ORLANDOAdding rituximab (Rituxan) to paclitaxel (Taxol)/topotecan (Hycamtin)
salvage therapy raises response rates by about 25%, more than triples complete
response rates, and is effective in both primary refractory and relapsed
aggressive B-cell lymphomas.
Phase II Study
Anas Younes, MD, and colleagues from M. D. Anderson Cancer Center reported
data from a 45-patient phase II study of the paclitaxel/topotecan/rituximab
regimen in a poster presentation at the 43rd Annual Meeting of the American
Society of Hematology (ASH abstract 1456).
"We concluded that rituximab improves the response rate of paclitaxel/topotecan
and increases the proportion of complete remissions. There was not a
significantly different toxicity profile with the addition of rituximab.
However, this is not frontline treatment yet," Dr. Younes told ONI in an
The study enrolled 45 patients with relapsed or refractory aggressive
non-Hodgkin’s lymphoma (NHL) and included 34 with diffuse large cell, 4 with
follicular large cell, and 7 with transformed disease. Twenty patients (44%)
had primary refractory disease, and 25 (56%) had relapsed after responding to
previous therapy. Most patients had received only a single previous regimen,
and 15 (33%) had received prior cytarabine/platinum. The median age was 58.
The regimen included paclitaxel 200 mg/m²IV given over 3 hours on day 1,
topotecan 1 mg/m² IV given each day on days 1 to 5, and rituximab 375 mg/m²
given 1 day before each paclitaxel/topotecan course. All patients also
received prophylactic filgrastim (G-CSF, Neupogen). Courses were repeated
every 3 weeks, and patients received a median of three courses.
In patients with primary refractory disease, adding rituximab to the regimen
increased the response rate to 55% from the 31% Dr. Younes had reported in a
previous study of paclitaxel/topotecan in a similar group of patients.