A phase II trial of RCHOP followed by radioimmunotherapy for early stage (stages I/II) diffuse large B-cell non-Hodgkin lymphoma: ECOG3402

Thomas E. Witzig, Fangxin Hong, Ivana N. Micallef, Randy D. Gascoyne, Ahmet Dogan, Henry Wagner Jr., Brad S. Kahl, Ranjana H. Advani, Sandra J. Horning

Research output: Contribution to journalArticle

12 Citations (Scopus)

Abstract

Patients with early stage diffuse large B-cell lymphoma (DLBCL) receive RCHOP (rituximab cyclophosphamide, doxorubicin, vincristine, prednisone) alone or with involved field radiotherapy (IFRT). Anti-CD20 radioimmunotherapy (RIT) delivers radiation to microscopic sites outside of known disease. This phase II study aimed to achieve a functional complete response (CR) rate of ≥75% to RCHOP and 90Yttrium-ibritumomab tiuxetan RIT. Patients with stages I/II DLBCL received 4-6 cycles of RCHOP followed by RIT [14·8 MBq/kg (0·4 mCi/kg)]; patients with positron emission tomographypositive sites of disease after RCHOP/RIT received 30 Gy IFRT. Of the 62 patients enrolled; 53 were eligible. 42% (22/53) had stage I/IE; 58% (31/53) stage II/IIE. After RCHOP, 79% (42/53) were in CR/unconfirmed CR. Forty-eight patients proceeded to RIT. One partial responder after RIT received IFRT and achieved a CR. The best response after RCHOP + RIT in all 53 patients was a functional CR rate of 89% (47/53; 95% confidence interval: 77-96%). With a median follow-up of 5·9 years, 7 (13%) patients have progressed and 4 (8%) have died (2 with DLBCL). At 5 years, 78% of patients remain in remission and 94% are alive. Chemoimmunotherapy and RIT is an active regimen for early stage DLBCL patients. Eighty-nine percent of patients achieved functional CR without the requirement of IFRT. This regimen is worthy of further study for early stage DLBCL in a phase III trial.

Original languageEnglish (US)
Pages (from-to)679-686
Number of pages8
JournalBritish Journal of Haematology
Volume170
Issue number5
DOIs
StatePublished - Sep 1 2015

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Radioimmunotherapy
Vincristine
B-Cell Lymphoma
Prednisone
Non-Hodgkin's Lymphoma
Doxorubicin
Cyclophosphamide
Lymphoma, Large B-Cell, Diffuse
Radiotherapy
Rituximab
Electrons
Confidence Intervals
Radiation

All Science Journal Classification (ASJC) codes

  • Hematology

Cite this

Witzig, Thomas E. ; Hong, Fangxin ; Micallef, Ivana N. ; Gascoyne, Randy D. ; Dogan, Ahmet ; Wagner Jr., Henry ; Kahl, Brad S. ; Advani, Ranjana H. ; Horning, Sandra J. / A phase II trial of RCHOP followed by radioimmunotherapy for early stage (stages I/II) diffuse large B-cell non-Hodgkin lymphoma : ECOG3402. In: British Journal of Haematology. 2015 ; Vol. 170, No. 5. pp. 679-686.
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abstract = "Patients with early stage diffuse large B-cell lymphoma (DLBCL) receive RCHOP (rituximab cyclophosphamide, doxorubicin, vincristine, prednisone) alone or with involved field radiotherapy (IFRT). Anti-CD20 radioimmunotherapy (RIT) delivers radiation to microscopic sites outside of known disease. This phase II study aimed to achieve a functional complete response (CR) rate of ≥75{\%} to RCHOP and 90Yttrium-ibritumomab tiuxetan RIT. Patients with stages I/II DLBCL received 4-6 cycles of RCHOP followed by RIT [14·8 MBq/kg (0·4 mCi/kg)]; patients with positron emission tomographypositive sites of disease after RCHOP/RIT received 30 Gy IFRT. Of the 62 patients enrolled; 53 were eligible. 42{\%} (22/53) had stage I/IE; 58{\%} (31/53) stage II/IIE. After RCHOP, 79{\%} (42/53) were in CR/unconfirmed CR. Forty-eight patients proceeded to RIT. One partial responder after RIT received IFRT and achieved a CR. The best response after RCHOP + RIT in all 53 patients was a functional CR rate of 89{\%} (47/53; 95{\%} confidence interval: 77-96{\%}). With a median follow-up of 5·9 years, 7 (13{\%}) patients have progressed and 4 (8{\%}) have died (2 with DLBCL). At 5 years, 78{\%} of patients remain in remission and 94{\%} are alive. Chemoimmunotherapy and RIT is an active regimen for early stage DLBCL patients. Eighty-nine percent of patients achieved functional CR without the requirement of IFRT. This regimen is worthy of further study for early stage DLBCL in a phase III trial.",
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A phase II trial of RCHOP followed by radioimmunotherapy for early stage (stages I/II) diffuse large B-cell non-Hodgkin lymphoma : ECOG3402. / Witzig, Thomas E.; Hong, Fangxin; Micallef, Ivana N.; Gascoyne, Randy D.; Dogan, Ahmet; Wagner Jr., Henry; Kahl, Brad S.; Advani, Ranjana H.; Horning, Sandra J.

In: British Journal of Haematology, Vol. 170, No. 5, 01.09.2015, p. 679-686.

Research output: Contribution to journalArticle

TY - JOUR

T1 - A phase II trial of RCHOP followed by radioimmunotherapy for early stage (stages I/II) diffuse large B-cell non-Hodgkin lymphoma

T2 - ECOG3402

AU - Witzig, Thomas E.

AU - Hong, Fangxin

AU - Micallef, Ivana N.

AU - Gascoyne, Randy D.

AU - Dogan, Ahmet

AU - Wagner Jr., Henry

AU - Kahl, Brad S.

AU - Advani, Ranjana H.

AU - Horning, Sandra J.

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Y1 - 2015/9/1

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