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Cancer Resources > Cancer News > Cancer News from Reuters > Reuters Cancer News > 2006 > January
Rituximab plus CHOP extends survival in advanced follicular lymphoma
Last Updated: 2006-01-06 14:31:46 -0400 (Reuters Health)
NEW YORK (Reuters Health) - Adding the monoclonal antibody rituximab to cyclophosphamide, doxorubicin, vincristine and prednisone (CHOP) as first-line treatment for patients with advanced follicular lymphoma improves survival without causing serious adverse effects, German researchers report.
Based on the results, as well as those of other studies showing benefit for rituximab in patients with advanced follicular lymphoma, "the question is no longer whether rituximab should be applied with first-line therapy for advanced-stage follicular lymphoma but how it should be applied," Dr. Wolfgang Hiddemann of the University of Munich and colleagues write in the December 1st issue of Blood.
Dr. Hiddemann and his team compared R-CHOP versus CHOP alone in 428 untreated patients with advanced follicular lymphoma. Patients younger than 60 years old who responded to treatment were offered intensification of therapy with stem cell support or interferon alpha maintenance, and patients 60 or older were given interferon alpha maintenance therapy.
During follow-up, which lasted a median of 18 months, overall response rates were 90% for the 205 patients treated with CHOP, and 96% for 223 given R-CHOP. Treatment failure occurred in 28 patients in the R-CHOP group, compared with 61 of those on CHOP only, amounting to a 60% decreased risk of treatment failure with R-CHOP.
After 3 years, six patients on R-CHOP had died, versus 17 on CHOP only, with estimated 2-year survival being 90% for CHOP alone and 95% for R-CHOP. Rate of relapse or progression after successful therapy was significantly lower with rituximab, while time to next therapy was longer.
While severe granulocytopenia occurred in a substantial proportion of the patients in the study -- 53% of those on CHOP only and 63% in those on R-CHOP -- severe infection occurred in only 5% of R-CHOP cycles and 7% of CHOP cycles, the researchers point out.
The findings, along with a 2004 report by Czuczman et al. with a 9-year follow-up period, "raise the specter of survival advantage, if not cure, with R-CHOP in follicular lymphoma," Dr. Wyndham H. Wilson of the National Cancer Institute writes in an accompanying editorial. Gene expression profiling may help identify patients who would benefit from rituximab along with "less 'hair-razing'" chemotherapy regimens, he added.
Blood 2005;106:3678-3679, 3725-3732.
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