hoogllanguage.blogg.se -

#Ritxumiab radiation unfolder trial update#
#Ritxumiab radiation unfolder trial trial#
#Ritxumiab radiation unfolder trial plus#

Conclusion: Significant improvement in OS and PFS in patients who received consolidative RT after R-CHOP.In matched-pair analysis (Stage I 44 pairs, all stages 74 pairs), RT improved OS (HR 0.5 and 0.3) Outcome: On MVA, RT influenced OS and PFS.Chemo 6+ cycles R-CHOP in 70%, RT given IFRT 30-39.6 Gy in 30% after chemo CR. MD Anderson 2010 (2001-2007) PMID 20713859 - "Benefit of Consolidative Radiation Therapy in Patients With Diffuse Large B-Cell Lymphoma Treated With R-CHOP Chemotherapy." (Phan J, J Clin Oncol.DSHNHL-2004-3 - "Phase III Randomized Study of Immunochemotherapy Comprising Rituximab, Cyclophosphamide, Doxorubicin Hydrochloride, Vincristine, and Prednisone (R-CHOP) With Versus Without Radiotherapy in Patients With Previously Untreated, Low-Risk, Aggressive, B-Cell Non-Hodgkin's Lymphoma".Fewer relapses in combined modality group but overall survival similar. Extended field RT +/- vincristine, streptonigrin, cyclophosphamide and prednisone.

#Ritxumiab radiation unfolder trial plus#

PMID 6406037, 1983 (1974-78) - "A randomized study of radiotherapy versus radiotherapy plus chemotherapy in stage I-II non-Hodgkin's lymphomas." Nissen NI et al.

The exact role of RT and CHOP-R in the treatment of Stage I/II aggressive lymphomas needs to be clarified.

Several trials established CHOP-R as superior to CHOP

The already complicated situation became even more complicated with the introduction of Rituxan.

However, follow-up is still short, and there is a concern about more long-term failures as in SWOG-8736

#Ritxumiab radiation unfolder trial trial#

GELA 93-1 Phase III trial evaluated CHOP x4 + involved field RT with dose-intense ACVBP in IPI=0 patients 60 years old.

There was a disease-free survival benefit, but no overall survival benefit

ECOG-1484 Phase III trial randomized higher risk patients (Stage I bulky/extranodal and Stage II) to CHOP x8 cycles alone versus CHOP x8 cycles + involved field RT.

#Ritxumiab radiation unfolder trial update#

Unfortunately, long-term update (abstract only) showed an excess distant failure rate in the combined modality arm after 5 years, suggesting that CHOP x3 is not sufficient to control the systemic disease in these patients.

Early results showed a survival benefit for the combined arm, and established it as the standard of care This resulted in SWOG-8736 Phase III trial, which compared CHOP x8 cycles alone to CHOP x3 cycles with involved field RT, in low risk patients (Stage I and non-bulky Stage II).CHOP became established as the standard therapy in Stage III/IV disease, and began to be used for Stage I/II trials as well Based on experience in advanced disease, observational studies around the same time suggested that chemotherapy alone was sufficient.The intent was to control microscopic systemic disease and reduce the size of the radiation fields.

Around 1980, several small trials demonstrated that adding chemotherapy after RT improved survival.

University of Chicago experience suggested that recurrences were not prevented by extended fields, and that Stage II patients should be treated with chemotherapy.

Stage II: all comers 5-year OS ~20% laparotomy-staged 35-55%.

Stage I: all comers 5-year OS ~50% laparotomy-staged 5-year OS >90%.

For non-verified Stage I, and particularly Stage II, results were poor For laparotomy-verified Stage I, results very excellent.