Shorter R-CHOP Regimen + 90Y-ibritumomab Tiuxetan 'Reasonable' for MCL

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(ChemotherapyAdvisor) – Rituximab plus cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) given for 4 cycles followed by yttrium-90 (90Y) –ibritumomab tiuxetan “compared favorably with historical results with 6 cycles of R-CHOP in patients with previously untreated mantle-cell lymphoma,” a study reported in the Journal of Clinical Oncology online July 30, 2012.

“This regimen was well tolerated and should be applicable to most patients with this disease,” noted Mitchell R. Smith, MD, PhD, Fox Chase Cancer Center, Philadelphia, PA, and colleagues.

The phase 2 Eastern Cooperative Oncology Group Study E1499 analyzed 56 treatment-naïve patients with histologically confirmed mantle-cell lymphoma expressing CD20 and cyclin D1 who received 4 cycles of R-CHOP, 52 of whom also received 90Y-ibritumomab tiuxetan. Median age was 60 years and 73% were men.

Overall response rate was 82%, 55% complete response (CR)/unconfirmed CR. At a median follow-up of 72 months, median time-to-treatment failure was 34.2 months and median overall survival had not been reached. Estimated 5-year OS was 73%; 79% for patients ≤65 years and 62% for those <65 years (log-rank P=0.08).

“Currently, in patients who cannot tolerate more-intensive regimens or clinical trials, R-CHOP for 4 cycles followed by 90Y-ibritumomab tiuxetan is a reasonable approach to the initial therapy of mantle cell lymphoma,” they concluded.


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