Maintenance rituximab useful for advanced indolent lymphoma

NEW YORK (Reuters Health) - Maintenance rituximab following cyclophosphamide, vincristine, and prednisone (CVP) therapy can increase progression-free survival in patients with stage III-IV indolent lymphoma, according to a new report.

The survival benefit attained with maintenance rituximab after CVP was "to a far greater extent than achieved by any prior strategy and with minimal toxicity," Dr. Howard S. Hochster, from New York University Cancer Institute, and colleagues note.

The study featured 311 patients with stable or responding disease after CVP therapy. The patients were randomized to receive maintenance rituximab 375 mg/meters-squared once per week for 4 weeks every 6 months for 2 years or observation only.

An improved disease response was seen in 22% of rituximab-treated patients versus just 7% of control subjects (p = 0.00006). Toxic effects were minimal in both groups. The findings are published in the March 2nd online issue of the Journal of Clinical Oncology.

Three-year progression-free survival was also higher in the rituximab group: 68% vs. 33% in controls. In the subgroup of 282 patients with follicular lymphoma, the corresponding rates were 64% and 33%. Higher overall survival rates were seen in the rituximab group as well, although the differences fell short of statistical significance.

Further analysis showed that rituximab therapy had beneficial effects regardless of prognostic score, tumor burden, histology, or residual disease.

"Observations from this study inform the design of future studies and add to a substantial body of evidence that the combination of rituximab with chemotherapy is a new standard for patients with indolent lymphoma who require treatment," the authors conclude.

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