J 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.

Basic information

Original name

Minimal Residual Disease Status Predicts Outcome in Patients With Previously Untreated Follicular Lymphoma: A Prospective Analysis of the Phase III GALLIUM Study

Authors

POTT, Christiane, Vindi JURINOVIC, Judith TROTMAN, Britta KEHDEN, Michael UNTERHALT, Michael HEROLD, van der Jagt RICHARD, Ann JANSSENS, Michael KNEBA, Jiří MAYER (203 Czech Republic, belonging to the institution), Moya YOUNG, Christian SCHMIDT, Andrea KNAPP, Tina NIELSEN, Helen BROWN, Nathalie SPIELEWOY, Chris HARBRON, Alessia BOTTOS, Kirsten MUNDT, Robert MARCUS, Wolfgang HIDDEMANN and Eva HOSTER

Edition

Journal of clinical oncology, PHILADELPHIA, LIPPINCOTT WILLIAMS & WILKINS, 2024, 0732-183X

Other information

Language

English

Type of outcome

Článek v odborném periodiku

Field of Study

30205 Hematology

Country of publisher

United States of America

Confidentiality degree

není předmětem státního či obchodního tajemství

References:

Impact factor

Impact factor: 45.300 in 2022

Organization unit

Faculty of Medicine

UT WoS

001235636300015

Keywords in English

Follicular Lymphoma

Tags

Tags

International impact, Reviewed
Změněno: 10/6/2024 14:37, Mgr. Tereza Miškechová

Abstract

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.