Rituximab combined with chemotherapy and interferon in follicular lymphoma patients: results of the GELA-GOELAMS FL2000 study.

Abstract

The FL2000 study was undertaken to evaluate the combination of the anti-CD20 monoclonal antibody rituximab with chemotherapy plus interferon in the first-line treatment of follicular lymphoma patients with a high tumor burden. Patients were randomly assigned to receive either 12 courses of the chemotherapy regimen CHVP (cyclophosphamide, adriamycin, etoposide, and prednisolone) plus interferon-alpha2a (CHVP+I arm) over 18 months or 6 courses of the same chemotherapy regimen combined with 6 infusions of 375 mg/m(2) rituximab and interferon for the same time period (R-CHVP+I arm). After a median follow-up of 5 years, event-free survival estimates were, respectively, 37% (95% confidence interval [CI], 29%-44%) and 53% (95% CI, 45%-60%) in the CHVP+I and R-CHVP+I arm (P = .001). Five-year overall survival estimates were not statistically different in the CHVP+I (79%; 95% CI, 72%-84%) and R-CHVP+I (84%; 95% CI, 78%-84%) arms. In a multivariate regression analysis, event-free survival was significantly influenced by both the Follicular Lymphoma International Prognostic Index score (hazard ratio = 2.08; 95% CI, 1.6%-2.8%) and the treatment arm (hazard ratio = 0.59; 95% CI, 0.44%-0.78%). With a 5-year follow-up, the combination of rituximab with CHVP+I provides superior disease control in follicular lymphoma patients despite a shorter duration of chemotherapy. This study's clinical trial was registered at the National Institutes of Health website as no. NCT00136552.

• Authors: Gilles Salles, Nicolas Mounier, Sophie de Guibert, Franck Morschhauser, Chantal Doyen, Jean-François Rossi, Corinne Haioun, Pauline Brice, Béatrice Mahé, Reda Bouabdallah, Bruno Audhuy, Christophe Ferme, Caroline Dartigeas, Pierre Feugier, Catherine Sebban, Luc Xerri, Charles Foussard
• Journal: Blood (Blood) Vol. 112 Issue 13 Pg. 4824-31 (Dec 15 2008) ISSN: 1528-0020 [Electronic] United States
• PMID: 18799723 (Publication Type: Journal Article, Multicenter Study, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)

Chemical References

• Antibodies, Monoclonal
• Antibodies, Monoclonal, Murine-Derived
• Interferon alpha-2
• Interferon-alpha
• Recombinant Proteins
• Rituximab
• Etoposide
• Doxorubicin
• Cyclophosphamide
• Prednisolone

Topics

• Antibodies, Monoclonal (administration & dosage)
• Antibodies, Monoclonal, Murine-Derived
• Antineoplastic Combined Chemotherapy Protocols (therapeutic use)
• Cyclophosphamide
• Doxorubicin
• Etoposide
• Humans
• Interferon alpha-2
• Interferon-alpha (administration & dosage)
• Lymphoma, Follicular (diagnosis, drug therapy, mortality)
• Prednisolone
• Prognosis
• Recombinant Proteins
• Rituximab
• Survival Analysis
• Treatment Outcome