Comparison of the effectiveness of frontline chemoimmunotherapy regimens for follicular lymphoma used in the United States. Issue 5 (May 2015)

• Record Type: Journal Article
• Authors: Nastoupil, Loretta J.; Sinha, Rajni; Byrtek, Michelle; Ziemiecki, Ryan; Taylor, Michael; Friedberg, Jonathan W.; Koff, Jean L.; Link, Brian K.; Cerhan, James R.; Dawson, Keith L.; Flowers, Christopher R.
• Is Part Of: Leukemia & lymphoma. Volume 56:Issue 5(2015:May)
• Page Start: 1295
• Page End: 1302
• Publication Date: 2015-05
• Subjects: Leukemia -- Periodicals; Lymphomas -- Periodicals; 616.99419
• DOI: 10.3109/10428194.2014.953144
• Languages: English
• ISSNs: 1042-8194

Abstract

<abstract> <title>Abstract</title> <p>To compare the effectiveness of frontline rituximab-chemotherapy regimens in clinical practice, we examined outcomes for patients with low-grade, stage III/IV follicular lymphoma receiving rituximab (R) with cyclophosphamide, doxorubicin, vincristine and prednisone (R-CHOP), R with cyclophosphamide, vincristine and prednisone (R-CVP) or R with a fludarabine-based regimen (R-Flu) as frontline therapy. In total, 611 patients meeting these criteria were identified in the National LymphoCare Study: 47% receiving R-CHOP (<italic>n</italic> = 287), 31% receiving R-CVP (<italic>n</italic> = 187) and 22% receiving R-Flu (<italic>n</italic> = 137). Overall response rates were high (R-CVP 87%, R-CHOP 93%, R-Flu 94%; <italic>p = </italic>0.017). Median follow-up was 7.4 years. R-CVP was associated with lower 5-year overall survival (R-CVP 76%, R-CHOP 86%, R-Flu 86%; <italic>p</italic> = 0.021) and progression-free survival (R-CVP 49%, R-CHOP 58%, R-Flu 64%; <italic>p = </italic>0.029). There were no significant differences in survival in Cox models adjusted for baseline clinical factors, practice region/setting and post-treatment R maintenance/observation.</p> </abstract>