Phase II trial of R-CHOP plus bortezomib induction therapy followed by bortezomib maintenance for newly diagnosed mantle cell lymphoma: SWOG S0601

Brian G. Till, Hongli Li, Steven H. Bernstein, Richard I. Fisher, W. Richard Burack, Lisa M Rimsza, Justin D. Floyd, Marco A. Dasilva, Dennis F. Moore, Olga Pozdnyakova, Sonali M. Smith, Michael Leblanc, Jonathan W. Friedberg

Research output: Contribution to journalArticle

20 Scopus citations

Abstract

Bortezomib is active in mantle cell lymphoma (MCL), with approval in upfront and relapsed settings. Given inevitable recurrence following induction chemoimmunotherapy, maintenance approaches are a rational strategy to improve clinical outcomes. We conducted a phase II study to evaluate the safety and efficacy of six cycles of R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, prednisone) plus bortezomib (1·3 mg/m2 days 1 and 4 of 21 d cycles) followed by bortezomib maintenance (1·3 mg/m2 days 1, 4, 8, and 11 every 3 months for 2 years). Sixty-five eligible patients were enrolled. The treatment was well tolerated and toxicities were mainly haematological. The rate of grade ≥3 peripheral neuropathy was low (5%). With a median follow-up of 6·8 years, 2-year progression-free survival (PFS) was 62%, and 2-year overall survival (OS) was 85%. At 5 years, PFS was 28% and OS was 66%. MCL International Prognostic Index scores were significantly associated with 2-year PFS, but did not predict long-term (≥5-year) PFS. Baseline Ki-67 index was significantly associated with survival. Combination R-CHOP with bortezomib followed by maintenance bortezomib appears to improve outcomes compared historically with R-CHOP alone, with prolonged remissions in a subset of patients. These results suggest that inclusion of bortezomib with induction chemotherapy and/or maintenance is promising in MCL and warrants further exploration.

Original languageEnglish (US)
Pages (from-to)208-218
Number of pages11
JournalBritish Journal of Haematology
Volume172
Issue number2
DOIs
StatePublished - Jan 1 2016

    Fingerprint

Keywords

  • Chemotherapy
  • Lymphoma
  • Maintenance therapy
  • Mantle cell lymphoma
  • Proteasome inhibition

ASJC Scopus subject areas

  • Hematology

Cite this

Till, B. G., Li, H., Bernstein, S. H., Fisher, R. I., Burack, W. R., Rimsza, L. M., Floyd, J. D., Dasilva, M. A., Moore, D. F., Pozdnyakova, O., Smith, S. M., Leblanc, M., & Friedberg, J. W. (2016). Phase II trial of R-CHOP plus bortezomib induction therapy followed by bortezomib maintenance for newly diagnosed mantle cell lymphoma: SWOG S0601. British Journal of Haematology, 172(2), 208-218. https://doi.org/10.1111/bjh.13818