Journal
BRITISH JOURNAL OF HAEMATOLOGY
Volume 155, Issue 2, Pages 190-197Publisher
WILEY
DOI: 10.1111/j.1365-2141.2011.08820.x
Keywords
bortezomib; chemotherapy; mantle cell lymphoma; non-Hodgkin lymphoma; rituximab
Categories
Funding
- University of Wisconsin Carbone Cancer Center, the Cancer Center Support [P30 CA14520]
- Millennium Pharmaceuticals, Inc.
- University of Wisconsin
- National Institutes of Health [P30 CA14520]
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Intensive chemotherapy regimens are not feasible in many adults with mantle cell lymphoma (MCL). We sought to build upon our previous experience with a non-intensive regimen, modified R-hyperCVAD chemotherapy (rituximab, cyclophosphamide, vincristine, doxorubicin, dexamethasone) with maintenance rituximab (MR), by the incorporation of bortezomib (VcR-CVAD) and the extension of MR beyond 2 years. Patients with previously untreated MCL received VcR-CVAD chemotherapy every 21 d for six cycles. Patients achieving at least a partial response to induction chemotherapy received rituximab consolidation (375 mg/m(2) x 4 weekly doses) and MR (375 mg/m(2) every 12 weeks x 20 doses). The primary end points were overall and complete response (CR), and secondary endpoints were progression-free (PFS) and overall survival (OS). Thirty patients were enrolled, with a median age of 61 years. All patients had advanced stage disease, and 60% had medium/high MCL International Prognostic Index risk factors. A CR or unconfirmed CR was achieved in 77% of patients. After a median follow-up of 42 months, the 3-year PFS and OS were 63% and 86%, respectively. The observed 3-year PFS and OS with VcR-CVAD in MCL were comparable to reported outcomes with more intensive regimens. A cooperative group trial (E1405) is attempting to replicate these promising results.
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