Skip to main content
Erschienen in: Medical Oncology 4/2012

01.12.2012 | Original Paper

Comparison on therapeutic effects of RFT and RCTVP regimen in the treatment of patients with indolent B-cell lymphoma in China

verfasst von: Yun Hou, Hua-qing Wang, Yi Ba

Erschienen in: Medical Oncology | Ausgabe 4/2012

Einloggen, um Zugang zu erhalten

Abstract

To compare the efficacy and safety of RFT (retuximab, fludarabine, pirarubicin) with RCTVP (retuximab, cyclophophamide, pirarubicin, vindesine and prednisone) in 248 indolent B-cell non-Hodgkin’s lymphoma (NHL) patients. Two hundred and forty-eight patients with indolent B-cell NHL were treated with combined chemotherapy, including RFT and RCTVP, from January 2002 to December 2010 in Tianjin Cancer Hospital. The rate of response, toxicity and long-term survival for the two regimens were analyzed retrospectively. For the previously untreated patients, overall response rate for RFT arm and RCTVP arm was 71.7 and 70.6%, and complete response rate was 47.5 and 54.9%, respectively (P > 0.05). For the refractory and relapsed patients, overall response (OR) rate and complete response (CR) rate were significantly improved in the RFT arm versus the RCTVP arm (P < 0.05). There were no statistically significant differences in overall survival (OS) between treatment groups. Comparing with RCTVP regimen, fludarabine-based treatment was associated with superior PFS both in previously untreated, refractory and relapsed patients. WHO grades 3 and 4 hematological adverse events were more common in the RFT arm. Neurotoxicity was more common in the RCTVP arm. For the previously untreated patients, there was no difference between RFT arm and RCTVP arm on OR and CR rates. For the refractory and relapsed indolent B-cell NHL patients who received RFT regimen achieved higher OR and CR rates compared with RCTVP-treated patients. No differences in OS were noted. RFT regimen was associated with superior PFS both in previously untreated, refractory and relapsed patients. RFT regimen is effective and well tolerated for patients with untreated, refractory and relapsed indolent B-cell NHL.
Literatur
1.
Zurück zum Zitat Nickenig C, Dreyling M, Hoster E, et al. Combined cyclophosphamide, vincristine, doxorubicin, and prednisone (CHOP) improves response rates but not survival and has lower hematologic toxicity compared with combined mitoxantrone, chlorambucil, and prednisone (MCP) in follicular and mantle cell lymphomas: results of a prospective randomized trial of the German Low-Grade Lymphoma Study Group. Cancer. 2006;107(5):1014–22.PubMedCrossRef Nickenig C, Dreyling M, Hoster E, et al. Combined cyclophosphamide, vincristine, doxorubicin, and prednisone (CHOP) improves response rates but not survival and has lower hematologic toxicity compared with combined mitoxantrone, chlorambucil, and prednisone (MCP) in follicular and mantle cell lymphomas: results of a prospective randomized trial of the German Low-Grade Lymphoma Study Group. Cancer. 2006;107(5):1014–22.PubMedCrossRef
2.
Zurück zum Zitat Heinzelmann F, Ottinger H, Engelhard M, et al. Advanced-stage III/IV follicular lymphoma: treatment strategies for individual patients. Strahlenther Oncol. 2010;186(5):247–54.CrossRef Heinzelmann F, Ottinger H, Engelhard M, et al. Advanced-stage III/IV follicular lymphoma: treatment strategies for individual patients. Strahlenther Oncol. 2010;186(5):247–54.CrossRef
3.
Zurück zum Zitat Robak T, Lech-Maranda E, Robak P. Rituximab plus fludarabine and cyclophosphamide or other agents in chronic lymphocytic leukemia. Expert Rev Anticancer Ther. 2010;10(10):1529–43.PubMedCrossRef Robak T, Lech-Maranda E, Robak P. Rituximab plus fludarabine and cyclophosphamide or other agents in chronic lymphocytic leukemia. Expert Rev Anticancer Ther. 2010;10(10):1529–43.PubMedCrossRef
4.
Zurück zum Zitat Schulz H, Bohlius JF, Trelle S, et al. Immunochemotherapy with rituximab and overall survival in patients with indolent or mantle cell lymphoma: a systematic review and meta-analysis. J Natl Cancer Inst. 2007;99(9):706–14.PubMedCrossRef Schulz H, Bohlius JF, Trelle S, et al. Immunochemotherapy with rituximab and overall survival in patients with indolent or mantle cell lymphoma: a systematic review and meta-analysis. J Natl Cancer Inst. 2007;99(9):706–14.PubMedCrossRef
5.
Zurück zum Zitat Luminari S, Marcheselli L, Sacchi S, et al. Anthracycline-fludarabine-containing regimens with or without rituximab in the treatment of patients with advanced follicular lymphoma. Cancer. 2009;115(9):1906–13.PubMedCrossRef Luminari S, Marcheselli L, Sacchi S, et al. Anthracycline-fludarabine-containing regimens with or without rituximab in the treatment of patients with advanced follicular lymphoma. Cancer. 2009;115(9):1906–13.PubMedCrossRef
6.
Zurück zum Zitat Klasa RJ, Meyer RM, Shustik C, et al. Randomized phase III study of fludarabine phosphate versus cyclophosphamide, vincristine, and prednisone in patients with recurrent low-grade non-Hodgkin’s lymphoma previously treated with an alkylating agent or alkylator-containing regimen. J Clin Oncol. 2002;20:4649–54.PubMedCrossRef Klasa RJ, Meyer RM, Shustik C, et al. Randomized phase III study of fludarabine phosphate versus cyclophosphamide, vincristine, and prednisone in patients with recurrent low-grade non-Hodgkin’s lymphoma previously treated with an alkylating agent or alkylator-containing regimen. J Clin Oncol. 2002;20:4649–54.PubMedCrossRef
