title: CVP chemotherapy plus rituximab compared with CVP as first-line treatment for advanced follicular lymphoma.
abstract: The combination of cyclophosphamide, vincristine, and prednisone (CVP) is one of several standard treatment options for advanced follicular lymphoma. This, like similar chemotherapeutic regimens, induces response rates of 60% to 80%, with a median response duration of under 2 years. Rituximab, a chimeric monoclonal antibody against CD20, is active in follicular lymphoma, both as monotherapy and in combination with chemotherapy. Previously untreated patients with stages III to IV follicular lymphoma were randomly assigned to receive either 8 cycles of CVP plus rituximab (R-CVP; n = 162) or CVP (n = 159). Overall and complete response rates were 81% and 41% in the R-CVP arm versus 57% and 10% in the CVP arm, respectively (P < .0001). At a median follow-up of 30 months, patients treated with R-CVP had a very significantly prolonged time to progression (median 32 months versus 15 months for CVP; P < .0001). Median time to treatment failure was 27 months in patients receiving R-CVP and 7 months in the CVP arm (P < .0001). Rituximab did not add significantly to the toxicity of CVP. The addition of rituximab to the CVP regimen significantly improves the clinical outcome in patients with previously untreated advanced follicular lymphoma, without increased toxicity.
authors.affiliation: Dept of Haematology, Addenbrookes Hospital, Cambridge CB2 2QQ, UK. robert.marcus@addenbrookes.nhs.uk
authors.forename: Robert
authors.initials: R
authors.lastname: Marcus
authors.forename: Kevin
authors.initials: K
authors.lastname: Imrie
authors.forename: Andrew
authors.initials: A
authors.lastname: Belch
authors.forename: David
authors.initials: D
authors.lastname: Cunningham
authors.forename: Eduardo
authors.initials: E
authors.lastname: Flores
authors.forename: John
authors.initials: J
authors.lastname: Catalano
authors.forename: Philippe
authors.initials: P
authors.lastname: Solal-Celigny
authors.forename: Fritz
authors.initials: F
authors.lastname: Offner
authors.forename: Jan
authors.initials: J
authors.lastname: Walewski
authors.forename: Joäo
authors.initials: J
authors.lastname: Raposo
authors.forename: Andrew
authors.initials: A
authors.lastname: Jack
authors.forename: Paul
authors.initials: P
authors.lastname: Smith
mesh_terms: D000328:Adult; D000911:Antibodies, Monoclonal / Q000008:administration & dosage / Q000009:adverse effects; D058846:Antibodies, Monoclonal, Murine-Derived; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D003520:Cyclophosphamide / Q000008:administration & dosage / Q000009:adverse effects; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008224:Lymphoma, Follicular / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D011241:Prednisone / Q000008:administration & dosage / Q000009:adverse effects; D011446:Prospective Studies; D000069283:Rituximab; D014750:Vincristine / Q000008:administration & dosage / Q000009:adverse effects
chemical_list: D000911:Antibodies, Monoclonal; D058846:Antibodies, Monoclonal, Murine-Derived; D000069283:Rituximab; D014750:Vincristine; D003520:Cyclophosphamide; D011241:Prednisone