Young patients with non-germinal center B-cell-like diffuse large B-cell lymphoma benefit from intensified chemotherapy with ACVBP plus rituximab compared with CHOP plus rituximab: analysis of data from the Groupe d'Etudes des Lymphomes de l'Adulte/lymphoma study association phase III trial LNH 03-2B
In: Journal of clinical oncology : official journal of the American Society of Clinical Oncology, Jg. 32 (2014-11-12), Heft 35
Online
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Zugriff:
Purpose To determine whether any tumor biomarkers could account for the survival advantage observed in the LNH 03-2B trial among patients with diffuse large B-cell lymphoma (DLBCL) and low-intermediate risk according to the International Prognostic Index when treated with dose-intensive rituximab, doxorubicin, cyclophosphamide, vindesine, bleomycin, and prednisone (R-ACVBP) compared with standard rituximab, doxorubicin, cyclophosphamide, vincristine, and prednisone (R-CHOP). Patients and Methods Using immunohistochemistry, expression of CD10, BCL6, MUM1, MYC, and BCL2 and coexpression of MYC/BCL2 were examined. The interaction effects between each biomarker and treatment arm on survival were studied in a restricted model and a full model incorporating clinical parameters. Results Among the 379 patients analyzed in the trial, 229 tumors were evaluable for germinal center B-cell–like (GCB)/non-GCB subclassification according to the Hans algorithm. Among all the biomarkers, only the interaction between the Hans algorithm and the treatment arm was significant for progression-free survival (PFS) and overall survival (OS) in univariable (PFS, P = .04; OS, P = .01) and multivariable (PFS, P = .03; OS, P = .01) analyses. Non-GCB tumors predicted worse PFS (hazard ratio [HR], 3.21; 95% CI, 1.29 to 8.00; P = .01) and OS (HR, 6.09; 95% CI, 1.37 to 27.03; P = .02) among patients treated with R-CHOP compared with patients who received R-ACVBP, whereas there were no significant survival differences between these regimens among patients with GCB tumors. Conclusion The survival benefit related to R-ACVBP over R-CHOP is at least partly linked to improved survival among patients with non-GCB DLBCL. Therefore, the Hans algorithm could be considered a theragnostic biomarker for selecting young patients with DLBCL who can benefit from an intensified R-ACVBP immunochemotherapy regimen.
Titel: |
Young patients with non-germinal center B-cell-like diffuse large B-cell lymphoma benefit from intensified chemotherapy with ACVBP plus rituximab compared with CHOP plus rituximab: analysis of data from the Groupe d'Etudes des Lymphomes de l'Adulte/lymphoma study association phase III trial LNH 03-2B
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Autor/in / Beteiligte Person: | Tilly, Hervé ; Casasnovas, Olivier ; Mounier, Nicolas ; Berger, Francoise ; Thieblemont, Catherine ; Haioun, Corinne ; Copin, Marie-Christine ; Leroy, Karen ; Jais, Jean-Philippe ; Canioni, Danielle ; Gaulard, Philippe ; Copie-Bergman, Christiane ; Coiffier, Bertrand ; Morschauser, Franck ; Petrella, Tony ; Recher, Christian ; Salles, Gilles ; Jardin, Fabrice ; Thierry Jo Molina ; Brière, Josette ; Fabiani, Bettina ; Fermé, Christophe |
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Zeitschrift: | Journal of clinical oncology : official journal of the American Society of Clinical Oncology, Jg. 32 (2014-11-12), Heft 35 |
Veröffentlichung: | 2014 |
Medientyp: | unknown |
ISSN: | 1527-7755 (print) |
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