Comparison of R-CHOP-14 and R-mini-CHOP in older adults with diffuse large B-cell lymphoma-A retrospective multicenter cohort study.

in European journal of haematology by Zelal Guel Dilbaz, Sophy Denker, Carla Ankermann, Joerg-Thomas Bittenbring, Dominic Kaddu-Mulindwa, Ameya S Kunte, Sascha Hünecke, Viola Poeschel, Stephan Stilgenbauer, Lorenz Thurner, Il-Kang Na, Moritz Bewarder, Konstantinos Christofyllakis

TLDR

  • This study looked at patients with a type of cancer called diffuse large B-cell lymphoma (DLBCL) who were aged 60 or older. The study compared two different treatments for this type of cancer: R-CHOP-14 and R-miniCHOP. The study found that there was no significant difference in the overall survival or progression-free survival between the two treatments. The study suggests that R-miniCHOP should be preferred for most patients with untreated DLBCL aged 60 or older due to the lack of a difference in survival between the two treatments. However, more research is needed to confirm these findings and to identify factors that may influence the choice of treatment in this population.

Abstract

Diffuse large B-cell lymphoma (DLBCL) is the most common lymphoma entity, and its incidence increases with age. There is a paucity of data regarding use of biweekly R-CHOP (R-CHOP-14) in patients ≥80 years of age. We performed a retrospective cohort study of patients with DLBCL aged ≥80 years treated with R-CHOP-14 and R-miniCHOP in two academic tertiary centers in Germany between 01/01/2005 and 12/30/2019. Overall, 79 patients were included. Median age was 84 years (range 80-91). Despite higher CR rates with R-CHOP-14 (71.4% vs. 52.4%), no statistically significant difference could be found between patients treated with R-CHOP-14 and R-miniCHOP regarding overall survival (OS) (p = .88, HR 0.94, 95% CI = 0.47-1.90) and progression-free survival (PFS) (p = .26, HR 0.66, 95% CI = 0.32-1.36). At a median follow-up of 40 months, the 2-year OS rates were 56% with R-CHOP-14 and 53% with R-miniCHOP. Two-year PFS rates were 46% for R-CHOP-14 and 50% for R-mini-CHOP. Relative dose intensity of chemotherapy did not correlate with OS (p = .72). With the caveat of a retrospective cohort study, we conclude that lacking a difference in OS, R-miniCHOP should be preferred for most patients with untreated DLBCL aged ≥80 years.

Overview

  • The study aims to compare the outcomes of patients with diffuse large B-cell lymphoma (DLBCL) aged ≥80 years treated with R-CHOP-14 and R-miniCHOP in two academic tertiary centers in Germany between 01/01/2005 and 12/30/2019. The study's primary objective is to determine if there is a difference in overall survival (OS) and progression-free survival (PFS) between patients treated with R-CHOP-14 and R-miniCHOP in this population. The study uses a retrospective cohort design and includes 79 patients with a median age of 84 years.

Comparative Analysis & Findings

  • The study found no statistically significant difference in OS and PFS between patients treated with R-CHOP-14 and R-miniCHOP. The 2-year OS rates were 56% with R-CHOP-14 and 53% with R-miniCHOP, while the 2-year PFS rates were 46% for R-CHOP-14 and 50% for R-miniCHOP. The relative dose intensity of chemotherapy did not correlate with OS.

Implications and Future Directions

  • The study suggests that R-miniCHOP should be preferred for most patients with untreated DLBCL aged ≥80 years due to the lack of a difference in OS between R-CHOP-14 and R-miniCHOP. Future research should focus on identifying factors that may influence the choice of treatment in this population, such as age, comorbidities, and patient preferences. Additionally, prospective studies are needed to confirm the findings of this retrospective cohort study.
Read Full Article