Difference between revisions of "Follicular lymphoma - historical"
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# Nickenig C, Dreyling M, Hoster E, Pfreundschuh M, Trumper L, Reiser M, Wandt H, Lengfelder E, Unterhalt M, Hiddemann W; German Low-Grade Lymphoma Study Group. Combined cyclophosphamide, vincristine, doxorubicin, and prednisone (CHOP) improves response rates but not survival and has lower hematologic toxicity compared with combined mitoxantrone, chlorambucil, and prednisone (MCP) in follicular and mantle cell lymphomas: results of a prospective randomized trial of the German Low-Grade Lymphoma Study Group. Cancer. 2006 Sep 1;107(5):1014-22. [http://onlinelibrary.wiley.com/doi/10.1002/cncr.22093/full link to original article] '''contains verified protocol''' [http://www.ncbi.nlm.nih.gov/pubmed/16878325 PubMed] | # Nickenig C, Dreyling M, Hoster E, Pfreundschuh M, Trumper L, Reiser M, Wandt H, Lengfelder E, Unterhalt M, Hiddemann W; German Low-Grade Lymphoma Study Group. Combined cyclophosphamide, vincristine, doxorubicin, and prednisone (CHOP) improves response rates but not survival and has lower hematologic toxicity compared with combined mitoxantrone, chlorambucil, and prednisone (MCP) in follicular and mantle cell lymphomas: results of a prospective randomized trial of the German Low-Grade Lymphoma Study Group. Cancer. 2006 Sep 1;107(5):1014-22. [http://onlinelibrary.wiley.com/doi/10.1002/cncr.22093/full link to original article] '''contains verified protocol''' [http://www.ncbi.nlm.nih.gov/pubmed/16878325 PubMed] | ||
# Herold M, Haas A, Srock S, Neser S, Al-Ali KH, Neubauer A, Dölken G, Naumann R, Knauf W, Freund M, Rohrberg R, Höffken K, Franke A, Ittel T, Kettner E, Haak U, Mey U, Klinkenstein C, Assmann M, von Grünhagen U; East German Study Group Hematology and Oncology Study. Rituximab added to first-line mitoxantrone, chlorambucil, and prednisolone chemotherapy followed by interferon maintenance prolongs survival in patients with advanced follicular lymphoma: an East German Study Group Hematology and Oncology Study. J Clin Oncol. 2007 May 20;25(15):1986-92. Epub 2007 Apr 9. [http://jco.ascopubs.org/content/25/15/1986.long link to original article] '''contains verified protocol''' [http://www.ncbi.nlm.nih.gov/pubmed/17420513 PubMed] | # Herold M, Haas A, Srock S, Neser S, Al-Ali KH, Neubauer A, Dölken G, Naumann R, Knauf W, Freund M, Rohrberg R, Höffken K, Franke A, Ittel T, Kettner E, Haak U, Mey U, Klinkenstein C, Assmann M, von Grünhagen U; East German Study Group Hematology and Oncology Study. Rituximab added to first-line mitoxantrone, chlorambucil, and prednisolone chemotherapy followed by interferon maintenance prolongs survival in patients with advanced follicular lymphoma: an East German Study Group Hematology and Oncology Study. J Clin Oncol. 2007 May 20;25(15):1986-92. Epub 2007 Apr 9. [http://jco.ascopubs.org/content/25/15/1986.long link to original article] '''contains verified protocol''' [http://www.ncbi.nlm.nih.gov/pubmed/17420513 PubMed] | ||
+ | |||
+ | =Relapsed/Refractory= | ||
+ | |||
+ | ==FMP {{#subobject:f1669a|Regimen=1}}== | ||
+ | {| class="wikitable" style="float:right; margin-left: 5px;" | ||
+ | |- | ||
+ | |[[#toc|back to top]] | ||
+ | |} | ||
+ | FMP: '''<u>F</u>'''ludarabine, '''<u>M</u>'''itoxantrone, '''<u>P</u>'''rednisone | ||
+ | |||
+ | ===Regimen {{#subobject:57301e|Variant=1}}=== | ||
+ | {| border="1" style="text-align:center;" !align="left" | ||
+ | |'''Study''' | ||
+ | |[[Levels_of_Evidence#Evidence|'''Evidence''']] | ||
+ | |- | ||
+ | |[http://www.ncbi.nlm.nih.gov/pubmed/7589345 Zinzani et al. 1995] | ||
+ | |<span | ||
+ | style="background:#EEEE00; | ||
+ | padding:3px 6px 3px 6px; | ||
+ | border-color:black; | ||
+ | border-width:2px; | ||
+ | border-style:solid;">Phase II</span> | ||
+ | |- | ||
+ | |} | ||
+ | |||
+ | ===References=== | ||
+ | # Zinzani PL, Bendandi M, Tura S. FMP regimen (fludarabine, mitoxantrone, prednisone) as therapy in recurrent low-grade non-Hodgkin's lymphoma. Eur J Haematol. 1995 Oct;55(4):262-6. [http://www.ncbi.nlm.nih.gov/pubmed/7589345 PubMed] |
Revision as of 15:30, 1 September 2015
Use of this site is subject to you reading and agreeing with the terms set forth in the disclaimer.
