Less toxic therapy for indolent lymphomas could replace R-CHOP

The results of a Phase III clinical trial presented at the American Society of Hematology meeting could have a significant impact on first-line therapy for indolent lymphomas.

Currently, the standard first-line therapy for Follicular Lymphoma, Mantle Cell Lymphoma and other indolent lymphomas is the combination chemotherapy regimen known as R-CHOP (Rituxan + cyclophosphamide, daunorubicin, vincristine, prednisone), but findings published at this weekend's American Society of Hematology meeting suggest that Rituxan's more ideal partner is bendamustine (Treanda).

Ultimately, overall response rates in the study for Rituxan + CHOP (91.3%) and for Rituxan + bendamustine (92.7%) were practically the same, but the latter therapy is significantly less toxic, speciflcally in two high-grade hematologic toxicities:

- Leukocytopenia: Rituxan + bendamustine (12.1%), Rituxan + CHOP (38.2%)
- Neutropenia: Rituxan + bendamustine (10.7%), Rituxan + CHOP (46.5%)

The trial was carried out at University Hospital in Giessen, Germany and is already being called "potentially practice-changing". However, until published in a peer-reviewed journal, its conclusions are considered preliminary only.