61 percent of patients had complete response to interferon alfa-2b; patients with high-grade disease showed expected response to chemo
By Elana Gotkine HealthDay Reporter
WEDNESDAY, April 12, 2023 (HealthDay News) — For low-grade lymphomatoid granulomatosis, interferon alfa-2b is efficacious, according to a study published online March 31 in The Lancet Haematology.
Christopher Melani, M.D., from the National Institutes of Health in Bethesda, Maryland, and colleagues enrolled 67 patients aged 12 years or older with untreated, relapsed, or refractory lymphomatoid granulomatosis. Patients with low-grade disease received dose-escalated interferon alfa-2b, and those with high-grade disease received six cycles of intravenous, dose-adjusted etoposide, prednisone, vincristine, cyclophosphamide, doxorubicin, and rituximab (DA-EPOCH-R). After initial therapy, patients with residual or progressive disease crossed over to alternative therapy.
Forty-five patients received initial treatment with interferon alfa-2b (16 crossed over to DA-EPOCH-R) and 18 received initial treatment with DA-EPOCH-R (eight crossed over to interferon alfa-2b); four only received surveillance. The researchers found that the overall response was 64 percent after initial treatment with interferon-alfa-2b (61 percent had complete response), while the overall response was 63 percent (50 percent with complete response) after cross-over treatment with interferon alfa-2b. The overall response rate was 76 percent after initial treatment with DA-EPOCH-R (47 percent had complete response), while the overall response was 67 percent (47 percent with complete response) after cross-over treatment with DA-EPOCH-R. Five-year progression-free survival was 48.5, 50.0, 25.4, and 62.5 percent, respectively, with initial treatment with interferon alfa-2b, cross-over treatment with interferon alfa-2b, initial treatment with DA-EPOCH-R, and cross-over treatment with DA-EPOCH-R, respectively.
“We have shown in this rare disorder that using a novel immunotherapy-based approach for low-grade disease is effective and improves survival compared with historical treatments such as chemotherapy and corticosteroids,” Melani said in a statement.
One author disclosed financial ties to the biopharmaceutical industry.
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