Follicular lymphoma: short-course BR followed by 90YIT consolidation delivers high, durable response

  • Lansigan F & al.
  • Clin Cancer Res
  • 26 Jun 2019

  • curated by David Reilly
  • Univadis Clinical Summaries
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Takeaway

  • Patients with previously untreated follicular lymphoma (FL) achieved high rates of durable response with a short course of first-line bendamustine+rituximab (BR) followed by consolidation 90Y ibritumomab tiuxetan (90YIT).
  • With 90YIT, more than 8 in 10 patients converted from partial response (PR) to complete response/complete response unconfirmed (CR/CRu).

Why this matters

  • Radioimmunotherapy (RIT) consolidation has demonstrated high CR after short courses of rituximab, cyclophosphamide, vincristine, and prednisone (R-CVP) or rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP).
  • BR has demonstrated improved tolerability and longer PFS as first-line therapy vs R-CHOP.  

Study design

  • Phase 2 study to investigate 4 cycles of BR followed by consolidation 90YIT in 39 patients with treatment-naive FL.
  • Median patient age, 57 (range, 31-75) years.
  • 82.1% had intermediate/high-risk Follicular Lymphoma International Prognostic Index 1 (FLIPI 1) scores.
  • Funding: Teva Pharmaceutical Industries Ltd.; Spectrum Pharmaceuticals, Inc.

Key results

  • 94.8% overall response rate.
  • 77% achieved CR/CRu as best response.
  • 81% conversion from PR to CR/CRu.
  • Median follow-up, 0.71 (95% CI, 0.57-0.89) PFS at 45 months.
  • BR was well tolerated; grade 3-4 toxicities during 90YIT included neutropenia (76%), thrombocytopenia (74%), and anemia (6%).

Limitations

  • Single-group study.