The purpose of this page is to provide references to regimens that are obsolete, outdated, or of historical interest only. As a general rule, this includes the inferior arm(s) of a randomized study, unless said regimens continue to be recommended by trustworthy sources such as the NCCN Guidelines. Please go to the follicular lymphoma regimen page to find other regimens.
30 regimens on this page
38 variants on this page
|
Untreated
CHOP
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CHOP: Cyclophosphamide, Hydroxydaunorubicin (Doxorubicin), Oncovin (Vincristine), Prednisone
Regimen #1
Study | Evidence | Comparator | Efficacy |
Hiddemann et al. 2005 | Phase III | R-CHOP | Decreased OS |
Nickenig et al. 2006 | Phase III | MCP | Equivalent OS |
- Cyclophosphamide (Cytoxan) 750 mg/m2 IV once on day 1
- Doxorubicin (Adriamycin) 50 mg/m2 IV once on day 1
- Vincristine (Oncovin) 1.4 mg/m2 (maximum dose of 2 mg per cycle) IV once on day 1
- Prednisone (Sterapred) 100 mg/m2 PO once per day on days 1 to 5
21-day cycles x 6 to 8 cycles
Regimen #2
Study | Evidence | Comparator | Efficacy |
Zinzani et al. 2004 | Phase III | FM; FMR; R-CHOP | Equivalent OS |
- Cyclophosphamide (Cytoxan) 750 mg/m2 IV once on day 1
- Doxorubicin (Adriamycin) 50 mg/m2 IV once on day 1
- Vincristine (Oncovin) 1.4 mg/m2 IV once on day 1
- Prednisone (Sterapred) 100 mg PO once per day on days 1 to 5
21-day cycles x 6 cycles; patients with PR or CR with detectable bcl-2/IgH fusion by PCR received:
- Rituximab (Rituxan) 375 mg/m2 IV once weekly on days 1, 8, 15, 22
4-week course
References
- Zinzani PL, Pulsoni A, Perrotti A, Soverini S, Zaja F, De Renzo A, Storti S, Lauta VM, Guardigni L, Gentilini P, Tucci A, Molinari AL, Gobbi M, Falini B, Fattori PP, Ciccone F, Alinari L, Martelli M, Pileri S, Tura S, Baccarani M. Fludarabine plus mitoxantrone with and without rituximab versus CHOP with and without rituximab as front-line treatment for patients with follicular lymphoma. J Clin Oncol. 2004 Jul 1;22(13):2654-61. Epub 2004 May 24. link to original article contains verified protocol PubMed
- Hiddemann W, Kneba M, Dreyling M, Schmitz N, Lengfelder E, Schmits R, Reiser M, Metzner B, Harder H, Hegewisch-Becker S, Fischer T, Kropff M, Reis HE, Freund M, Wörmann B, Fuchs R, Planker M, Schimke J, Eimermacher H, Trümper L, Aldaoud A, Parwaresch R, Unterhalt M. Frontline therapy with rituximab added to the combination of cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP) significantly improves the outcome for patients with advanced-stage follicular lymphoma compared with therapy with CHOP alone: results of a prospective randomized study of the German Low-Grade Lymphoma Study Group. Blood. 2005 Dec 1;106(12):3725-32. Epub 2005 Aug 25. link to original article contains verified protocol PubMed
- Nickenig C, Dreyling M, Hoster E, Pfreundschuh M, Trumper L, Reiser M, Wandt H, Lengfelder E, Unterhalt M, Hiddemann W; German Low-Grade Lymphoma Study Group. Combined cyclophosphamide, vincristine, doxorubicin, and prednisone (CHOP) improves response rates but not survival and has lower hematologic toxicity compared with combined mitoxantrone, chlorambucil, and prednisone (MCP) in follicular and mantle cell lymphomas: results of a prospective randomized trial of the German Low-Grade Lymphoma Study Group. Cancer. 2006 Sep 1;107(5):1014-22. link to original article contains verified protocol PubMed
