ASH: Rituximab Plus CHOP Improves Survival of Indolent Lymphoma in Older Patients

December 12, 2006

ORLANDO -- For older patients with follicular lymphoma, the addition of Rituxan (rituximab) to standard CHOP chemotherapy boosted overall response rates, prolonged time to treatment failure, and improved overall survival.

ORLANDO, Dec. 12 -- For older patients with follicular lymphoma, the addition of Rituxan (rituximab) to standard CHOP chemotherapy boosted overall response rates, prolonged time to treatment failure, and improved overall survival, German researchers said here.

In a prospective multicenter randomized trial, patients treated with the combination, called R-CHOP, had a median time to treatment failure of 5.0 years, compared with 2.1 years for patients treated with standard CHOP alone, reported Christian Buske, M.D., of the Klinikum Grosshadern in Munich.

"The addition of rituximab to CHOP in treating advanced stage follicular lymphoma significantly improves the outcome of patients with previously untreated follicular lymphoma, not only in young patients, but also in patients of advanced age," said Dr. Buske at the American Society of Hematology meeting.

Follicular lymphoma is an indolent lymphoma with an incidence that rises sharply with age, Dr. Buske noted. More than 40% of patients with follicular lymphoma are older than 60 at the time of diagnosis, and there is an age-specific incidence peaking above 75.

"Our challenge for the future is that there will be a strong increase in the number of elderly patients with follicular lymphoma, and we need for these patients therapies with increased efficacy without greater toxicity," Dr. Buske said.

He and colleagues in the German Low-Grade Lymphoma Study Group conducted an analysis of 221 patients older than 60 who were part of a larger multicenter phase III study.

Patients with advanced-stage, treatment-nave follicular lymphoma were randomly assigned to R-CHOP (109 patients) or CHOP alone (112 patients). The R-CHOP group received standard CHOP -- Cytoxan (cyclophosphamide), Adriamycin (doxorubicin), Oncovin (vincristine), and prednisone -- with one infusion of Rituxan at 375 mg/m2 on the day before chemotherapy began. In both groups, CHOP was given for six to eight cycles.

The authors found that the older patients tolerated R-CHOP well without additional toxicities over CHOP alone. The most common adverse event was myelosuppression, which was similar in both groups.

They found that R-CHOP induced higher overall response rates and significantly prolonged the time-to-treatment-failure, with a median of 5.0 years for patients on R-CHOP, compared with 2.1 years for those on CHOP alone (logrank test, P