7.
Zurück zum Zitat Demidem A, Lam T, Alas S, et al. Chimeric anti-CD20 (IDEC-C2B8) monoclonal antibody sensitizes a B cell lymphoma cell line to cell killing by cytotoxic drugs. Cancer Biother Radiopharm. 1997;12:177–86.PubMedCrossRef Demidem A, Lam T, Alas S, et al. Chimeric anti-CD20 (IDEC-C2B8) monoclonal antibody sensitizes a B cell lymphoma cell line to cell killing by cytotoxic drugs. Cancer Biother Radiopharm. 1997;12:177–86.PubMedCrossRef
8.
Zurück zum Zitat Lin TS, Blum KA, Fischer DB, et al. Flavopiridol, fludarabine, and rituximab in mantle cell lymphoma and indolent B-cell lymphoproliferative disorders. J Clin Oncol. 2010;28(3):418–23.PubMedCrossRef Lin TS, Blum KA, Fischer DB, et al. Flavopiridol, fludarabine, and rituximab in mantle cell lymphoma and indolent B-cell lymphoproliferative disorders. J Clin Oncol. 2010;28(3):418–23.PubMedCrossRef
9.
Zurück zum Zitat Hiddemann W, Forstpointner R, Fiedler F, et al. The addition of rituximab to combination chemotherapy with fludarabine, cyclophosphamide, mitoxantrone (FCM) results in a significant increase of overall response as compared to FCM alone in patients with relapsed or refractory follicular (FCL) and mantle cell lymphomas (MCL): results of a prospective randomized comparison of the German Low Grade Study Group (GLSG). Blood. 2001; 98:844a (abstr 3507). Hiddemann W, Forstpointner R, Fiedler F, et al. The addition of rituximab to combination chemotherapy with fludarabine, cyclophosphamide, mitoxantrone (FCM) results in a significant increase of overall response as compared to FCM alone in patients with relapsed or refractory follicular (FCL) and mantle cell lymphomas (MCL): results of a prospective randomized comparison of the German Low Grade Study Group (GLSG). Blood. 2001; 98:844a (abstr 3507).
10.
Zurück zum Zitat McLaughlin P, Hagemeister FB, Rodriguez MA, et al. Safety of fludarabine, mitoxantrone, and dexamethasone combined with rituximab in the treatment of stage IV indolent lymphoma. Semin Oncol. 2000;27(6 Suppl 12):37–41.PubMed McLaughlin P, Hagemeister FB, Rodriguez MA, et al. Safety of fludarabine, mitoxantrone, and dexamethasone combined with rituximab in the treatment of stage IV indolent lymphoma. Semin Oncol. 2000;27(6 Suppl 12):37–41.PubMed
11.
Zurück zum Zitat Zinzani PL, Magagnoli M, Moretti L, et a1. Randomized Trial of Fludarabine Versus Fludarabine and darubicin as frontline treatment in patients with indolent or mantle-cell lymphoma [J]. J Clin Oncol. 2003; 18:773–779. Zinzani PL, Magagnoli M, Moretti L, et a1. Randomized Trial of Fludarabine Versus Fludarabine and darubicin as frontline treatment in patients with indolent or mantle-cell lymphoma [J]. J Clin Oncol. 2003; 18:773–779.
12.
Zurück zum Zitat Hagenbeek A, Eghbali H, Monfardini S, et al. Phase III intergroup study of fludarabine phosphate compared with cyclophosphamide, vincristine, and prednisone chemotherapy in newly diagnosed patients with stage III and IV low-grade malignant Non-Hodgkin’s lymphoma. J Clin Oncol. 2006;24(10):1590–6.PubMedCrossRef Hagenbeek A, Eghbali H, Monfardini S, et al. Phase III intergroup study of fludarabine phosphate compared with cyclophosphamide, vincristine, and prednisone chemotherapy in newly diagnosed patients with stage III and IV low-grade malignant Non-Hodgkin’s lymphoma. J Clin Oncol. 2006;24(10):1590–6.PubMedCrossRef
13.
Zurück zum Zitat Hagenbeek H, Eghbali S, Monfardini E, et al. Fludarabine versus conventional CVP chemotherapy in newly diagnosed patients with stages 3 and 4 low grade malignant non-Hodgkin’s: Preliminary results from a prospective randomized phase 3 clinical trial in 381 patients. Blood. 1998;92:1294. Hagenbeek H, Eghbali S, Monfardini E, et al. Fludarabine versus conventional CVP chemotherapy in newly diagnosed patients with stages 3 and 4 low grade malignant non-Hodgkin’s: Preliminary results from a prospective randomized phase 3 clinical trial in 381 patients. Blood. 1998;92:1294.
14.
Zurück zum Zitat Carney DA, Westerman DA, Tam CS, Milner A, Prince HM, Kenealy M, Wolf M, Januszewicz EH, Ritchie D, Came N, Seymour JF. Therapy-related myelodysplastic syndrome and acute myeloid leukemia following fludarabine combination chemotherapy. Leukemia. 2010;24(12):2056–62. Carney DA, Westerman DA, Tam CS, Milner A, Prince HM, Kenealy M, Wolf M, Januszewicz EH, Ritchie D, Came N, Seymour JF. Therapy-related myelodysplastic syndrome and acute myeloid leukemia following fludarabine combination chemotherapy. Leukemia. 2010;24(12):2056–62.
15.
Zurück zum Zitat Gill S, Carney D, Ritchie D, et al. The frequency, manifestations, and duration of prolonged cytopenias after first-line fludarabine combination chemotherapy. Ann Oncol. 2010; 21(2):331–4 (Epub 22nd July 2009). Gill S, Carney D, Ritchie D, et al. The frequency, manifestations, and duration of prolonged cytopenias after first-line fludarabine combination chemotherapy. Ann Oncol. 2010; 21(2):331–4 (Epub 22nd July 2009).
Metadaten
Titel
Comparison on therapeutic effects of RFT and RCTVP regimen in the treatment of patients with indolent B-cell lymphoma in China
verfasst von
Yun Hou
Hua-qing Wang
Yi Ba
Publikationsdatum
01.12.2012
Verlag
Springer US
Erschienen in
Medical Oncology / Ausgabe 4/2012
Print ISSN: 1357-0560
Elektronische ISSN: 1559-131X
DOI
https://doi.org/10.1007/s12032-012-0184-1

