Time to treatment response in patients with follicular lymphoma treated with bortezomib is longer compared with other histologic subtypes Journal Article

Authors: O'Connor, O. A.; Portlock, C.; Moskowitz, C.; Hamlin, P.; Straus, D.; Gerecitano, J.; Gonen, M.; Dumitrescu, O.; Sarasohn, D.; Butos, J.; Neylon, E.; Cortelli, B. M. G.; Blumel, S.; Evens, A. M.; Zelenetz, A. D.; Wright, J.; Cooper, B.; Winter, J.; Vose, J.
Article Title: Time to treatment response in patients with follicular lymphoma treated with bortezomib is longer compared with other histologic subtypes
Abstract: Purpose: To determine the antitumor activity of the novel proteasome inhibitor bortezomib in patients with indolent non-Hodgkin's lymphoma. Experimental Design: Patients with follicular lymphoma (FL), marginal zone lymphoma, mantle cell lymphoma, small lymphocytic lymphoma/chronic lymphocytic leukemia, and Waldenstrom's macroglobulinemia were eligible for study. Bortezomib was given at a dose of 1.5 mg/m2 as an i.v. push on days 1, 4, 8, and 11 of a 21-day cycle. Eligibility included the following: (a) no more than three prior therapies, (b) at least 1 month since prior chemotherapy, (c) measurable disease, and (d) an absolute neutrophil count of >1,000/μL and a platelet count >50,000/μL for the first dose of any cycle. Results: Seventy-seven patients were registered, of which 69 were assessable for response based on the completion of two cycles of therapy. Subtypes included FL (59.5%), mantle cell lymphoma (52%), small lymphocytic lymphoma/chronic lymphocytic leukemia (16.2%), marginal zone lymphoma (21.6%), and one Waldenstrom's macroglobulinemia. The median number of prior therapies was three. Themost common grade 3 toxicity was lymphopenia (35%) and thrombocytopenia (31%). Twenty-five patients experienced grade ≤2 sensory neuropathy (32), and 8% experienced grade 3 neurosensory toxicity. The overall response rate was 45% (40% on an intention to treat) including 10 complete remissions. Of 18 patients with FL, 9 responded with 4 complete response. The median time to treatment response for FL was 12 weeks, whereas the median time to treatment response for other subtypes of non-Hodgkin's lymphoma was only 4 weeks. Conclusions: These data suggest that bortezomib has significant single agent activity in patients with FL, and that longer durations of treatment may improve overall response. ©2010 AACR.
Keywords: adult; cancer survival; clinical article; controlled study; treatment outcome; aged; aged, 80 and over; disease-free survival; middle aged; survival analysis; clinical trial; constipation; fatigue; diarrhea; drug dose reduction; monotherapy; side effect; treatment duration; progression free survival; bortezomib; controlled clinical trial; drug eruption; mantle cell lymphoma; multiple cycle treatment; neutrophil count; phase 2 clinical trial; sensory neuropathy; thrombocyte; boronic acids; pyrazines; anemia; nausea; thrombocytopenia; recurrence; aciclovir; creatinine; herpes zoster; waldenstroem macroglobulinemia; antineoplastic activity; time factors; asthenia; coughing; hyperglycemia; lymphocytopenia; alanine aminotransferase; alkaline phosphatase; aspartate aminotransferase; bilirubin; chemotherapy induced emesis; hyperkalemia; hypoalbuminemia; hypokalemia; lymphoma, b-cell; cancer regression; neutrophil; disease progression; multicenter study; drug response; thrombocyte count; hypoglycemia; chronic lymphatic leukemia; neuropathic pain; follicular lymphoma; marginal zone lymphoma; lymphoma, follicular; leukocyte; lymphocytoma; hypernatremia; hypocalcemia; opportunistic infection
Journal Title: Clinical Cancer Research
Volume: 16
Issue: 2
ISSN: 1078-0432
Publisher: American Association for Cancer Research  
Date Published: 2010-01-15
Start Page: 719
End Page: 726
Language: English
DOI: 10.1158/1078-0432.ccr-08-2647
PUBMED: 20068103
PROVIDER: scopus
Notes: --- - "Cited By (since 1996): 4" - "Export Date: 20 April 2011" - "CODEN: CCREF" - "Source: Scopus"
Altmetric Score
MSK Authors
  1. Carol Portlock
    178 Portlock
  2. Craig Moskowitz
    368 Moskowitz
  3. Mithat Gonen
    701 Gonen
  4. Andrew D Zelenetz
    546 Zelenetz
  5. Paul Hamlin
    170 Hamlin
  6. David J Straus
    205 Straus
  7. John N Butos
    5 Butos