Premium
VcR‐CVAD induction chemotherapy followed by maintenance rituximab in mantle cell lymphoma: a Wisconsin Oncology Network study
Author(s) -
Chang Julie E.,
Peterson Christopher,
Choi Sangbum,
Eickhoff Jens C.,
Kim KyungMann,
Yang David T.,
Gilbert Leslie A.,
Rogers Eric S.,
Werndli Jae E.,
Huie Michael S.,
McFarland Thomas A.,
Volk Michael,
Blank Jules,
Callander Natalie S.,
Longo Walter L.,
Kahl Brad S.
Publication year - 2011
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/j.1365-2141.2011.08820.x
Subject(s) - medicine , mantle cell lymphoma , rituximab , vincristine , regimen , induction chemotherapy , chemotherapy , oncology , bortezomib , cyclophosphamide , chemotherapy regimen , international prognostic index , progression free survival , surgery , lymphoma , multiple myeloma
Summary Intensive chemotherapy regimens are not feasible in many adults with mantle cell lymphoma (MCL). We sought to build upon our previous experience with a non‐intensive regimen, modified R‐hyperCVAD chemotherapy (rituximab, cyclophosphamide, vincristine, doxorubicin, dexamethasone) with maintenance rituximab (MR), by the incorporation of bortezomib (VcR‐CVAD) and the extension of MR beyond 2 years. Patients with previously untreated MCL received VcR‐CVAD chemotherapy every 21 d for six cycles. Patients achieving at least a partial response to induction chemotherapy received rituximab consolidation (375 mg/m 2 × 4 weekly doses) and MR (375 mg/m 2 every 12 weeks × 20 doses). The primary end points were overall and complete response (CR), and secondary endpoints were progression‐free (PFS) and overall survival (OS). Thirty patients were enrolled, with a median age of 61 years. All patients had advanced stage disease, and 60% had medium/high MCL International Prognostic Index risk factors. A CR or unconfirmed CR was achieved in 77% of patients. After a median follow‐up of 42 months, the 3‐year PFS and OS were 63% and 86%, respectively. The observed 3‐year PFS and OS with VcR‐CVAD in MCL were comparable to reported outcomes with more intensive regimens. A cooperative group trial (E1405) is attempting to replicate these promising results.