Journal ArticleDOI
Attenuated immunochemotherapy regimen (R-miniCHOP) in elderly patients older than 80 years with diffuse large B-cell lymphoma: a multicentre, single-arm, phase 2 trial.
Frederic Peyrade,Fabrice Jardin,Catherine Thieblemont,Antoine Thyss,Jean-François Emile,Sylvie Castaigne,Bertrand Coiffier,Corinne Haioun,Serge Bologna,Olivier Fitoussi,Gérard Lepeu,Christophe Fruchart,Dominique Bordessoule,Michel Blanc,Richard Delarue,Maud Janvier,Bruno Salles,Marc André,Marion Fournier,Philippe Gaulard,Hervé Tilly +20 more
Reads0
Chats0
TLDR
In this article, the authors investigated the efficacy and safety of a decreased dose of CHOP (doxorubicin, cyclophosphamide, vincristine, and prednisone) chemotherapy with a conventional dose of rituximab in elderly patients with diffuse large B-cell lymphoma.Abstract:
Summary Background Diffuse large B-cell lymphoma is a common cancer in elderly patients. Although treatment has been standardised in younger patients, no prospective study has been done in patients over 80 years old. We aimed to investigate the efficacy and safety of a decreased dose of CHOP (doxorubicin, cyclophosphamide, vincristine, and prednisone) chemotherapy with a conventional dose of rituximab in elderly patients with diffuse large B-cell lymphoma. Methods We did a prospective, multicentre, single-arm, phase 2 study of patients aged over 80 years who had diffuse large B-cell lymphoma. Patients were included from 38 centres in France and Belgium. All patients received six cycles of rituximab combined with low-dose CHOP (R-miniCHOP) at 3-week intervals. Patients received 375 mg/m 2 rituximab, 400 mg/m 2 cyclophosphamide, 25 mg/m 2 doxorubicin, and 1 mg vincristine on day 1 of each cycle, and 40 mg/m 2 prednisone on days 1–5. The primary endpoint was overall survival, both unadjusted and adjusted for treatment and baseline prognostic factors. Analysis was by intention to treat. This study is registered with ClinicalTrials.gov, NCT01087424. Findings 150 patients were enrolled between Jan 9, 2006, and Jan 23, 2009 and 149 were included in the intention-to-treat analyses. Median age was 83 years (range 80–95). After a median follow-up of 20 months (range 0–45), the median overall survival was 29 months (95% CI 21 to upper limit not reached); 2-year overall survival was 59% (49–67%). In multivariate analyses, overall survival was only affected by a serum albumin concentration of 35 g/L or less (hazard ratio 3·2, 95% CI 1·4–7·1; p=0·0053). Median progression-free survival was 21 months (95% CI 13 to upper limit not reached), with a 2-year progression free survival of 47% (38–56). 58 deaths were reported, 33 of which were secondary to lymphoma progression. 12 deaths were attributed to toxicity of the treatment. The most frequent side-effect was haematological toxicity (grade ≥3 neutropenia in 59 patients; febrile neutropenia in 11 patients). Interpretation R-miniCHOP offers a good compromise between efficacy and safety in patients aged over 80 years old. R-miniCHOP should be considered as the new standard treatment in this subgroup of patients. Funding Groupe d'Etude des Lymphomes de l'Adulte (GELA).read more
Citations
More filters
Journal ArticleDOI
Diffuse large B-cell lymphoma (DLBCL): ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up
Hervé Tilly,M. Gomes da Silva,Umberto Vitolo,Andrew Jack,Michel Meignan,Armando López-Guillermo,Jan Walewski,Marc André,Peter Johnson,Michael Pfreundschuh,Marco Ladetto +10 more
TL;DR: This work presents the results of a double-blind, placebo-controlled study conducted at the University of Southampton over a two-week period in June and July of last year that demonstrated clear trends in prognosis for breast cancer in smokers and women with a history of smoking.
Journal ArticleDOI
Event-Free Survival at 24 Months Is a Robust End Point for Disease-Related Outcome in Diffuse Large B-Cell Lymphoma Treated With Immunochemotherapy
Matthew J. Maurer,Hervé Ghesquières,Hervé Ghesquières,Jean-Philippe Jais,Thomas E. Witzig,Corinne Haioun,Carrie A. Thompson,Richard Delarue,Ivana N. Micallef,Frederic Peyrade,William R. Macon,Thierry Jo Molina,Nicolas Ketterer,Sergei Syrbu,Olivier Fitoussi,Paul J. Kurtin,Cristine Allmer,Emmanuelle Nicolas-Virelizier,Susan L. Slager,Thomas M. Habermann,Brian K. Link,Gilles Salles,Hervé Tilly,James R. Cerhan +23 more
TL;DR: Patients withDLBCL who achieve EFS24 have a subsequent overall survival equivalent to that of the age- and sex-matched general population, and should be considered as an end point for future studies of newly diagnosed DLBCL.
Journal ArticleDOI
Trial watch: Chemotherapy with immunogenic cell death inducers.
Erika Vacchelli,Laura Senovilla,Alexander M.M. Eggermont,Wolf Hervé Fridman,Jérôme Galon,Laurence Zitvogel,Guido Kroemer,Lorenzo Galluzzi +7 more
TL;DR: The latest advances on the use of cyclophosphamide, doxorubicin, epirubic in, oxaliplatin, and mitoxantrone in cancer patients are summarized, discussing high-impact studies that have been published during the last 13 months as well as clinical trials that have be initiated in the same period to assess the antineoplastic profile of these immunogenic drugs as off-label therapeutic interventions.
