In a nutshell
This study evaluated the long-term effectiveness and safety of a new chemotherapy regimen in patients with previously untreated indolent (painless) non-Hodgkin’s lymphoma (NHL). This study concluded that this regimen is effective and well-tolerated for these patients.
There are three common types of painless NHL. These include follicular lymphoma (FL), marginal zone lymphoma (MZL), and small lymphocytic lymphoma (SLL). After initial treatment, many patients experience cancer recurrence. This leads to receiving several lines of therapy. More first-line treatment options are needed for these patients.
One new treatment option is the PCR regimen (pentostatin, cyclophosphamide, and rituximab). This regimen combines chemotherapy with immunotherapy. It contains pentostatin (Nipent), a new chemotherapy drug. This drug blocks cancer cell growth. This leads to cancer cell death. The long-term outcomes of the PCR regimen for patients with untreated painless NHL remain under investigation.
Methods & findings
This study included 83 patients with painless NHL that was not treated before. Most (43.4%) patients had FL. 38.5% had SLL, and 18.1% had MZL. All patients were treated with the PCR regimen. Patients were followed-up for an average of 108 months.
Overall, 92% of all patients responded to treatment. 71% of patients had a complete response (complete disappearance of all signs of cancer). In patients with FL, 97% had a complete response. 100% of patients with MZL and 83.9% of those with CLL had a complete response.
On average, 87% of all patients were still alive at 5 years after treatment. This rate was 64% at 10 years after treatment. On average, 64% of all patients were still alive without tumor growth or spread at 5 years after treatment. This rate was 42% at 10 years after treatment. Significantly more patients who did not have cancer cells in their bone marrow were still alive 10 years later without tumor growth or spread compared to patients who did (72% vs. 29%).
13% of patients experienced severe low white blood cell count. At an average of 30 months after treatment, 21.7% of patients developed second cancers.
The bottom line
This study concluded that PCR therapy is effective and well-tolerated in patients with previously untreated painless NHL.
The fine print
This study was a Phase 2 trial. Also, this study had a small patient population. More studies are needed to confirm these results.
Published By :
British Journal of Haematology
Feb 28, 2019
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