Comparative effectiveness of 6x R-CHOP21 versus 6x R-CHOP21 + 2 R for patients with advanced-stage diffuse large B-cell lymphoma.

Autor: Maas CCHM; Department of Public Health, Erasmus University Medical Centre, Rotterdam, The Netherlands. c.h.m.maas@erasmusmc.nl.; Department of Research and Development, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, The Netherlands. c.h.m.maas@erasmusmc.nl., van Klaveren D; Department of Public Health, Erasmus University Medical Centre, Rotterdam, The Netherlands., Durmaz M; Department of Research and Development, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, The Netherlands.; Amsterdam UMC, Department of Hematology, Cancer Center Amsterdam, Amsterdam, The Netherlands., Visser O; Department of Registration, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, The Netherlands., Issa DE; Department of Internal Medicine, Jeroen Bosch Hospital, Den Bosch, The Netherlands., Posthuma EFM; Department of Internal Medicine, Reinier de Graaf Gasthuis, Delft, The Netherlands.; Department of Hematology, Leiden University Medical Center, Leiden, The Netherlands., Zijlstra JM; Amsterdam UMC, Department of Hematology, Cancer Center Amsterdam, Amsterdam, The Netherlands., Chamuleau MED; Amsterdam UMC, Department of Hematology, Cancer Center Amsterdam, Amsterdam, The Netherlands., Lugtenburg PJ; Erasmus MC Cancer Institute, University Medical Center Rotterdam, Department of Hematology, Rotterdam, The Netherlands., Kersten MJ; Amsterdam UMC, Department of Hematology, Cancer Center Amsterdam, Amsterdam, The Netherlands.; LYMMCARE (Lymphoma and Myeloma Center Amsterdam), Amsterdam, The Netherlands., Dinmohamed AG; Department of Public Health, Erasmus University Medical Centre, Rotterdam, The Netherlands. a.dinmohamed@iknl.nl.; Department of Research and Development, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, The Netherlands. a.dinmohamed@iknl.nl.; Amsterdam UMC, Department of Hematology, Cancer Center Amsterdam, Amsterdam, The Netherlands. a.dinmohamed@iknl.nl.; LYMMCARE (Lymphoma and Myeloma Center Amsterdam), Amsterdam, The Netherlands. a.dinmohamed@iknl.nl.
Jazyk: angličtina
Zdroj: Blood cancer journal [Blood Cancer J] 2024 Sep 12; Vol. 14 (1), pp. 157. Date of Electronic Publication: 2024 Sep 12.
DOI: 10.1038/s41408-024-01137-0
Abstrakt: First-line treatment for advanced-stage diffuse large B-cell lymphoma (DLBCL) typically involves 6x R-CHOP21 or 6x R-CHOP21 with two additional rituximab administrations (6x R-CHOP21 + 2 R). In contemporary practice, this treatment choice might be guided by interim PET scan results. This nationwide, population-based study investigates the comparative effectiveness of these treatment regimens in an era where interim PET-guided treatment decisions were not standard practice. Utilizing the Netherlands Cancer Registry, we identified 1577 adult patients diagnosed with advanced-stage DLBCL between 2014-2018 who completed either 6x R-CHOP21 (43%) or 6x R-CHOP21 + 2 R (57%). We used propensity scores to assess differences in event-free survival (EFS) and overall survival (OS). At five years, EFS (hazard ratio of 6x R-CHOP21 + 2 R versus 6x R-CHOP21 [HR] = 0.89; 95% confidence interval [CI], 0.72-1.09) and OS (HR = 0.93; 95% CI, 0.73-1.18) were not significantly different between both regimens. In exploratory risk-stratified analysis according to the International Prognostic Index (IPI), high-IPI patients (i.e., scores of 4-5) benefit most from 6x R-CHOP21 + 2 R (5-year absolute risk difference of EFS = 16.8%; 95% CI, -0.4%-34.1% and OS = 12.1%; 95% CI, -5.4-29.6%). Collectively, this analysis reveals no significant differences on average in EFS and OS between the two treatments. However, the potential benefits for high-risk patients treated with 6x R-CHOP21 + 2 R underscore the need for future research.
(© 2024. The Author(s).)
Databáze: MEDLINE
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