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一项比较 R-CHOP 方案治疗后缓解的新诊断滤泡性淋巴瘤患者采用单次伊布替昔单抗替妥昔单抗巩固治疗与利妥昔单抗维持治疗 2 年的随机 II 期研究。长期随访结果。

A randomized phase II study comparing consolidation with a single dose of Y ibritumomab tiuxetan maintenance with rituximab for two years in patients with newly diagnosed follicular lymphoma responding to R-CHOP. Long-term follow-up results.

机构信息

Hematopathology Department, Hospital Clinic de Barcelona, Barcelona, Spain.

Hematology Department, Hospital La Paz, Madrid, Spain.

出版信息

Leuk Lymphoma. 2022 Jan;63(1):93-100. doi: 10.1080/10428194.2021.1971216. Epub 2021 Aug 30.

DOI:10.1080/10428194.2021.1971216
PMID:34459702
Abstract

This is a randomized phase-2 trial aimed to compare consolidation vs. maintenance in untreated patients with follicular lymphoma (FL) responding to induction. 146 patients were enrolled from 25 Spanish institutions (ZAR2007; ClinicalTrials.gov #NCT00662948). Patients in PR or CR/CR[u] after R-CHOP were randomized 1:1 to Y-ibritumomab-tiuxetan 0.4 mCi/kg (arm A) vs. rituximab 375 mg/m every 8 weeks for 2 years (arm B). After a median follow-up of 10.55 years, 53 patients eventually progressed with a 10-year PFS of 50% vs. 56% for patients in arm A and B, respectively (HR = 1.42;  > 0.1). No significant differences were seen in OS (10-year OS 78% vs. 84.5%; HR = 1.39,  > .1). Patients receiving Y-ibritumomab-tiuxetan showed higher incidence of second neoplasms than those in arm B (10-year cumulative incidence 18.5 vs. 2%, respectively;  = .038). In conclusion, in FL patients responding to R-CHOP, no significant differences were found between consolidation and maintenance, although with higher late toxicity for consolidation.

摘要

这是一项旨在比较未经治疗的滤泡性淋巴瘤(FL)患者在诱导缓解后巩固治疗与维持治疗的随机 2 期试验。146 名患者来自 25 家西班牙机构(ZAR2007;ClinicalTrials.gov #NCT00662948)。在接受 R-CHOP 后达到 PR 或 CR/CR[u]的患者按 1:1 随机分为 Y-ibritumomab-tiuxetan 0.4 mCi/kg(A 组)与利妥昔单抗 375 mg/m2,每 8 周一次,持续 2 年(B 组)。中位随访 10.55 年后,53 名患者最终进展,A 组和 B 组的 10 年 PFS 分别为 50%和 56%(HR = 1.42;>0.1)。OS 无显著差异(10 年 OS 分别为 78%和 84.5%;HR = 1.39;>0.1)。接受 Y-ibritumomab-tiuxetan 的患者比 B 组发生第二肿瘤的几率更高(10 年累积发生率分别为 18.5%和 2%;=0.038)。综上,在对 R-CHOP 有反应的 FL 患者中,巩固治疗与维持治疗之间未发现显著差异,尽管巩固治疗的晚期毒性更高。

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