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KEY: CR = Complete Response | Tx = Treatment | m = Maintenance | x4 = 4 rounds |
TTP = Time to Progression | Mng = Management | D = durable remission / cure
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Options for follicular NHL
|
Goal
of Tx
|
TTP/EFS
mo
|
Response notes |
Notes |
Related
articles
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| Prednisone |
Mng |
|
fast acting |
toxicity with extended use |
articles |
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| Rituxan x4 |
Mng |
TTP
12
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54%; 14 pts 36% stable or minor response |
More specific, less toxic than
chemo; effect on overall
survival unknown |
articles |
| Rituxan x4 / x8 /m |
Mng |
TTP
34
|
56% (8% CR). |
while promising, affect on overall
survival is unknown |
articles |
| Rituxan x4 / x8 |
Mng |
EFS
36
|
Event-free survival (EFS) was 12 months in the no further treatment arm vs. 23 months in the prolonged treatment arm (p=0.02), the difference being particularly notable in chemotherapy-naive patients (19 vs. 36 months, p=0.009) and in patients responding to induction treatment (16 vs. 36 months, p=0.004). |
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Blood. 2004 Feb 19 PMID: 14976046
articles
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| Rituxan + gm-csf x4/x8/m |
Mng |
-
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20 patients with relapsed disease, the combination of granulocyte-colony stimulating factor with rituximab resulted in a longer duration of response than normally seen with rituximab monotherapy. - Kimby |
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articles |
| Rituxan + IL-2 |
Mng |
-
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articles |
| Rituxan + Prednisone |
Mng |
-
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articles |
| Rituxan + Interferon-alpha |
Mng |
TTP
22.3 and 25.2
|
Data for relapsed setting. |
INF-alpha can cause unpleasant side effects. |
articles |
| Rituxan + Pentostatin |
Mng |
TTP
15
|
77% responded - 22.3% CR;
Previously untreated vs previously
treated pts was 83% vs 63% |
|
articles |
| Rituxan + Fludarabine |
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articles |
| Radiotherapy, localized |
D |
|
For stage I and II can
be curative (C) |
surviving patients ranged from
3.5 to 28.7 years (median 19.0) |
articles |
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articles |
| Chlorambucil |
Mng |
|
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articles |
| Fludarabine |
D |
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Fludarabine, cyclophosphamide and mitoxantrone for untreated follicular lymphoma: a report from the non-Hodgkin's lymphoma co-operative study group. Leuk Lymphoma. 2004 Jun;45(6):1141-7. PMID: 15359993 | |
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Related articles |
| CVP / COP |
Mng/D |
|
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|
articles |
Combination chemo
with adjuvant radiotherapy
to bulky nodes |
D |
|
71% survival at 20 years for
pts with advanced disease |
Intriguing report, Some experts
question methodology. |
articles |
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related articles |
| CVP + Rituxan |
D |
TTP
32
|
CVP chemotherapy plus Rituximab compared with CVP as first-line treatment for advanced follicular lymphoma. [322 patient study] Blood. 2004 Oct 19 PMID: 15494430 | |
Overall and complete response rates were
81% and 41% in the R-CVP arm vs. 57% and 10% in the CVP arm, respectively (P < 0.0001). Median Time to progression: 32 months vs. 15 months for CVP; P < 0.0001). |
Related articles
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| Chlorambucil + Rituxan |
Mng |
|
|
(PMID: 14531908) |
articles |
Rituxan > Chlorambucil
(added if needed) |
Mng |
|
|
|
none |
| MC + Rituxan |
D |
TTP
30
|
|
PMID: 14579238 |
articles |
| FCM + Rituxan |
D |
|
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PMID: 12652460 |
articles |
| CNOP + Rituxan |
D |
|
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PMID: 12750729 |
articles |
| FND + Rituxan |
D |
|
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PMID: 11225999 |
articles |
| CHOP + Rituxan |
D |
TTP
82
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Prolonged Clinical and Molecular Remission in Patients With Low-Grade or Follicular Non-Hodgkin's Lymphoma Treated With Rituximab Plus CHOP Chemotherapy: 9-Year Follow-Up. J Clin Oncol. 2004 Oct 13 |
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articles |
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| Rituxan > FavId vaccine |
Mng/D |
|
|
|
articles |
CVP > vaccine vs.
CVP > control |
D |
|
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|
articles |
| CHOP+Bexxar vs. CHOP+Rituxan |
D |
|
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|
articles |
| F is Fludarabine | M/N is Mitoxantrone | C is Cyclophosphamide | D is Dexamethasone | V/O is Vincristine | P is Prednisone | H is Doxorubicin |
