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Progression-Free Survival Not Tied to R-CHOP Dose Density

No significant difference for patients with indolent B-cell lymphoma treated with R-CHOP-14 or -21

TUESDAY, Sept. 20 (HealthDay News) -- There is no significant difference in progression-free survival (PFS) for patients with indolent B-cell lymphoma treated with rituximab with cyclophosphamide, doxorubicin, vincristine, and prednisolone (R-CHOP) along with granulocyte colony-stimulating factor (G-CSF) every three weeks (R-CHOP-21) or every two weeks (R-CHOP-14), according to a study published online Sept. 19 in the Journal of Clinical Oncology.

Takashi Watanabe, M.D., Ph.D., from the National Cancer Center Hospital in Tokyo, and colleagues investigated whether dose-dense immunochemotherapy with R-CHOP improves PFS in 299 patients with stage III to IV indolent B-cell lymphoma. Participants were randomly assigned to six cycles of R-CHOP-21 or R-CHOP-14 with G-CSF, but no rituximab maintenance. The median follow-up time was 5.2 years.

The investigators found that the two treatment groups had no significant differences in PFS. The median PFS time was 3.7 years for R-CHOP-21 and 4.7 years for R-CHOP-14. For R-CHOP-21, PFS at three and six years was 57 and 41 percent, respectively, compared with 58 and 43 percent, respectively, for R-CHOP-14 (hazard ratio [HR], 0.92; 95 percent confidence interval [CI], 0.68 to 1.25). Neither treatment group achieved the median overall survival (OS) time, with no significant difference in the OS with R-CHOP-21 versus R-CHOP-14 (six-year OS, 87 versus 88 percent, respectively; HR, 1.15; 95 percent CI, 0.57 to 2.30). R-CHOP was feasible in both groups although grade 4 neutropenia and grade 3 infections were more frequent in the R-CHOP-21 group.

"The R-CHOP dose-dense strategy failed to improve PFS of patients with untreated indolent B-cell lymphoma," the authors write.

Several of the study authors disclosed financial ties to Chugai Pharmaceuticals.

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