Multicenter, Open-Label, Phase II Study of Bendamustine and Rituximab Followed by 90-Yttrium (Y) Ibritumomab Tiuxetan for Untreated Follicular Lymphoma (Fol-BRITe)

Abstract

Purpose: Bendamustine and rituximab (BR) has been established as a superior frontline therapy over R-CHOP in the treatment of follicular lymphoma (FL). Yttrium-90 Ibritumomab tiuxetan (90 YIT) is an effective consolidation strategy after chemotherapy induction. This prospective, single-arm, multicenter, phase II trial evaluated the response rate, progressionfree survival (PFS), and tolerability of BR followed by consolidation with 90 YIT in patients with untreated FL. Patients and Methods: The study included grade 1 to 3a FL patients aged 18 years, chemotherapy-na€ ve, and requiring treatment for stage II-IV disease. Study treatment included an initial rituximab treatment, followed by four cycles of BR. Patients were eligible for consolidation with 90 YIT, 6 to 12 weeks after BR, if they obtained at least a partial response after induction had adequate count recovery and bone marrow infiltration < 25%. Results: Thirty-nine patients were treated. Eighty-two percent had an intermediate or high-risk Follicular Lymphoma International Prognostic Index score, and 6 of 39 (15%) were grade 3a. The response rate was 94.8%, and the complete response(CR)/CR unconfirmed (CRu) rate was 77% in the intention-to-treat analysis. The conversion rate from PR to CR/Cru after 90 YIT was 81%. After median follow-up of 45 months, the PFS was 0.71 (95% confidence interval, 0.57-0.89). Conclusions: This report demonstrates that four cycles of BR followed by consolidation with 90 YIT achieve high response rates that are durable. In addition, consolidation with 90 YIT results in a high conversion rate of PR to CR/CRu. A short course of BR followed by 90 YIT is a safe and effective regimen for frontline treatment of FL.

A Systematic Review of Clinical Applications of Anti-CD20 Radioimmunotherapy for Lymphoma

“…At a median follow-up of 45 months, OS and PFS were 96% and 71%, respectively. 9 Although this study included a relatively small number of patients, the high ORR and proportion obtaining CR/CRu, compares favorably to the BRIGHT and StiL studies of 6 cycles of rituximab-bendamustine, demonstrating a CR of 31% and 40%, respectively. 10 , 11 …”

“…Fol-BRITe was a prospective multicenter trial that evaluated the response rate, PFS, and tolerability of BR followed by consolidation with 90Y-IT in patients with untreated FL. 9 The study included 39 chemotherapy-naïve patients with stages II-IV disease treated with rituximab, 375 mg/m 2 , followed by four 28-day cycles of rituximab 375 mg/m 2 on day 1 and bendamustine 90 mg/m 2 on days 1 and 2. Patients were eligible for consolidation with 90Y-IT, 6-12 weeks later, if they obtained a PR after induction and had adequate count recovery and bone marrow infiltration <25%.…”

Consolidation with 90Yttrium‐ibritumomab tiuxetan after bendamustine and rituximab for relapsed follicular lymphoma

“…To date, several randomized and non‐randomized trials have demonstrated the utility of 90 Y‐IT as a consolidation therapy after initial FL treatment, including one evaluating the combination with 90 Y‐IT consolidation and rituximab maintenance (Table 4). 3,4,11–16 In addition to these promising results, the data from the BRiZ study demonstrate that patients with FL may also benefit from 90 Y‐IT consolidation, if they can achieve a high‐quality response after second or third‐line immunochemotherapy with BR.…”

Integrative Bioinformatics Approaches to Screen Potential Prognostic Immune-Related Genes and Drugs in the Cervical Cancer Microenvironment

“…Cetuximab, an anti-epidermal growth factor receptor monoclonal antibody, is a standard option for the treatment of advanced cervical cancer (Meira et al, 2009). Fourteen drugs were identified, including catumaxomab, aldesleukin, trastuzumab, and ibritumomab tiuxetan, all of which have been confirmed for various cancers, including malignant ascites (Kietpeerakool et al, 2019), renal cell carcinoma (Fishman et al, 2019), gastric cancer (Kimura et al, 2018), and lymphoma (Lansigan et al, 2019), respectively. Among drug-interactions obtained, Staurosporine has been reported to target ZAP70 (Overington et al, 2006), but their interaction in cancer research is still blank.…”