Combination chemotherapy followed by an immunotoxin (anti-B4-blocked ricin) in patients with indolent lymphoma: Results of a phase II study

Citation
Dl. Longo et al., Combination chemotherapy followed by an immunotoxin (anti-B4-blocked ricin) in patients with indolent lymphoma: Results of a phase II study, CANCER J, 6(3), 2000, pp. 146-150
Citations number
10
Language
INGLESE
art.tipo
Article
Categorie Soggetti
Oncology,"Onconogenesis & Cancer Research
Journal title
CANCER JOURNAL
ISSN journal
1528-9117 → ACNP
Volume
6
Issue
3
Year of publication
2000
Pages
146 - 150
Database
ISI
SICI code
1528-9117(200005/06)6:3<146:CCFBAI>2.0.ZU;2-#
Abstract
The purpose of this article was to evaluate the antitumor effects of a comb ination chemotherapy program based on ProMACE (prednisone, methotrexate, do xorubicin [Adriamycin], cyclophosphamide, etoposide) followed by a B cell-s pecific immunotoxin in the treatment of patients with advanced-stage indole nt histology non-Hodgkin's lymphomas. We performed a prospective phase II c linical trial in a referral-based patient population. After confirmation of diagnosis and staging evaluation, 44 patients (10 small lymphocytic lympho ma, 27 follicular lymphoma, 7 mantle cell lymphoma; 30 without prior therap y, 14 previously treated) received six cycles of ProMACE-CytaBOM (cytarabin e, bleomycin, vincristine [Oncovin], mechlorethamine) combination chemother apy (with etoposide given orally daily for five days) followed by a 7-day c ontinuous infusion of anti-B4-blocked ricin immunotoxin at 30 mu g/kg/day g iven every 14 days for up to six cycles. A complete response was achieved i n 25 of 44 patients (57%), 21 from the chemotherapy alone, 3 converted from partial to complete response with the immunotoxin, and 1 patient became a complete responder after a surgical procedure to remove an enlarged spleen that was histologically negative for lymphoma. With a median follow-up of 5 years, 14 of 25 complete responders have relapsed (56%); median remission duration was 2 years, and overall survival was 61%. Forty-two percent of th e complete responders have been in continuous remission for more than 4 yea rs. The median number of courses of immunotoxin delivered was two usually b ecause of the development of human anti-ricin antibodies. ProMACE- CytaBOM plus anti-B4-blocked ricin does not produce durable complete remissions in the majority of patients with indolent lymphoma. However, the remissions ap pear quite durable (> 4 years) in about 40% of the complete responders.