Randomized comparison of MACOP-B with CHOP in patients with intermediate-grade non-Hodgkin's lymphoma. The Australian and New Zealand Lymphoma Group.

Cooper, I.; Wolf, M.; Robertson, T. I.; Fox, Richard M.; Stone, Julius; Ding, J. C.; Dart, G; Matthews, JP; Firkin, Frank

doi:10.1200/jco.1994.12.4.769

Cited by 92 publications

(31 citation statements)

References 21 publications

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“…Before the advent of rituximab, a number of dose-intensified cytotoxic therapies were introduced but these regimens failed to provide substantial improvement over the standard anthracycline based combination of cyclophosphamide, vincristine, doxorubicin and prednisone (CHOP) or CHOP-like chemotherapy. [6][7][8][9][10] In contrast, the addition of rituximab, a monoclonal antibody with a different mechanism of action than traditional cytotoxic chemotherapy, significantly improved the results of initial therapies. [1][2][3][4] Based on these and other studies, R-CHOP (rituximab-cyclophosphamide, doxorubicin, vincristine, and prednisone) has become the standard of care therapy for patients with newly diagnosed aggressive B-cell lymphoma.…”

Section: Introductionmentioning

confidence: 99%

Lenalidomide can be safely combined with R-CHOP (R2CHOP) in the initial chemotherapy for aggressive B-cell lymphomas: phase I study

et al. 2011

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Lenalidomide was shown to have significant single-agent activity in relapsed aggressive non-Hodgkin's lymphoma (NHL). We conducted a phase I trial to establish the maximum tolerated dose of lenalidomide that could be combined with R-CHOP (rituximab-cyclophosphamide, doxorubicin, vincristine, and prednisone). Eligible patients were adults with newly diagnosed, untreated CD20 positive diffuse large cell or follicular grade III NHL. Patients received oral lenalidomide on days 1-10 with standard dose R-CHOP every 21 days. All patients received pegfilgrastim on day 2 of the cycle and aspirin prophylaxis. The lenalidomide dose levels tested were 15, 20 and 25 mg. A total of 24 patients were enrolled. The median age was 65 (35-82) years and 54% were over 60 years. Three patients received 15 mg, 3 received 20 mg and 18 received 25 mg of lenalidomide. No dose limiting toxicity was found, and 25 mg on days 1-10 is the recommended dose for phase II. The incidence of grade IV neutropenia and thrombocytopenia was 67% and 21%, respectively. Febrile neutropenia was rare (4%) and there were no toxic deaths. The overall response rate was 100% with a complete response rate of 77%. Lenalidomide at the dose of 25 mg/day administered on days 1 to 10 of 21-day cycle can be safely combined with R-CHOP in the initial chemotherapy of aggressive B-cell lymphoma.

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Section: Introductionmentioning

confidence: 99%

Lenalidomide can be safely combined with R-CHOP (R2CHOP) in the initial chemotherapy for aggressive B-cell lymphomas: phase I study

et al. 2011

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“…Retrospective reviews in the 1990s suggested an association between an increase in relative dose intensity (RDI) and improved response rates and survival [2,3]. This association was consistent with in vitro studies demonstrating a log-linear relationship between chemotherapy dose and tumour cell kill [4][5][6][7].…”

Section: Introductionmentioning

confidence: 55%

“…Despite the publication of trials comparing different chemotherapy regimens, at the time of trial design there were no studies specifically evaluating dose as the only treatment variable in aggressive NHL [2,3]. In this context, the Australian and New Zealand Lymphoma Group (now the ALLG) designed a study to compare the effectiveness of a high-dose (intensive) CEOP (cyclophosphamide, epirubicin, vincristine, and prednisolone) regimen (i-CEOP) with a standard CEOP regimen (s-CEOP) in patients with advanced aggressive NHL with epirubicin and cyclophosphamide doses in i-CEOP double those in s-CEOP.…”

