Follicular lymphoma: 13-year data for rituximab-based frontline therapy

  • Bruna R, et al.
  • Haematologica
  • 11 Apr 2019

  • curated by David Reilly
  • Univadis Clinical Summaries
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Takeaway

  • Patients with advanced follicular lymphoma (FL) treated with frontline rituximab-based therapy achieved excellent long-term survival with approximately 13 years of follow-up, regardless of the use of intensified or conventional treatment.

Why this matters

  • This study has the longest follow-up data reported in this setting.  

Study design

  • Study to investigate the superiority of high-dose chemotherapy+rituximab and autologous hematopoietic stem cell transplantation (R-HDS) vs conventional R-CHOP chemoimmunotherapy (rituximab, cyclophosphamide, doxorubicin, and prednisone) as frontline treatment in 136 patients with Ann Arbor stage III/IV FL.
  • Funding: Ministero Italiano Università e Ricerca; Banca del Piemonte; Compagnia di San Paolo; Regione Piemonte; Roche.

Key results

  • 68.5% 13-year estimated OS with R-CHOP vs 64.5% with R-HDS (P=.523).
  • 59.1% of patients achieved complete remission (CR) with R-CHOP vs 86.7% with R-HDS.
  • In multivariate analysis (without polymerase chain reaction), achievement of CR was the strongest factor for improved survival (HR for CR vs no CR, 3.82; 95% CI, 2.12-6.89; P<.001>
  • 26.6% 13-year estimated EFS with R-CHOP vs 48.5% with R-HDS (P=.002).
  • 28.8% 13-year estimated PFS with R-CHOP vs 59.1% with R-HDS (P<.001>

Limitations

  • Clinical prognostic scores have since been updated.

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