Early reports suggested that therapy with rituximab(Drug information on rituximab) might be less effective in patients with bulky nodal disease. At the ASH meeting, Davis et al (abstract #1711) reported on 31 patients with indolent NHL and masses measuring ³ 10 cm who received rituximab in four weekly infusions. Of the 31 patients, 1 patient (4%) had a complete remission, and 11 patients responded partially, for an overall response rate of 43%. However, the duration of response was only 8.1 months.
This response rate does not appear to be significantly worse than that observed in patients with smaller tumors, although responses may be less durable. Therefore, the presence of a high tumor burden, such as bulky nodes, should not discourage the use of this antibody.
Bruce D. Cheson, MD