Hematopathology Department, Hospital Clinic de Barcelona, Barcelona, Spain.
Hematology Department, Hospital La Paz, Madrid, Spain.
Leuk Lymphoma. 2022 Jan;63(1):93-100. doi: 10.1080/10428194.2021.1971216. Epub 2021 Aug 30.
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.
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。