1. Initial report of a phase II study with R-FND followed by ibritumomab tiuxetan radioimmunotherapy and rituximab maintenance in patients with untreated high-risk follicular lymphoma
- Author
-
Erin Taylor, Felipe Samaniego, Loretta J. Nastoupil, Lei Feng, Sattva S. Neelapu, Peter McLaughlin, Fredrick B. Hagemeister, Barbara Pro, Nathan Fowler, Maria Alma Rodriguez, and Michelle A. Fanale
- Subjects
Oncology ,Cancer Research ,medicine.medical_specialty ,medicine.medical_treatment ,Follicular lymphoma ,Ibritumomab tiuxetan ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,Antineoplastic Combined Chemotherapy Protocols ,medicine ,Humans ,Yttrium Radioisotopes ,B-cell lymphoma ,Lymphoma, Follicular ,Mitoxantrone ,business.industry ,Antibodies, Monoclonal ,Hematology ,Radioimmunotherapy ,medicine.disease ,Fludarabine ,Regimen ,Treatment Outcome ,030220 oncology & carcinogenesis ,Rituximab ,business ,030215 immunology ,medicine.drug - Abstract
R-FND (rituximab, fludarabine, mitoxantrone, and dexamethasone) can induce molecular remissions in indolent lymphoma. The addition of 90yttrium ibritumomab tiuxetan (90YIT) radioimmunotherapy following first-line induction treatment in patients with advanced follicular lymphoma (FL) may improve remission rates. We now report 10-year follow-up results from our sequential treatment approach with an abbreviated regimen of R-FND followed by 90YIT consolidation and rituximab maintenance. Forty-nine patients were enrolled; 47 received treatment. Patients had high-risk (FLIPI score ≥3) FL of grade 1-3A and stage III/IV with adequate hematologic function. Following R-FND, the complete and partial response rates were 91% and 8.5%, respectively. After 90YIT consolidation, the CR rate increased to 97%. The 10-year PFS rate was 49%. The most common non-hematologic, grade 3 or 4 adverse events were fatigue, dyspnea, and myalgia. Five developed myelodysplastic syndrome (MDS). This treatment approach is most appropriate in FLIPI-based high-risk patients whose outlook with standard therapy is inadequate.
- Published
- 2020