Prolonged treatment with rituximab in patients with follicular lymphoma significantly increases event-free survival and response duration compared with the standard weekly x 4 schedule

Abstract

The potential benefits of extended rituximab treatment have been investigated in a randomized trial comparing the standard schedule with prolonged treatment in 202 patients with newly diagnosed or refractory/relapsed follicular lymphoma (FL). All patients received standard treatment (rituximab 375 mg/m 2 weekly ؋ 4). In 185 evaluable patients, the overall response rate was 67% in chemotherapynaive patients and 46% in pretreated cases (P < .01). Patients responding or with stable disease at week 12 (n ‫؍‬ 151) were randomized to no further treatment

Preclinical and clinical evaluation of epratuzumab (anti-CD22 IgG) in B-cell malignancies

“…Anti-CD20 therapy with rituximab Rituximab, a chimeric anti-CD20 monoclonal antibody (MAb), has been demonstrated to induce responses (mostly partial) in approximately 50% of previously treated patients and 67% of chemotherapy-naı¨ve patients (McLaughlin et al, 1998;Ghielmini et al, 2004). Adding rituximab to combination chemotherapy increases the response rate and response duration compared to chemotherapy alone in FL .…”

“…Retreatment of indolent NHL patients who respond to a course of rituximab single agent therapy for at least 6 months and then progress can result in a second objective response of about 40% of the time (Davis et al, 2000). This observation has led to the development of extended induction or maintenance regimens, designed to provide additional rituximab doses while the patient is in response after an initial induction regimen, in order to potentially extend remission and improve longer-term outcomes (Ghielmini et al, 2004;Hainsworth, 2004).…”

Quality of life during maintenance therapy with the anti-CD20 antibody rituximab in patients with B cell non-Hodgkin’s lymphoma: results of a prospective randomized controlled trial

“…Current studies have shown that a prolonged exposure to rituximab after the end of the primary treatment may reduce relapse rate and improve event-free survival in patients with FL and MCL [13][14][15]. In follicular lymphoma, rituximab maintenance therapy is now part of the standard of care in relapsed disease [10,15].…”

“…Hochster et al [12] reported a significant prolongation of response duration and even survival by R maintenance in patients with previously untreated advanced-stage FL responding to initial therapy without R comprising chemotherapy by cyclophosphamide, vincristine, and prednisone (CVP) alone. In former investigations, Hainsworth et al [13] and Ghielmini et al [14] already had found that R maintenance was beneficial when given to patients with FL who achieved a partial remission or complete remission after initial singleagent first-line R therapy. In a recent publication, R maintenance after R chemotherapy was investigated in patients with recurring or refractory FL and MCL.…”

The role of fludarabine in the treatment of follicular and mantle cell lymphoma

“…In patients with FL, the anti-CD20 antibody rituximab yielded impressive overall response rates (approximately 50 -60%). [65][66][67][68] Because in vitro data suggest that combined immunochemotherapy regimens may exert synergistic effects, various Phase II studies have investigated the efficacy of fludarabinecontaining combinations administered in conjunction with rituximab. To date, such studies have produced encouraging results (Table 6).…”