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Dose-Dense Rituximab-CHOP versus Standard Rituximab-CHOP in Newly Diagnosed Chinese Patients with Diffuse Large B-Cell Lymphoma: A Randomized, Multicenter, Open-Label Phase 3 Trial / Journal of the Korean Cancer Association, 대한암학회지
Cancer Research and Treatment ; : 919-932, 2019.
Article in English | WPRIM | ID: wpr-763187
ABSTRACT

PURPOSE:

Rituximab with cyclophosphamide, doxorubicin, vincristine, and prednisone administered every 3 weeks (R-CHOP-21) is the standard care for diffuse large B-cell lymphoma (DLBCL). It is unknown whether the dose-dense R-CHOP (R-CHOP-14) could improve the outcome of the disease in Asian population. MATERIALS AND

METHODS:

Newly diagnosed DLBCL patients were centrally, randomly assigned (11) to receive R-CHOP-14 or R-CHOP-21. R-CHOP-14 was administered every 2 weeks, and R-CHOP-21 was administered every 3 weeks. Primary end point was disease-free survival (DFS). Secondary end points included overall survival (OS), progression-free survival (PFS), response rate and toxicities.

RESULTS:

Seven hundred and two patients were randomly assigned to receive R-CHOP-14 (n=349) or R-CHOP-21 (n=353). With a median follow-up of 45.6 months, the two groups did not differ significantly in 3-year DFS (79.6% for R-CHOP-14 vs. 83.2% for R-CHOP-21, p=0.311), 3-year OS (77.5% for R-CHOP-14 vs. 77.6% for R-CHOP-21, p=0.903), or 3-year PFS (63.2% for R-CHOP-14 vs. 66.1% for R-CHOP-21, p=0.447). Patients with an International Prognostic Index (IPI) score ≥ 2 had a poorer prognosis compared to those with an IPI score < 2. Grade 3/4 hematologic and non-hematologic toxicities were manageable and similar between R-CHOP-14 and R-CHOP-21.

CONCLUSION:

R-CHOP-14 did not improve the outcome of DLBCL compared to R-CHOP-21 in Asian population. With manageable and similar toxicities, both of the two regimens were suitable for Asian DLBCL patients. For high-risk patients with IPI ≥ 2, new combination regimens based on R-CHOP deserve further investigation to improve efficacy.
Subject(s)

Full text: Available Index: WPRIM (Western Pacific) Main subject: Prognosis / Vincristine / Prednisone / B-Lymphocytes / Doxorubicin / Follow-Up Studies / Lymphoma, B-Cell / Disease-Free Survival / Cyclophosphamide / Asian People Type of study: Controlled clinical trial / Diagnostic study / Observational study / Prognostic study Limits: Humans Language: English Journal: Cancer Research and Treatment Year: 2019 Type: Article

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Full text: Available Index: WPRIM (Western Pacific) Main subject: Prognosis / Vincristine / Prednisone / B-Lymphocytes / Doxorubicin / Follow-Up Studies / Lymphoma, B-Cell / Disease-Free Survival / Cyclophosphamide / Asian People Type of study: Controlled clinical trial / Diagnostic study / Observational study / Prognostic study Limits: Humans Language: English Journal: Cancer Research and Treatment Year: 2019 Type: Article