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Combination therapy for gastric mucosa-associated lymphoid tissue lymphoma

March's issue of the Alimentary Pharmacology & Therapeutics compares rituximab, alkylating agents or combination therapy for gastric mucosa-associated lymphoid tissue lymphoma.

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There is no consensus on the standard treatment of gastric mucosa-associated lymphoid tissue (MALT) lymphoma for Helicobacter pylori-negative patients and for patients with persistent disease despite H. pylori eradication.

Dr Amiot and colleagues from France evaluated the comparative efficacy and safety of alkylating agents and rituximab alone or in combination.

In this monocentric retrospective study, which included 106 patients who had not been previously treated with anti-cancer agents, the team evaluated the efficacy and safety of oral alkylating agents monotherapy, rituximab monotherapy and the therapy combining both drugs.

The researchers performed evaluations at weeks 6, 25, and 52 and after 2 years.

The 5-year progression-free survival probabilities were 89% with combination therapy
Alimentary Pharmacology & Therapeutics

After a median follow-up period of 5 years, complete remission and overall response were significantly higher in patients in the combination therapy group at week 104 compared with patients treated with alkylating agents alone, and rituximab alone.

The 5-year progression-free survival probabilities were 68%, 70% and 89% in patients treated with alkylating agents alone, rituximab alone and combination therapy respectively.

The team reported hematological adverse events in 30% of patients, and were more frequent in the two groups receiving alkylating agents.

The research team observed no toxicity-related deaths.

Dr Amiot concludes, "The use of anti-cancer systemic therapy is safe and efficient in gastric MALT lymphoma."

"In this retrospective study, the combination of rituximab plus chlorambucil seems more efficient than rituximab or alkylating agents alone."

"Rituximab has a better safety profile than regimens containing alkylating agents."

Aliment Pharmacol Ther 2014: 39(6): 619–628
04 March 2014

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