CONSOLIDATION THERAPY USING 90Y-IBRITUMOMAB TIUXETAN AFTER BENDAMUSTINE AND RITUXIMAB IN PATIENTS WITH RELAPSED FOLLICULAR LYMPHOMA; A MULTICENTER, PHASE II STUDY (BRIZ2012)
Author(s): ,
Hideki Tsujimura
Affiliations:
Division of Medical Oncology,Chiba Cancer Center,Chiba,Japan
,
Katsuhiro Miura
Affiliations:
Division of Hematology and Rheumatology,Nihon University School of Medicine,Tokyo,Japan
,
Masatoshi Kanno
Affiliations:
Oncology Center,Nara Medical University Hospital,Kashihara,Japan
,
Yasufumi Masaki
Affiliations:
Department of Hematology and Immunology,Kanazawa Medical University,Ishikawa,Japan
,
Masaki Iino
Affiliations:
Department of Medical Oncology,Yamanashi Prefectural Central Hospital,Kofu,Japan
,
Jun Takizawa
Affiliations:
Department of Hematology, Endocrinology and Metabolism,Niigata University Faculty of Medicine,Niigata,Japan
,
Yoshinobu Maeda
Affiliations:
Department of Hematology and Oncology,Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences,Okayama,Japan
,
Kazuhiko Yamamoto
Affiliations:
Department of Hematology,Okayama City Hospital,Okayama,Japan
,
Shinobu Tamura
Affiliations:
Department of Hematology/Oncology,Kinan Hospital,Tanabe,Japan
,
Akiyo Yoshida
Affiliations:
Department of Hematology,Toyama Prefectural Central Hospital,Toyama,Japan
,
Hideo Yagi
Affiliations:
Department of Hematology and Oncology,Nara Prefecture General Medical Center,Nara,Japan
,
Isao Yoshida
Affiliations:
Department of Hematologic Oncology,National Hospital Organization, Shikoku Cancer Center,Matsuyama,Japan
,
Koichi Kitazume
Affiliations:
Department of Hematology,Showa General Hospital,Tokyo,Japan
,
Taro Matsunari
Affiliations:
Department of Infectious Diseases,Chugoku Central Hospital,Fukuyama,Japan
,
Ilseung Choi
Affiliations:
Department of Hematology,National Hospital Organization, Kyushu Cancer Center,Fukuoka,Japan
,
Yasutaka Kakinoki
Affiliations:
Department of Hematology,Asahikawa City Hospital,Asahikawa,Japan
,
Tadashi Yoshino
Affiliations:
Department of Pathology,Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences,Okayama,Japan
,
Shigeo Nakamura
Affiliations:
Department of Pathology and Biological Response,Nagoya University Graduate School of Medicine,Nagoya,Japan
Takashi Yoshida
Affiliations:
Member,Society of Lymphoma Treatment in Japan,Kanazawa,Japan
EHA Library. Tsujimura H. Jun 15, 2019; 266880; PS1263
Dr. Hideki Tsujimura
Dr. Hideki Tsujimura
Contributions
Abstract

Abstract: PS1263

Type: Poster Presentation

Presentation during EHA24: On Saturday, June 15, 2019 from 17:30 - 19:00

Location: Poster area

Background
The role of consolidation therapy with 90Y-ibritumomab tiuxetan (90YIT) for patients with follicular lymphoma (FL) after receiving second or third line immunochemotherapy has not been established.

Aims
Thus, we conducted a multicenter phase II trial evaluating the efficacy and toxicities of bendamustine and rituximab (BR) followed by 90YIT for patients with relapsed FL.

Methods
This study included patients who had biopsy-proven, relapsed FL (Grade 1/2 or 3a); one or two prior therapies; age of 20–74 years; ECOG performance status of 0–2; measurable lesion(s); no severe organ dysfunction; 3 months or longer life expectancy; and written informed consent. BR consisted of rituximab (375 mg/m2, day 1) and bendamustine (90 mg/m2, day 2 and 3), and repeated every 4 weeks up to 4–6 cycles. As the consolidation therapy, 14.8 MBq/kg of 90YIT was administered to patients who achieved complete response (CR) or partial response after BR therapy. The primary endpoint was 2-year progression-free survival (PFS) after the consolidation with 90YIT. The secondary endpoints were response rates after BR therapy, response rates after consolidation with 90YIT, 2-year overall survival (OS) rate after the consolidation with 90YIT, and toxicities.

Results
A total of 30 patients were registered between 2013 and 2015. Of these patients, 6 were excluded from the study because of pathological diagnoses other than FL in the central review (n = 3), unmet criteria (n = 2), and the other advanced cancer found (n = 1), respectively. Thus, 24 patients with a median 60 years of age (range 47–74 years) and a median of 6.7 years (range 1.6–14.8 years) of duration from the initial diagnosis were evaluated. Among them, R-CHOP based chemotherapy was the most common initial treatment (92%). The FLIPI2 score at the time of registration was high in 3, intermediate in 7, and low in 14 patients, respectively. After re-induction treatment with BR, 22 patients (92%) ultimately received consolidation with 90YIT, resulting in an overall response rate of 95% and a CR rate of 91%, respectively. Within the 2-year observation period, 10 patients relapsed and 3 of them had a histological transformation to diffuse large B-cell lymphoma. Severe non-hematological toxicities were rare and no treatment-related mortality was observed. Within the observation period, one patient died of disease progression. Second primary malignancies were not observed. Consequently, the 2-year PFS and OS rates after the consolidation were 58%, and 94%, respectively.

Conclusion
Consolidation therapy with 90YIT after BR re-induction therapy was feasible in patients with relapsed FL. Clinical efficacy was comparable, but the long-term effect should be further investigated. Trial protocol number: UMIN000008793, release date: 03. September 2012

Session topic: 18. Indolent and mantle-cell non-Hodgkin lymphoma - Clinical

Keyword(s): Consolidation, Follicular lymphoma, Rituximab

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