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Randomized Controlled Trial
. 2010 Sep 23;116(12):2040-5.
doi: 10.1182/blood-2010-03-276246. Epub 2010 Jun 14.

Long-term outcome of patients in the LNH-98.5 trial, the first randomized study comparing rituximab-CHOP to standard CHOP chemotherapy in DLBCL patients: a study by the Groupe d'Etudes des Lymphomes de l'Adulte

Bertrand Coiffier  1 , Catherine Thieblemont, Eric Van Den Neste, Gérard Lepeu, Isabelle Plantier, Sylvie Castaigne, Sophie Lefort, Gérald Marit, Margaret Macro, Catherine Sebban, Karim Belhadj, Dominique Bordessoule, Christophe Fermé, Hervé Tilly
Affiliations
Randomized Controlled Trial

Long-term outcome of patients in the LNH-98.5 trial, the first randomized study comparing rituximab-CHOP to standard CHOP chemotherapy in DLBCL patients: a study by the Groupe d'Etudes des Lymphomes de l'Adulte

Bertrand Coiffier et al. Blood. .

Abstract

We report the outcome of patients included in the LNH-98.5 study, which compared cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP) to rituximab plus CHOP (R-CHOP) therapy in 399 patients with diffuse large B-cell lymphoma (DLBCL) aged 60 to 80 years, with a median follow-up time of 10 years. Clinical event information was updated in all living patients (with the exception of 3 patients) in 2009. Survival end points were improved in patients treated with R-CHOP: the 10-year progression-free survival was 36.5%, compared with 20% with CHOP alone, and the 10-year overall survival was 43.5% compared with 27.6%. The same risk of death due to other diseases, secondary cancers, and late relapses was observed in both study arms. Relapses occurring after 5 years represented 7% of all disease progressions. The results from the 10-year analysis confirm the benefits and tolerability of the addition of rituximab to CHOP. Our findings underscore the need to treat elderly patients as young patients, with the use of curative chemotherapy.

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Figures

Figure 1
Figure 1
Progression-free survival in patients treated with CHOP and R-CHOP. Median progression-free survival (PFS) was 1.2 years (95% CI: .9-1.8) in the cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP) arm and 4.8 years (95% CI: 2.7-7.6) in the CHOP plus rituximab (R-CHOP) arm (P < .0001).
Figure 2
Figure 2
Overall survival in patients treated with CHOP and R-CHOP. Median overall survival (OS) was 3.5 years (95% CI: 2.2-5.5) in the CHOP arm and 8.4 years (95% CI: 5.4-not reached) in the R-CHOP arm (P < .0001).
Figure 3
Figure 3
Disease-free survival in patients treated with CHOP and R-CHOP. Median disease-free survival (DFS) was 3.4 years (95% CI: 1.6-not reached) in the CHOP arm and was not yet reached (95% CI: not reached-not reached) in the R-CHOP arm (P < .0001).
Figure 4
Figure 4
Survival after disease progression in patients initially treated with CHOP or R-CHOP. P not significant.
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Comment in

  • A decade of R-CHOP.
    Sehn LH. Sehn LH. Blood. 2010 Sep 23;116(12):2000-1. doi: 10.1182/blood-2010-07-293407. Blood. 2010. PMID: 20864584 No abstract available.

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