Real life clinical outcomes of relapsed/refractory diffuse large B cell lymphoma in the rituximab era: The STRIDER study.

Humans Lymphoma, Large B-Cell, Diffuse / drug therapy Male Female Rituximab / therapeutic use Middle Aged Aged Retrospective Studies Antineoplastic Combined Chemotherapy Protocols / therapeutic use Adult Aged, 80 and over Neoplasm Recurrence, Local / drug therapy Treatment Outcome Drug Resistance, Neoplasm Young Adult Prednisone / therapeutic use Salvage Therapy Italy Cyclophosphamide / therapeutic use Vincristine / therapeutic use Progression-Free Survival Doxorubicin / therapeutic use

chemotherapy diffuse large B cell lymphoma real world refractory disease relapse rituximab transplantation

Journal

Cancer medicine

ISSN: 2045-7634

Titre abrégé: Cancer Med

Pays: United States

ID NLM: 101595310

Informations de publication

Date de publication:
Jul 2024

Historique:

revised: 11 06 2024

received: 13 03 2024

accepted: 24 06 2024

medline: 20 7 2024

pubmed: 20 7 2024

entrez: 20 7 2024

Statut: ppublish

Résumé

Relapse and refractory (R/R) rates after first-line R-CHOP in diffuse large B cell lymphomas (DLBCL) are ~40% and ~15% respectively. We conducted a retrospective real-world analysis aimed at evaluating clinical outcomes of R/R DLBCL patients. Overall, 403 consecutive DLBCL patients treated in two large hematological centers in Torino, Italy were reviewed. At a median follow up of 50 months, 5-year overall survival from diagnosis (OS-1) was 66.5%, and 2-year progression free survival (PFS-1) was 68%. 134 (34.4%) patients relapsed (n = 46, 11.8%) or were refractory (n = 88, 22.6%) to R-CHOP. Most employed salvage treatments included platinum salt-based regimens in 38/134 (28.4%), lenalidomide in 14 (10.4%). Median OS and PFS after disease relapse or progression (OS-2 and PFS-2) were 6.7 and 5.1 months respectively. No significant difference in overall response rate, OS-2 or PFS-2 in patients treated with platinum-based regimens versus other regimens was observed. By multivariate analysis, age between 60 and 80 years, germinal center B cell type cell of origin and extranodal involvement of <2 sites were associated with better OS-2. Our findings confirm very poor outcomes of R/R DLBCL in the rituximab era. Widespread approval by national Medicine Agencies of novel treatments such as CAR-T cells and bispecific antibodies as second-line is eagerly awaited to improve these outcomes.

Sections du résumé

BACKGROUND BACKGROUND

Relapse and refractory (R/R) rates after first-line R-CHOP in diffuse large B cell lymphomas (DLBCL) are ~40% and ~15% respectively.

AIMS OBJECTIVE

We conducted a retrospective real-world analysis aimed at evaluating clinical outcomes of R/R DLBCL patients.

MATERIAL AND METHODS METHODS

Overall, 403 consecutive DLBCL patients treated in two large hematological centers in Torino, Italy were reviewed.

RESULTS RESULTS

At a median follow up of 50 months, 5-year overall survival from diagnosis (OS-1) was 66.5%, and 2-year progression free survival (PFS-1) was 68%. 134 (34.4%) patients relapsed (n = 46, 11.8%) or were refractory (n = 88, 22.6%) to R-CHOP. Most employed salvage treatments included platinum salt-based regimens in 38/134 (28.4%), lenalidomide in 14 (10.4%). Median OS and PFS after disease relapse or progression (OS-2 and PFS-2) were 6.7 and 5.1 months respectively. No significant difference in overall response rate, OS-2 or PFS-2 in patients treated with platinum-based regimens versus other regimens was observed. By multivariate analysis, age between 60 and 80 years, germinal center B cell type cell of origin and extranodal involvement of <2 sites were associated with better OS-2.

DISCUSSION CONCLUSIONS

Our findings confirm very poor outcomes of R/R DLBCL in the rituximab era. Widespread approval by national Medicine Agencies of novel treatments such as CAR-T cells and bispecific antibodies as second-line is eagerly awaited to improve these outcomes.

Identifiants

DOI: 10.1002/cam4.7448 PMID: 39030982

pubmed: 39030982

doi: 10.1002/cam4.7448

doi:

Substances chimiques

Rituximab 4F4X42SYQ6

Prednisone VB0R961HZT

R-CHOP protocol 0

Cyclophosphamide 8N3DW7272P

Vincristine 5J49Q6B70F

Doxorubicin 80168379AG

Types de publication

Journal Article Multicenter Study

Langues

eng

Sous-ensembles de citation

Pagination

e7448

Informations de copyright

Références

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