Rationale for Consolidation to Improve Progression-Free Survival in Patients with Non-Hodgkin’s Lymphoma: A Review of the Evidence
Autor: | Ama Z. S. Rohatiner, Fredrick B. Hagemeister, Martin Dreyling, Franck Morschhauser, Angelika Bischof Delaloye |
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Rok vydání: | 2009 |
Předmět: |
Oncology
Cancer Research medicine.medical_specialty Pathology medicine.medical_treatment Follicular lymphoma Disease-Free Survival immune system diseases hemic and lymphatic diseases Internal medicine Antineoplastic Combined Chemotherapy Protocols medicine Humans Yttrium Radioisotopes Progression-free survival neoplasms Complete response business.industry Immunotoxins Lymphoma Non-Hodgkin Standard treatment Antibodies Monoclonal Radioimmunotherapy medicine.disease Combined Modality Therapy Lymphoma Non-Hodgkin's lymphoma Mantle cell lymphoma business |
Zdroj: | The Oncologist. 14:17-29 |
ISSN: | 1549-490X 1083-7159 |
Popis: | Non-Hodgkin’s lymphoma (NHL) comprises both indolent forms, including follicular lymphoma (FL) and marginal zone lymphoma (MZL), and aggressive forms, including diffuse large B-cell lymphoma (DLBCL) and mantle cell lymphoma (MCL). FL and DLBCL are the most common subtypes of indolent and aggressive NHL, respectively. Although these lymphomas exhibit different clinical behaviors and outcomes, the prognosis is negatively affected in both DLBCL and FL by the lack of a complete response (CR) with standard treatment options. The aim of therapy should therefore be achievement of a CR, which is not only associated with longer progression-free survival (PFS) and overall survival times, but is also a prerequisite for a cure, particularly in DLBCL. Consolidation treatment with radioimmunotherapy (RIT) is an innovative treatment approach to increase CR rates. Phase II studies have indicated promising results with yttrium-90 (90Y)-ibritumomab tiuxetan and iodine-131 (131I)-tositumomab as consolidation following induction therapy for previously untreated patients with advanced FL. More recently, investigators reported a marked increase in CR rates and significant improvements in PFS using standard chemotherapy regimens followed by 90Y-ibritumomab tiuxetan in a phase III randomized trial in patients with previously untreated FL. Data also suggest that RIT may play a role in the treatment of high-risk DLBCL, with encouraging PFS results from a phase II trial of 90Y-ibritumomab tiuxetan consolidation following induction with rituximab plus chemotherapy in elderly patients with previously untreated DLBCL. With the higher CR rates and longer PFS times observed in patients with FL and DLBCL, as well as encouraging early data from MZL and MCL consolidation trials, RIT appears to have an important role in the treatment of patients with NHL. |
Databáze: | OpenAIRE |
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