Journal ArticleDOI
End Points and Trial Design in Geriatric Oncology Research: A Joint European Organisation for Research and Treatment of Cancer–Alliance for Clinical Trials in Oncology–International Society of Geriatric Oncology Position Article
Hans Wildiers,Murielle Mauer,Athanasios G. Pallis,Arti Hurria,Supriya G. Mohile,Andrea Luciani,Giuseppe Curigliano,Martine Extermann,Stuart M. Lichtman,Karla V. Ballman,Harvey J. Cohen,Hyman B. Muss,Ulrich Wedding +12 more
TL;DR: Specific clinical end points in oncology and their advantages and disadvantages for older individuals are discussed.
Journal ArticleDOI
Diffuse Large B-Cell Lymphoma.
Laurie H. Sehn,Gilles Salles +1 more
TL;DR: Diffuse Large B-Cell Lymphoma DLBCL, an aggressive cancer, accounts for about 30% of all lymphomas and empirical combination chemotherapy cures about 65% of patients initially, with another 20 to 25%...
References
More filters
Journal ArticleDOI
Assessment of Older People: Self-Maintaining and Instrumental Activities of Daily Living
M. P. Lawton,Elmne M. Brody +1 more
TL;DR: Two scales first standardized on their own population are presented, one of which taps a level of functioning heretofore inadequately represented in attempts to assess everyday functional competence, and the other taps a schema of competence into which these behaviors fit.
Journal ArticleDOI
Toxicity and response criteria of the Eastern Cooperative Oncology Group
Martin M. Oken,Richard H. Creech,Douglass C. Tormey,John Horton,Thomas E. Davis,Eleanor T. McFadden,Paul P. Carbone +6 more
TL;DR: The Eastern Cooperative Oncology Group criteria for toxicity and response are presented to facilitate future reference and to encourage further standardization among those conducting clinical trials.
Journal ArticleDOI
CHOP Chemotherapy plus Rituximab Compared with CHOP Alone in Elderly Patients with Diffuse Large-B-Cell Lymphoma
Bertrand Coiffier,Eric Lepage,Josette Brière,Raoul Herbrecht,Hervé Tilly,Reda Bouabdallah,Pierre Morel,Eric Van Den Neste,Gilles Salles,Philippe Gaulard,Felix Reyes,Pierre Lederlin,Christian Gisselbrecht +12 more
TL;DR: A randomized trial to compare CHOP chemotherapy plus rituximab with CHOP alone in elderly patients with diffuse large-B-cell lymphoma found the rate of complete response was significantly higher in the group that received CHOP plus r ituximabs than in thegroup that receivedCHOP alone.
Journal ArticleDOI
E.S. Jaffe, N.L. Harris, H. Stein, J.W. Vardiman (eds). World Health Organization Classification of Tumours: Pathology and Genetics of Tumours of Haematopoietic and Lymphoid Tissues
Journal Article
A predictive model for aggressive non-Hodgkin's lymphoma
Margaret A. Shipp,D. P. Harrington,James R. Anderson,James Olen Armitage,Gianni Bonadonna,G. Brittinger,Fernando Cabanillas,George P. Canellos,Bertrand Coiffier,Joseph M. Connors,R. A. Cowan,D. Crowther,Steve Dahlberg,M. Engelhard,Richard I. Fisher,Christian Gisselbrecht,Sandra J. Horning,Eric Lepage,T. A. Lister,J. H. Meerwaldt,Emili Montserrat,Nis I. Nissen,M. M. Oken,Bruce A. Peterson,Carlo Tondini,W. A. Velasquez,B. Y. Yeap +26 more
TL;DR: The international index and the age-adjusted international index should be used in the design of future therapeutic trials in patients with aggressive non-Hodgkin's lymphoma and in the selection of appropriate therapeutic approaches for individual patients.
Related Papers (5)
A predictive model for aggressive non-Hodgkin's lymphoma
Margaret A. Shipp,D. P. Harrington,James R. Anderson,James Olen Armitage,Gianni Bonadonna,G. Brittinger,Fernando Cabanillas,George P. Canellos,Bertrand Coiffier,Joseph M. Connors,R. A. Cowan,D. Crowther,Steve Dahlberg,M. Engelhard,Richard I. Fisher,Christian Gisselbrecht,Sandra J. Horning,Eric Lepage,T. A. Lister,J. H. Meerwaldt,Emili Montserrat,Nis I. Nissen,M. M. Oken,Bruce A. Peterson,Carlo Tondini,W. A. Velasquez,B. Y. Yeap +26 more
Revised response criteria for malignant lymphoma
Bruce D. Cheson,Beate Pfistner,Malik E. Juweid,Randy D. Gascoyne,Lena Specht,Sandra J. Horning,Bertrand Coiffier,Richard I. Fisher,Anton Hagenbeek,Emanuele Zucca,Steven T. Rosen,Sigrid Stroobants,T. Andrew Lister,Richard T. Hoppe,Martin Dreyling,Kensei Tobinai,Julie M. Vose,Joseph M. Connors,Massimo Federico,Volker Diehl +19 more