Rituximab plus fludarabine and cyclophosphamide prolongs progression-free survival compared with fludarabine and cyclophosphamide alone in previously treated chronic lymphocytic leukemia

Tadeusz Robak, Anna Dmoszynska, Philippe Solal-Céligny, Krzysztof Warzocha, Javier Loscertales, John Catalano, Boris V. Afanasiev, Loree Larratt, Christian H. Geisler, Marco Montillo, Ilya S. Zyuzgin, Peter S. Ganly, Caroline Dartigeas, András Rosta, Jörg Maurer, Myriam Mendila, M. Wayne Saville, Nancy Valente, Michael K. Wenger, Sergey I. Moiseev

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Abstract

Purpose: Rituximab, a monoclonal antibody that targets the CD20 cell surface antigen, has clinical activity in patients with non-Hodgkin's lymphoma and other B-lymphocyte disorders when administered alone or in combination with chemotherapy. Promising results have previously been reported in nonrandomized studies in patients with chronic lymphocytic leukemia (CLL). This trial was designed to compare chemoimmunotherapy with chemotherapy alone in patients with previously treated CLL. Patients and Methods: This international, multicenter, randomized trial compared six cycles of rituximab plus fludarabine and cyclophosphamide (R-FC) with six cycles of fludarabine and cyclophosphamide alone (FC) in patients with previously treated CLL. A total of 552 patients with Binet stage A (10%), B (59%), or C (31%) disease entered the study and were randomly assigned to receive R-FC (n = 276) or FC (n = 276). Results: After a median follow-up time of 25 months, rituximab significantly improved progression-free survival in patients with previously treated CLL (hazard ratio = 0.65; P < .001; median, 30.6 months for R-FC v 20.6 months for FC). Event-free survival, response rate, complete response rate, duration of response, and time to new CLL treatment or death were also significantly improved. Although the rates of adverse events, grade 3 or 4 events, and serious adverse events were slightly higher in the R-FC arm, R-FC was generally well tolerated, with no new safety findings and no detrimental effect on quality of life. Conclusion: R-FC significantly improved the outcome of patients with previously treated CLL.

Original languageEnglish
Pages (from-to)1756-1765
Number of pages10
JournalJournal of Clinical Oncology
Volume28
Issue number10
DOIs
Publication statusPublished - 1 Apr 2010

Cite this

Robak, T., Dmoszynska, A., Solal-Céligny, P., Warzocha, K., Loscertales, J., Catalano, J., Afanasiev, B. V., Larratt, L., Geisler, C. H., Montillo, M., Zyuzgin, I. S., Ganly, P. S., Dartigeas, C., Rosta, A., Maurer, J., Mendila, M., Saville, M. W., Valente, N., Wenger, M. K., & Moiseev, S. I. (2010). Rituximab plus fludarabine and cyclophosphamide prolongs progression-free survival compared with fludarabine and cyclophosphamide alone in previously treated chronic lymphocytic leukemia. Journal of Clinical Oncology, 28(10), 1756-1765. https://doi.org/10.1200/JCO.2009.26.4556