PURPOSE: Although rituximab (R) is commonly used for patients with advanced follicular lymphoma (FL) requiring treatment, the optimal associated chemotherapy regimen has yet to be clarified. PATIENTS AND METHODS: We conducted an open-label, multicenter, randomized trial among adult patients with previously untreated stages II to IV FL to compare efficacy of eight doses of R associated with eight cycles of cyclophosphamide, vincristine, and prednisone (CVP) or six cycles of cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP) or six cycles of fludarabine and mitoxantrone (FM). The principal end point of the study was time to treatment failure (TTF). RESULTS: There were 534 patients enrolled onto the study. Overall response rates were 88%, 93%, and 91% for R-CVP, R-CHOP, and R-FM, respectively (P=.247). After a median follow-up of 34 months, 3-year TTFs were 46%, 62%, and 59% for the respective treatment groups (R-CHOP v R-CVP, P=.003; R-FM v R-CVP, P=.006; R-FM v R-CHOP, P=.763). Three-year progression-free survival (PFS) rates were 52%, 68%, and 63% (overall P=.011), respectively, and 3-year overall survival was 95% for the whole series. R-FM resulted in higher rates of grade 3 to 4 neutropenia (64%) compared with R-CVP (28%) and R-CHOP (50%; P< .001). Overall, 23 second malignancies were registered during follow-up: four in R-CVP, five in R-CHOP, and 14 in R-FM. CONCLUSION: In this study, R-CHOP and R-FM were superior to R-CVP in terms of 3-year TTF and PFS. In addition, R-CHOP had a better risk-benefit ratio compared with R-FM.
RCT Entities:
PURPOSE: Although rituximab (R) is commonly used for patients with advanced follicular lymphoma (FL) requiring treatment, the optimal associated chemotherapy regimen has yet to be clarified. PATIENTS AND METHODS: We conducted an open-label, multicenter, randomized trial among adult patients with previously untreated stages II to IV FL to compare efficacy of eight doses of R associated with eight cycles of cyclophosphamide, vincristine, and prednisone (CVP) or six cycles of cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP) or six cycles of fludarabine and mitoxantrone (FM). The principal end point of the study was time to treatment failure (TTF). RESULTS: There were 534 patients enrolled onto the study. Overall response rates were 88%, 93%, and 91% for R-CVP, R-CHOP, and R-FM, respectively (P=.247). After a median follow-up of 34 months, 3-year TTFs were 46%, 62%, and 59% for the respective treatment groups (R-CHOP v R-CVP, P=.003; R-FM v R-CVP, P=.006; R-FM v R-CHOP, P=.763). Three-year progression-free survival (PFS) rates were 52%, 68%, and 63% (overall P=.011), respectively, and 3-year overall survival was 95% for the whole series. R-FM resulted in higher rates of grade 3 to 4 neutropenia (64%) compared with R-CVP (28%) and R-CHOP (50%; P< .001). Overall, 23 second malignancies were registered during follow-up: four in R-CVP, five in R-CHOP, and 14 in R-FM. CONCLUSION: In this study, R-CHOP and R-FM were superior to R-CVP in terms of 3-year TTF and PFS. In addition, R-CHOP had a better risk-benefit ratio compared with R-FM.
Authors: Kami Maddocks; Paul M Barr; Bruce D Cheson; Richard F Little; Lawrence Baizer; Brad S Kahl; John P Leonard; Nathan Fowler; Leo I Gordon; Brian K Link; Jonathan W Friedberg; Stephen M Ansell Journal: J Natl Cancer Inst Date: 2016-12-31 Impact factor: 13.506
Authors: Nathan H Fowler; R Eric Davis; Seema Rawal; Loretta Nastoupil; Fredrick B Hagemeister; Peter McLaughlin; Larry W Kwak; Jorge E Romaguera; Michelle A Fanale; Luis E Fayad; Jason R Westin; Jatin Shah; Robert Z Orlowski; Michael Wang; Francesco Turturro; Yasuhiro Oki; Linda C Claret; Lei Feng; Veerabhadran Baladandayuthapani; Tariq Muzzafar; Kenneth Y Tsai; Felipe Samaniego; Sattva S Neelapu Journal: Lancet Oncol Date: 2014-10-15 Impact factor: 41.316
Authors: Jacob D Soumerai; Andy Ni; Anna Alperovich; Connie Batlevi; Kurt S Bantilan; Thais Fischer; Amanda R Copeland; Katy Smith; Zhitao Ying; Anas Younes; Andrew D Zelenetz Journal: Leuk Lymphoma Date: 2020-07-15
Authors: Chaitra S Ujjani; Sin-Ho Jung; Brandelyn Pitcher; Peter Martin; Steven I Park; Kristie A Blum; Sonali M Smith; Myron Czuczman; Matthew S Davids; Ellis Levine; Lionel D Lewis; Scott E Smith; Nancy L Bartlett; John P Leonard; Bruce D Cheson Journal: Blood Date: 2016-10-03 Impact factor: 22.113