Rituximab combined with chemotherapy and interferon in follicular lymphoma patients: results of the GELA-GOELAMS FL2000 study
Gilles Salles, Nicolas Mounier, Sophie de Guibert, Franck Morschhauser, Chantal Doyen, Jean-François Rossi, Corinne Haioun, Pauline Brice, Béatrice Mahé, Reda Bouabdallah, Bruno Audhuy, Christophe Ferme, Caroline Dartigeas, Pierre Feugier, Catherine Sebban, Luc Xerri, Charles Foussard, Gilles Salles, Nicolas Mounier, Sophie de Guibert, Franck Morschhauser, Chantal Doyen, Jean-François Rossi, Corinne Haioun, Pauline Brice, Béatrice Mahé, Reda Bouabdallah, Bruno Audhuy, Christophe Ferme, Caroline Dartigeas, Pierre Feugier, Catherine Sebban, Luc Xerri, Charles Foussard
Abstract
The FL2000 study was undertaken to evaluate the combination of the anti-CD20 monoclonal antibody rituximab with chemotherapy plus interferon in the first-line treatment of follicular lymphoma patients with a high tumor burden. Patients were randomly assigned to receive either 12 courses of the chemotherapy regimen CHVP (cyclophosphamide, adriamycin, etoposide, and prednisolone) plus interferon-alpha2a (CHVP+I arm) over 18 months or 6 courses of the same chemotherapy regimen combined with 6 infusions of 375 mg/m(2) rituximab and interferon for the same time period (R-CHVP+I arm). After a median follow-up of 5 years, event-free survival estimates were, respectively, 37% (95% confidence interval [CI], 29%-44%) and 53% (95% CI, 45%-60%) in the CHVP+I and R-CHVP+I arm (P = .001). Five-year overall survival estimates were not statistically different in the CHVP+I (79%; 95% CI, 72%-84%) and R-CHVP+I (84%; 95% CI, 78%-84%) arms. In a multivariate regression analysis, event-free survival was significantly influenced by both the Follicular Lymphoma International Prognostic Index score (hazard ratio = 2.08; 95% CI, 1.6%-2.8%) and the treatment arm (hazard ratio = 0.59; 95% CI, 0.44%-0.78%). With a 5-year follow-up, the combination of rituximab with CHVP+I provides superior disease control in follicular lymphoma patients despite a shorter duration of chemotherapy. This study's clinical trial was registered at the National Institutes of Health website as no. NCT00136552.
Source: PubMed