FCR or FR? Which is better?

[Miee]

Hi, everyone and Chris,

In Canada, tbe treatment is FR is major, not FCR. Do you know why? Does cyclophosphamide have any toxic effects, although FCR is more effective than FR ?

Miee

[Cllcanada Top Poster CURE Hero]

Hi Miee

There is no standard of care for CLL in Canada... it varies by province..

I could have had FCR or FR, in British Columbia, Canada ....FR front line is the perferred choice because it is less myelotoxic. However, in Alberta, FCR is the choice first line. The Rituxan dose in the FCR is also lower in BC than Alberta... might be cost factor...

I think my decision based on discussions with a number of CLL experts was to save marrow to fight another day... so it was FR... followed immediatey by RCHOP, so I got buckets of cyclophosphamide anyhow...

The question is, would FCR have prevented ot delayed an RT? Unlikely.

FR Protocol

bccancer.bc.ca/NR/rdonlyres...

FCR

bccancer.bc.ca/NR/rdonlyres...

Note that the fludara and cyclophosphamide are ORAL in BC for most patients, but they can be IV as well...

Alberta CLL Protocols

albertahealthservices.ca/hp...

Manitoba Protocol

cancercare.mb.ca/resource/F...

[Miee in reply to Cllcanada]

Hi Chris,

Thank you so much for detailed and kind informations. I have understood well. Myelotoxity of cyclophosphamide, not increase of RT risk by cyclophosphamide.

Thank you!

Miee