ORLANDO, FloridaAdding rituximab (Rituxan) to standard chemotherapy
for follicular lymphoma regimens improves the rate and quality of responses
and increases clearance of the bcl-2/IgH chimeric gene, according to studies
from US and Italian cooperative groups reported at the 43rd Annual Meeting
of the American Society of Hematology.
David G. Maloney, MD, PhD, reported on behalf of the Southwest Oncology
Group (SWOG) that treating advanced-stage follicular lymphoma with a cycle
of rituximab after standard CHOP (cyclophosphamide [Cytoxan, Neosar],
doxorubicin HCl, vincristine [Oncovin], prednisone) significantly improved
the quality of responses in 19% of patients, and brought the complete
response rate to 54%.
Pier Luigi Zinzani, MD, PhD, reported on behalf of the Italian
Cooperative Study Group on Lymphoma that adding rituximab to either FM
(fludarabine [Fludara], mitoxantrone [Novantrone]) or CHOP improved both the molecular clearance rate and
the quality of responses in patients with follicular lymphoma.
Dr. Maloney, an associate member at the Fred Hutchinson Cancer Research
Center in Seattle, reported data from the SWOG-9800 trial. "There is currently no consensus on what should be first-line therapy
for advanced follicular non-Hodgkin’s lymphoma (NHL)," Dr. Maloney
said. "Combination chemotherapy usually induces remissions, but nearly
all patients eventually progress and there is no clear plateau on
disease-free survival analysis."
Dr. Maloney reported that SWOG designed a major study of CHOP plus
rituximab because CHOP produces a high response rate, and rituximab is
effective in patients with nonbulky disease and has activity in relapsed
disease. "Single-agent treatment with rituximab induces response rates
of approximately 50% to 60% in patients with relapsed follicular NHL. In
some patients, the molecular detection of disease by polymerase chain
reaction (PCR) assay may be eliminated following antibody therapy," he
End Points Include Safety and Failure-Free Survival