RESEARCH ARTICLE Long-term follow-up of chemoimmunotherapy with rituximab, oxaliplatin, cytosine arabinoside, dexamethasone (ROAD) in patients with relapsed CD201 B–cell non-Hodgkin lymphoma: Results of a study of the Mayo Clinic Cancer Center Research Consortium (MCCRC) MC0485 now known as academic and community cancer research united (ACCRU) Thomas E. Witzig 1 | Patrick B. Johnston 1 | Betsy R. LaPlant 2 | Paul J. Kurtin 3 | Levi D. Pederson 2 | Dennis F. Moore Jr 4 | Nassim H. Nabbout 4 | Daniel A. Nikcevich 5 | Kendrith M. Rowland 6 | Axel Grothey 7 1 Division of Hematology, Department of Medicine, Mayo Clinic Rochester, Rochester, Minnesota; 2 Division of Biomedical Statistics and Bioinformatics, Department of Health Sciences Research, Mayo Clinic Rochester, Rochester, Minnesota; 3 Division of Hematopathology, Department of Laboratory Medicine and Pathology, Mayo Clinic Rochester, Rochester, Minnesota; 4 Cancer Center of Kansas, Wichita, Kansas; 5 Essentia Health Saint Mary’s Medical Center, Duluth, Minnesota; 6 Carle Cancer Center CCOP, Urbana, Illinois; 7 Division of Medical Oncology, Mayo Clinic, Rochester, Minnesota Correspondence Thomas E. Witzig, Division of Hematology, Department of Medicine, Mayo Clinic, Mayo Clinic, 200 First St. SW, Rochester, MN 55905. Email: witzig.thomas@mayo.edu Abstract Patients with relapsed aggressive non-Hodgkin lymphoma (NHL) are often treated with platinum- based chemoimmunotherapy regimens in preparation for autologous stem cell transplant. We sought to reduce toxicity and maintain efficacy by using oxaliplatin with rituximab, cytarabine and dexameth- asone (ROAD) in a phase II clinical trial in patients who had relapsed after one prior regimen. ROAD was delivered q21 days and consisted of rituximab 375 mg/m 2 IV weekly x 4 doses (cycle 1 only); dexamethasone 40 mg PO/IV d2 – 5; oxaliplatin 130 mg/m 2 IV day 2; cytarabine 2000 mg/m 2 IV 3 two doses on days 2 to 3; and pegfilgrastim 6 mg SC on day 4. Forty-five eligible patients were accrued between 2006 and 2008. Patient characteristics were a median age of 69 years; 96% had received prior rituximab; 53% were within one year of diagnosis. The median number of cycles received was 2 (range, 1-6). Forty-four % received ROAD as an outpatient. The overall response rate was 71% with 27% (12/45) CR and 44% (20/45) PR. Forty-four % (20/45) of all patients and 69% (18/26) of patients whom responded after 2 cycles proceeded to transplant. Median overall survival was 26 mos (95% CI: 7.3 mos—not reached) and median progression-free survival was 11 mos (95% CI: 6—104 mos). There was no grade 3/4 nephrotoxicity; the rate of grade 3/4 neuropathy was 4%. Forty-two percent of all patients and 69% of patients transplanted remain alive at 5 years. ROAD represents an acceptable salvage therapeutic option for patients with relapsed aggressive NHL. 1 | INTRODUCTION In 2017, patients with relapsed aggressive B-cell lymphoma who fail standard induction therapy with an anthracycline-containing regimen are typically treated with chemoimmunotherapy containing a platinum compound. The most commonly used platinum-based regimens include DHAP (dexamethasone, cytosine arabinoside (cytarabine), cisplatin), ICE (ifosfamide, carboplatin, etoposide), or GDP (gemcitidine, dexa- methasone, cisplatin). These regimens are commonly combined with rituximab. Patients who respond with at least a partial regression after 2 to 3 cycles are typically considered eligible for high-dose therapy *Additional participating institutions include: Mayo Clinic Arizona, Phoenix, AZ (Donald W. Northfelt, MD); Mayo Clinic Florida, Jacksonville, FL (Alvaro Moreno-Aspitia, MD); Metro Minnesota Community Oncology Research Con- sortium, St. Louis Park, MN (Daniel M. Anderson, MD); Michigan Cancer Research Consortium NCORP, Ann Arbor, MI (Philip J. Stella, MD); Sanford Cancer Center Oncology Clinic, Sioux Falls, SD (Miroslaw A. Mazurczak, MD); Siouxland Regional Cancer Center, Sioux City, IA (Donald B. Wender, MD, PhD); Spartanburg Medical Center, Spartanburg, SC (James D. Bearden, III, MD) † This trial was registered at www.clinicaltrials.gov as #NCT00166439 1004 | V C 2017 Wiley Periodicals, Inc. wileyonlinelibrary.com/journal/ajh Am J Hematol. 2017;92:1004–1010. Received: 18 April 2017 | Revised: 7 June 2017 | Accepted: 12 June 2017 DOI: 10.1002/ajh.24824 AJH AJH