Rituximab, a chimeric monoclonal antibody against the B-cell CD20 antigen, has previously been shown to be effective for the treatment of relapsed or refractory indolent lymphomas and has activity in relapsed or refractory diffuse large-B-cell lymphoma. Currently, the standard treatment for large-B-cell lymphoma is cyclophosphamide, doxorubicin, vincristine and prednisone (CHOP), which is effective in younger patients, but induces complete responses in only 40-50% of elderly patients, with three-year event-free and overall survival rates of 30% and 35-40%, respectively. A recent study has examined the benefits of adding rituximab to the CHOP regimen, to see how this treatment compares to CHOP alone.
The researchers randomized previously untreated patients with diffuse large-B-cell lymphoma, 60-80 years old, to receive either eight cycles of CHOP every three weeks, or eight cycles of CHOP plus rituximab given on day one of each cycle. They found that the rate of complete response was significantly higher in the group that received CHOP + rituximab and with a median follow-up of two years, event-free and overall survival times were significantly higher in this group. In addition, this treatment significantly reduced the risk of treatment failure and death and there was no significant increase in treatment-related toxicity.
Non-Hodgkin's lymphoma is the fifth most common cancer in Canada, and there are expected to be 6,200 new cases diagnosed this year.
Source
- Coiffier B, Lepage E, Briere J et al. CHOP chemotherapy plus rituximab compared with CHOP alone in elderly patients with diffuse large-B-cell lymphoma. NEJM 2002;346:235-242.
