Originally published as JCO Early Release 10.1200/JCO.2005.06.146 on January 31 2005
Journal of Clinical Oncology, Vol 23, No 10 (April 1), 2005: pp. 2215-2223
© 2005 American Society of Clinical Oncology.
Meta-Analysis to Evaluate the Role of Interferon in Follicular Lymphoma
A.Z.S. Rohatiner,
W.M. Gregory,
B. Peterson,
E. Borden,
P. Solal-Celigny,
A. Hagenbeek,
R.I. Fisher,
M. Unterhalt,
R. Arranz,
T. Chisesi,
A. Aviles,
T.A. Lister
From St Bartholomew's Hospital, London, UK; University of Minnesota, Minneapolis, MN; Taussig Cancer Center, Cleveland, OH; Centre Jean Bernard, Le Mans, France; University Medical Center, Utrecht, The Netherlands; Wilmot Cancer Center, University of Rochester, Rochester, NY; Georg-August-University, Gottingen, Germany; Hospital Universitario de la Princesa, Madrid, Spain; Ospedale Civile, Venice, Italy; Oncology Hospital, IMSS, Mexico City, Mexico
Address reprint requests to A.Z.S. Rohatiner, MD, FRCP, Department of Medical Oncology, St Bartholomew's Hospital, 45 Little Britain, London, EC1A 7BE, United Kingdom; e-mail: ama.rohatiner{at}cancer.org.uk
PURPOSE: To determine whether interferon (IFN) - 2, when given with or following chemotherapy, influences response rate, remission duration, and survival in newly diagnosed patients with follicular lymphoma.
PATIENTS AND METHODS: Ten phase III studies evaluating the role of IFN-2 in 1,922 newly diagnosed patients with follicular lymphoma were analyzed. Updated individual patient data were used to perform meta-analyses for response, survival, and remission duration.
RESULTS: The addition of IFN-2 to initial chemotherapy did not significantly influence response rate. An overall meta-analysis for survival showed a significant difference in favor of IFN-2, but also showed significant heterogeneity between studies. Further analyses were carried out in order to explain this heterogeneity, and to define the circumstances in which IFN-2 prolonged survival. The survival advantage was seen when IFN-2 was given: (1) in conjunction with relatively intensive initial chemotherapy (2P = .00005), (2) at a dose  5 million units (2P = .000002), (3) at a cumulative dose 36 million units per month (2P = .000008), and (4) with chemotherapy rather than as maintenance therapy (P = .004). With regard to remission duration, there was also a significant difference in favor of IFN-2, irrespective of the intensity of chemotherapy used, IFN dose, or whether IFN was given as a maintenance strategy or with chemotherapy.
CONCLUSION: When given in the context of relatively intensive initial chemotherapy, and at a dose 5 million units ( 36 x 106 units per month), IFN-2 prolongs survival and remission duration in patients with follicular lymphoma.
Supported in part by a grant from Schering-Plough.
Authors' disclosures of potential conflicts of interest are found at the end of this article.
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