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W Hiddemann, E Hoster, C Buske, M Dreyling, M Kneba, M Hallek, E Lengfelder, H Wandt, M Unterhalt PowerPoint Presentation
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W Hiddemann, E Hoster, C Buske, M Dreyling, M Kneba, M Hallek, E Lengfelder, H Wandt, M Unterhalt - PowerPoint PPT Presentation


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Significant improvement of short- and long-term outcome in advanced stage follicular lymphoma: a 10-year analysis of GLSG trials. W Hiddemann, E Hoster, C Buske, M Dreyling, M Kneba, M Hallek, E Lengfelder, H Wandt, M Unterhalt. Hiddemann W, et al. Blood 2006;108:147a (Abstract 483).

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Significant improvement of short- and long-term outcome in advanced stage follicular lymphoma:a 10-year analysis of GLSG trials

W Hiddemann, E Hoster, C Buske, M Dreyling, M Kneba, M Hallek,

E Lengfelder, H Wandt, M Unterhalt

Hiddemann W, et al. Blood 2006;108:147a (Abstract 483)

overall survival in follicular lymphoma
Overall survival infollicular lymphoma

100

80

60

40

20

0

1987–1996 (n=668)

1976–1987 (n=513)

1960–1976 (n=195)

Percentage

0 5 10 15 20 25 30

Horning SJ. Semin Oncol 1993;20(5 Suppl. 5):75–88

overall survival in follicular lymphoma cont d
Overall survival infollicular lymphoma (cont’d)

100

80

60

40

20

0

CHOP + MoAb

ProMACE

Percentage

CHOP

0 2 4 6 8 10

Years after registration

Fisher RI, et al. J Clin Oncol 2005;23:8447–52

comparison of two consecutive study generations of the glsg
Comparison of two consecutive study generations of the GLSG

R

a

n

d

o

m

i

s

a

t

i

o

n

GLSG 1996

CHOP

R

a

n

d

o

m

i

s

a

t

i

o

n

Patients <60 years

PBSCT

MCP

IFN-maintenance

GLSG 2000

R

a

n

d

o

m

i

s

a

t

i

o

n

6–8 x CHOP +

rituximab

Patients ≥60 years

IFN-maintenance

6–8 x CHOP

Hiddemann W, et al. Blood 2006;108:147a (Abstract 483)

comparison of two consecutive study generations of the glsg1
Comparison of two consecutive study generations of the GLSG

Eligibility criteria

  • Previously untreated FL at stage III or IV and requirement for therapeutic intervention
    • B symptoms
    • bulky disease
    • rapid progression
    • haemopoietic impairment

Hiddemann W, et al. Blood 2006;108:147a (Abstract 483)

comparison of two consecutive study generations of the glsg2
Comparison of two consecutive study generations of the GLSG

R

a

n

d

o

m

i

s

a

t

i

o

n

GLSG 1996

No. of patients

CHOP

381

MCP

148

GLSG 2000

R

a

n

d

o

m

i

s

a

t

i

o

n

6–8 x CHOP +

rituximab

436

6–8 x CHOP

279

Hiddemann W, et al. Blood 2006;108:147a (Abstract 483)

comparison of two consecutive study generations of the glsg3
Comparison of two consecutive study generations of the GLSG

Risk profile according to initial therapy

Hiddemann W, et al. Blood 2006;108:147a (Abstract 483)

comparison of two consecutive study generations of the glsg4
Comparison of two consecutive study generations of the GLSG

Risk profile over time

140

120

100

80

60

40

20

0

Parameters

1 2 3 4 5 6 7 8 9 10

Years

Age

Stage IV

ECOG>1

LDH quotient to ULN

LDH > ULN

Hb g/L

No. nodal areas

IR FLIPI

HR FLIPI

Hiddemann W, et al. Blood 2006;108:147a (Abstract 483)

comparison of two consecutive study generations of the glsg5
Comparison of two consecutive study generations of the GLSG

