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Chemotherapy plus Rituximab versus chemotherapy alone for B-cell non-Hodgkin's lymphoma
H Schulz1, J Bohlius, N Skoetz
1Univerisity Hospital Cologne, Cochrane Haematological Malignancies Group - Department of Internal Medicine 1, Kerpener Str 62, Köln (Cologne), Germany, D 50924. Holger.Schulz@uni-koeln.de
The Cochrane Database of Systematic Reviews
|October 19, 2007
Summary
Adding rituximab to chemotherapy improves overall survival for indolent lymphoma patients. This combination therapy, rituximab-chemotherapy, also enhances response rates and disease control compared to chemotherapy alone.
Area of Science:
- Hematology
- Oncology
- Clinical Trials
Background:
- Rituximab (R) plus chemotherapy (R-chemo) improves response rates and progression-free survival in indolent and mantle cell lymphomas.
- The impact of R-chemo on overall survival (OS) has been unclear.
Purpose of the Study:
- To systematically review and compare OS in patients receiving R-chemo versus chemotherapy alone.
- To evaluate other endpoints including overall response rate (ORR), toxicity, and disease control (TTF, EFS, PFS, TTP).
Main Methods:
- Systematic review and meta-analysis of randomized controlled trials (RCTs) published from 1990-2005.
- Searched CENTRAL, MEDLINE, EMBASE, and conference proceedings.
- Included RCTs comparing R-chemo with chemotherapy alone in newly diagnosed or relapsed indolent lymphoma and mantle cell lymphoma (MCL).
Main Results:
- Seven RCTs involving 1943 patients were analyzed.
- R-chemo significantly improved OS (HR 0.65; 95% CI 0.54-0.78), ORR (RR 1.21; 95% CI 1.16-1.27), and disease control (HR 0.62; 95% CI 0.55-0.71).
- OS benefits were observed in follicular lymphoma and mantle cell lymphoma subgroups, though heterogeneity was noted in MCL.
Conclusions:
- R-chemo demonstrates improved OS for patients with indolent lymphoma.
- Significant survival benefits were particularly noted in follicular and mantle cell lymphoma subgroups.
- R-chemo is a superior treatment option compared to chemotherapy alone for these patient populations.
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