Cvetković Risto S, Perry Caroline M
Adis International Limited, 41 Centorian Drive, Mairangi Bay, Auckland 1311, New Zealand.
Drugs. 2006;66(6):791-820. doi: 10.2165/00003495-200666060-00005.
Rituximab (MabThera, Rituxan) is an anti-CD20 monoclonal antibody that induces lysis and apoptosis of normal and malignant human B cells, and sensitises malignant B cells to the cytotoxic effect of chemotherapy. In phase III trials in patients with indolent or aggressive B-cell non-Hodgkin's lymphoma (NHL), intravenous rituximab in combination with chemotherapy was more effective as first- or second-line therapy than chemotherapy alone in providing tumour remission and patient survival. Likewise, in patients with chronic lymphocytic leukaemia (CLL), rituximab in combination with chemotherapy appeared more effective than chemotherapy alone as either first- or second-line treatment. In addition, rituximab maintenance therapy was shown to significantly prolong tumour remission and patient survival in patients with indolent B-cell NHL or CLL. The combination of rituximab with cyclophosphamide, doxorubicin, vincristine and prednisone (CHOP) was cost effective as first-line therapy for advanced-stage diffuse large B-cell NHL compared with CHOP alone. Rituximab, either alone or in combination with chemotherapy, was generally well tolerated in patients with NHL or CLL. Overall, rituximab in combination with chemotherapy, is a valuable option for first- and second-line therapy in patients with advanced-stage indolent or aggressive B-cell NHL, and possibly those with B-cell CLL, and is included in current treatment guidelines for these indications. The drug is also potentially useful as maintenance therapy in patients with indolent B-cell NHL or CLL.
利妥昔单抗（美罗华，Rituxan）是一种抗CD20单克隆抗体，可诱导正常和恶性人B细胞的裂解和凋亡，并使恶性B细胞对化疗的细胞毒性作用敏感。在惰性或侵袭性B细胞非霍奇金淋巴瘤（NHL）患者的III期试验中，静脉注射利妥昔单抗联合化疗作为一线或二线治疗，在实现肿瘤缓解和患者生存方面比单纯化疗更有效。同样，在慢性淋巴细胞白血病（CLL）患者中，利妥昔单抗联合化疗作为一线或二线治疗似乎比单纯化疗更有效。此外，利妥昔单抗维持治疗被证明可显著延长惰性B细胞NHL或CLL患者的肿瘤缓解期和生存期。与单纯CHOP方案相比，利妥昔单抗联合环磷酰胺、阿霉素、长春新碱和泼尼松（CHOP）方案作为晚期弥漫性大B细胞NHL的一线治疗具有成本效益。利妥昔单抗单独或联合化疗，在NHL或CLL患者中一般耐受性良好。总体而言，利妥昔单抗联合化疗是晚期惰性或侵袭性B细胞NHL患者以及可能的B细胞CLL患者一线和二线治疗的有价值选择，并被纳入这些适应症的当前治疗指南。该药物在惰性B细胞NHL或CLL患者中作为维持治疗也可能有用。
