IELSG38: phase II trial of front-line chlorambucil plus subcutaneous rituximab induction and maintenance in mucosa-associated lymphoid tissue lymphoma.

Stathis, Anastasios; Pirosa, Maria Cristina; Orsucci, Lorella; Feugier, Pierre; Tani, Monica; Ghesquières, Hervé; Musuraca, Gerardo; Rossi, Francesca Gaia; Merli, Francesco; Guièze, Romain; Gyan, Emmanuel; Gini, Guido; Marino, Dario; Gressin, Remy; Morschhauser, Franck; Cavallo, Federica; Palombi, Francesca; Conconi, Annarita; Tessoulin, Benoît; Tilly, Hervé; ... (2024). IELSG38: phase II trial of front-line chlorambucil plus subcutaneous rituximab induction and maintenance in mucosa-associated lymphoid tissue lymphoma. (In Press). Haematologica - the hematology journal Ferrata-Storti Foundation 10.3324/haematol.2023.283918

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The IELSG38 trial was conducted to investigate the effects of subcutaneous (SC) rituximab on the complete remission (CR) rate and the benefits of SC maintenance in patients with extranodal marginal zone lymphoma (MZL) who received frontline treatment with chlorambucil plus rituximab. Study treatment comprised an induction phase with chlorambucil 6 mg/m2/day orally on weeks 1-6, 9-10, 13-14, 17-18, and 21-22, and rituximab 375 mg/m2 intravenously on day 1 of weeks 1-4, and 1400 mg SC on weeks 9, 13, 17, and 21. Then, a maintenance phase followed with rituximab administered at 1400 mg SC every two months for two years. Of the 112 patients enrolled, 109 were evaluated for efficacy. The CR rates increased from 52% at the end of the induction phase to 70% upon completion of the maintenance phase. With a median follow-up of 5.8 years, the 5-year event-free, progression-free, and overall survival rates were 87% (95% CI, 78-92), 84% (95% CI, 75-89), and 93% (95% CI, 86-96), respectively. The most common grade ≥3 toxicities were neutropenia (33%) and lymphocytopenia (16%). Six patients experienced treatment-related serious adverse events, including fever of unknown origin, sepsis, pneumonia, respiratory failure, severe cerebellar ataxia, and fatal acute myeloid leukemia. The trial showed that subcutaneous rituximab did not improve the complete remission rate at the conclusion of the induction phase, which was the main endpoint. Nevertheless, SC maintenance might have facilitated long-term disease control, potentially contributing to enhanced event-free and progression-free survival.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Haematology, Oncology, Infectious Diseases, Laboratory Medicine and Hospital Pharmacy (DOLS) > Clinic of Medical Oncology

Subjects:

600 Technology > 610 Medicine & health

ISSN:

0390-6078

Publisher:

Ferrata-Storti Foundation

Language:

English

Submitter:

Pubmed Import

Date Deposited:

22 Feb 2024 15:46

Last Modified:

22 Feb 2024 15:46

Publisher DOI:

10.3324/haematol.2023.283918

PubMed ID:

38385243

URI:

https://boris.unibe.ch/id/eprint/193175

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