Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Comparative Study
. 2025 May;43(3):e70099.
doi: 10.1002/hon.70099.

Comparative Effectiveness of R-miniCOMP Versus R-miniCHOP in Older Non-Fit Patients With Diffuse Large B-Cell Lymphoma: Insights From a "Fondazione Italiana Linfomi" Cohort Study

Alberto Bavieri  1   2 , Sara Veronica Usai  3 , Michele Merli  4 , Alice Di Rocco  5 , Federica Cavallo  6 , Vittorio Ruggero Zilioli  7 , Manuela Zanni  8 , Flenghi Leonardo  9 , Dario Marino  10 , Annalisa Arcari  11 , Emanuele Cencini  12 , Guido Gini  13 , Barbara Botto  14 , Alessandra Tucci  15 , Clara Deambrogi  16 , Plenteda Caterina  17 , Bianchi Maria Paola  18 , Stefan Hohaus  19 , Manuel Gotti  20 , Benedetta Puccini  21 , Daniela Dessì  3 , Coscia Marta  4 , Luigi Petrucci  22 , Simone Ragaini  6 , Emanuela Chimienti  23 , Luigi Marcheselli  24 , Caterina Mammi  25 , Stefano Luminari  2   26 , Michele Spina  23 , Francesco Merli  2
Affiliations
Comparative Study

Comparative Effectiveness of R-miniCOMP Versus R-miniCHOP in Older Non-Fit Patients With Diffuse Large B-Cell Lymphoma: Insights From a "Fondazione Italiana Linfomi" Cohort Study

Alberto Bavieri et al. Hematol Oncol. 2025 May.

Abstract

The R-miniCHOP regimen is the standard first-line treatment for diffuse large B-cell lymphoma (DLBCL) in older unfit or frail patients. Recent research suggests that replacing doxorubicin with non-PEGylated liposomal doxorubicin (NPLD) is safe and effective for DLBCL. However, the outcomes of DLBCL patients receiving NPLD as part of a reduced-intensity regimen approach have yet to be investigated. This study aimed to assess non-fit DLBCL patients enrolled in the Elderly Project (EP) conducted by the Fondazione Italiana Linfomi (FIL) who were treated with R-miniCHOP or R-miniCOMP. The primary and secondary endpoints were overall survival (OS) and progression-free survival (PFS), respectively. Of the 1163 cases within the EP cohort, we identified 176 patients (18%) who resulted unfit or frail at simplified geriatric assessment (sGA) and received either R-miniCHOP (89 cases; 51%) or R-miniCOMP (87 cases; 49%). Both cohorts exhibited similar clinical characteristics, a similar distribution of unfit and frail cases using the sGA and similar Elderly Prognostic Index (EPI) scores. After a median follow-up of 28 months, the 3-year OS and PFS rates were 61% and 54% respectively, with no significant difference between R-miniCHOP and R-miniCOMP. Notably, the therapeutic regimen had no significant impact on OS (HR 1.07, 95% CI: 0.63-1.82, p = 0.798) or PFS (HR 1.00, 95% CI: 0.62-1.6, p = 0.999) even after adjusting for propensity score (PS) and inverse probability weighting (IPW). A comprehensive survival analysis within vulnerable geriatric categories (unfit and frail patients) confirmed non-significant variations in predictive efficacy between R-miniCHOP and R-miniCOMP. Of note the independent prognostic role of EPI is confirmed for both OS and PFS. This study suggests that R-miniCHOP is still the preferred treatment for unfit and frail older DLBCL. The role of R-miniCOMP for specific subgroups of older DLBCLs warrants confirmation in larger studies.

Keywords: diffuse large B‐cell lymphoma; elderly prognostic index; geriatric assessment; non‐PEGylated liposomal doxorubicin; prognosis.

PubMed Disclaimer

References

    1. L. H. Sehn and G. Salles, “Diffuse Large B‐Cell Lymphoma,” New England Journal of Medicine 384, no. 9 (March 2021): 842–858, https://doi.org/10.1056/nejmra2027612.
    1. L. M. Morton, S. S. Wang, S. S. Devesa, P. Hartge, D. D. Weisenburger, and M. S. Linet, “Lymphoma Incidence Patterns by WHO Subtype in the United States, 1992‐2001,” Blood 107, no. 1 (January 2006): 265–276, https://doi.org/10.1182/blood‐2005‐06‐2508.
    1. “National Cancer Institute Cancer Stat Facts,” accessed on 15 February 2021, https://seer.cancer.gov/statfacts/.
    1. N. Howlader, A. M. Noone, and M. Krapcho, SEER Cancer Statistics Review, 1975–2017 (National Cancer Institute, 2017).
    1. M. Di, S. F. Huntington, and A. J. Olszewski, “Challenges and Opportunities in the Management of Diffuse Large B‐Cell Lymphoma in Older Patients,” Oncologist 26, no. 2 (February 2021): 120–132, https://doi.org/10.1002/onco.13610.

MeSH terms

LinkOut - more resources