Effectiveness of R-CHOP versus R-CHOEP for treatment of young patients with high-risk diffuse large B-cell lymphoma: A Danish observational population-based study

• Published in: European journal of haematology Vol. 113; no. 5; pp. 641 - 650
• Main Authors: Rask Kragh Jørgensen, Rasmus, Jakobsen, Lasse Hjort, Eloranta, Sandra, Smedby, Karin E, Pedersen, Robert Schou, Jørgensen, Judit M, Clausen, Michael Roost, Brown, Peter, Gang, Anne Ortved, Gade, Inger-Lise, Larsen, Thomas Stauffer, Jerkeman, Mats, El-Galaly, Tarec Christoffer
• Format: Journal Article
• Language: English
• Published: England Wiley Subscription Services, Inc 01.11.2024
• Subjects: Adolescent; Adult; Antineoplastic Combined Chemotherapy Protocols - adverse effects; Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Clinical trials; Cyclophosphamide - therapeutic use; Denmark - epidemiology; Doxorubicin - therapeutic use; Etoposide; Etoposide - administration & dosage; Etoposide - therapeutic use; Female; Humans; Lymphoma; Lymphoma, Large B-Cell, Diffuse - diagnosis; Lymphoma, Large B-Cell, Diffuse - drug therapy; Lymphoma, Large B-Cell, Diffuse - mortality; Male; Medicin och hälsovetenskap; Middle Aged; Population studies; Population Surveillance; Prednisolone; Prednisone - therapeutic use; Registries; Rituximab - administration & dosage; Rituximab - therapeutic use; Treatment Outcome; Vincristine - therapeutic use; Young Adult; Denmark; DLBCL; optimizing treatment outcome; treatment of high‐risk patients; lymphoma; R‐CHOP vs R‐CHOEP; real world data; toxicity after treatment
• ISSN: 0902-4441; 1600-0609; 1600-0609
• DOI: 10.1111/ejh.14275

Etoposide to standard R-CHOP is used for high-risk diffuse large B-cell lymphoma (DLBCL) in some countries. Due to the lack of randomized trials, a real-world data study using matching methods was used to test the potential effectiveness of R-CHOEP over R-CHOP. This study included patients from the Danish Lymphoma Register diagnosed between 2006 and 2020 at the age of 18-60 years with de novo DLBCL and age-adjusted IPI ≥2. R-CHOEP treated patients were matched 1:1 without replacement to R-CHOP treated patients using a hybrid exact and genetic matching technique. Primary endpoints were progression-free survival (PFS) and overall survival (OS). In total, 396 patients were included; 213 received R-CHOEP and 183 received R-CHOP. Unadjusted 5-year PFS and OS for R-CHOEP were 69% (95% Confidence intervals [CI]; 63%-76%) and 79% (CI;73%-85%) versus 62% (CI;55%-70%) and 76% (CI;69%-82%) for R-CHOP (log-rank test, PFS p = .25 and OS p = .31). A total of 127 patients treated with R-CHOEP were matched to 127 patients treated with R-CHOP. Matching-adjusted 5-year PFS and OS were 65% (CI; 57%-74%) and 79% (CI; 72%-84%) for R-CHOEP versus 63% (CI; 55%-73%) and 79% (CI;72%-87%) for R-CHOP (log-rank test, PFS p = .90 and OS p = .63). The present study did not confirm superiority of R-CHOEP over R-CHOP for young patients with high-risk DLBCL.