Safety and Efficacy of Subcutaneous Rituximab in Previously Untreated Patients with CD20+ Diffuse Large B-Cell Lymphoma or Follicular Lymphoma: Results from an Italian Phase IIIb Study

Subcutaneous (SC) rituximab may be beneficial in terms of convenience and tolerability, with potentially fewer and less severe administration-related reactions (ARRs) compared to the intravenous (IV) form. This report presents the results of a phase IIIb study conducted in Italy. The study included...

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Main Authors: Mario Petrini, Gianluca Gaidano, Andrea Mengarelli, Ugo Consoli, Armando Santoro, Anna Maria Liberati, Marco Ladetto, Vincenzo Fraticelli, Attilio Guarini, Donato Mannina, Paola Ferrando, Paolo Corradini, Pellegrino Musto, Caterina Stelitano, Dario Marino, Andrea Camera, Marco Murineddu, Roberta Battistini, Giuseppe Caparrotti, Mauro Turrini, Luca Arcaini, Simone Santini, Manuela Cerqueti, Andres J. M. Ferreri, Nicola Cantore, Alessandro Inzoli, Giovanni Cardinale, Benedetto Ronci, Giorgio La Nasa, Stefano Massimi, Gianfranco Gaglione, Valentina Barbiero, Maurizio Martelli
Format: Article
Language:English
Published: Wiley 2022-01-01
Series:Advances in Hematology
Online Access:http://dx.doi.org/10.1155/2022/5581772
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author Mario Petrini
Gianluca Gaidano
Andrea Mengarelli
Ugo Consoli
Armando Santoro
Anna Maria Liberati
Marco Ladetto
Vincenzo Fraticelli
Attilio Guarini
Donato Mannina
Paola Ferrando
Paolo Corradini
Pellegrino Musto
Caterina Stelitano
Dario Marino
Andrea Camera
Marco Murineddu
Roberta Battistini
Giuseppe Caparrotti
Mauro Turrini
Luca Arcaini
Simone Santini
Manuela Cerqueti
Andres J. M. Ferreri
Nicola Cantore
Alessandro Inzoli
Giovanni Cardinale
Benedetto Ronci
Giorgio La Nasa
Stefano Massimi
Gianfranco Gaglione
Valentina Barbiero
Maurizio Martelli
author_facet Mario Petrini
Gianluca Gaidano
Andrea Mengarelli
Ugo Consoli
Armando Santoro
Anna Maria Liberati
Marco Ladetto
Vincenzo Fraticelli
Attilio Guarini
Donato Mannina
Paola Ferrando
Paolo Corradini
Pellegrino Musto
Caterina Stelitano
Dario Marino
Andrea Camera
Marco Murineddu
Roberta Battistini
Giuseppe Caparrotti
Mauro Turrini
Luca Arcaini
Simone Santini
Manuela Cerqueti
Andres J. M. Ferreri
Nicola Cantore
Alessandro Inzoli
Giovanni Cardinale
Benedetto Ronci
Giorgio La Nasa
Stefano Massimi
Gianfranco Gaglione
Valentina Barbiero
Maurizio Martelli
author_sort Mario Petrini
collection DOAJ
description Subcutaneous (SC) rituximab may be beneficial in terms of convenience and tolerability, with potentially fewer and less severe administration-related reactions (ARRs) compared to the intravenous (IV) form. This report presents the results of a phase IIIb study conducted in Italy. The study included adult patients with CD20+ DLBCL or FL having received at least one full dose of IV RTX 375 mg/m2 during induction or maintenance. Patients on induction received ≥4 cycles of RTX SC 1400 mg plus standard chemotherapy and FL patients on maintenance received ≥6 cycles of RTX SC. Overall, 159 patients (73 DLBCL, 86 FL) were enrolled: 103 (54 DLBCL, 49 FL) completed induction and 42 patients with FL completed 12 maintenance cycles. ARRs were reported in 10 patients (6.3%), 3 (4.2%) with DLBCL and 7 (8.1%) with FL, all of mild severity, and resolved without dose delay/discontinuation. Treatment-emergent adverse events (TEAEs) and serious adverse events occurred in 41 (25.9%) and 14 patients (8.9%), respectively. Two patients with DLBCL had fatal events: Klebsiella infection (related to rituximab) and septic shock (related to chemotherapy). Neutropenia (14 patients, 8.9%) was the most common treatment-related TEAE. Two patients with DLBCL (2.8%) and 6 with FL (7.0%) discontinued rituximab due to TEAEs. 