Weitere Artikel der Ausgabe 4/2012

Medical Oncology 4/2012 Zur Ausgabe

Adjuvante Immuntherapie verlängert Leben bei RCC

25.04.2024 Nierenkarzinom Nachrichten

Nun gibt es auch Resultate zum Gesamtüberleben: Eine adjuvante Pembrolizumab-Therapie konnte in einer Phase-3-Studie das Leben von Menschen mit Nierenzellkarzinom deutlich verlängern. Die Sterberate war im Vergleich zu Placebo um 38% geringer.

Alectinib verbessert krankheitsfreies Überleben bei ALK-positivem NSCLC

25.04.2024 NSCLC Nachrichten

Das Risiko für Rezidiv oder Tod von Patienten und Patientinnen mit reseziertem ALK-positivem NSCLC ist unter einer adjuvanten Therapie mit dem Tyrosinkinase-Inhibitor Alectinib signifikant geringer als unter platinbasierter Chemotherapie.

Bei Senioren mit Prostatakarzinom auf Anämie achten!

24.04.2024 DGIM 2024 Nachrichten

Patienten, die zur Behandlung ihres Prostatakarzinoms eine Androgendeprivationstherapie erhalten, entwickeln nicht selten eine Anämie. Wer ältere Patienten internistisch mitbetreut, sollte auf diese Nebenwirkung achten.

ICI-Therapie in der Schwangerschaft wird gut toleriert

Müssen sich Schwangere einer Krebstherapie unterziehen, rufen Immuncheckpointinhibitoren offenbar nicht mehr unerwünschte Wirkungen hervor als andere Mittel gegen Krebs.

Update Onkologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.