Rituximab after Autologous Stem-Cell Transplantation in Mantle-Cell Lymphoma

Gouill, Steven Le; Thiéblemont, Catherine; Obéric, Lucie; Moreau, Philippe; Bouabdallah, Krimo; Dartigeas, Caroline; Damaj, Gandhi; Gastinne, Thomas; Ribrag, Vincent; Feugier, Pierre; Casasnovas, Olivier; Zerazhi, Hacène; Haı̈oun, Corinne; Maisonneuve, Hervé; Houot, Roch; Jardin, Fabrice; Neste, Éric Van Den; Tournilhac, Olivier; Dû, Katell Le; Morschhauser, Franck; Cartron, Guillaume; Fornecker, Luc‐Matthieu; Canioni, Danielle; Callanan, Mary; Béné, Marie C.; Salles, Gilles; Tilly, Hervé; Lamy, Thierry; Gressin, Rémy; Hermine, Olivier

doi:10.1056/nejmoa1701769

Cited by 337 publications

(302 citation statements)

References 15 publications

Supporting

Mentioning

290

Contrasting

Unclassified

Order By: Relevance

“…Common induction regimens include the Nordic MCL2 regimen (rituximab [R], cyclophosphamide, vincristine, doxorubicin, prednisone [R‐maxi‐CHOP]) alternating with high‐dose cytarabine and hyperfractionated cyclophosphamide, vincristine, doxorubicin, and dexamethasone alternating with high‐dose methotrexate/cytarabine (R‐hyper‐CVAD/MA) . Other approaches studied in recent years include R‐CHOP alternating with dexamethasone, high‐dose cytarabine, and a platinum derivative (DHAP) or 4 cycles of R‐DHAP …”

Section: Introductionmentioning

confidence: 99%

A multicenter retrospective comparison of induction chemoimmunotherapy regimens on outcomes in transplant‐eligible patients with previously untreated mantle cell lymphoma

Bishton

Ritchie

et al. 2019

Hematological Oncology

View full text Add to dashboard Cite

Mantle cell lymphoma (MCL) is an uncommon and typically aggressive form of lymphoma. Although often initially chemosensitive, relapse is common. Several induction and conditioning regimens are used in transplant‐eligible patients, and the optimal approach remains unknown. We performed an international, retrospective study of transplant‐eligible patients to assess impact of induction chemoimmunotherapy and conditioning regimens on clinical outcomes. We identified 228 patients meeting inclusion criteria. Baseline characteristics were similar among the induction groups except for some variation in age. The type of induction chemoimmunotherapy received did not influence overall response rates (ORRs) (0.43), progression‐free survival (PFS) (P > .67), or overall survival (OS) (P > .35) on multivariate analysis (PFS and OS). Delivery of autologous stem cell transplant (ASCT) was associated with favorable PFS and OS (0.01) on univariate analysis only; this benefit was not seen on multivariate analysis—PFS (0.36) and OS (0.21). Compared with busulfan and melphalan (BuMel), the use of the carmustine, etoposide, cytarabine, melphalan (BEAM)–conditioning regimen was associated with inferior PFS (HR = 2.0 [95% CI 1.1‐3.6], 0.02) but not OS (HR = 1.1 [95% CI 0.5‐2.3], 0.81) on univariate analysis only. Within the limits of a retrospective study and modest power for some comparisons, type of induction therapy did not influence ORR, PFS, or OS for transplant‐eligible patients with MCL. International efforts are required to perform randomized clinical trials evaluating chemoimmunotherapy induction regimens.

show abstract

Section: Introductionmentioning

confidence: 99%

A multicenter retrospective comparison of induction chemoimmunotherapy regimens on outcomes in transplant‐eligible patients with previously untreated mantle cell lymphoma

Bishton

Ritchie

et al. 2019

Hematological Oncology

View full text Add to dashboard Cite

show abstract

“…However, the response rates and PFS seen with the SCR regimen compare favourably with other less intensive induction regimens. For example, the CR rate with SCR was higher than that seen in prospective studies using BR (40%), R‐cladribine (52%), R‐CHOP (34–42%), and VR‐CAP (rituximab, cyclophosphamide, doxorubicin and prednisone plus bortezomib; 53%) (Kluin‐Nelemans et al , ; Robak et al , ; Chen et al , ; Le Gouill et al , ; Visco et al , ; Chang et al , ; Ruan et al , ; Tam et al , ). Furthermore, although MRD testing was only available for 14 responding patients, all were MRD‐negative after induction.…”