CHOP-B
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CHOP-B: Cyclophosphamide, Hydroxydaunorubicin (Doxorubicin), Oncovin (Vincristine), Prednisone, Bleomycin
Regimen
Study | Evidence | Comparator | Efficacy |
Peterson et al. 2003 (CALGB 7951) | Phase III | Cyclophosphamide | Equivalent OS |
- Cyclophosphamide (Cytoxan) 750 mg/m2 IV once on day 1
- Doxorubicin (Adriamycin) 50 mg/m2 IV once on day 1
- Vincristine (Oncovin) 1.4 mg/m2 (maximum dose of 2 mg per cycle) IV once on day 1
- Prednisone (Sterapred) 60 mg/m2 PO once per day on days 1 to 5
- Bleomycin (Blenoxane) 10 units/m2 IM once on day 1
3-week cycle x 6 cycles, then CHOP continues every 4 weeks (see paper for details)
References
- Peterson BA, Petroni GR, Frizzera G, Barcos M, Bloomfield CD, Nissen NI, Hurd DD, Henderson ES, Sartiano GP, Johnson JL, Holland JF, Gottlieb AJ. Prolonged single-agent versus combination chemotherapy in indolent follicular lymphomas: a study of the cancer and leukemia group B. J Clin Oncol. 2003 Jan 1;21(1):5-15. link to original article contains verified protocol PubMed
CVP
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CVP: Cyclophosphamide, Vincristine, Prednisone
Synonyms: COP, COP protocol 2, VCP
Structured Concept: C9573 (NCI-T), C0056633 (NCI-MT/UMLS)
Regimen
Study | Evidence | Comparator | Efficacy | Toxicity |
Marcus et al. 2005 | Phase III | R-CVP | Worsened OS | Similar toxicity |
- Cyclophosphamide (Cytoxan) 750 mg/m2 IV once on day 1
- Vincristine (Oncovin) 1.4 mg/m2 (maximum dose of 2 mg per cycle) IV once on day 1
- Prednisone (Sterapred) 40 mg/m2 PO once per day on days 1 to 5
21-day cycles x up to 8 cycles
References
- Marcus R, Imrie K, Belch A, Cunningham D, Flores E, Catalano J, Solal-Celigny P, Offner F, Walewski J, Raposo J, Jack A, Smith P. CVP chemotherapy plus rituximab compared with CVP as first-line treatment for advanced follicular lymphoma. Blood. 2005 Feb 15;105(4):1417-23. link to original article contains protocol PubMed
- Update: Marcus R, Imrie K, Solal-Celigny P, Catalano JV, Dmoszynska A, Raposo JC, Offner FC, Gomez-Codina J, Belch A, Cunningham D, Wassner-Fritsch E, Stein G. Phase III study of R-CVP compared with cyclophosphamide, vincristine, and prednisone alone in patients with previously untreated advanced follicular lymphoma. J Clin Oncol. 2008 Oct 1;26(28):4579-86. Epub 2008 Jul 28. link to original article PubMed
FM
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FM: Fludarabine, Mitoxantrone
Regimen
Study | Evidence | Comparator | Efficacy |
Zinzani et al. 2004 | Phase III | CHOP; FMR; R-CHOP | Equivalent OS |
- Fludarabine (Fludara) 25 mg/m2 IV once per day on days 1 to 3
- Mitoxantrone (Novantrone) 10 mg/m2 IV once on day 1
21-day cycles x 6 cycles; patients with PR or CR with detectable bcl-2/IgH fusion by PCR received:
- Rituximab (Rituxan) 375 mg/m2 IV once weekly on days 1, 8, 15, 22
4-week course
References
- Zinzani PL, Pulsoni A, Perrotti A, Soverini S, Zaja F, De Renzo A, Storti S, Lauta VM, Guardigni L, Gentilini P, Tucci A, Molinari AL, Gobbi M, Falini B, Fattori PP, Ciccone F, Alinari L, Martelli M, Pileri S, Tura S, Baccarani M. Fludarabine plus mitoxantrone with and without rituximab versus CHOP with and without rituximab as front-line treatment for patients with follicular lymphoma. J Clin Oncol. 2004 Jul 1;22(13):2654-61. Epub 2004 May 24. link to original article contains verified protocol PubMed
