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Single-Agent Monoclonal Antibody Efficacy in Bulky Non-Hodgkin's Lymphoma: Results of a Phase II Trial of Rituximab

From the Stanford University Medical Center, Stanford; IDEC Pharmaceuticals Corp, San Diego; Hoag Cancer Center, Newport Beach; Kenneth Norris Cancer Center, Los Angeles, CA; St. Louis University Medical Center, St. Louis, MO; University of Iowa General Hospital, Iowa City, IA; Fred Hutchinson Cancer Research Center, Seattle, WA; and University of Virginia Health Science Center, Charlottesville, VA.

Address reprint requests to Thomas A. Davis, MD, EPN 715, 6130 Executive Blvd, Rockville, MD 20852; email davist{at}ctep.nci.nih.gov

PURPOSE: A phase II trial was performed to evaluate the safety and efficacy of rituximab, a chimeric anti-CD20 monoclonal antibody, in patients with bulky (> 10-cm lesion) relapsed or refractory low-grade or follicular non-Hodgkin's lymphoma (NHL).

PATIENTS AND METHODS: Thirty-one patients received intravenous infusions of rituximab 375 mg/m² weekly for four doses. All patients had at least one prior therapy (median, three; range, one to 13) and had progressive disease at study entry. Patients were a median of 4 years from diagnosis.

RESULTS: No patient had treatment discontinued because of an adverse event. No patient developed human antichimeric antibody. The overall response rate in 28 assessable patients was 43% with a median time to progression of 8.1 months (range, 4.5 to 18.6+ months) and median duration of response of 5.9 months (range, 2.8 to 12.1+ months). The average decrease in lesion size in patients who achieved a partial response was 76%, and patients with stable disease had a decrease in average lesion size of 26%. Median serum antibody concentration was higher in responders compared with nonresponders, and a negative correlation was shown between antibody concentration and tumor bulk at baseline.

CONCLUSION: Rituximab single-agent outpatient therapy is safe and shows significant clinical activity in patients with bulky relapsed or refractory low-grade or follicular B-cell NHL.

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