2024
Minimal Residual Disease Status Predicts Outcome in Patients With Previously Untreated Follicular Lymphoma: A Prospective Analysis of the Phase III GALLIUM Study
POTT, Christiane, Vindi JURINOVIC, Judith TROTMAN, Britta KEHDEN, Michael UNTERHALT et. al.Základní údaje
Originální název
Minimal Residual Disease Status Predicts Outcome in Patients With Previously Untreated Follicular Lymphoma: A Prospective Analysis of the Phase III GALLIUM Study
Autoři
POTT, Christiane, Vindi JURINOVIC, Judith TROTMAN, Britta KEHDEN, Michael UNTERHALT, Michael HEROLD, van der Jagt RICHARD, Ann JANSSENS, Michael KNEBA, Jiří MAYER (203 Česká republika, domácí), Moya YOUNG, Christian SCHMIDT, Andrea KNAPP, Tina NIELSEN, Helen BROWN, Nathalie SPIELEWOY, Chris HARBRON, Alessia BOTTOS, Kirsten MUNDT, Robert MARCUS, Wolfgang HIDDEMANN a Eva HOSTER
Vydání
Journal of clinical oncology, PHILADELPHIA, LIPPINCOTT WILLIAMS & WILKINS, 2024, 0732-183X
Další údaje
Jazyk
angličtina
Typ výsledku
Článek v odborném periodiku
Obor
30205 Hematology
Stát vydavatele
Spojené státy
Utajení
není předmětem státního či obchodního tajemství
Odkazy
Impakt faktor
Impact factor: 45.300 v roce 2022
Organizační jednotka
Lékařská fakulta
UT WoS
001235636300015
Klíčová slova anglicky
Follicular Lymphoma
Příznaky
Mezinárodní význam, Recenzováno
Změněno: 10. 6. 2024 14:37, Mgr. Tereza Miškechová
Anotace
V originále
Purpose: We report an analysis of minimal residual/detectable disease (MRD) as a predictor of outcome in previously untreated patients with follicular lymphoma (FL) from the randomized, multicenter GALLIUM (ClinicalTrials.gov identifier: NCT01332968) trial. Patients and methods: Patients received induction with obinutuzumab (G) or rituximab (R) plus bendamustine, or cyclophosphamide, doxorubicin, vincristine, prednisone (CHOP) or cyclophosphamide, vincristine, prednisone (CVP) chemotherapy, followed by maintenance with the same antibody in responders. MRD status was assessed at predefined time points (mid-induction [MI], end of induction [EOI], and at 4-6 monthly intervals during maintenance and follow-up). Patients with evaluable biomarker data at diagnosis were included in the survival analysis. Results: MRD positivity was associated with inferior progression-free survival (PFS) at MI (hazard ratio [HR], 3.03 [95% CI, 2.07 to 4.45]; P < .0001) and EOI (HR, 2.25 [95% CI, 1.53 to 3.32]; P < .0001). MRD response was higher after G- versus R-chemotherapy at MI (94.2% v 88.9%; P = .013) and at EOI (93.1% v 86.7%; P = .0077). Late responders (MI-positive/EOI-negative) had a significantly poorer PFS than early responders (MI-negative/EOI-negative; HR, 3.11 [95% CI, 1.75 to 5.52]; P = .00011). The smallest proportion of MRD positivity was observed in patients receiving bendamustine at MI (4.8% v 16.0% in those receiving CHOP; P < .0001). G appeared to compensate for less effective chemotherapy regimens, with similar MRD response rates observed across the G-chemo groups. During the maintenance period, more patients treated with R than with G were MRD-positive (R-CHOP, 20.7% v G-CHOP, 7.0%; R-CVP, 21.7% v G-CVP, 9.4%). Throughout maintenance, MRD positivity was associated with clinical relapse. Conclusion: MRD status can determine outcome after induction and during maintenance, and MRD negativity is a prerequisite for long-term disease control in FL. The higher MRD responses after G- versus R-based treatment confirm more effective tumor cell clearance.