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R-CHOP-14 versus R-CHOP-14/CHASER for upfront autologous transplantation in diffuse large B-cell lymphoma: JCOG0908 study.


ABSTRACT: The efficiency of upfront consolidation with high-dose chemotherapy/autologous stem-cell transplantation (HDCT/ASCT) for newly diagnosed high-risk diffuse large B-cell lymphoma (DLBCL) may be influenced by induction chemotherapy. To select better induction chemotherapy regimens for HDCT/ASCT, a randomized phase II study was conducted in high-risk DLBCL patients having an age-adjusted International Prognostic Index (aaIPI) score of 2 or 3. As induction chemotherapy, 6 cycles of R-CHOP-14 (arm A) or 3 cycles of R-CHOP-14 followed by 3 cycles of CHASER (arm B) were planned, and patients who responded proceeded to HDCT with LEED and ASCT. The primary endpoint was 2-y progression-free survival (PFS), and the main secondary endpoints included overall survival, overall response rate, and adverse events (AEs). In total, 71 patients were enrolled. With a median follow-up of 40.3 mo, 2-y PFS in arms A and B were 68.6% (95% confidence interval [CI], 50.5%-81.2%) and 66.7% (95% CI: 48.8%-79.5%), respectively. Overall survival at 2 y in arms A and B was 74.3% (95% CI: 56.4%-85.7%) and 83.3% (95% CI: 66.6%-92.1%). Overall response rates were 82.9% in arm A and 69.4% in arm B. During induction chemotherapy, 45.7% and 75.0% of patients in arms A and B, respectively, had grade ? 3 non-hematologic toxicities. One patient in arm A and 6 in arm B discontinued induction chemotherapy due to AEs. In conclusion, R-CHOP-14 showed higher 2-y PFS and less toxicity compared with R-CHOP-14/CHASER in patients with high-risk DLBCL, suggesting the former to be a more promising induction regimen for further investigations (UMIN-CTR, UMIN000003823).

SUBMITTER: Kagami Y 

PROVIDER: S-EPMC7540987 | biostudies-literature | 2020 Aug

REPOSITORIES: biostudies-literature

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R-CHOP-14 versus R-CHOP-14/CHASER for upfront autologous transplantation in diffuse large B-cell lymphoma: JCOG0908 study.

Kagami Yoshitoyo Y   Yamamoto Kazuhito K   Shibata Taro T   Tobinai Kensei K   Imaizumi Yoshitaka Y   Uchida Toshiki T   Shimada Kazuyuki K   Minauchi Koichiro K   Fukuhara Noriko N   Kobayashi Hirofumi H   Yamauchi Nobuhiko N   Tsujimura Hideki H   Hangaishi Akira A   Tominaga Ryo R   Suehiro Youko Y   Yoshida Shinichiro S   Inoue Yoshiko Y   Suzuki Sachiko S   Tokuhira Michihide M   Kusumoto Shigeru S   Kuroda Junya J   Yakushijin Yoshihiro Y   Takamatsu Yasushi Y   Kubota Yasushi Y   Nosaka Kisato K   Morishima Satoko S   Nakamura Shigeo S   Ogura Michinori M   Maruyama Dai D   Hotta Tomomitsu T   Morishima Yasuo Y   Tsukasaki Kunihiro K   Nagai Hirokazu H  

Cancer science 20200911 10


The efficiency of upfront consolidation with high-dose chemotherapy/autologous stem-cell transplantation (HDCT/ASCT) for newly diagnosed high-risk diffuse large B-cell lymphoma (DLBCL) may be influenced by induction chemotherapy. To select better induction chemotherapy regimens for HDCT/ASCT, a randomized phase II study was conducted in high-risk DLBCL patients having an age-adjusted International Prognostic Index (aaIPI) score of 2 or 3. As induction chemotherapy, 6 cycles of R-CHOP-14 (arm A)  ...[more]

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