Short duration immunochemotherapy followed by radioimmunotherapy consolidation is effective and well tolerated in relapsed follicular lymphoma: 5-year results from a UK National Cancer Research Institute Lymphoma Group study.

Abstract

UNLABELLED:

We report a phase II study to evaluate the efficacy and toxicity of abbreviated immunochemotherapy followed by (90) Y Ibritumomab tiuxetan ((90) Y-IT) in patients with recurrent follicular lymphoma. Of the 52 patients enrolled, 50 were treated with three cycles of R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, prednisolone) or R-CVP (rituximab, cyclophosphamide, vincristine, prednisolone), followed by (90) Y-IT regimen (15 MBq/kg, maximum 1200 MBq) preceded by two infusions of 250 mg/m(2) rituximab. The overall response rate was 98% with complete response (CR) 30% and partial response (PR) 68%. 18 patients with a PR following chemotherapy improved to a CR following (90) Y-IT: a conversion rate of 40%. Seven patients with PR following (90) Y-IT subsequently improved to a CR 12-18 months later, leading to an overall CR rate of 44%. With a median follow-up of 5 years, median progression-free survival was 23·1 months and overall survival was 77·5% at 5 years. High trough serum rituximab levels (median 112 μg/ml; range 52-241) were attained after four doses of rituximab, prior to (90) Y-IT; this was not found to influence response rates. The treatment was well tolerated with few (13·5%) grade 3 or 4 infective episodes and manageable haematological toxicity. Abbreviated immunochemotherapy followed by (90) Y-IT is an effective and well-tolerated treatment in recurrent follicular lymphoma patients previously exposed to rituximab.

TRIAL REGISTRATION:

clinicaltrials.gov identifier: NCT00637832.

• Authors: Tim M Illidge, Hayley S McKenzie, Sam Mayes, Andrew Bates, Andrew J Davies, Ruth Pettengell, Louise Stanton, Kelly Cozens, Grace Hampson, Caroline Dive, Maureen Zivanovic, Jill Tipping, Eve Gallop-Evans, John A Radford, Peter W M Johnson
• Journal: British journal of haematology (Br J Haematol) Vol. 173 Issue 2 Pg. 274-82 (Apr 2016) ISSN: 1365-2141 [Electronic] England
• PMID: 26849853 (Publication Type: Clinical Trial, Phase II, Journal Article, Multicenter Study, Research Support, Non-U.S. Gov't)
• Copyright: © 2016 John Wiley & Sons Ltd.

Chemical References

• Antibodies, Monoclonal
• Antibodies, Monoclonal, Murine-Derived
• Antineoplastic Agents
• R-CHOP protocol
• Radiopharmaceuticals
• Rituximab
• ibritumomab tiuxetan
• Vincristine
• Doxorubicin
• Cyclophosphamide
• Prednisone

Topics

• Adult
• Aged
• Aged, 80 and over
• Antibodies, Monoclonal (administration & dosage, adverse effects)
• Antibodies, Monoclonal, Murine-Derived (administration & dosage, adverse effects)
• Antineoplastic Agents (pharmacokinetics)
• Antineoplastic Combined Chemotherapy Protocols (administration & dosage, adverse effects, therapeutic use)
• Cyclophosphamide (administration & dosage, adverse effects)
• Doxorubicin (administration & dosage, adverse effects)
• Female
• Humans
• Immunotherapy (adverse effects, methods)
• Lymphoma, Follicular (therapy)
• Male
• Middle Aged
• Neoplasm Recurrence, Local (therapy)
• Prednisone (administration & dosage, adverse effects)
• Prospective Studies
• Radioimmunotherapy (adverse effects, methods)
• Radiopharmaceuticals (administration & dosage, adverse effects)
• Rituximab (pharmacokinetics)
• Treatment Outcome
• Vincristine (administration & dosage, adverse effects)