No cumulative or additional toxicities were seen with maintenance courses.ĬONCLUSION: Rituximab is highly active and extremely well tolerated as first-line single-agent therapy for indolent NHL. Two patients experienced grade 3/4 toxicity with the first dose one patient was removed from treatment. Median actuarial progression-free survival was 34 months. Response was similar in patients with follicular versus small lymphocytic subtypes (76% v 70%, respectively). With continued maintenance, final response rate increased to 73%, with 37% complete responses. The objective response rate at 6 weeks was 47% 45% of patients had stable disease. All have now completed rituximab therapy 36 (58%) received four courses at 6-month intervals. RESULTS: Sixty patients (97%) completed the first 4-week course of rituximab and were assessable for response.
#Now with vitamin r trial
Between March 1998 and May 1999, 62 patients were entered onto this trial minimum follow-up was 24 months. Maintenance was continued for a maximum of four rituximab courses or until progression. Patients were restaged at week 6 for response those with objective response or stable disease received maintenance rituximab courses (identical dose and schedule) at 6-month intervals. PATIENTS AND METHODS: Patients with indolent NHL (follicular or small lymphocytic subtypes) previously untreated with systemic therapy received rituximab 375 mg/m ² intravenously weekly for 4 weeks. PURPOSE: To evaluate response to single-agent rituximab in patients with indolent non-Hodgkin’s lymphoma (NHL) and no previous systemic therapy, and the feasibility, toxicity, and efficacy of maintenance rituximab, administered at 6-month intervals, in patients with objective response or stable disease after first-line rituximab therapy. In this review, we hypothesize that the combination of an optimized biological treatment together with radiolabeled antibodies and chemotherapy early in the disease course of advanced-stage follicular lymphoma may represent the best approach to achieve prolonged disease-free survival and eventually cure. Unlabeled antibody treatment could potentially benefit from the combination of antibodies directed against different target antigens or combination therapy with cytokines capable of further mobilizing patients' cellular defenses. Repeat administrations of RIT using appropriate radioisotopes for treatment of residual disease or new targeting strategies might afford additional benefits. Despite the therapeutic efficacy of both approaches, the potential exists to further improve both modalities. Rituximab and RIT have clearly distinct mechanisms of action, the first acting exclusively as a biological treatment, while the second acts by a combination of biologic mechanisms and radiation effects. Multiple studies have also shown the efficacy of radioimmunotherapy (RIT) both as a single agent and in combination with chemotherapy. Rituximab has been introduced in various combinations with chemotherapy and has resulted in a significantly superior treatment outcome compared with chemotherapy alone. After completing this course, the reader will be able to: Summarize current upfront treatment options in follicular lymphoma.Differentiate biological treatment options with demonstrated efficacy from promising new developments in research and clinical trials.Better understand RIT and its therapeutic promise.ĬME This article is available for continuing medical education credit at Īdvanced-stage follicular lymphoma is incurable by conventional treatment.
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