In a nutshell
This study compared the safety and effectiveness of two first-line chemotherapy regimens for diffuse large B-cell lymphoma. This study concluded that the R-THP-COP regimen was as effective as conventional R-CHOP for diffuse large B-cell lymphoma.
Some background
R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, prednisone) is the current standard first-line treatment for diffuse large B-cell lymphoma (DLBCL). However, doxorubicin is associated with heart-related side effects, even at low doses.
Pirarubicin is a derivative of doxorubicin. This agent may be less toxic than doxorubicin. The safety and effectiveness of R-CHOP with pirarubicin instead of doxorubicin (R-THP-COP) as a first-line treatment for DLBCL remains under investigation.
Methods & findings
This study compared the safety and effectiveness of R-CHOP versus R-THP-COP as a first-line therapy for diffuse large B-cell lymphoma. This study involved 81 previously untreated patients. Patients received R-CHOP (49.4%) or R-THP-COP (50.6%). 64.2% of patients had stage 3 – 4 disease. The average follow-up time was 75.2 months.
Overall, 88% (R-CHOP) and 90% (R-THP-COP) of patients responded to treatment. 85% of patients in both groups achieved a complete response (disappearance of all signs of cancer).
Five-year overall survival (patients alive 5 years later) was 87% (R-CHOP) and 82% (R-THP-COP). Five-year progression-free survival (patients alive without a return of the disease) was 74% (R-CHOP) and 79% (R-THP-COP).
40.0% (R-CHOP) versus 56.1% (R-THP-COP) reported low red blood cell count. 87.5% (R-CHOP) versus 90.2% (R-THP-COP) reported low white blood cell count. 15.0% (R-CHOP) versus 22% (R-THP-COP) reported low platelet (cells involved in blood clotting) count. These were all severe or life-threatening.
17.5% (R-CHOP) versus 31.7% (R-THP-COP) reported low white blood cell count with fever. The R-CHOP group had significantly more infections (20.0%) than the R-THP-CHOP group (4.9%). These ranged from mild to life-threatening.
The bottom line
This study concluded that the R-THP-COP regimen was no worse than conventional R-CHOP for diffuse large B-cell lymphoma. The authors suggest that R-THP-COP may be an alternative treatment for patients who cannot tolerate doxorubicin.
The fine print
The number of patients in this study was quite small. Larger studies are needed to confirm these results.
Published By :
Hematological Oncology
Date :
Jun 08, 2018