65.2% and 69.7% of patients with DLBCL and 67.9% and 73.6% of patients with FL had complete response (CR) and CR unconfirmed, respectively. The median time to events (EFS, PFS, and OS) was not estimable due to the low rate of events. At a median follow-up of 29.5 and 47.8 months in patients with DLBCL and FL, respectively, EFS, PFS, and OS were 70.8%, 70.8%, and 80.6% in patients with DLBCL and 77.9%, 77.9%, and 95.3% in patients with FL, respectively. The switch from IV to SC rituximab in patients with DLBCL and FL was associated with low risk of ARRs and satisfactory response in both groups. This trial was registered with NCT01987505.
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spelling doaj-art-3480b587a0d945b293f445ff21680c7d2025-02-03T01:10:37ZengWileyAdvances in Hematology1687-91122022-01-01202210.1155/2022/5581772Safety and Efficacy of Subcutaneous Rituximab in Previously Untreated Patients with CD20+ Diffuse Large B-Cell Lymphoma or Follicular Lymphoma: Results from an Italian Phase IIIb StudyMario Petrini0Gianluca Gaidano1Andrea Mengarelli2Ugo Consoli3Armando Santoro4Anna Maria Liberati5Marco Ladetto6Vincenzo Fraticelli7Attilio Guarini8Donato Mannina9Paola Ferrando10Paolo Corradini11Pellegrino Musto12Caterina Stelitano13Dario Marino14Andrea Camera15Marco Murineddu16Roberta Battistini17Giuseppe Caparrotti18Mauro Turrini19Luca Arcaini20Simone Santini21Manuela Cerqueti22Andres J. M. Ferreri23Nicola Cantore24Alessandro Inzoli25Giovanni Cardinale26Benedetto Ronci27Giorgio La Nasa28Stefano Massimi29Gianfranco Gaglione30Valentina Barbiero31Maurizio Martelli32Section of HematologyDivision of HematologyHematology UnitDivision of HematologyHumanitas Clinical and Research Center-IRCCSAzienda Ospedaliera “Santa Maria”Hematology DivisionDepartment of HematologyHematology and Cell Therapy UnitHematology UnitMedical OncologyFondazione IRCCS Instituto Nazionale dei TumoriDepartment of Emergency and Organ Transplantation “Aldo Moro”Division of HaematologyDepartment of Clinical and Experimental OncologyHematology UnitHematology & Bone Marrow Transplant UnitHematology UnitDepartment of HaematologyDivision of HematologyDivision of HematologyASL Toscana CentroGeneral MedicineDepartment of Onco-HaematologyHematology and Hematopoietic Transplantation UnitHematology UnitOnco-hematology UnitHematology UnitDepartment of Medical Science and Public HealthRoche S. p. A.Roche S. p. A.Roche S. p. A.Department of Translational and Precision MedicineSubcutaneous (SC) rituximab may be beneficial in terms of convenience and tolerability, with potentially fewer and less severe administration-related reactions (ARRs) compared to the intravenous (IV) form. This report presents the results of a phase IIIb study conducted in Italy. The study included adult patients with CD20+ DLBCL or FL having received at least one full dose of IV RTX 375 mg/m2 during induction or maintenance. Patients on induction received ≥4 cycles of RTX SC 1400 mg plus standard chemotherapy and FL patients on maintenance received ≥6 cycles of RTX SC. Overall, 159 patients (73 DLBCL, 86 FL) were enrolled: 103 (54 DLBCL, 49 FL) completed induction and 42 patients with FL completed 12 maintenance cycles. ARRs were reported in 10 patients (6.3%), 3 (4.2%) with DLBCL and 7 (8.1%) with FL, all of mild severity, and resolved without dose delay/discontinuation. Treatment-emergent adverse events (TEAEs) and serious adverse events occurred in 41 (25.9%) and 14 patients (8.9%), respectively. Two patients with DLBCL had fatal events: Klebsiella infection (related to rituximab) and septic shock (related to chemotherapy). Neutropenia (14 patients, 8.9%) was the most common treatment-related TEAE. Two patients with DLBCL (2.8%) and 6 with FL (7.0%) discontinued rituximab due to TEAEs. 65.2% and 69.7% of patients with DLBCL and 67.9% and 73.6% of patients with FL had complete response (CR) and CR unconfirmed, respectively. The median time to events (EFS, PFS, and OS) was not estimable due to the low rate of events. At a median follow-up of 29.5 and 47.8 months in patients with DLBCL and FL, respectively, EFS, PFS, and OS were 70.8%, 70.8%, and 80.6% in patients with DLBCL and 77.9%, 77.9%, and 95.3% in patients with FL, respectively. The switch from IV to SC rituximab in patients with DLBCL and FL was associated with low risk of ARRs and satisfactory response in both groups. This trial was registered with NCT01987505.http://dx.doi.org/10.1155/2022/5581772
spellingShingle Mario Petrini
Gianluca Gaidano
Andrea Mengarelli
Ugo Consoli
Armando Santoro
Anna Maria Liberati
Marco Ladetto
Vincenzo Fraticelli
Attilio Guarini
Donato Mannina
Paola Ferrando
Paolo Corradini
Pellegrino Musto
Caterina Stelitano
Dario Marino
Andrea Camera
Marco Murineddu
Roberta Battistini
Giuseppe Caparrotti
Mauro Turrini
Luca Arcaini
Simone Santini
Manuela Cerqueti
Andres J. M. Ferreri
Nicola Cantore
Alessandro Inzoli
Giovanni Cardinale
Benedetto Ronci
Giorgio La Nasa
Stefano Massimi
Gianfranco Gaglione
Valentina Barbiero
Maurizio Martelli
Safety and Efficacy of Subcutaneous Rituximab in Previously Untreated Patients with CD20+ Diffuse Large B-Cell Lymphoma or Follicular Lymphoma: Results from an Italian Phase IIIb Study
Advances in Hematology
title Safety and Efficacy of Subcutaneous Rituximab in Previously Untreated Patients with CD20+ Diffuse Large B-Cell Lymphoma or Follicular Lymphoma: Results from an Italian Phase IIIb Study
title_full Safety and Efficacy of Subcutaneous Rituximab in Previously Untreated Patients with CD20+ Diffuse Large B-Cell Lymphoma or Follicular Lymphoma: Results from an Italian Phase IIIb Study
title_fullStr Safety and Efficacy of Subcutaneous Rituximab in Previously Untreated Patients with CD20+ Diffuse Large B-Cell Lymphoma or Follicular Lymphoma: Results from an Italian Phase IIIb Study
title_full_unstemmed Safety and Efficacy of Subcutaneous Rituximab in Previously Untreated Patients with CD20+ Diffuse Large B-Cell Lymphoma or Follicular Lymphoma: Results from an Italian Phase IIIb Study
title_short Safety and Efficacy of Subcutaneous Rituximab in Previously Untreated Patients with CD20+ Diffuse Large B-Cell Lymphoma or Follicular Lymphoma: Results from an Italian Phase IIIb Study
title_sort safety and efficacy of subcutaneous rituximab in previously untreated patients with cd20 diffuse large b cell lymphoma or follicular lymphoma results from an italian phase iiib study
url http://dx.doi.org/10.1155/2022/5581772
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