Rituximab combined with chemotherapy and interferon in follicular lymphoma patients: results of the GELA-GOELAMS FL2000 study

摘要

The FL2000 study was undertaken to evaluate the combination of the anti-CD20 monoclonal antibody rituximab with chemotherapy plus interferon in the first-line treatment of follicular lymphoma patients with a high tumor burden. Patients were randomly assigned to receive either 12 courses of the chemotherapy regimen CHVP (cyclophosphamide, adriamycin, eto-poside, and prednisolone) plus interferon-?a (CHVP+1 arm) over 18 months or 6 courses of the same chemotherapy regimen combined with 6 infusions of 375 mg/m2rituximab and interferon for the same time period (R-CHVP+I arm). After a median follow-up of 5 years, event-free survival estimates were, respectively, 37% (95% confidence interval [Cl], 29%-44%) and 53% (95% Cl, 45%-60%) in the CHVP+I and R-CHVP+I arm (P=.001). Five-year overall survival estimates were not statistically different in the CHVP+I (79%; 95% Cl, 72%-84%) and R-CHVP+I (84%; 95% Cl, 78%-84%) arms. In a multivariate regression analysis, event-free survival was significantly influenced by both the Follicular Lymphoma InternationalPrognostic Index score (hazard ratio = 2.08; 95% Cl, 1.6%-2.8%) and the treatment arm (hazard ratio = 0.59; 95% Cl, 0.44%-0.78%). With a 5-year follow-up, the combination of rituximab with CHVP+I provides superior disease control in follicular lymphoma patients despite a shorter duration of chemotherapy. This study's clinical trial was registered at the National Institutes of Health website as no. NCT00136552.