Leonard John P, Schuster Stephen J, Emmanouilides Christos, Couture Felix, Teoh Nick, Wegener William A, Coleman Morton, Goldenberg David M
Center for Lymphoma and Myeloma, Division of Hematology/Oncology, Weill Cornell Medical College and New York Presbyterian Hospital, New York, New York, USA.
Cancer. 2008 Nov 15;113(10):2714-23. doi: 10.1002/cncr.23890.
In this international, multicenter trial, the authors evaluated rituximab (anti-CD20) plus epratuzumab (anti-CD22) in patients with postchemotherapy relapsed/refractory, indolent non-Hodgkin lymphoma (NHL), including long-term efficacy.
Forty-nine patients with follicular NHL (FL) (N = 41) or small lymphocytic lymphoma (SLL) (N = 7) received intravenous epratuzumab 360 mg/m2 and then intravenous rituximab 375 mg/m2 weekly x4. The regimen was tolerated well.
Twenty-two of 41 patients with FL (54%) had an objective response (OR), including 10 (24%) complete responses (CR) (CR/unconfirmed CR [CRu]), whereas 4 of 7 patients with SLL (57%) had ORs, including 3 (43%) with CR/CRu. Rituximab-naive patients (N = 34) had an OR rate of 50% (26% CR/CRu rate), whereas patients who previously responded to rituximab (N = 14) had an OR rate of 64% (29% CR/CRu rate). An OR rate of 85% was observed in patients with FL who had Follicular Lymphoma International Prognostic Index (FLIPI) risk scores of 0 or 1 (N = 13), whereas 28 patients with intermediate or high-risk FLIPI scores (> or =2) had an OR rate of 39% (18% CR/CRu rate). In patients with FL, the median response duration was 13.4 months, and that duration increased to 29.1 months for 10 patients who had a CR/CRu, including 4 patients who had durable responses with remissions that continued for >4 years. In patients with SLL, the median response duration was 20 months, including 1 patient who had a response that continued for >3 years.
The combination of epratuzumab and rituximab induced durable responses in patients with recurrent, indolent NHL.
在这项国际多中心试验中，作者评估了利妥昔单抗（抗CD20）联合依帕珠单抗（抗CD22）用于化疗后复发/难治性惰性非霍奇金淋巴瘤（NHL）患者的疗效，包括长期疗效。
49例滤泡性NHL（FL）患者（n = 41）或小淋巴细胞淋巴瘤（SLL）患者（n = 7）接受静脉注射依帕珠单抗360mg/m²，随后静脉注射利妥昔单抗375mg/m²，每周1次，共4次。该方案耐受性良好。
41例FL患者中有22例（54%）获得客观缓解（OR），包括10例（24%）完全缓解（CR）（CR/未确认的CR [CRu]），而7例SLL患者中有4例（57%）获得OR，包括3例（43%）CR/CRu。初治利妥昔单抗患者（n = 34）的OR率为50%（CR/CRu率为26%），而先前对利妥昔单抗有反应的患者（n = 14）的OR率为64%（CR/CRu率为29%）。滤泡性淋巴瘤国际预后指数（FLIPI）风险评分为0或1的FL患者（n = 13）的OR率为85%，而28例FLIPI评分中或高风险（≥2）的患者的OR率为39%（CR/CRu率为18%）。在FL患者中，中位缓解持续时间为13.4个月，10例CR/CRu患者的缓解持续时间延长至29.1个月，其中4例患者有持续超过4年的持久缓解。在SLL患者中，中位缓解持续时间为20个月，包括1例缓解持续超过3年的患者。
依帕珠单抗和利妥昔单抗联合用药可使复发惰性NHL患者获得持久缓解。
