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Rituximab zur Therapie des Non-Hodgkin-Lymphoms

Rituximab for the therapy of non-Hodgkin’s lymphoma

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Zusammenfassung

Rituximab ist der erste monoklonale Antikörper, der für die Behandlung des Non-Hodgkin-Lymphoms zugelassen wurde. Die Kombination Rituximab plus Chemotherapie ist der alleinigen Chemotherapie in allen bislang geprüften Indikationen eindeutig überlegen. Zur Primärtherapie des follikulären Lymphoms mit Rituximab plus Chemotherapie liegen jetzt 4 große randomisierte Studien vor, die alle eine statistisch signifikante und klinisch relevante Überlebensverlängerung durch die Kombination mit Rituximab zeigen konnten. In der Primärtherapie des follikulären Lymphoms ist die Kombination mit Rituximab deshalb heute Standard. Darüber hinaus zeigen 2 weitere Phase-III-Studien, dass mit Rituximab auch beim rezidivierten follikulären Lymphom eine Überlebensverlängerung zu erreichen ist. Zum einen durch eine kombinierte Rituximab-Chemotherapie-Induktionsbehandlung, zum anderen mit einer Rituximab-Erhaltungstherapie, die auch nach der Rituximab-Chemotherapie-Induktionsbehandlung hoch wirksam und sehr gut verträglich ist. Das Risiko zu sterben wird durch die Rituximab-Erhaltungstherapie halbiert. Damit ist Rituximab beim rezidivierten follikulären Lymphom sowohl zur Remissionsinduktion als auch zur Erhaltungstherapie die überlegene Therapieform. Auch beim diffus großzelligen B-Zell-Lymphom ist die Rituximab-Chemotherapie heute therapeutischer Standard. In 4 großen randomisierten Studien ist die Verbesserung der Heilungschancen klar dokumentiert worden. Dies gilt für alle Altersgruppen und für alle Risikogruppen. Lediglich die Zahl der Therapiezyklen und die Dosisdichte sind je nach Alter und Risikogruppe der Patienten verschieden.

Abstract

Rituximab is the first monoclonal antibody to be approved for the treatment of non-Hodgkin’s lymphoma. Compared to chemotherapy alone, the combination of rituximab and chemotherapy is superior for all indications so far tested. For the primary therapy of follicular lymphoma with rituximab and chemotherapy, there are now four large, randomized studies available, all of which show a statistically significant and clinically relevant prolongation of life due to the combination therapy. Thus, rituximab is today the standard primary therapy for this form of lymphoma. In addition, two other phase III studies show that treatment with rituximab also leads to a prolongation of life in patients suffering from recurrent follicular lymphoma. This is the case for both combined rituximab/chemotherapy induction treatment, as well as for rituximab maintenance therapy, which is also highly effective after the rituximab/chemotherapy and is well tolerated. The risk of dying is halved by the use of rituximab maintenance therapy, indicating that rituximab is the best available therapy for recurrent follicular lymphoma, as well as for the induction of remission of the disease and as a maintenance therapy. In cases of diffuse large B-cell lymphoma, rituximab combined with chemotherapy is the therapeutic standard, with four large, randomized studies showing a clear improvement in cure rate. This applies to all age groups and risk categories, which may, however, differ in the number of therapy cycles and the dose rate.

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  1. Schwerpunkt Hämatologie, Universitätsklinik Gießen, Klinikstraße 36, 35385, Gießen, Deutschland

    M.J. Rummel

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Rummel, M. Rituximab zur Therapie des Non-Hodgkin-Lymphoms. Onkologe 13, 227–235 (2007). https://doi.org/10.1007/s00761-007-1188-x

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  • DOI: https://doi.org/10.1007/s00761-007-1188-x

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