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Posted by on Oct 5, 2018 in Non-Hodgkin lymphoma | 0 comments

In a nutshell

This study investigated the long-term outcomes of radioimmunotherapy following first-line (primary) R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, prednisone) in previously untreated patients with advanced-stage follicular lymphoma (FL). This study concluded that this treatment approach is effective and well-tolerated in these patients.

Some background

One of the main goals in the management of FL is to increase long-term survival. Relapse (cancer recurrence) is the main cause of treatment failure in patients with FL. New treatment options that get rid of remaining disease after first-line treatment, are needed. This type of treatment is called consolidation treatment.

Radioimmunotherapy is one possible consolidation treatment. It uses immunotherapy drugs that release radiation directly on the tumor. Previous studies have shown that 60 – 80% of patients with previously untreated FL respond to this treatment. The long-term outcomes of these patients after radioimmunotherapy remains under investigation.

Methods & findings

This study involved 30 patients with previously untreated FL. All patients received first-line R-CHOP chemoimmunotherapy followed by radioimmunotherapy with ibritumomab tiuxetan (Zevalin). Patients were followed-up for an average of 8.5 years.

After R-CHOP, 40% of patients achieved a complete response (disappearance of all signs of cancer). After radioimmunotherapy, this rate was 76.6%. 16.7% of patients achieved a partial response (tumor shrinkage). 30% of patients experienced a relapse.

5-year overall survival (patients still alive 5 years later; OS) was 90%. 5-year progression-free survival (patients still alive a 5 years later without disease progression; PFS) was 70%. At 8 years, these rates were 80% (PFS) and 66% (OS). Patients who achieved a complete response after treatment had a significantly higher 5-year OS (91%) and PFS (82%) compared to patients who did not (86%, OS; 28%, PFS).

The bottom line

This study concluded that first-line R-CHOP followed by ibritumomab tiuxetan is effective and well-tolerated in patients with advanced FL, including those with high-risk disease.

The fine print

The patient population in this study was quite small. Larger studies are needed to confirm these results.

Published By :

Leukemia & lymphoma

Date :

Sep 20, 2018

Original Title :

Consolidation treatment with yttrium-90 ibritumomab tiuxetan after new induction regimen in advanced stage follicular lymphoma: update results from the Spanish Lymphoma Oncology Group trial after a median follow-up of 8.5-years.

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