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. 2021 Mar 9;5(5):1483-1489.
doi: 10.1182/bloodadvances.2020002982.

Long-term outcomes of R-CEOP show curative potential in patients with DLBCL and a contraindication to anthracyclines

Alden A Moccia  1   2 , Kimberly Schaff  3 , Ciara Freeman  1 , Paul J Hoskins  1 , Richard J Klasa  1 , Kerry J Savage  1 , Tamara N Shenkier  1 , Randy D Gascoyne  4 , Joseph M Connors  1 , Laurie H Sehn  1
Affiliations

Long-term outcomes of R-CEOP show curative potential in patients with DLBCL and a contraindication to anthracyclines

Alden A Moccia et al. Blood Adv. .

Abstract

Doxorubicin plays an integral role in the treatment of patients with diffuse large B-cell lymphoma (DLBCL) but can be associated with significant toxicity. Treatment guidelines of British Columbia (BC) Cancer recommend the substitution of etoposide for doxorubicin in standard-dose R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone) (R-CEOP) for patients who have a contraindication to anthracyclines; however, it is unknown if this compromises treatment outcome. We identified all patients with newly diagnosed DLBCL who were treated in BC with curative intent with R-CEOP (n = 70) within the study period. Outcome in this population was compared with a 2:1 case-matched control group (n = 140) treated with R-CHOP and matched for age, clinical stage, and International Prognostic Index score. The 10-year time to progression and disease-specific survival were not significantly different for patients treated with R-CEOP compared with patients in the R-CHOP control group (53% vs 62% [P = .089] and 58% vs 67% [P = .251], respectively). The 10-year overall survival was lower in the R-CEOP group (30% vs 49%, P = .002), reflecting the impact of underlying comorbidities and frailty of this population. R-CEOP represents a useful treatment alternative for patients with DLBCL and an absolute contraindication to the use of anthracyclines, with curative potential.

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Conflict of interest statement

Conflict-of-interest disclosure: A.A.M. has served on the advisory board of Roche, Janssen, and Takeda. C.F. received research funding from Roche and Teva and honoraria from Seattle Genetics, Janssen, Amgen, Celgene, AbbVie, and Sanofi. T.N.S. has served on the advisory board of Eli Lilly, Roche, Novartis, and Purdue. L.H.S. discloses honoraria from Abbvie, Celgene, Janssen, and Lundbeck; honoraria from and consultancy for Acerta, Amgen, apobiologix, AstraZeneca, Gilead, Karyopharm, Kite, Merck, Morphosys, Takeda, Teva, and TG Therapeutics; and consultancy for and honoraria and research funding from Roche/Genetech. The remaining authors declare no competing financial interests.

Figures

None
Graphical abstract
Figure 1.
Figure 1.
TTP in patients treated with R-CEOP compared with a matched control group treated with R-CHOP.
Figure 2.
Figure 2.
TTP according to the clinical stage at presentation in patients treated with R-CEOP compared with a matched control group treated with R-CHOP. (A) Limited stage. (B) Advanced stage.
Figure 3.
Figure 3.
OS in patients treated with R-CEOP compared with a matched control group treated with R-CHOP.
Figure 4.
Figure 4.
DSS in patients treated with R-CEOP compared with a matched control group treated with R-CHOP.
See this image and copyright information in PMC

References

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