January 10, 2018
by Arturo Loaiza-Bonilla, MD, MSEd
Two widely used regimens for advanced-stage follicular lymphoma led to similar high rates of long-term survival, as reported in the Journal of Clinical Oncology.
The 8-year overall survival was 83% and did not differ significantly between patients treated with the combination of rituximab (Rituxan), cyclophosphamide, vincristine, and prednisone (R-CVP) and those who received rituximab, cyclophosphamide, doxorubicine, vincristine, and prednisone (R-CHOP). Progression-free survival (PFS) also did not differ between the regimens in an unadjusted analysis. Adjustment for Follicular Lymphoma Prognostic Index 2 status yielded a 27% reduction in the hazard ratio for PFS in favor of R-CHOP.
Patients initially treated with R-CVP had more on-treatment progression and were more likely to require additional treatments. However, R-CVP had a more favorable tolerability profile.
Both regimens demonstrated superiority to the combination of rituximab, fludarabine, and mitoxantrone (R-FM) in the primary analysis performed after 34 months of follow-up. The long-term survival and PFS findings came from a post-hoc analysis of the randomized FOLL05 trial after a median follow-up of 84 months. The trial evaluated R-CVP, R-CHOP, and R-FM as initial therapy for 504 patients grade 1-3/Ann Arbor stage II-IV follicular lymphoma.
These results are important because we could have discussions with our patients about our potential choice of R-CHOP as a preferred line in appropriately selected patients.
Loiaza-Bonilla is affiliated with Cancer Treatment Centers of America.