Intensified First Cycle of Rituximab Plus Eight Cycles of Cyclophosphamide, Doxorubicin, Vincristine, and Prednisolone with Rituximab Chemotherapy for Advanced-Stage or Bulky Diffuse Large B-Cell Lymphoma: A Multicenter Phase II Consortium for Improving Survival of Lymphoma (CISL) Study
- 주제(키워드) Key words Rituximab , Diffuse large B-cell lymphoma , R-CHOP , Response
- 주제(기타) Oncology
- 설명문(일반) [Kim, Yu Ri; Kim, Jin Seok] Yonsei Univ, Coll Med, Severance Hosp, Div Hematol,Dept Internal Med, 50-1 Yonsei Ro, Seoul 120752, South Korea; [Kim, Won Seog] Sungkyunkwan Univ, Dept Med, Samsung Med Ctr, Sch Med, Seoul, South Korea; [Eom, Hyeon Seok] Natl Canc Ctr, Hematol Oncol Clin, Goyang, South Korea; [Yang, Deok-Hwan] Chonnam Natl Univ, Hwasun Hosp, Dept Hematol Oncol, Hwasun, South Korea; [Bae, Sung Hwa] Daegu Catholic Univ, Dept Internal Med, Med Ctr, Daegu, South Korea; [Kim, Hyo Jung] Hallym Univ, Sacred Heart Hosp, Dept Internal Med, Anyang, South Korea; [Lee, Jae Hoon] Gachon Univ, Gil Med Ctr, Dept Internal Med, Incheon, South Korea; [Oh, Suk-Joong] Sungkyunkwan Univ, Sch Med, Kangbuk Samsung Hosp, Dept Internal Med, Seoul, South Korea; [Yoon, Sung-Soo] Seoul Natl Univ, Coll Med, Dept Internal Med, Seoul Natl Univ Hosp, Seoul, South Korea; [Kwak, Jae-Yong] Chonbuk Natl Univ, Med Sch, Dept Internal Med, Jeonju, South Korea; [Choi, Chul Won] Korea Univ, Coll Med, Dept Internal Med, Seoul, South Korea; [Kim, Min Kyoung] Yeungnam Univ, Coll Med, Dept Internal Med, Daegu, South Korea; [Oh, Sung Young] Dong A Univ, Coll Med, Dept Internal Med, Busan, South Korea; [Kang, Hye Jin] Korea Inst Radiol & Med Sci, Korea Canc Ctr Hosp, Dept Internal Med, Seoul, South Korea; [Nam, Seung Hyun] Vet Hlth Serv Med Ctr, Dept Internal Med, Seoul, South Korea; [Shim, Hyeok] Wonkwang Univ, Sch Med, Dept Internal Med, Iksan, South Korea; [Park, Joon Seong] Ajou Univ, Sch Med, Dept Hematol Oncol, Suwon, South Korea; [Mun, Yeung-Chul] Ewha Womans Univ, Sch Med, Dept Internal Med, Seoul, South Korea; [Suh, Cheolwon] Univ Ulsan, Coll Med, Asan Med Ctr, Dept Oncol, 88 Olymp Ro 43 Gil, Seoul 05505, South Korea; [Oh, Suk-Joong] Hanyang Univ, Seoul Hosp, Dept Hematol & Oncol, Seoul, South Korea; [Nam, Seung Hyun] Kyung Hee Univ Hosp Gangdong, Dept Internal Med, Seoul, South Korea
- 등재 SCIE, SCOPUS, KCI등재
- OA유형 Green Published; Gold Open Access
- 발행기관 KOREAN CANCER ASSOCIATION
- 발행년도 2023
- 총서유형 Journal
- URI http://www.dcollection.net/handler/ewha/000000213467
- 본문언어 영어
- Published As https://doi.org/10.4143/crt.2023.271
초록/요약
Purpose This phase II, open-label, multicenter study aimed to investigate the efficacy and safety of a rituximab intensification for the 1st cycle with every 21-day of rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisolone (R-CHOP-21) among patients with previously untreated advanced-stage or bulky diffuse large B-cell lymphoma (DLBCL). Materials and Methods Ninety-two patients with stage III/IV or bulky DLBCL from 21 institutions were administered 8 cycles of RCHOP-21 with an additional one dose of rituximab intensification on day 0 of the 1st cycle (RR-CHOP). The primary endpoint was a complete response (CR) rate after 3 cycles of chemotherapy. Results Among the 92 DLBCL patients assessed herein, the response rate after 3 cycles of chemotherapy was 88.0% (38.0% CR+50.0% partial response [PR]). After the completion of 8 cycles of chemotherapy, the overall response rate was observed for 68.4% (58.7% CR+9.8% PR). The 3-year progression-free survival rate was 64.0%, and the 3-year overall survival rate was 70.4%. Febrile neutropenia was one of the most frequent >= grade 3 adverse events (40.0%) and five treatment-related deaths occurred. Compared with the clinical outcomes of patients who received R-CHOP chemotherapy as a historical control, the interim CR rate was higher in male patients with RR-CHOP (20.5% vs. 48.8%, p=0.016). Conclusion Rituximab intensification on days 0 to the 1st cycle of the standard 8 cycles R-CHOP-21 for advanced DLBCL yielded favorable response rates after the 3 cycles of chemotherapy and acceptable toxicities, especially for male patients (ClinicalTrials.gov ID: NCT01054781).
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