Indolent lymphoma - null regimens
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The purpose of this page is to provide references to "null therapy" such as placebo and observation. These references provide further insight into the historical development of the treatment landscape. See the main iNHL page for regimens that include active anticancer treatment.
| Last updated on 2024-12-02: 2 regimens on this page
2 variants on this page
|
Early disease, consolidation
Observation
Regimen
| Study | Dates of enrollment | Evidence | Comparator | Comparative Efficacy |
|---|---|---|---|---|
| Kelsey et al. 1994 | 1974-1981 | Randomized (C) | Chlorambucil | Did not meet primary endpoint of OS |
| Yahalom et al. 1993 | 1980-1988 | Randomized (C) | CHOP x 6 | Seems to have inferior RFS |
No further treatment.
Preceding treatment
- Definitive Radiation therapy
References
- Yahalom J, Varsos G, Fuks Z, Myers J, Clarkson BD, Straus DJ. Adjuvant cyclophosphamide, doxorubicin, vincristine, and prednisone chemotherapy after radiation therapy in stage I low-grade and intermediate-grade non-Hodgkin lymphoma: results of a prospective randomized study. Cancer. 1993 Apr 1;71(7):2342-50. link to original article PubMed
- Kelsey SM, Newland AC, Hudson GV, Jelliffe AM. A British National Lymphoma Investigation randomised trial of single agent chlorambucil plus radiotherapy versus radiotherapy alone in low grade, localised non-Hodgkins lymphoma. Med Oncol. 1994;11(1):19-25. link to original article PubMed
Consolidation after first-line therapy
Observation
Regimen
| Study | Dates of enrollment | Evidence | Comparator | Comparative Efficacy |
|---|---|---|---|---|
| Hagenbeek et al. 1998 | 1985-1992 | Phase 3 (C) | Interferon alfa | Might have inferior TTP |
| Fisher et al. 2000 (SWOG S8809) | 1988-1994 | Phase 3 (C) | Interferon alfa | Did not meet co-primary endpoints of PFS/OS |
| Hochster et al. 2009 (ECOG E1496) | Not reported | Phase 3 (C) | Rituximab | Inferior PFS |
| Rule et al. 2022 (MabCute) | Not reported | Phase 3 (C) | SC Rituximab indefinitely | Did not meet primary endpoint of PFS |
No further treatment after induction therapy.
Preceding treatment
- ECOG E1496: First-line CVP x 6 to 8
- MabCute: SC rituximab maintenance x 2 y
References
- Hagenbeek A, Carde P, Meerwaldt JH, Somers R, Thomas J, De Bock R, Raemaekers JM, van Hoof A, De Wolf-Peeters C, van Glabbeke M; EORTC Lymphoma Cooperative Group. Maintenance of remission with human recombinant interferon alfa-2a in patients with stages III and IV low-grade malignant non-Hodgkin's lymphoma. J Clin Oncol. 1998 Jan;16(1):41-7. link to original article PubMed
- SWOG S8809: Fisher RI, Dana BW, LeBlanc M, Kjeldsberg C, Forman JD, Unger JM, Balcerzak SP, Gaynor ER, Roy V, Miller T. Interferon alpha consolidation after intensive chemotherapy does not prolong the progression-free survival of patients with low-grade non-Hodgkin's lymphoma: results of the Southwest Oncology Group randomized phase III study 8809. J Clin Oncol. 2000 May;18(10):2010-6. link to original article PubMed
- ECOG E1496: Hochster H, Weller E, Gascoyne RD, Habermann TM, Gordon LI, Ryan T, Zhang L, Colocci N, Frankel S, Horning SJ. Maintenance rituximab after cyclophosphamide, vincristine, and prednisone prolongs progression-free survival in advanced indolent lymphoma: results of the randomized phase III ECOG1496 Study. J Clin Oncol. 2009 Apr 1;27(10):1607-14. Epub 2009 Mar 2. link to original article dosing details in manuscript have been reviewed by our editors link to PMC article PubMed NCT00003204
- Update: Barta SK, Li H, Hochster HS, Hong F, Weller E, Gascoyne RD, Habermann TM, Gordon LI, Colocci N, Bengtson EM, Horning SJ, Kahl BS. Randomized phase 3 study in low-grade lymphoma comparing maintenance anti-CD20 antibody with observation after induction therapy: A trial of the ECOG-ACRIN Cancer Research Group (E1496). Cancer. 2016 Oct;122(19):2996-3004. Epub 2016 Jun 28. link to original article link to PMC article PubMed
- MabCute: Rule S, Barreto WG, Briones J, Carella AM, Casasnovas O, Pocock C, Wendtner CM, Zaja F, Robson S, MacGregor L, Tschopp RR, Nick S, Dreyling M. Efficacy and safety assessment of prolonged maintenance with subcutaneous rituximab in patients with relapsed or refractory indolent non-Hodgkin lymphoma: results of the phase III MabCute study. Haematologica. 2022 Feb 1;107(2):500-509. link to original article link to PMC article PubMed NCT01461928