Source: Sun Yat-sen University Cancer Center
Written by: Sun Yat-sen University Cancer Center
Edited by: Wang Dongmei

Recently, the top-level medical journal, the New England Journal of Medicine (NEJM), published the results of a prospective international multicenter clinical trial for patients with newly diagnosed mantle-cell lymphoma ineligible for autologous transplant (LYM 3002 trial), demonstrating that bortezomib-based chemotherapy improved outcomes of patients with mantle-cell lymphoma compared with R-CHOP regimen. Professor Huiqiang Huang (the second author) come from Sun Yat-sen University Cancer Center (SYSUCC), and it is the first time that our center’s research has been published in the medical journal with highest rating.

Mantle-cell lymphoma (MCL) is a unique subtype of malignant lymphoma with both aggressive and indolent clinical features, accounting for 6% of all non-Hodgkin’s lymphoma (about 2.5% in China). MCL is characterized by t(11; 14) and Cyclin D1 overexpression, high onset age, poor response to conventional chemotherapy with high relapsed risk, and the prognosis is dismal for elderly cases. Bortezomib is a proteasome inhibitor that showed favorable efficacy in multiple myeloma and relapsed/refractory mantle-cell lymphoma in previous studies as a single agent. This phase 3 trial aimed to investigate whether bortezomib in frontline therapy could improve outcomes of R-CHOP for patients with newly diagnosed mantle-cell lymphoma. One hundred and twenty hospitals worldwide were involved in this global clinical trial, and Professor Franco Cavalli from Switzerland was the Principal Investigator. The trial randomly assigned 487 adults with newly diagnosed mantle-cell lymphoma who were ineligible for stem-cell transplantation to receive six to eight cycles of R-CHOP-21 or VR-CAP (R-CHOP regimen, but replacing vincristine with bortezomib at a dose of 1.3 mg per square meter of body-surface area on days 1, 4, 8, and 11). After a median follow-up of 40 months, median progression-free survival was 14.4 months in the R-CHOP group versus 24.7 months in the VR-CAP group (P < 0.001), with a relative improvement of 59%. besides, the complete response rate, the median duration of complete response, the median treatment-free interval, and the 4-year overall survival rate were consistently improved in the vr-cap group. the results of the trial changed the treatment choice for elderly patients with mantle-cell lymphoma at the first time. in this trial, professor huang’s team from sysucc won two gold medals rewarded for both of the highest incrollment in number and the best quality of recruitment.

NEJM is a renowned medical journal managed by the Massachusetts Medical Society (MMS), with an impact factor of 55.8 in 2014. Publication in this journal is a strong indicator for great contribution of clinical LYM 3002 and the capability of SYSUCC to conduct high-level clinical researches.