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Lymphoma and Pets
Dose-intense regimen out-performs standard of care in DLBCL
According to results from a study conducted by the Groupe d'Etude des Lymphomes de I'Adulte (GELA), patients with diffuse large B-cell lymphoma (DLBCL) who are under 60 years of age see greater benefit from an intensive chemotherapy regimen as opposed to the current standard of care.
The study, reported in The Lancet, divided 379 patients into two arms:
-- Eight cycles of standard treatment (R-CHOP) at three week intervals.
-- Four cycles of dose-intensive chemotherapy (doxorubicin, cyclophosphamide, vindesine, bleomycin, and prednisone) (R-ACVBP) at two week intervals
After a follow-up of three years, investigators determined that the more intensive chemotherapy regimen (R-ACVBP) had longer survival times and were in remission longer, than patients receiving R-CHOP.
The drawback to the more intense regimen is as one would expect: more serious adverse side effects than in the R-CHOP arm, including higher rates of febrile neutropenia.
While this study will not, on its own, change the current standard of care for patients with DLBCL, further studies of dose-intense regimens might.
Récher C et al Intensified chemotherapy with ACVBP plus rituximab versus standard CHOP plus rituximab for the treatment of diffuse large B-cell lymphoma (LNH03-2B): an open-label randomised phase 3 trial. Lancet. doi:10.1016/S0140-6736(11)61040-4