How effective is rituximab plus gemcitabine and oxaliplatin for patients with refractory/relapsed DLBCL?

This study aimed to evaluate the efficacy and safety of R-GemOx (rituximab, gemcitabine, and oxaliplatin) for the treatment of patients with relapsed or refractory (r/r) diffuse large B-cell lymphoma (DLBCL).

The authors concluded that R-GemOx is an effective treatment regimen in patients ineligible for intensive treatment.

DLBCL is a common type of non-Hodgkin’s lymphoma (NHL). It occurs mostly in older patients. Rituximab (Rituxan) combined with CHOP (cyclophosphamide, doxorubicin, vincristine, and prednisone) chemotherapy (R-CHOP) has greatly improved outcomes of patients with DLBCL. Despite this, there are still patients that do not respond to treatment (refractory) or relapse (cancer returns) sooner.

The current standard of care for patients with r/r DLBCL involves salvage (treatment given after the cancer has not responded to other treatments) immunochemotherapy followed by autologous stem cell transplantation (ASCT). ASCT involves transplanting healthy stem cells back to the patient.

However, a large proportion of r/r DLBCL patients are not eligible to receive this treatment because of many different factors. These include age or that they have already received an ASCT. The combination of rituximab with gemcitabine (Gemzar) and oxaliplatin (Eloxatin) (R-GemOx) is commonly used in these patients due to low toxicity. However, there is little knowledge on the effectiveness of R-GemOx combination for the treatment of patients with r/r DLBCL.

196 adult patients with r/r DLBCL were enrolled in this study. All patients were treated with an average of 5 cycles of R-GemOx. Patients were followed up for an average of 22 months.

After R-GemOx treatment, 38% of patients experienced an overall response and 33% experienced a complete response (CR; complete disappearance of all signs of cancer).

After 2 years, 18% of patients survived without cancer worsening. 32% of patients were alive after 2 years. In patients who achieved a CR, 50% were alive without cancer worsening after 2 years. 66% of patients who achieved a CR were alive after 2 years. The number of previous lines of treatment (one or more) did not significantly impact survival.

Medium to severe side effects were reported in 31% of patients and were mainly blood associated disorders. 35% of patients needed blood transfusions.

The authors concluded that R-GemOx was a safe and effective treatment for patients with r/r DLBCL that were not eligible for intensive treatment.

This study was based on medical records. Some information might have been incomplete. This may have affected the results.