Phase 2 trial of bortezomib in combination with rituximab plus hyperfractionated cyclophosphamide, vincristine, doxorubicin, and dexamethasone alternating with bortezomib, rituximab, methotrexate, and cytarabine for untreated mantle cell lymphoma

Jorge E. Romaguera*, Michael Wang, Lei Feng, Luis E. Fayad, Frederick Hagemeister, Peter McLaughlin, M. Alma Rodriguez, Michelle Fanale, Robert Orlowski, Larry W. Kwak, Sattva Neelapu, Yasuhiro Oki, Barbara Pro, Anas Younes, Felipe Samaniego, Nathan Fowler, Kimberly Hartig, Marisa Valentinetti, Judy Smith, Peggy FordAdam Naig, L. Jeffrey Medeiros, Hagop M. Kantarjian, Andre Goy

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

9 Scopus citations

Abstract

BACKGROUND: Although the outcomes of patients with mantle cell lymphoma (MCL) have improved, there is still no cure. Bortezomib has a 33% response rate in relapsed/refractory MCL and has shown additive and/or synergistic effects in preclinical trials with known effective agents. METHODS: This is a report of a prospective phase 2 trial of bortezomib added to rituximab plus hyperfractionated cyclophosphamide, vincristine, doxorubicin, and dexamethasone (BzR-hyperCVAD)/rituximab, high-dose methotrexate, and high-dose cytarabine (BzR-MA) for 95 patients with newly diagnosed MCL. RESULTS: The overall and complete response rates were 100% and 82%, respectively. Hematologic toxicity was high but expected and did not lead to an increased incidence of neutropenic fever or dose reductions in comparison with a similar reported regimen without bortezomib. After a median follow-up of 44 months, the median overall survival had not been reached, and the time to treatment failure (TTF) was 55 months, which is not different from that of historical controls. CONCLUSIONS: BzR-hyperCVAD/BzR-MA at the dose and schedule studied produced high rates of response and a TTF similar to that of historical reports without bortezomib. Cancer 2018;124:2561-9.

Original languageEnglish (US)
Pages (from-to)2561-2569
Number of pages9
JournalCancer
Volume124
Issue number12
DOIs
StatePublished - Jun 15 2018

Keywords

  • and dexamethasone (R-hyperCVAD)
  • bortezomib
  • doxorubicin
  • mantle cell lymphoma
  • rituximab plus hyperfractionated cyclophosphamide
  • vincristine

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

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