Response to initial therapy

Hiddemann W, et al. Blood 2006;108:147a (Abstract 483)

comparison of two consecutive study generations of the glsg6
Comparison of two consecutive study generations of the GLSG

Response to initial therapy

Hiddemann W, et al. Blood 2006;108:147a (Abstract 483)

*Adjusted for FLIPI and rituximab

comparison of two consecutive study generations of the glsg7
Comparison of two consecutive study generations of the GLSG

Time to treatment failure

1.0

0.9

0.8

0.7

0.6

0.5

0.4

0.3

0.2

0.1

0.0

NHL 2000, median = 48 NHL 1996, median = 32

p<0.0001

Survival probability

0 12 24 36 48 60 72 84 96 108 120

Months since start of therapy

Numbers of patients at risk

NHL 1996 528 388 286 241 197 161 106 48 13 0NHL 2000 714 519 308 154 55 5 0

Hiddemann W, et al. Blood 2006;108:147a (Abstract 483)

comparison of two consecutive study generations of the glsg8
Comparison of two consecutive study generations of the GLSG

Time to treatment failure

1.0

0.9

0.8

0.7

0.6

0.5

0.4

0.3

0.2

0.1

0.0

MCP

CHOP1

CHOP2

R-CHOP

p<0.0001

Survival probability

0 12 24 36 48 60 72 84 96 108 120

Months since start of therapy

Numbers of patients at risk

MCP 148 112 81 69 57 49 41 23 7 0

CHOP1 308 276 205 172 140 112 65 25 6 0

CHOP2 278 210 125 60 22 2 0

R-CHOP 436 309 183 94 33 3 0

Hiddemann W, et al. Blood 2006;108:147a (Abstract 483)

comparison of two consecutive study generations of the glsg9
Comparison of two consecutive study generations of the GLSG

Time to treatment failure

Hiddemann W, et al. Blood 2006;108:147a (Abstract 483)

*Adjusted for FLIPI and rituximab

comparison of two consecutive study generations of the glsg10
Comparison of two consecutive study generations of the GLSG

Overall survival

1.0

0.9

0.8

0.7

0.6

0.5

0.4

0.3

0.2

0.1

0.0

Survival probability

NHL 2000, median not reached

NHL 1996, median not reached

p<0.0001

0 12 24 36 48 60 72 84 96 108 120

Months since registration

Numbers of patients at risk

NHL 1996 538 485 457 419 386 332 242 125 46 0NHL 2000 794 621 440 250 108 8 0

Hiddemann W, et al. Blood 2006;108:147a (Abstract 483)

comparison of two consecutive study generations of the glsg cont d
Comparison of two consecutive study generations of the GLSG (cont’d)

Overall survival

1.0

0.9

0.8

0.7

0.6

0.5

0.4

0.3

0.2

0.1

0.0

MCP

CHOP1

CHOP2

R-CHOP

p<0.0001

Survival probability

0 12 24 36 48 60 72 84 96 108 120

Months since registration

Numbers of patients at risk

MCP 150 132 123 110 98 87 80 55 22 0

CHOP1 383 351 332 307 286 243 161 70 24 0

CHOP2 287 260 208 120 53 3 0

R-CHOP 474 352 230 130 55 5 0

Hiddemann W, et al. Blood 2006;108:147a (Abstract 483)

comparison of two consecutive study generations of the glsg cont d1
Comparison of two consecutive study generations of the GLSG (cont’d)

Overall survival

Hiddemann W, et al. Blood 2006;108:147a (Abstract 483)

*Adjusted for FLIPI and rituximab

conclusions
Conclusions
  • Comparison of the two consecutive GLSG studies 1996 and 2000 reveals for the 2000 trial a significant improvement of
    • response rate
    • TTF
    • OS
  • This improvement is due to the addition of rituximab

Hiddemann W, et al. Blood 2006;108:147a (Abstract 483)