Bortezomib-Based Frontline Therapy Boosts Survival in Mantle Cell Lymphoma

Share this content:
Replacement of vincristine with bortezomib in R-CHOP regimen significantly improved median OS in previously untreated patients with mantle cell lymphoma.
Replacement of vincristine with bortezomib in R-CHOP regimen significantly improved median OS in previously untreated patients with mantle cell lymphoma.

In transplant-ineligible patients with previously untreated mantle cell lymphoma, frontline bortezomib plus rituximab, cyclophosphamide, doxorubicin, and prednisone (VR-CAP) showed better survival compared with rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP).1 The results of LYM-3002, a randomized phase 3 clinical trial (ClinicalTrials.org Identifier: NCT00722137), were reported online October 19, 2018, in The Lancet Oncology.

A total of 487 participants were enrolled in the LYM-3002 trial between 2008 and 2011 across 128 centers in 28 countries. Eligible participants had treatment-naive stage II to stage IV mantle cell lymphoma and were ineligible for bone marrow transplantation. Patients were randomized in a 1:1 fashion to receive either 6 or 8 cycles (cycles of 21 days each) of VR-CAP or R-CHOP.

For the follow-up analysis, 268 participants were included (140 participants from the VR-CAP arm and 128 from the R-CHOP arm). At a median follow-up of 82 months, participants who received VR-CAP had a nearly 35-month longer median overall survival than those who received R-CHOP (90.7 months vs 55.7 months; hazard ration [HR] = 0.66; P = .001). In the VR-CAP arm, 42% of participants (103 of 243) had died by the time of analysis, whereas 57% (138 of 244) in the R-CHOP arm had died.

As for safety, 3 new adverse events were seen. In the R-CHOP arm, 1 patient had grade 2 pneumonia. In the VR-CAP arm, 1 patient had grade 4 lung adenocarcinoma and 1 patient had grade 4 gastric cancer.

“This follow-up study showed that replacement of vincristine with bortezomib in the R-CHOP regimen (ie, VR-CAP) significantly improved median overall survival in previously untreated patients with mantle cell lymphoma,” the study authors wrote. “Our results support further assessment of VR-CAP in patients with previously untreated mantle cell lymphoma.”

Disclosure: This study was funded by Janssen Research & Development. For a full list of disclosures, please refer to the original study.

Reference

  1. Robak T, Jin J, Pylypenko H, et al. Frontline bortezomib, rituximab, cyclophosphamide, doxorubicin, and prednisone (VR-CAP) versus rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) in transplantation-ineligible patients with newly diagnosed mantle cell lymphoma: final overall survival results of a randomised, open-label, phase 3 study [published online October 19, 2018]. Lancet Oncol. doi: 10.1016/S1470-2045(18)30685-5

Related Resources

You must be a registered member of Cancer Therapy Advisor to post a comment.

Sign Up for Free e-newsletters



Regimen and Drug Listings

GET FULL LISTINGS OF TREATMENT Regimens and Drug INFORMATION

Bone Cancer Regimens Drugs
Brain Cancer Regimens Drugs
Breast Cancer Regimens Drugs
Endocrine Cancer Regimens Drugs
Gastrointestinal Cancer Regimens Drugs
Gynecologic Cancer Regimens Drugs
Head and Neck Cancer Regimens Drugs
Hematologic Cancer Regimens Drugs
Lung Cancer Regimens Drugs
Other Cancers Regimens
Prostate Cancer Regimens Drugs
Rare Cancers Regimens
Renal Cell Carcinoma Regimens Drugs
Skin Cancer Regimens Drugs
Urologic Cancers Regimens Drugs