PMID- 24668580
OWN - NLM
STAT- MEDLINE
DCOM- 20140930
LR  - 20240322
IS  - 1097-0142 (Electronic)
IS  - 0008-543X (Print)
IS  - 0008-543X (Linking)
VI  - 120
IP  - 12
DP  - 2014 Jun 15
TI  - The use and effectiveness of rituximab maintenance in patients with follicular 
      lymphoma diagnosed between 2004 and 2007 in the United States.
PG  - 1830-7
LID - 10.1002/cncr.28659 [doi]
AB  - BACKGROUND: The authors examined the "real-world" effectiveness of rituximab (R) 
      maintenance therapy (R-maintenance) compared with observation after R-based 
      induction therapy in patients with previously untreated follicular lymphoma (FL) 
      in the United States. METHODS: The National LymphoCare Study is a prospective, 
      multicenter, observational study that enrolled > 2700 untreated patients with FL 
      diagnosed from 2004 to 2007 at 265 sites in the United States. Among these, 
      patients who achieved at least stable disease after R-based induction therapy 
      were eligible for the current analysis. Patients who initiated R-maintenance 
      within 215 days of completing induction therapy were categorized as the 
      R-maintenance group, and those who did not initiate therapy during this period 
      were categorized as the observation group. The objective of the current study was 
      to determine the effect of R-maintenance on progression-free survival (PFS), time 
      to next treatment (TTNT), and overall survival (OS). RESULTS: A total of 1439 
      patients completed R-based induction therapy, 1186 of whom met all inclusion 
      criteria (541 patients received R-maintenance and 645 patients were observed). 
      Characteristics that were found to be predictive of receiving R-maintenance were 
      histology grade (1/2), Ann Arbor stage of disease (III/IV), geographic region 
      (region other than the West), and practice setting (community practice). With a 
      median follow-up of 5.7 years, R-maintenance was associated with superior PFS 
      (hazards ratio [HR], 0.68; 95% confidence interval [95% CI], 0.56-0.84 
      [P = .0003]) and TTNT (HR, 0.66; 95% CI, 0.52-0.84 [P = .0007]). No significant 
      difference in OS was observed (HR, 0.81; 95% CI, 0.58-1.14 [P = .23]). 
      CONCLUSIONS: R-maintenance in patients with FL and at least stable disease after 
      R-based induction therapy provided significantly longer PFS and TTNT in 
      comparison with observation, but no significant difference in OS was observed 
      with 5-years of follow-up. This comparative effectiveness study aligns with the 
      results of randomized trials suggesting that similar outcomes occur with 
      R-maintenance in FL with the treatment variations observed in clinical practice.
CI  - (c) 2014 The Authors.Cancer published by Wiley Periodicals, Inc. on behalf of 
      American Cancer Society.
FAU - Nastoupil, Loretta J
AU  - Nastoupil LJ
AD  - Department of Lymphoma/Myeloma, The University of Texas MD Anderson Cancer 
      Center, Houston, Texas.
FAU - Sinha, Rajni
AU  - Sinha R
FAU - Byrtek, Michelle
AU  - Byrtek M
FAU - Zhou, Xiaolei
AU  - Zhou X
FAU - Taylor, Michael D
AU  - Taylor MD
FAU - Friedberg, Jonathan W
AU  - Friedberg JW
FAU - Link, Brian K
AU  - Link BK
FAU - Cerhan, James R
AU  - Cerhan JR
FAU - Dawson, Keith
AU  - Dawson K
FAU - Flowers, Christopher R
AU  - Flowers CR
LA  - eng
PT  - Journal Article
PT  - Multicenter Study
PT  - Observational Study
PT  - Research Support, Non-U.S. Gov't
DEP - 20140325
PL  - United States
TA  - Cancer
JT  - Cancer
JID - 0374236
RN  - 0 (Antibodies, Monoclonal, Murine-Derived)
RN  - 4F4X42SYQ6 (Rituximab)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Antibodies, Monoclonal, Murine-Derived/adverse effects/*therapeutic use
MH  - Antineoplastic Combined Chemotherapy Protocols/adverse effects/*therapeutic use
MH  - Disease-Free Survival
MH  - Female
MH  - Humans
MH  - Induction Chemotherapy
MH  - Lymphoma, Follicular/*drug therapy/epidemiology/pathology/therapy
MH  - Maintenance Chemotherapy
MH  - Male
MH  - Middle Aged
MH  - Prospective Studies
MH  - Randomized Controlled Trials as Topic
MH  - Rituximab
MH  - Survival Analysis
MH  - Treatment Outcome
MH  - United States/epidemiology
MH  - Young Adult
PMC - PMC4265986
OTO - NOTNLM
OT  - follicular lymphoma
OT  - frontline therapy
OT  - non-Hodgkin lymphoma
OT  - outcomes
OT  - rituximab maintenance
EDAT- 2014/03/29 06:00
MHDA- 2014/10/01 06:00
CRDT- 2014/03/27 06:00
PHST- 2013/10/31 00:00 [received]
PHST- 2013/12/20 00:00 [revised]
PHST- 2014/01/23 00:00 [accepted]
PHST- 2014/03/27 06:00 [entrez]
PHST- 2014/03/29 06:00 [pubmed]
PHST- 2014/10/01 06:00 [medline]
AID - 10.1002/cncr.28659 [doi]
PST - ppublish
SO  - Cancer. 2014 Jun 15;120(12):1830-7. doi: 10.1002/cncr.28659. Epub 2014 Mar 25.