Randomized phase II study of concurrent and sequential rituximab and CHOP chemotherapy in untreated indolent B-cell lymphoma.

Abstract

CHOP combined with rituximab (R-CHOP) is regarded as one of the most effective treatments for indolent B-cell non-Hodgkin lymphoma (B-NHL), however, its optimal combination schedule remains unknown. We performed a randomized phase II study to explore a more promising schedule in untreated, advanced indolent B-NHL. Patients were randomized to receive either six courses of CHOP concurrently with rituximab (Arm C), or six courses of CHOP followed by six courses of weekly rituximab (Arm S). A total of 69 patients received the concurrent (n=34) or sequential (n=35) regimen. Overall response rate (ORR) in Arm C was 94% (95% confidence interval [CI], 79 to 99), including a 66% complete response (CR) compared with 97% (95% CI, 85-100), including a 68% CR in Arm S. Patients in Arm C experienced more grade 4 neutropenia (85%versus 70%) and experienced more grade 3 or greater non-hematological toxicities (21%versus 12%). Both arms were tolerated well. With a median follow-up of 28.2 months, the median progression-free survival (PFS) time was 34.2 months in Arm C, and was not reached in Arm S. R-CHOP is highly effective in untreated indolent B-NHL, either concurrent or in a sequential combination. Both combination schedules deserve further investigation.

• Authors: Michinori Ogura, Yasuo Morishima, Yoshitoyo Kagami, Takashi Watanabe, Kuniaki Itoh, Tadahiko Igarashi, Tomomitsu Hotta, Tomohiro Kinoshita, Yasuo Ohashi, Shigeo Mori, Takashi Terauchi, Kensei Tobinai
• Journal: Cancer science (Cancer Sci) Vol. 97 Issue 4 Pg. 305-12 (Apr 2006) ISSN: 1347-9032 [Print] England
• PMID: 16630123 (Publication Type: Clinical Trial, Phase II, Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)
• Copyright: (Cancer Sci 2006; 97: 305 - 312).

Chemical References

• Antibodies, Monoclonal
• Antibodies, Monoclonal, Murine-Derived
• Rituximab
• Vincristine
• Doxorubicin
• Cyclophosphamide
• Prednisolone

Topics

• Adult
• Aged
• Antibodies, Monoclonal (administration & dosage)
• Antibodies, Monoclonal, Murine-Derived
• Antineoplastic Combined Chemotherapy Protocols (administration & dosage, therapeutic use)
• Cyclophosphamide (administration & dosage)
• Doxorubicin (administration & dosage)
• Female
• Humans
• Lymphoma, B-Cell (drug therapy)
• Lymphoma, Follicular (drug therapy)
• Lymphoma, Non-Hodgkin (drug therapy)
• Male
• Middle Aged
• Prednisolone (administration & dosage)
• Rituximab
• Survival Rate
• Treatment Outcome
• Vincristine (administration & dosage)