Skip to main content

Researchers reported in the journal The Lancet Oncology that the addition of lenalidomide to the standard R-CHOP21 regimen elicited a high response rate in elderly patients with untreated diffuse large B-cell lymphoma. In addition, the combination therapy was deemed to be safe in this population.

Diffuse large B-cell lymphoma (DLBCL) is the most common form of non-Hodgkin lymphoma, which is a cancer that begins in the cells of the immune system. The most widely used treatment for DLBCL is R-CHOP, which is a mixture of rituximab and several chemotherapy drugs (cyclophosphamide, doxorubicin, vincristine, and prednisone).

In a European phase II trial (REAL07) Vitolo et al studied a population of 49 patients, age 60 – 80 (median age of 69), with untreated CD20-positive Ann Arbor stage II to IV diffuse large B-cell lymphoma or grade 3b follicular lymphoma. Patients had to have Eastern Cooperative Oncology Group (ECOG) performance status of 0 to 2 and International Prognostic Index (IPI) risk of low-intermediate, intermediate-high, or high and had to be fit according to comprehensive geriatric assessment. The primary endpoint of the study was overall response assessed by 18F-fluorodeoxyglucose positron-emission tomography (PET).

Researchers observed response in 45 patients (92%). Complete response was reported in 42 patients (86%). Three patients (6%) did not respond, and one (2%) died from causes unrelated to treatment or disease. After a 28-month follow up, the two-year survival rate was 92%. Progression-free survival was 80%, and event-free survival was 70%.

Scroll to Continue

Recommended Articles

274864752_633879297819598_1001345989349798990_n

Neulasta Treatment of Neutropenia Improves Treatment

Understand the role of Neulasta treatment of Neutropenia to prevent infection and improve chemotherapy treatment.

Ask The Experts About COVID-19 and Myeloproliferative Neoplasms (MF - PV - ET) Komrokji Verstovsek Promo

Ask The Experts About COVID-19 and Myeloproliferative Neoplasms (MF - PV - ET)

PV, ET and MF are effectively treated during the COVID-19 pandemic - ask the experts about how best to manage your MPN.

Sun Safety

Sun Safety During Cancer Treatment

Chemotherapy, radiation, and other cancer therapies may cause skin irritations, making you more vulnerable to UV damage.

The primary hematological side effects of the combination therapy included grade 3 and 4 neutropenia (decrease in neutrophil cells), leukopenia (decrease in white blood cells), thrombocytopenia (decrease in platelets), and anemia (decrease in red blood cells). Non blood-related side effects included neurologic events (4% of patients) and deep-vein thrombosis (4% of patients.) There were no deaths associated with drug toxicity.

The researchers concluded that lenalidomide added to standard R-CHOP21 therapy could be an effective and safe treatment for elderly, untreated diffuse large B-cell lymphoma patients. They recommended holding a phase III randomized trial comparing lenalidomide plus R-CHOP21 with R-CHOP21 alone.

Reference: Vitolo, Umberto et al**.** Lenalidomide plus R-CHOP21 in elderly patients with untreated diffuse large B-cell lymphoma: results of the REAL07 open-label, multicentre, phase 2 trial. The Lancet Oncology, [Volume 15, Issue 7](http://www.thelancet.com/journals/lanonc/issue/vol15no7/PIIS1470-2045(14%29X7165-2), pp 730 – 737, June 2014.

Copyright © 2018 CancerConnect. All Rights Reserved.