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A phase II trial of RCHOP followed by radioimmunotherapy for early stage (stages I/ II ) diffuse large B‐cell non‐Hodgkin lymphoma: ECOG 3402
Author(s) -
Witzig Thomas E.,
Hong Fangxin,
Micallef Iva.,
Gascoyne Randy D.,
Dogan Ahmet,
Wagner Henry,
Kahl Brad S.,
Advani Ranjana H.,
Horning Sandra J.
Publication year - 2015
Publication title -
british journal of haematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.907
H-Index - 186
eISSN - 1365-2141
pISSN - 0007-1048
DOI - 10.1111/bjh.13493
Subject(s) - radioimmunotherapy , medicine , diffuse large b cell lymphoma , rituximab , chemoimmunotherapy , phases of clinical research , lymphoma , nuclear medicine , chemotherapy , immunology , monoclonal antibody , antibody
Summary Patients with early stage diffuse large B‐cell lymphoma ( DLBCL ) receive RCHOP (rituximab cyclophosphamide, doxorubicin, vincristine, prednisone) alone or with involved field radiotherapy ( IFRT ). Anti‐ CD 20 radioimmunotherapy ( RIT ) delivers radiation to microscopic sites outside of known disease. This phase II study aimed to achieve a functional complete response ( CR ) rate of ≥75% to RCHOP and 90 Yttrium‐ibritumomab tiuxetan RIT . Patients with stages I/ II DLBCL received 4–6 cycles of RCHOP followed by RIT [14·8 MBq/kg (0·4 mCi/kg)]; patients with positron emission tomographypositive sites of disease after RCHOP / RIT received 30 Gy IFRT . Of the 62 patients enrolled; 53 were eligible. 42% (22/53) had stage I/ IE ; 58% (31/53) stage II / IIE . After RCHOP , 79% (42/53) were in CR /unconfirmed CR . Forty‐eight patients proceeded to RIT . One partial responder after RIT received IFRT and achieved a CR . The best response after RCHOP + RIT in all 53 patients was a functional CR rate of 89% (47/53; 95% confidence interval: 77–96%). With a median follow‐up of 5·9 years, 7 (13%) patients have progressed and 4 (8%) have died (2 with DLBCL ). At 5 years, 78% of patients remain in remission and 94% are alive. Chemoimmunotherapy and RIT is an active regimen for early stage DLBCL patients. Eighty‐nine percent of patients achieved functional CR without the requirement of IFRT . This regimen is worthy of further study for early stage DLBCL in a phase III trial.