755 0732-183X |
| DOI: | 10.1200/jco.2005.05.004 |
| Popis: | Purpose To evaluate the feasibility and efficacy of rituximab with short-duration chemotherapy in the first-line treatment of patients with follicular non-Hodgkin’s lymphoma (NHL). Patients and Methods Patients with previously untreated stage II-IV follicular NHL, grade 1 or 2, were eligible for this multicenter phase II trial. All patients received four weekly doses of rituximab (375 mg/m2 intravenous), followed by three courses of combination chemotherapy (either cyclophosphamide, doxorubicin, vincristine, and prednisone [CHOP], or cyclophosphamide, vincristine, and prednisone [CVP]) plus rituximab. Patients were evaluated for response after completing treatment, and were then followed up at 3-month intervals. Results Between January 2000 and July 2001, 86 patients were treated. Eight-two patients (95%) completed treatment; no patient was withdrawn due to toxicity. The overall response rate was 93%, with 55% complete responses. After a median follow-up of 42 months, the 3- and 4-year actuarial progression-free survivals were 71% and 62%, respectively. Five patients (6%) died from lymphoma; the overall actuarial survival at 3 years was 95%. Grade 3/4 leukopenia occurred in 53% of patients, but only six patients (7%) had neutropenia or fever. Grade 3/4 nonhematologic toxicities were uncommon. Conclusion Rituximab plus short-course chemotherapy is well tolerated as first-line treatment for patients with follicular NHL. The overall and complete response rates are similar to those reported with chemotherapy/rituximab combinations of longer duration. The actuarial progression-free survival of 62% at 4 years is encouraging, but further follow-up is necessary. Rituximab plus short-course chemotherapy may prove to be as effective as longer-duration chemotherapy and currently provides an attractive option for first-line treatment of elderly patients and others who tolerate chemotherapy poorly. |
| Databáze: | OpenAIRE |
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