Section: Introductionmentioning

confidence: 99%

A phase III randomized trial of high‐dose CEOP + filgrastim versus standard‐dose CEOP in patients with non‐Hodgkin lymphoma: 10‐year follow‐up data: Australasian Leukaemia and Lymphoma Group (ALLG) NHL07 trial

et al. 2014

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on behalf of the ALLG Increasing dose intensity (DI) of chemotherapy for patients with aggressive non-Hodgkin lymphoma (NHL) may improve outcomes at the cost of increased toxicity. This issue was addressed in a randomized trial aiming to double the DI of myelosuppressive drugs. Between 1994 and 1999, 250 patients with previously untreated aggressive NHL were randomized to treatment with six cycles of 3-weekly standard (s) or intensive (i) chemotherapy: s-CEOP-cyclophosphamide 750, epirubicin 75, vincristine 1.4 mg/m 2 all on day 1, and prednisolone 100 mg days 1-5; i-CEOP-cyclophosphamide 1,500, epirubicin 150, vincristine 1.4 mg/m 2 all on day 1, and prednisolone 100 mg days 1-5. Primary endpoint was 5-year overall survival (OS). Relative to s-CEOP patients, i-CEOP patients achieved a 78% increase in the DI of cyclophosphamide and epirubicin. Despite this, there was no significant difference in any outcome: 5-year OS (56.7% i-CEOP; 55.1% s-CEOP; P 5 0.80), 5-year progression free survival (PFS; 41% i-CEOP; 43% s-CEOP; P 5 0.73), 5-year time to progression (TTP; 44% i-CEOP; 47% s-CEOP; P 5 0.72), or complete remission (CR) 1 unconfirmed CR (CRu) rates (53% i-CEOP; 59% s-CEOP; P 5 0.64). Long-term follow up at 10 years also showed no significant differences in OS, PFS, or TTP. The i-CEOP arm had higher rates of febrile neutropenia (70 vs. 26%), hospitalisations, blood product utilisation, haematological and gastrointestinal toxicities, and lower quality of life scores during treatment, although without significant differences 6-month later. In the treatment of aggressive NHL in the prerituximab era, increasing DI did not result in improved outcomes, while at the same time lead to increased toxicity.

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“…Although preliminary studies invariably showed very high response rates for the so-called second-and third-generation regimens, a definitive demonstration of superiority over the firstgeneration combinations, in particular the CHOP regimen (cyclophosphamide, doxorubicin, vincristine and prednisone), has not been reached (Fisher et al, 1993;Cooper et al, 1994).…”

Section: Discussionmentioning

confidence: 99%

High-dose intensity cyclophosphamide, epidoxorubicin, vincristine and prednisone by shortened intervals and granulocyte colony-stimulating factor in non-Hodgkin's lymphoma: a phase II study

Pronzato¹,

Lionetto²,

Botto³

et al. 1998

Br J Cancer

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Summary Twenty patients with non-Hodgkin's lymphoma were treated with a combination of cyclophosphamide (750 mg m-2, day 1), epidoxorubicin (60 mg m-2, day 1), vincristine (1.4 mg m-2, day 1) and prednisone (100 mg m-2, days 1-5) every 14 days. Shortening of intervals was associated with the prophylactic employment of granulocyte colony-stimulating factor (G-CSF; specifically, filgrastim) administered at a dose of 300 gg subcutaneously from day 6 to day 11. The ratio between actually delivered dose intensity and planned dose intensity was 1.0 in 18 out the 20 patients. Toxicity was acceptable; response rate and survival are in the expected range. The present study demonstrated the feasibility of acceleration of chemotherapy cycles to obtain dose intensification in non-Hodgkin's lymphoma.

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Randomized comparison of MACOP-B with CHOP in patients with intermediate-grade non-Hodgkin's lymphoma. The Australian and New Zealand Lymphoma Group.

Cited by 92 publications

References 21 publications

Lenalidomide can be safely combined with R-CHOP (R2CHOP) in the initial chemotherapy for aggressive B-cell lymphomas: phase I study

Lenalidomide can be safely combined with R-CHOP (R2CHOP) in the initial chemotherapy for aggressive B-cell lymphomas: phase I study

A phase III randomized trial of high‐dose CEOP + filgrastim versus standard‐dose CEOP in patients with non‐Hodgkin lymphoma: 10‐year follow‐up data: Australasian Leukaemia and Lymphoma Group (ALLG) NHL07 trial

High-dose intensity cyclophosphamide, epidoxorubicin, vincristine and prednisone by shortened intervals and granulocyte colony-stimulating factor in non-Hodgkin's lymphoma: a phase II study

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