title: Rituximab in lymphoma: a systematic review and consensus practice guideline from Cancer Care Ontario.
abstract: Rituximab is the first antibody-based therapy approved in cancer. The role of this treatment for non-Hodgkin's lymphoma has evolved significantly since its introduction. We aimed to systematically review the literature on rituximab in non-Hodgkin's lymphoma and provide consensus guidelines as to the rational use of this agent. Validated methodology from the Cancer Care Ontario Program in Evidence-Based Care was applied. A comprehensive literature search was completed by reviewers from the Hematology Disease Site Group of Cancer Care Ontario. Data were abstracted from randomized controlled trials of rituximab-containing regimens for patients with non-Hodgkin's lymphoma. Twenty-three randomized controlled trials (RCTs) of rituximab-based therapy were analyzed. Consistent and clinically important benefits in progression-free and overall survival and were seen in the following settings: (1) addition of rituximab to combination chemotherapy for initial treatment of diffuse large B-cell lymphoma and other aggressive B-cell lymphomas; (2) addition of rituximab to combination chemotherapy for initial and subsequent treatment of follicular lymphoma and other indolent B-cell lymphomas; and (3) use of rituximab alone as extended maintenance therapy in patients with indolent B-cell lymphomas who have responded to initial treatment. The consensus opinion of the Hematology Disease Site Group is that rituximab is recommended for these indications.
authors.affiliation: Cancer Care Ontario Program in Evidence-Based Care, McMaster University, Hamilton, Ont., Canada L8S 4L8. matthew.cheung@utoronto.ca <matthew.cheung@utoronto.ca>
authors.forename: Matthew C
authors.initials: MC
authors.lastname: Cheung
authors.forename: Adam E
authors.initials: AE
authors.lastname: Haynes
authors.forename: Ralph M
authors.initials: RM
authors.lastname: Meyer
authors.forename: Adrienne
authors.initials: A
authors.lastname: Stevens
authors.forename: Kevin R
authors.initials: KR
authors.lastname: Imrie
mesh_terms: D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D058846:Antibodies, Monoclonal, Murine-Derived; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D002986:Clinical Trials as Topic; D006801:Humans; D008228:Lymphoma, Non-Hodgkin / Q000188:drug therapy*; D009864:Ontario; D017410:Practice Guidelines as Topic; D000069283:Rituximab
chemical_list: D000911:Antibodies, Monoclonal; D058846:Antibodies, Monoclonal, Murine-Derived; D000970:Antineoplastic Agents; D000069283:Rituximab