Ofatumumab in combination with ICE or DHAP chemotherapy in relapsed or refractory intermediate grade B-cell lymphoma Journal Article


Authors: Matasar, M. J.; Czuczman, M. S.; Rodriguez, M. A.; Fennessy, M.; Shea, T. C.; Spitzer, G.; Lossos, I. S.; Kharfan-Dabaja, M. A.; Joyce, R.; Fayad, L.; Henkel, K.; Liao, Q.; Edvardsen, K.; Jewell, R. C.; Fecteau, D.; Singh, R. P.; Lisby, S.; Moskowitz, C. H.
Article Title: Ofatumumab in combination with ICE or DHAP chemotherapy in relapsed or refractory intermediate grade B-cell lymphoma
Abstract: Standard treatment of transplant-eligible patients with relapsed diffuse large B-cell lymphoma (DLBCL) consists of rituximab and platinum-based chemotherapy, either ifosfamide, carboplatin, and etoposide (ICE) or dexamethasone, cytarabine, and cisplatin (DHAP), with autologous transplant consolidation for those with chemosensitive disease. Nonetheless, outcomes are suboptimal for patients failing rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP). We performed a multi-center phase II trial investigating the safety and efficacy of ofatumumab, a monoclonal antibody against CD20, combined with ICE or DHAP second-line therapy in patients with relapsed or refractory DLBCL, grade 3b follicular lymphoma, or transformed follicular lymphoma. Sixty-one patients were treated with either ofatumumab-ICE (35) or ofatumumab-DHAP (26). The overall response rate (ORR) was 61%, and the complete response (CR) rate was 37%. In patients with 2 or 3 adverse risk factors according to the second-line, age-adjusted, international prognostic index, the ORR was 59% and CR 31%, and in patients with early-relapsing or primary refractory disease, the ORR was 55% and CR 30%. Toxicity was largely hematologic, and stem cell mobilization was successful in 43 of 45 patients. Substitution of ofatumumab for rituximab in standard second-line regimens following failure of R-CHOP is a promising approach. This trial was registered at www.clinicaltrials.gov as NCT00823719. Copyright © 2011 by The American Society of Hematology; all rights reserved.
Keywords: survival; adult; aged; middle aged; survival analysis; treatment failure; young adult; mortality; cisplatin; cytarabine; methodology; antineoplastic agent; cancer grading; carboplatin; phase 2 clinical trial; etoposide; antineoplastic combined chemotherapy protocols; recurrence; dexamethasone; drug effect; drug resistance; pathology; drug resistance, neoplasm; ifosfamide; monoclonal antibody; b cell lymphoma; lymphoma, b-cell; antibodies, monoclonal; immunotherapy; multicenter study; recurrent disease; ofatumumab; neoplasm grading
Journal Title: Blood
Volume: 122
Issue: 4
ISSN: 0006-4971
Publisher: American Society of Hematology  
Date Published: 2013-07-25
Start Page: 499
End Page: 506
Language: English
DOI: 10.1182/blood-2012-12-472027
PUBMED: 23692856
PROVIDER: scopus
PMCID: PMC3724189
DOI/URL:
Notes: --- - Cited By (since 1996):2 - "Export Date: 2 December 2013" - "CODEN: BLOOA" - "Source: Scopus"
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  1. Craig Moskowitz
    407 Moskowitz
  2. Matthew J Matasar
    290 Matasar
  3. Kristen Diana Henkel
    1 Henkel