The prognostic significance of PFS24 in follicular lymphoma following firstline immunotherapy: A combined analysis of 3 CALGB trials

Follicular lymphoma (FL) patients treated with firstline R‐CHOP who experience progression of disease (POD) within 2 years have a shorter survival than those who do not have POD within 2 years. Whether this observation holds for patients treated initially with biologic immunotherapy alone is unknown...

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Bibliographic Details
Published in:Cancer medicine (Malden, MA) MA), 2019-01, Vol.8 (1), p.165-173
Main Authors: Lansigan, Frederick, Barak, Ian, Pitcher, Brandelyn, Jung, Sin‐Ho, Cheson, Bruce D., Czuczman, Myron, Martin, Peter, Hsi, Eric, Schöder, Heiko, Smith, Scott, Bartlett, Nancy L., Leonard, John P., Blum, Kristie A.
Format: Article
Language:English
Subjects:
Adult
Aged
Aged, 80 and over
Antibodies, Monoclonal - administration & dosage
Antibodies, Monoclonal, Humanized - administration & dosage
Antineoplastic Combined Chemotherapy Protocols - administration & dosage
biologic agents
CD22 antigen
CD80 antigen
Clinical Cancer Research
Clinical trials
early progression
Female
follicular lymphoma
Humans
Immunotherapy
Lenalidomide - administration & dosage
Lymphoma
Lymphoma, Follicular - drug therapy
Lymphoma, Follicular - mortality
Male
Middle Aged
Monoclonal antibodies
Original Research
PFS24
Prognosis
Progression-Free Survival
Risk factors
Rituximab
Rituximab - administration & dosage
Survival
Targeted cancer therapy
Young Adult
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Summary:Follicular lymphoma (FL) patients treated with firstline R‐CHOP who experience progression of disease (POD) within 2 years have a shorter survival than those who do not have POD within 2 years. Whether this observation holds for patients treated initially with biologic immunotherapy alone is unknown. We performed a retrospective analysis of 174 patients pooled from three frontline rituximab (R)‐based nonchemotherapy doublet trials: R‐galiximab (Anti‐CD80, CALGB 50402), R‐epratuzumab (Anti‐CD22, CALGB 50701), and R‐lenalidomide (CALGB 50803) to determine outcomes of early progressors and risk factors for early POD, defined as progression within 24 months from study entry. Twenty‐eight percent (48/174) of patients had early POD. After adjusting for the Follicular Lymphoma International Prognostic Index (FLIPI), patients with early POD from study entry had a worse OS compared with patients who did not progress within 2 years (HR = 4.33 (95% CI 1.50‐12.5), P = 0.007). For early POD, the 2‐year survival was 80% vs 99% for nonearly POD, and the 5‐year survival was 74% vs 90%, respectively. These findings suggest that the adverse survival of patients with early POD may be independent of initial treatment modality. In this combined analysis of three CALGB clinical trials, patients with early progression of follicular lymphoma following frontline immunotherapy doublets are at increased risk of death. PFS24 is a prognostic marker for overall survival in patients treated with rituximab‐containing immunotherapy.
ISSN:2045-7634
2045-7634
DOI:10.1002/cam4.1918