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利妥昔单抗联合或不联合干扰素-α2a进行的两个疗程、每周一次共四周的输注:一项针对有症状的惰性B细胞淋巴瘤的随机III期研究的最终结果

Two courses of four weekly infusions of rituximab with or without interferon-α2a: final results from a randomized phase III study in symptomatic indolent B-cell lymphomas.

作者信息

Kimby Eva, Östenstad Björn, Brown Peter, Hagberg Hans, Erlanson Martin, Holte Harald, Linden Ola, Johansson Ann-Sofie, Ahlgren Tomas, Wader Karin, Wahlin Björn Engelbrekt, Delabie Jan, Sundström Christer

机构信息

a Division of Hematology, Department of Medicine at Huddinge , Karolinska Institute and University Hospital , Stockholm , Sweden.

b Department of Oncology , Oslo University Hospital , Oslo , Norway.

出版信息

Leuk Lymphoma. 2015;56(9):2598-607. doi: 10.3109/10428194.2015.1014363. Epub 2015 Mar 11.

Abstract

Patients with advanced CD20 + indolent lymphoma, requiring therapy, were randomized to rituximab (four weekly infusions of 375 mg/m(2)) or to rituximab combined with 5 weeks of interferon-α2a (IFN-α2a) (3-4.5 MIU daily) as priming. Responding patients were eligible for a second cycle with the same allocated treatment. In total, 156 patients were randomized to rituximab and 157 to rituximab + IFN-α2a. In the intention-to treat (ITT) population, 244 patients (78%) responded to cycle 1. After a second cycle the complete remission/complete remission unconfirmed (CR/CRu) rate was 41% with the combination versus 24% with monotherapy (p = 0.005). The median time to treatment failure (primary endpoint) in ITT patients was 28 vs. 21.5 months, respectively (p = 0.302). After a long median follow-up (61 months), 33% (42% of patients responding to cycle 1) were still failure-free with an overall survival rate of 88% and with no difference between the treatment groups. The trial was registered at ClinicalTrials.gov Identifier: NCT01609010.

摘要

需要治疗的晚期CD20+惰性淋巴瘤患者被随机分为接受利妥昔单抗治疗组(每周静脉输注1次,共4次,每次375mg/m²)或利妥昔单抗联合α-2a干扰素(IFN-α2a)诱导治疗组(5周,每日3-4.5MIU)。缓解的患者有资格接受相同分配治疗的第二个周期。总共156例患者被随机分配接受利妥昔单抗治疗,157例患者被随机分配接受利妥昔单抗+IFN-α2a治疗。在意向性治疗(ITT)人群中,244例患者(78%)对第1周期治疗有反应。在第二个周期后,联合治疗组的完全缓解/未确认的完全缓解(CR/CRu)率为41%,而单药治疗组为24%(p=0.005)。ITT患者中至治疗失败(主要终点)的中位时间分别为28个月和21.5个月(p=0.302)。经过较长的中位随访期(61个月),33%(对第1周期治疗有反应的患者中的42%)仍无治疗失败,总生存率为88%,且治疗组之间无差异。该试验已在ClinicalTrials.gov注册,标识符为:NCT01609010。

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