A trial of CHOP chemotherapy, with or without rituximab for follicular non Hodgkin lymphoma that has come back (EORTC 20981)

Cancer type:

Blood cancers

Low grade lymphoma

Lymphoma

Non-Hodgkin lymphoma

Status:

Results

Phase:

Phase 3

This trial looked at rituximab with chemotherapy for follicular lymphoma that had come back after treatment.

Follicular NHL is a type of low grade lymphoma. It is usually possible to control this type of lymphoma for a number of years, but it is difficult to cure. Doctors usually treat it with chemotherapy to get it into remission. This means there is no sign of the disease, but it is still there and is likely to come back at some time in the future. Each time follicular NHL comes back, it is harder to get it into remission.

This trial was in 2 parts. The aim in the first part was to see if adding a monoclonal antibody called rituximab (Mabthera) to CHOP chemotherapy would make it easier to get follicular NHL that has come back into another remission.

The aim of the second part was to see if continuing to treat follicular NHL with rituximab after chemotherapy would keep follicular NHL in remission for longer.

Summary of results

The trial team found that rituximab with CHOP (R-CHOP) was better for putting follicular NHL into remission than CHOP alone. They also found that continuing rituximab after chemotherapy kept it in remission for longer.

The trial team were able to look at 465 of the 474 people this trial recruited. Of these 465 people

231 had CHOP
234 had R-CHOP

The follicular NHL responded to treatment in 167 of the 231 people who had CHOP alone. Of these

In 36 people it went away completely – this means the researchers could not find it in routine blood and bone marrow tests (complete remission )
In 131 people it did not completely go away (partial response )

The follicular NHL responded to treatment in 199 of the 234 people who had R-CHOP. Of these

69 people had a complete remission
130 people had a partial response

The second part of the trial was only open to people whose follicular NHL responded to treatment. Of these 366 people, 334 were able to take part. They were put into 1 of 2 groups

167 had rituximab after their chemotherapy finished
167 did not

For those who had rituximab the average time it took for their follicular NHL to come back was 51 and a half months. For those who did not have rituximab the average time was just under 15 months.

After 3 years, 142 people who had rituximab after chemotherapy were still alive. And 129 people who did not have rituximab after chemotherapy were still alive.

The researchers concluded that adding rituximab to CHOP made it easier to get follicular NHL into remission after it had come back. They also concluded that having rituximab after chemotherapy would keep follicular NHL in remission for longer.

We have based this summary on information from the team who ran the trial. The information they sent us has been reviewed by independent specialists (peer reviewed Open a glossary item ) and published in a medical journal. The figures we quote above were provided by the trial team. We have not analysed the data ourselves.