Comparative analysis of rituximab or obinutuzumab combined with CHOP in first-line treatment of follicular lymphoma.

Autor: Claustre G; Department of Pharmacy, CHU Reims, Rue Général Koenig, 51092, Reims Cedex, France. gwladys81@msn.com., Boulanger C; Department of Pharmacy, CHU Reims, Rue Général Koenig, 51092, Reims Cedex, France., Maloisel F; Department of Hematology, Strasbourg Oncologie Libérale, Sainte-Anne non-profit Clinic, Rue Philippe Thys, 67000, Strasbourg, France., Etienne-Selloum N; Department of Pharmacy, ICANS, 17 Rue Albert Calmette, 67200, Strasbourg, France.; Laboratory of Bioimaging and Pathology, UMR7021 CNRS, Faculty of Pharmacy, University of Strasbourg, 74 Route du Rhin, 67400, Illkirch, France., Fornecker LM; Department of Hematology, CHRU Strasbourg, 5 Avenue Molière, 67200, Strasbourg, France., Durot E; Department of Hematology, CHU Reims, Rue Général Koenig, 51092, Reims Cedex, France., Slimano F; Department of Pharmacy, CHU Reims, Rue Général Koenig, 51092, Reims Cedex, France.; EA7506 BioSpecT, Faculty of Pharmacy, Reims Champagne-Ardenne University, 51 Rue Cognacq-Jay, 51095, Reims Cedex, France., Graff V; Department of Pharmacy, Sainte-Anne non-profit Clinic, Rue Philippe Thys, 67000, Strasbourg, France.
Jazyk: angličtina
Zdroj: Journal of cancer research and clinical oncology [J Cancer Res Clin Oncol] 2023 May; Vol. 149 (5), pp. 1883-1893. Date of Electronic Publication: 2022 Jul 05.
DOI: 10.1007/s00432-022-04155-2
Abstrakt: Purpose: Rituximab (R) or obinutuzumab (G) combined with CHOP chemotherapy are used in previously untreated follicular lymphoma (FL). The aim is to compare in real life setting the efficacy and safety of these therapeutic strategies and assess the economic impact of introducing G.
Methods: This retrospective study, performed in 3 centers, included data from all patients who received R-CHOP or G-CHOP for previous untreated FL from June 1st, 2016 to December 31st, 2020. Progression-Free Survival (PFS) were estimated according to the Kaplan-Meier method. A budgetary impact model was performed from the French health care system's perspective.
Results: N = 124 patients were included (58 G-CHOP; 66 R-CHOP). Fifty-one and 57 patients achieved a complete response at the end of induction in the G-CHOP and R-CHOP group, respectively. PFS was not significantly longer in the G-CHOP group (HR 0.28; 95% CI 0.08-0.97; p value = 0.14). Hematological toxicity occurred more frequently with G-CHOP than R-CHOP during induction treatment (n = 58; 100% vs. n = 61; 92%), including higher severe neutropenia (grade ≥ 3) (n = 26; 45% vs. n = 23; 35%). Infusion-related reactions during the first infusion occurred more frequently with G-CHOP (n = 19; 33% vs. n = 16; 24%). The introduction of a completed G treatment (induction and maintenance) results in an additional cumulative cost per patient estimated at more than €30,000.
Conclusion: Similar results were found in the GALLIUM subgroup analysis study, suggesting that at this time there is no absolute benefit to administer G-CHOP instead of R-CHOP in all patients with previously untreated FL and may encourage clinical and economic trials including quality of life data.
(© 2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)
Databáze: MEDLINE
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