VcR-CVAD induction chemotherapy followed by maintenance rituximab in mantle cell lymphoma: A Wisconsin Oncology Network study

Julie E. Chang, Christopher Peterson, Sangbum Choi, Jens C. Eickhoff, Kyungmann Kim, David T. Yang, Leslie A. Gilbert, Eric S. Rogers, Jae E. Werndli, Michael S. Huie, Thomas A. Mcfarland, Michael Volk, Jules Blank, Natalie S. Callander, Walter L. Longo, Brad S. Kahl

Research output: Contribution to journalArticlepeer-review

51 Scopus citations

Abstract

Intensive chemotherapy regimens are not feasible in many adults with mantle cell lymphoma (MCL). We sought to build upon our previous experience with a non-intensive regimen, modified R-hyperCVAD chemotherapy (rituximab, cyclophosphamide, vincristine, doxorubicin, dexamethasone) with maintenance rituximab (MR), by the incorporation of bortezomib (VcR-CVAD) and the extension of MR beyond 2years. Patients with previously untreated MCL received VcR-CVAD chemotherapy every 21d for six cycles. Patients achieving at least a partial response to induction chemotherapy received rituximab consolidation (375mg/m 2×4weekly doses) and MR (375mg/m 2 every 12weeks×20 doses). The primary end points were overall and complete response (CR), and secondary endpoints were progression-free (PFS) and overall survival (OS). Thirty patients were enrolled, with a median age of 61years. All patients had advanced stage disease, and 60% had medium/high MCL International Prognostic Index risk factors. A CR or unconfirmed CR was achieved in 77% of patients. After a median follow-up of 42months, the 3-year PFS and OS were 63% and 86%, respectively. The observed 3-year PFS and OS with VcR-CVAD in MCL were comparable to reported outcomes with more intensive regimens. A cooperative group trial (E1405) is attempting to replicate these promising results.

Original languageEnglish
Pages (from-to)190-197
Number of pages8
JournalBritish Journal of Haematology
Volume155
Issue number2
DOIs
StatePublished - Oct 2011

Keywords

  • Bortezomib
  • Chemotherapy
  • Mantle cell lymphoma
  • Non-Hodgkin lymphoma
  • Rituximab

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