FND
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FND: Fludarabine, Novantrone (Mitoxantrone), Dexamethasone
Regimen
Study | Evidence |
McLaughlin et al. 1996 | Phase II |
- Fludarabine (Fludara) 25 mg/m2 IV once per day on days 1 to 3
- Mitoxantrone (Novantrone) 10 mg/m2 IV once on day 1
- Dexamethasone (Decadron) 20 mg/day PO/IV on days 1 to 5
28-day cycle x up to 8 cycles
References
- McLaughlin P, Hagemeister FB, Romaguera JE, Sarris AH, Pate O, Younes A, Swan F, Keating M, Cabanillas F. Fludarabine, mitoxantrone, and dexamethasone: an effective new regimen for indolent lymphoma. J Clin Oncol. 1996 Apr;14(4):1262-8. link to original article PubMed
MCP
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MCP: Mitoxantrone, Chlorambucil, Prednisolone
Regimen #1
Study | Evidence | Comparator | Efficacy |
Nickenig et al. 2006 | Phase III | CHOP | Equivalent OS |
- Mitoxantrone (Novantrone) 8 mg/m2 IV once per day on days 1 & 2
- Chlorambucil (Leukeran) 3 mg/m2 PO TID (written in the reference as "3 x 3 mg/m2"; total daily dose is 9 mg/m2) on days 1 to 5
- Prednisone (Sterapred) 25 mg/m2 PO once per day on days 1 to 5
28-day cycles x 6 to 8 cycles
Regimen #2
Study | Evidence | Comparator | Efficacy |
Herold et al. 2007 | Phase III | R-MCP | Worsened OS |
- Mitoxantrone (Novantrone) 8 mg/m2 IV once per day on days 1 & 2
- Chlorambucil (Leukeran) 3 mg/m2 PO TID (written in the reference as "3 x 3 mg/m2"; total daily dose is 9 mg/m2) on days 1 to 5
- Prednisolone (Millipred) 25 mg/m2 PO once per day on days 1 to 5
28-day cycles x up to 8 cycles
All patients who achieved a PR or CR were placed on maintenance interferon alfa-2a within 4 to 8 weeks of completion of chemotherapy.
References
- Nickenig C, Dreyling M, Hoster E, Pfreundschuh M, Trumper L, Reiser M, Wandt H, Lengfelder E, Unterhalt M, Hiddemann W; German Low-Grade Lymphoma Study Group. Combined cyclophosphamide, vincristine, doxorubicin, and prednisone (CHOP) improves response rates but not survival and has lower hematologic toxicity compared with combined mitoxantrone, chlorambucil, and prednisone (MCP) in follicular and mantle cell lymphomas: results of a prospective randomized trial of the German Low-Grade Lymphoma Study Group. Cancer. 2006 Sep 1;107(5):1014-22. link to original article contains verified protocol PubMed
- Herold M, Haas A, Srock S, Neser S, Al-Ali KH, Neubauer A, Dölken G, Naumann R, Knauf W, Freund M, Rohrberg R, Höffken K, Franke A, Ittel T, Kettner E, Haak U, Mey U, Klinkenstein C, Assmann M, von Grünhagen U; East German Study Group Hematology and Oncology Study. Rituximab added to first-line mitoxantrone, chlorambucil, and prednisolone chemotherapy followed by interferon maintenance prolongs survival in patients with advanced follicular lymphoma: an East German Study Group Hematology and Oncology Study. J Clin Oncol. 2007 May 20;25(15):1986-92. Epub 2007 Apr 9. link to original article contains verified protocol PubMed
Relapsed/Refractory
FMP
back to top |
FMP: Fludarabine, Mitoxantrone, Prednisone
Regimen
Study | Evidence |
Zinzani et al. 1995 | Phase II |
References
- Zinzani PL, Bendandi M, Tura S. FMP regimen (fludarabine, mitoxantrone, prednisone) as therapy in recurrent low-grade non-Hodgkin's lymphoma. Eur J Haematol. 1995 Oct;55(4):262-6. PubMed