ASH: Modified Regimen Slows Diffuse Large B-Cell Lymphoma

Risk for disease progression, relapse, or death lower with modified R-CHOP regimen in which vincristine is replaced with polatuzumab vedotin

iv intravenous drip
Adobe Stock

TUESDAY, Dec. 14, 2021 (HealthDay News) -- For patients with diffuse large B-cell lymphoma (DLBCL), a modification of the regimen of rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP), in which vincristine is replaced with polatuzumab vedotin (pola-R-CHP), results in a lower risk for disease progression, relapse, or death, according to a study published online Dec. 14 in the New England Journal of Medicine. The research was published to coincide with the annual meeting of the American Society of Hematology, held from Dec. 11 to 14 in Atlanta.

Hervé Tilly, M.D., from the University of Rouen in France, and colleagues conducted a double-blind international phase 3 trial to assess pola-R-CHP compared with standard R-CHOP. A total of 879 patients ages 18 to 80 years with previously untreated intermediate-risk or high-risk DLBCL were randomly assigned 1:1 to receive either pola-R-CHP or R-CHOP (440 and 439 patients, respectively), plus two cycles of rituximab alone.

The researchers found that after a median follow-up of 28.2 months, the percentage of patients surviving without progression was 76.7 and 70.2 percent at two years in the pola-R-CHP and R-CHOP groups, respectively (stratified hazard ratio for progression, relapse, or death, 0.73; 95 percent confidence interval, 0.57 to 0.95; P = 0.02). At two years, overall survival did not differ significantly between the groups (88.7 and 88.6 percent, respectively; hazard ratio for death, 0.94; 95 percent confidence interval, 0.65 to 1.37; P = 0.75). The groups had a similar safety profile.

"Among patients with DLBCL, first-line treatment with the pola-R-CHP combination evaluated in the current trial showed a progression-free survival benefit over the R-CHOP regimen at two years and had a similar safety profile," the authors write.

The study was funded by F. Hoffmann-La Roche/Genentech, the manufacturer of polatuzumab vedotin.

Abstract/Full Text (subscription or payment may be required)

More Information

Physician's Briefing