MACOP-B versus ProMACE-MOPP in the treatment of advanced diffuse non-Hodgkin's lymphoma: Results of a prospective randomized trial by the non-Hodgkin's lymphoma cooperative study group

Mario Roberto Sertoli, Gino Santini, Teodoro Chisesi, Angela Marina Congiu, Alessandra Rubagotti, Antonio Contu, Luigi Salvagno, Paolo Coser, Adolfo Porcellini, Michele Vespignani, Giovanni Capnist, Edoardo Rossi, Lina Mangoni, Paolo Fabris, Orazio Vinante, Lucilla Tedeschi, Luigi Endrizzi, Luigi Pio Miglio, Alessandra Perrotta, Riccardo RossoEugenio Damasio, Vittorio Rizzoli

Research output: Contribution to journalArticlepeer-review

Abstract

Purpose: The aim of our study was to compare in a multicentric randomized trial two regimens widely used in the treatment of advanced-stage intermediate- to high-grade non-Hodgkin's lymphoma and to assess whether a third-generation regimen (methotrexate with leucovorin, doxorubicin, cyclophosphamide, vincristine, prednisone, and bleomycin [MACOP-B]) was superior to a second-generation regimen (procarbazine, methotrexate with leucovorin, doxorubicin, cyclophosphamide, and etoposide [ProMACE-MOPP]). Patients and Methods: Between January 1987 and August 1991, 221 patients with diffuse intermediate- to high-grade non-Hodgkin's lymphoma (Working Formulation groups F, G, H, and K), stage II bulky (> 10 cm), III, or IV, were randomized by the Non-Hodgkin's Lymphoma Cooperative Study Group (NHLCSG) to receive ProMACE-MOPP for six cycles or MACOP-B for 12 weeks. Survival, progression-free survival, and disease-free survival were determined, and multivariate analysis of prognostic factors was performed. Results: In the two groups of patients, there was no significant difference in terms of complete remission (CR) rate (49.1% with ProMACE-MOPP and 52.3% with MACOP-B), 3-year overall survival rate (45.2% with PROMACE-MOPP and 52.3% with MACOP-B), and 3-year progression-free survival rate (36.4% with ProMACE-MOPP and 36.1% with MACOP-B). In terms of toxicity, no significantly greater toxicity occurred in either arm. Overall toxicity was acceptable. The most frequent side effects were grade II through IV leukopenia, infection, mucositis, and anemia. Treatment-related deaths were equally distributed. Conclusion: No significant differences in terms of efficacy and/or toxicity between ProMACE-MOPP and MACOP-B are evident. These results are consistent with recent randomized trials showing that the new-generation aggressive regimens are no better than previous ones.

Original languageEnglish
Pages (from-to)1366-1374
Number of pages9
JournalJournal of Clinical Oncology
Volume12
Issue number7
Publication statusPublished - Jul 1994

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

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