Figure 3.

A 67-year-old man with stage IVA diffuse large B-cell lymphoma. He was treated with rituximab, cyclophosphamide, vincristine and prednisone × 6 with an initial complete response, only to relapse 7 months later. He responded to salvage chemotherapy and received an autologous stem cell transplantation with a 6-month TTP. After failing single-agent rituximab, he joined this study. He responded to tipifarnib 300 mg twice daily. Because of myelosuppression, the dose was reduced to 100 mg twice daily. He maintained remission for 25 months before progressing on therapy. Tumor biopsies before and after tipifarnib demonstrated low bcl-2 protein tumor content at baseline with a marked increase in Bim isoforms and decrease in p-ERK after tipifarnib (patient 6; Figure 2C).