Centrum Hämatologie/Onkologie Bethanien, Frankfurt, Germany.
MVZ Onkologie im Elisenhof, München, Germany.
Eur J Haematol. 2019 Nov;103(5):460-471. doi: 10.1111/ejh.13295. Epub 2019 Sep 4.
R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, prednisone) is the standard therapy for patients with previously untreated diffuse large B-cell lymphomas (DLBCL). Dose-dense two-weekly 'R-CHOP-14' was not superior over three-weekly 'R-CHOP-21' in randomised clinical trials (RCTs). We present real-world data on effectiveness of R-CHOP-14 and R-CHOP-21 in patients with DLBCL treated in German routine practice.
We identified 582 patients with DLBCL treated with R-CHOP-14 or R-CHOP-21 in 92 sites from the prospective clinical cohort study Tumour Registry Lymphatic Neoplasms. Patients' schedules were classified by (a) length of the initial first cycle and (b) length of cycles 1-4.
About 55% of patients received R-CHOP-21, 45% R-CHOP-14, in median 6 cycles. 51% and 55% of patients, respectively, were able to continue their initial R-CHOP-14 and R-CHOP-21 schedule. While most characteristics between the patient cohorts were similar, patients receiving R-CHOP-21 presented slightly more often with tumour stage I and lower IPI risk. 3-year overall survival of patients with R-CHOP-14 and R-CHOP-21 did not differ: 84% vs 84% (first cycle), 87% vs 89% (cycles 1-4).
Patients with DLBCL in Germany are slightly more likely to receive R-CHOP-21 than R-CHOP-14. Both schedules are similarly effective in routine practice confirming the results from RCTs.
利妥昔单抗(rituximab)、环磷酰胺、多柔比星、长春新碱、泼尼松的 R-CHOP 方案是未经治疗的弥漫性大 B 细胞淋巴瘤(DLBCL)患者的标准治疗方法。在随机临床试验(RCT)中,两周密集型“R-CHOP-14”方案并不优于三周密集型“R-CHOP-21”方案。我们提供了德国常规实践中治疗 DLBCL 患者的 R-CHOP-14 和 R-CHOP-21 的真实世界数据。
我们从前瞻性临床队列研究肿瘤登记处淋巴瘤中确定了 92 个地点的 582 例接受 R-CHOP-14 或 R-CHOP-21 治疗的 DLBCL 患者。根据(a)初始第一个周期的长度和(b)周期 1-4 的长度对患者的方案进行分类。
约 55%的患者接受了 R-CHOP-21 治疗,45%的患者接受了 R-CHOP-14 治疗,中位数为 6 个周期。分别有 51%和 55%的患者能够继续接受初始的 R-CHOP-14 和 R-CHOP-21 方案。尽管两个患者队列的大多数特征相似,但接受 R-CHOP-21 治疗的患者肿瘤分期 I 期和 IPI 风险较低的比例略高。接受 R-CHOP-14 和 R-CHOP-21 治疗的患者 3 年总生存率无差异:第一周期为 84%比 84%(R-CHOP-14 组)和 87%比 89%(R-CHOP-21 组);周期 1-4 为 87%比 89%(R-CHOP-14 组)和 88%比 90%(R-CHOP-21 组)。
德国的 DLBCL 患者接受 R-CHOP-21 治疗的可能性略高于 R-CHOP-14。两种方案在常规实践中均具有相似的疗效,证实了 RCT 的结果。