Section: Discussionmentioning

confidence: 95%

“…Furthermore, many patients are not eligible for this approach or opt not to pursue aggressive therapy. Instead, they are treated with less intensive therapies, such as BR (bendamustine plus rituximab), R‐cladribine, R‐CHOP with or without R maintenance, R‐CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, prednisolone) plus bortezemib and BR plus low dose cytarabine (RBAC500) (Kluin‐Nelemans et al , ; Le Gouill et al , ). In our study, we opted to include a broad age range of patients as (i) there are no randomized data available demonstrating the superiority of aggressive therapies and (ii) a number of trials that incorporate less aggressive chemotherapy backbones and novel agents that have shown promising results have included younger patients.…”

Section: Discussionmentioning

confidence: 99%

Phase 1–2 study of vorinostat (SAHA), cladribine and rituximab (SCR) in relapsed B‐cell non‐Hodgkin lymphoma and previously untreated mantle cell lymphoma

et al. 2019

View full text Add to dashboard Cite

Summary Altered DNA methylation and histone acetylation in lymphoma provided the rationale for using vorinostat (SAHA), cladribine and rituximab (SCR) in non‐Hodgkin lymphomas (NHL) in this phase 1–2 study (NCT00764517). Treatment included cladribine 5 mg/m2 intravenously (IV) (days 1–5), rituximab 375 mg/m2 IV (weekly 4× for cycle 1 and 1×/month) and vorinostat orally once daily (days 1–14) every 28 days for up to six cycles. Phase 1 included relapsed patients (n = 10) in a standard 3 + 3 dose escalation design (vorinostat: 200, 300 and 400 mg). No dose‐limiting toxicities were seen. The phase 2 dose for vorinostat was 400 mg po (days 1–14). The majority of phase 2 patients had mantle cell lymphoma (MCL) (n = 57; 39 previously untreated, 10 relapsed). The primary objective was objective response rate [complete response (CR) + partial response] which was 39% (7/18) in relapsed patients and 97% (38/39) with 80% (31/39) attaining a CR in previously untreated MCL. At a median follow‐up of 42 months, median progression‐free survival (PFS) and overall survival (OS) for relapsed NHL were 19·5 [95% confidence interval (CI): 2·0–33·0] and 25·0 (95% CI: 12·0–45·0) months respectively. Median PFS for previously untreated MCL was 84·0 months; OS could not be estimated. Toxicities were primarily haematological.

show abstract

“…Maintenance aims for longer remission duration with overall goal to eliminate residual disease following induction treatment and ultimately achieve a cure for the patients. Although maintenance therapy has proven efficacy in FL and mantle cell lymphoma, its role in DLBCL is not yet established (Table ).…”

Section: Introductionmentioning

confidence: 99%

Frontline treatment of diffuse large B‐cell lymphoma: Beyond R‐CHOP

Mondello

Mian

2019

Hematological Oncology

View full text Add to dashboard Cite

Although the majority of patients with diffuse large B‐cell lymphoma (DLBCL) can be cured with the standard immunochemotherapy R‐CHOP, one‐third of them relapses with a dismal outcome in most cases. In the recent years, remarkable advances have been achieved based on the discovery of molecular genetics in DLBCL. In addition to the major cell‐of‐origin designations of germinal center B‐cell and activated B‐cell subtypes, next‐generation sequencing has unveiled the remarkable complexity of DLBCL and identified potential molecular targets for tailored therapies. Despite these findings, the current standard of care for DLBCL patients is still R‐CHOP, and optimization of frontline therapy remains an important goal. In this review, we summarize recent updates on the evolution of frontline therapies for DLBCL.

show abstract

Rituximab after Autologous Stem-Cell Transplantation in Mantle-Cell Lymphoma

Cited by 337 publications

References 15 publications

A multicenter retrospective comparison of induction chemoimmunotherapy regimens on outcomes in transplant‐eligible patients with previously untreated mantle cell lymphoma

A multicenter retrospective comparison of induction chemoimmunotherapy regimens on outcomes in transplant‐eligible patients with previously untreated mantle cell lymphoma

Phase 1–2 study of vorinostat (SAHA), cladribine and rituximab (SCR) in relapsed B‐cell non‐Hodgkin lymphoma and previously untreated mantle cell lymphoma

Frontline treatment of diffuse large B‐cell lymphoma: Beyond R‐CHOP

Contact Info

Product

Resources

About