TY - JOUR
T1 - A non-randomized risk-adjusted comparison of lenalidomide + R-CHOP versus R-CHOP for MYC-rearranged DLBCL patients
AU - de Jonge, A. Vera
AU - van Werkhoven, Erik
AU - Dinmohamed, Avinash G.
AU - Nijland, Marcel
AU - Zwinderman, Aeilko H.
AU - Bossuyt, Patrick M.
AU - Veldhuis, Martine S.
AU - Rutten, Emma G. G. M.
AU - Mous, Rogier
AU - Vermaat, Joost S. P.
AU - Sandberg, Yorick
AU - de Jongh, Eva
AU - Bilgin, Yavuz M.
AU - Boersma, Rinske
AU - Koene, Harry
AU - Kersten, Marie José
AU - de Jong, Daphne
AU - Chamuleau, Martine E. D.
N1 - Funding Information: The authors thank all study investigators and coordinators of the participating site of the HOVON-130 and HOVON-900 studies, the data-managers of the Netherlands Cancer Registry who helped retrieve the data, in particular Henrike Bretveld, and the HOVON Data Center in Rotterdam. Celgene provided financial support of the HOVON-130 trial (004414). Dutch Cancer Society (KWF) provided financial support of the HOVON-900 (VUMC 2013-6269) and HOVON-130 (EMCR 2014-7436). Publisher Copyright: © 2023, The Author(s).
PY - 2023/12/1
Y1 - 2023/12/1
N2 - Patients with MYC rearranged (MYC-R) diffuse large B-cell lymphoma (DLBCL) have a poor prognosis. Previously, we demonstrated in a single-arm phase II trial (HOVON-130) that addition of lenalidomide to R-CHOP (R2CHOP) is well-tolerated and yields similar complete metabolic remission rates as more intensive chemotherapy regimens in literature. In parallel with this single-arm interventional trial, a prospective observational screening cohort (HOVON-900) was open in which we identified all newly diagnosed MYC-R DLBCL patients in the Netherlands. Eligible patients from the observational cohort that were not included in the interventional trial served as control group in the present risk-adjusted comparison. R2CHOP treated patients from the interventional trial (n = 77) were younger than patients in the R-CHOP control cohort (n = 56) (median age 63 versus 70 years, p = 0.018) and they were more likely to have a lower WHO performance score (p = 0.013). We adjusted for differences at baseline using 1:1 matching, multivariable analysis, and weighting using the propensity score to reduce treatment-selection bias. These analyses consistently showed improved outcome after R2CHOP with HRs of 0.53, 0.51, and 0.59, respectively, for OS, and 0.53, 0.59, and 0.60 for PFS. Thus, this non-randomized risk-adjusted comparison supports R2CHOP as an additional treatment option for MYC-R DLBCL patients. [Figure not available: see fulltext.]
AB - Patients with MYC rearranged (MYC-R) diffuse large B-cell lymphoma (DLBCL) have a poor prognosis. Previously, we demonstrated in a single-arm phase II trial (HOVON-130) that addition of lenalidomide to R-CHOP (R2CHOP) is well-tolerated and yields similar complete metabolic remission rates as more intensive chemotherapy regimens in literature. In parallel with this single-arm interventional trial, a prospective observational screening cohort (HOVON-900) was open in which we identified all newly diagnosed MYC-R DLBCL patients in the Netherlands. Eligible patients from the observational cohort that were not included in the interventional trial served as control group in the present risk-adjusted comparison. R2CHOP treated patients from the interventional trial (n = 77) were younger than patients in the R-CHOP control cohort (n = 56) (median age 63 versus 70 years, p = 0.018) and they were more likely to have a lower WHO performance score (p = 0.013). We adjusted for differences at baseline using 1:1 matching, multivariable analysis, and weighting using the propensity score to reduce treatment-selection bias. These analyses consistently showed improved outcome after R2CHOP with HRs of 0.53, 0.51, and 0.59, respectively, for OS, and 0.53, 0.59, and 0.60 for PFS. Thus, this non-randomized risk-adjusted comparison supports R2CHOP as an additional treatment option for MYC-R DLBCL patients. [Figure not available: see fulltext.]
UR - http://www.scopus.com/inward/record.url?scp=85159844803&partnerID=8YFLogxK
U2 - https://doi.org/10.1038/s41408-023-00854-2
DO - https://doi.org/10.1038/s41408-023-00854-2
M3 - Article
C2 - 37217463
SN - 2044-5385
VL - 13
JO - Blood Cancer Journal
JF - Blood Cancer Journal
IS - 1
M1 - 85
ER -