Rituximab maintenance stage iii iv follicular lymphoma ecog calgb e1496
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Rituximab Maintenance: Stage III/IV Follicular Lymphoma (ECOG/CALGB E1496) PowerPoint PPT Presentation


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R A N D O M I Z E. Observation (OBS) vs Rituximab Maintenance (MR). CVP x 6-8 → PR/CR (cyclophosphamide, vincristine, prednisone). Rituximab Maintenance: Stage III/IV Follicular Lymphoma (ECOG/CALGB E1496). Subset: 237 FL pts. P = .03 (one-sided).

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Rituximab Maintenance: Stage III/IV Follicular Lymphoma (ECOG/CALGB E1496)

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Rituximab maintenance stage iii iv follicular lymphoma ecog calgb e1496

R

A

N

D

O

M

I

Z

E

Observation (OBS)

vs

Rituximab Maintenance (MR)

CVP x 6-8 → PR/CR

(cyclophosphamide,

vincristine, prednisone)

Rituximab Maintenance: Stage III/IV Follicular Lymphoma (ECOG/CALGB E1496)

Subset: 237 FL pts

P = .03 (one-sided)

  • Hochster H et al. ASH 2005. Abstract 349.


Cvp rituximab stage iii iv follicular lymphoma

R

A

N

D

O

M

I

Z

E

R

E

S

T

A

G

E

CVP x 4

vs

R-CVP x4

CVP x 4

vs

R-CVP x 4

Stage III/IV FL→

CR/PR →

CVP + Rituximab:Stage III/IV Follicular Lymphoma

CVP = cyclophosphamide, vincristine, prednisone

  • Solal-Celigny P et al. ASH 2005. Abstract 350.


Maintenance rituximab relapsed stage iii iv follicular lymphoma

Maintenance Rituximab:Relapsed Stage III/IV Follicular Lymphoma

  • Intergroup Phase 3 (update)

    CHOP vs R-CHOP → Observation vs Maintenance Rituximab

    • Randomization 1: R-CHOP vs CHOP

      • CR: 29% vs 16% (P < .0001)

      • PFS, median: 33 months vs 20 months

    • Randomization 2: Maintenance Rituximab vs Observation

      • PFS: 52 months vs 15 months, P < .0001

      • OS, 3 years: 85 months vs 77 months, P = .01

        Benefit with maintenance rituximab even after R-CHOP

  • GLGLSG Phase 3: Relapsed/refractory FL; Mantle cell

    FCM vs R-FCM → Observation vs Maintenance Rituximab

    • Overall benefit of MR: median response duration for MR not reached

      ( vs 17 months in the observation arm)

    • Role of MR following R-FCM in FL: median response duration

      for MR not reached(vs 26 months in the observation arm)

Van Oers et al. ASH 2005. Abstract 353.

Hiddemann et al. ASH 2005. Abstract 920.


R chop 14 vs chop 14 dlbcl

R-CHOP-14 vs CHOP-14: DLBCL*

RICOVER-60:Interim analysis (n=828)

Results

6 CYCLES vs 8 CYCLES

-No differences for entire population

-Small nonsignificant benefit for CHOP-14, 8 vs 6

-No benefit for R-CHOP-14, 8 vs 6

R-CHOP-14 vs CHOP-14

-CR, 81% vs 73% (P = .008)

-Time to treatment failure (at 26 months), 70% vs 57% (P = .000025)

HOVON/Nordic Lymphoma Group:Interim analysis (n=250)–DLBCL, FL, MCL

Results

CHOP-14 x 8 v R-CHOP-14 x 8

-CR, No difference

Failure-free survival (at 18 months) favors R-CHOP-14: 51% vs 33%, P = .005

Conclusion:

Dose-dense R-CHOP is feasible and produces results

superior to dose-dense CHOP. Results need to be confirmed.

*61-80 years of age

  • Pfreundschuh M et al. ASH 2005. Abstract 13.

  • Sonneveld, P et al. ASH 2005. Abstract 16.


Immunomodulatory drugs in cll

Immunomodulatory Drugs in CLL

Phase 1/2 Initial Therapy With Fludarabine

and Thalidomide in Stage I-IV CLL

N=13 (evaluable)

-10 CR (77%), 3 PR (23%)

-Overall response rate, intent-to-treat population 100%

  • Flare reaction, 46%

  • Nonhematologic grade 3/4 toxicities, 11%

    (diarrhea, fatigue, pedal edema)

    Phase 2 Study of Lenalidomide

    in Relapsed/Refractory CLL

    N=17 (evaluable)

    -2 CR (11.7%), 9 PR (52.9%), 5 SD (24.9%), 1 PD

  • Flare reaction, most patients

  • Grade 3/4 hematologic toxicity (7), tumor lysis syndrome (2), febrile neutropenia (3)

  • Chanan-Khan AA. ASH 2005. Abstracts 2974 and 447.


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