Frontline bortezomib and rituximab for the treatment of newly diagnosed high tumour burden indolent non-Hodgkin lymphoma: A multicentre phase II study

Andrew M. Evens, Mitchell R. Smith, Izidore Lossos, Irene Helenowski, Michael Millenson, Jane N. Winter, Steve T. Rosen, Leo I. Gordon

Research output: Contribution to journalArticle

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Abstract

There is a lack of published data examining non-cytotoxic options for the frontline treatment of patients with high-tumour burden (HTB) indolent non-Hodgkin lymphoma (iNHL). We completed a multicentre phase II study for patients with untreated HTB iNHL (NCT00369707) consisting of three induction cycles of weekly bortezomib and rituximab followed by an abbreviated consolidation. Forty-two patients were treated and all were evaluable; the most common histology was follicular lymphoma (FL) (n = 33, 79%). Patient characteristics included median age 62 years (40-86); 38% bulky disease; 19% malignant effusions; 91% advanced-stage disease; and median FL International Prognostic Index (FLIPI) score was 3. Therapy was well tolerated with few grade 3/4 toxicities including minimal neurotoxicity. On intent-to-treat, the overall response rate (ORR) at end of therapy was 70% with a complete remission (CR) rate of 40% (FL: ORR 76%, CR 44%). With 50-month median follow-up, 4-year progression-free survival (PFS) was 44% with 4-year overall survival (OS) of 87% (FL: 44% and 97%, respectively). Four-year PFS for FLIPI 0-2 vs. 3-5 was 60% vs. 26% respectively (P = 0·02), with corresponding OS rates of 92% and 81% respectively (P = 0·16). Collectively, bortezomib/rituximab is a non-cytotoxic therapeutic regimen that was well tolerated and resulted in long-term survival rates approximating prior rituximab/cytotoxic chemotherapy series for untreated HTB FL.

Original languageEnglish
Pages (from-to)514-520
Number of pages7
JournalBritish Journal of Haematology
Volume166
Issue number4
DOIs
StatePublished - Jan 1 2014

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Follicular Lymphoma
Tumor Burden
Non-Hodgkin's Lymphoma
Disease-Free Survival
Survival Rate
Therapeutics
Histology
Bortezomib
Rituximab
Drug Therapy
Survival

Keywords

  • Bortezomib
  • Cancer
  • Follicular lymphoma
  • Prognosis
  • Treatment

ASJC Scopus subject areas

  • Hematology

Cite this

Frontline bortezomib and rituximab for the treatment of newly diagnosed high tumour burden indolent non-Hodgkin lymphoma : A multicentre phase II study. / Evens, Andrew M.; Smith, Mitchell R.; Lossos, Izidore; Helenowski, Irene; Millenson, Michael; Winter, Jane N.; Rosen, Steve T.; Gordon, Leo I.

In: British Journal of Haematology, Vol. 166, No. 4, 01.01.2014, p. 514-520.

Research output: Contribution to journalArticle

Evens, Andrew M. ; Smith, Mitchell R. ; Lossos, Izidore ; Helenowski, Irene ; Millenson, Michael ; Winter, Jane N. ; Rosen, Steve T. ; Gordon, Leo I. / Frontline bortezomib and rituximab for the treatment of newly diagnosed high tumour burden indolent non-Hodgkin lymphoma : A multicentre phase II study. In: British Journal of Haematology. 2014 ; Vol. 166, No. 4. pp. 514-520.
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