title: Time to treatment response in patients with follicular lymphoma treated with bortezomib is longer compared with other histologic subtypes.
abstract: OBJECTIVE
  To determine the antitumor activity of the novel proteasome inhibitor bortezomib in patients with indolent non-Hodgkin's lymphoma.
  
  
  METHODS
  Patients with follicular lymphoma (FL), marginal zone lymphoma, mantle cell lymphoma, small lymphocytic lymphoma/chronic lymphocytic leukemia, and Waldenstrom's macroglobulinemia were eligible for study. Bortezomib was given at a dose of 1.5 mg/m(2) as an i.v. push on days 1, 4, 8, and 11 of a 21-day cycle. Eligibility included the following: (a) no more than three prior therapies, (b) at least 1 month since prior chemotherapy, (c) measurable disease, and (d) an absolute neutrophil count of >1,000/microL and a platelet count >50,000/microL for the first dose of any cycle.
  
  
  RESULTS
  Seventy-seven patients were registered, of which 69 were assessable for response based on the completion of two cycles of therapy. Subtypes included FL (59.5%), mantle cell lymphoma (52%), small lymphocytic lymphoma/chronic lymphocytic leukemia (16.2%), marginal zone lymphoma (21.6%), and one Waldenstrom's macroglobulinemia. The median number of prior therapies was three. The most common grade 3 toxicity was lymphopenia (35%) and thrombocytopenia (31%). Twenty-five patients experienced grade <or=2 sensory neuropathy (32), and 8% experienced grade 3 neurosensory toxicity. The overall response rate was 45% (40% on an intention to treat) including 10 complete remissions. Of 18 patients with FL, 9 responded with 4 complete response. The median time to treatment response for FL was 12 weeks, whereas the median time to treatment response for other subtypes of non-Hodgkin's lymphoma was only 4 weeks.
  
  
  CONCLUSIONS
  These data suggest that bortezomib has significant single agent activity in patients with FL, and that longer durations of treatment may improve overall response.
authors.affiliation: NYU Cancer Institute, NYU Langone Medical Center, New York, New York, USA. oo2130@columbia.edu
authors.forename: Owen A
authors.initials: OA
authors.lastname: O'Connor
authors.forename: Carol
authors.initials: C
authors.lastname: Portlock
authors.forename: Craig
authors.initials: C
authors.lastname: Moskowitz
authors.forename: Paul
authors.initials: P
authors.lastname: Hamlin
authors.forename: David
authors.initials: D
authors.lastname: Straus
authors.forename: John
authors.initials: J
authors.lastname: Gerecitano
authors.forename: Mithat
authors.initials: M
authors.lastname: Gonen
authors.forename: Otilia
authors.initials: O
authors.lastname: Dumitrescu
authors.forename: Debra
authors.initials: D
authors.lastname: Sarasohn
authors.forename: John
authors.initials: J
authors.lastname: Butos
authors.forename: Ellen
authors.initials: E
authors.lastname: Neylon
authors.forename: Barbara
authors.initials: B
authors.lastname: Mac-Gregor Cortelli
authors.forename: Susan
authors.initials: S
authors.lastname: Blumel
authors.forename: Andrew M
authors.initials: AM
authors.lastname: Evens
authors.forename: Andrew D
authors.initials: AD
authors.lastname: Zelenetz
authors.forename: John
authors.initials: J
authors.lastname: Wright
authors.forename: Brenda
authors.initials: B
authors.lastname: Cooper
authors.forename: Jane
authors.initials: J
authors.lastname: Winter
authors.forename: Julie
authors.initials: J
authors.lastname: Vose
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001897:Boronic Acids / Q000627:therapeutic use*; D000069286:Bortezomib; D018450:Disease Progression; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D016393:Lymphoma, B-Cell / Q000175:diagnosis / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology; D008224:Lymphoma, Follicular / Q000175:diagnosis / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology; D008297:Male; D008875:Middle Aged; D011719:Pyrazines / Q000627:therapeutic use*; D012008:Recurrence; D016019:Survival Analysis; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D001897:Boronic Acids; D011719:Pyrazines; D000069286:Bortezomib