A phase 2 trial of extended induction epratuzumab and rituximab for previously untreated follicular lymphoma: CALGB 50701.
A phase 2 trial of extended induction epratuzumab and rituximab for previously untreated follicular lymphoma: CALGB 50701.
复制标题
DOI：
10.1002/cncr.28299
复制
发表时间：
2013-11-01
期刊：
影响因子：
6.2
通讯作者：
Cheson, Bruce D.
中科院分区：
文献类型：
--
作者：
Grant, Barbara W.;Jung, Sin-Ho;Johnson, Jeffrey L.;Kostakoglu, Lale;Hsi, Eric;Byrd, John C.;Jones, Jeffrey;Leonard, John P.;Martin, S. Eric;Cheson, Bruce D.
利妥昔单抗联合化疗改善了以前未接受治疗的滤泡性淋巴瘤(FL)患者的生存率。然而，许多患者既不想也不能耐受化疗，这导致了对生物方法的兴趣。Epratuzumab是一种人源化的抗CD22单抗，对复发性FL有疗效。由于利妥昔单抗和依普拉单抗在FL中都有单一的药物活性，我们评估了抗体组合作为FL患者的初始治疗。59例初治FL患者每周接受依普拉妥珠单抗360 mg/m2联合利妥昔单抗375 mg/m2，共4次诱导剂量。在12周、20周、28周和36周，这种组合继续作为延长诱导。CT评估的反应与临床危险因素、第3周的FDG-PET结果、FCG基因多态性、免疫组织化学标记物和他汀类药物的使用相关。治疗耐受性良好，毒副作用与利妥昔单抗治疗预期的相似。可评价患者52例(88.2%)，其中完全缓解25例(42.4%)，部分缓解27例(45.8%)。经3年随访，60%的患者仍处于缓解期。滤泡性淋巴瘤国际预后指数强烈预测无进展生存期(p=0.022)。用这种抗体组合观察到的高应答率和更长的进展时间与标准的化学免疫治疗后观察到的结果相当，并进一步支持为这些患者开发生物、非化疗方法。
Rituximab combined with chemotherapy has improved the survival of previously untreated patients with follicular lymphoma (FL). Nevertheless, many patients neither want nor can tolerate chemotherapy, leading to interest in biological approaches. Epratuzumab is a humanized anti-CD22 monoclonal antibody with efficacy in relapsed FL. Since both rituximab and epratuzumab have single agent activity in FL, we evaluated the antibody combination as initial treatment of patients with FL. Fifty-nine untreated patients with FL received epratuzumab 360 mg/m2 with rituximab 375 mg/m2 weekly for four induction doses. This combination was continued as extended induction in weeks 12, 20, 28, and 36. Response assessed by CT was correlated with clinical risk factors, FDG-PET findings at week 3, Fcg polymorphisms, immunohistochemical markers, and statin use. Therapy was well-tolerated with toxicities similar to expected with rituximab monotherapy. Fifty-two (88.2%) evaluable patients responded, including 25 complete responses (CR)(42.4%), and 27 partial responses (45.8%). At 3 years follow-up, 60% of patients remain in remission. Follicular Lymphoma International Prognostic Index (FLIPI) risk strongly predicted progression-free survival (p=0.022). The high response rate and prolonged time to progression observed with this antibody combination are comparable to those observed after standard chemo-immunotherapies and further support the development of biologic, non-chemotherapeutic approaches for these patients.
登录
查看更多内容
影响因子：
20.3
作者：
Carreras, Joaquim;Lopez-Guillermo, Armando;Banham, Alison H.
通讯作者：
Banham, Alison H.
影响因子：
20.3
作者：
Micallef, Ivana N. M.;Maurer, Matthew J.;Witzig, Thomas E.
通讯作者：
Witzig, Thomas E.
影响因子：
20.3
作者：
Hiddemann, W;Kneba, M;Unterhalt, M
通讯作者：
Unterhalt, M
影响因子：
50.5
作者：
Czuczman, M. S.;Leonard, J. P.;Cheson, B. D.
通讯作者：
Cheson, B. D.
影响因子：
45.3
作者：
Czuczman, MS;Thall, A;Leigh, BR
通讯作者：
Leigh, BR