Response Criteria for NHL: Importance of “Normal” Lymph Node Size and Correlations With Response

Publication
Article
OncologyONCOLOGY Vol 13 No 3
Volume 13
Issue 3

There are standard response criteria for solid tumors, chronic lymphocytic leukemia, Hodgkin’s disease, and acute myelogenous

There are standard response criteria for solid tumors, chronic lymphocytic leukemia, Hodgkin’s disease, and acute myelogenous leukemia but none for non-Hodgkin’s lymphoma (NHL). A panel was convened to develop response criteria for NHL (Proc Am Soc Clin Oncol, 1997), which were later endorsed by an international group of lymphoma experts (Proc Int Soc Exper Hematol, 1997).

The response criteria were applied by a third-party, blinded panel of NHL experts (LEXCOR) to a 166-patient study of rituximab (Rituxan). The database includes measurements for all measurable lesions, allowing a computerized evaluation of different sets of response criteria. We performed an analysis applying our rigorous criterion for “normal” lymph node size (£ 1 × 1 cm) compared with two alternative criteria (£ 1.5 × 1.5 cm and £ 2 × 2 cm).

As anticipated, our £ 1 × 1 cm criterion resulted in a lower complete response (CR) rate than the less stringent criteria. The overall response rate was not affected. Our response criteria also required a confirmatory evaluation at ³ 28 days after the first evidence of a response. When this criterion was not applied, a progressive increase in CR rates was seen: criteria A, B, and C; 12%, 26%, and 36%, respectively. There is no reason to restrict study entry according to lymph node size, as this did not affect response rates when our rigorous criteria were applied.

CONCLUSION: Efficacy of NHL anticancer agents must be carefully weighed in literature reports without clearly defined response criteria. Standard response criteria are now being developed by the National Cancer Institute (NCI) in collaboration with international experts and based on our rigorous response criteria for NHL.

Click here for Dr. Bruce Cheson’s commentary on this abstract.

Articles in this issue

WHO Declares Lymphatic Mapping to Be the Standard of Care for Melanoma
Rituximab: Phase II Retreatment Study in Patients With Low-Grade or Follicular Non-Hodgkin’s Lymphoma
Response Criteria for NHL: Importance of “Normal” Lymph Node Size and Correlations With Response
Chemotherapy Plus Radiation Improves Survival in Patients With Cervical Cancer
A Randomized Trial of Fludarabine, Mitoxantrone (FM) Versus Doxorubicin, Cyclophosphamide, Vindesine, Prednisone (CHEP) as First Line Treatment in Patients With Advanced Low-Grade Non-Hodgkin's Lymphoma: A Multicenter Study by GOELAMS Group
Navelbine Increased Elderly Lung Cancer Patients’ Survival
Fludarabine Versus Conventional CVP Chemotherapy in Newly C Diagnosed Patients With Stages III and IV Low-Grade Malignant Non-Hodgkin’s Lymphoma: Preliminary Results From a Prospective, Randomized Phase III Clinical Trial in 381 Patients
Multicenter, Phase III Study of Iodine-131 Tositumomab (Anti-B1 Antibody) for Chemotherapy-Refractory Low-Grade or Transformed Low-Grade Non-Hodgkin’s Lymphoma
T-Cell–Depleted Allogeneic Bone Marrow Transplant From HLA-Matched Sibling Donors for Non-Hodgkin’s Lymphoma
Consensus Statement on Prevention and Early Diagnosis of Lung Cancer
In Vivo Purging and Adjuvant Immunotherapy With Rituximab During PBSC Transplant For NHL
Fludarabine and Cyclophosphamide: A Highly Active and Well-Tolerated Regimen for Patients With Previously Untreated Indolent Lymphomas
Campath-1H Monoclonal Antibody in Therapy for Advanced Low-Grade Non-Hodgkin’s Lymphomas: A Phase II Study
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Rituximab Therapy in Previously Treated Waldenström’s Macroglobulinemia: Preliminary Evidence of Activity
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