Faculty Collaboration Database

VcR-CVAD induction chemotherapy followed by maintenance rituximab in mantle cell lymphoma: a Wisconsin Oncology Network study. Br J Haematol 2011 Oct;155(2):190-7

Date

08/19/2011

Pubmed ID

21848883

Pubmed Central ID

PMC3188692

DOI

10.1111/j.1365-2141.2011.08820.x

Scopus ID

2-s2.0-80053567237 (requires institutional sign-in at Scopus site)   51 Citations

Abstract

Intensive chemotherapy regimens are not feasible in many adults with mantle cell lymphoma (MCL). We sought to build upon our previous experience with a non-intensive regimen, modified R-hyperCVAD chemotherapy (rituximab, cyclophosphamide, vincristine, doxorubicin, dexamethasone) with maintenance rituximab (MR), by the incorporation of bortezomib (VcR-CVAD) and the extension of MR beyond 2 years. Patients with previously untreated MCL received VcR-CVAD chemotherapy every 21 d for six cycles. Patients achieving at least a partial response to induction chemotherapy received rituximab consolidation (375 mg/m(2) × 4 weekly doses) and MR (375 mg/m(2) every 12 weeks × 20 doses). The primary end points were overall and complete response (CR), and secondary endpoints were progression-free (PFS) and overall survival (OS). Thirty patients were enrolled, with a median age of 61 years. All patients had advanced stage disease, and 60% had medium/high MCL International Prognostic Index risk factors. A CR or unconfirmed CR was achieved in 77% of patients. After a median follow-up of 42 months, the 3-year PFS and OS were 63% and 86%, respectively. The observed 3-year PFS and OS with VcR-CVAD in MCL were comparable to reported outcomes with more intensive regimens. A cooperative group trial (E1405) is attempting to replicate these promising results.

Author List

Chang JE, Peterson C, Choi S, Eickhoff JC, Kim K, Yang DT, Gilbert LA, Rogers ES, Werndli JE, Huie MS, McFarland TA, Volk M, Blank J, Callander NS, Longo WL, Kahl BS

Author

Walter L. Longo MD Professor in the Medicine department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Aged
Antibodies, Monoclonal, Murine-Derived
Antineoplastic Combined Chemotherapy Protocols
Boronic Acids
Bortezomib
Cyclophosphamide
Dexamethasone
Disease-Free Survival
Doxorubicin
Female
Granulocyte Colony-Stimulating Factor
Hematologic Diseases
Humans
Kaplan-Meier Estimate
Lymphoma, Mantle-Cell
Male
Middle Aged
Peripheral Nervous System Diseases
Proportional Hazards Models
Protease Inhibitors
Pyrazines
Remission Induction
Rituximab
Treatment Outcome
Vincristine