R-CHOP with or without bevacizumab in patients with previously untreated diffuse large B-cell lymphoma: final MAIN study outcomes
Why the study?
Does adding bevacizumab to R-CHOP improve progression-free survival in patients with previously untreated diffuse large B-cell lymphoma?
Population
787 patients with previously untreated CD20-positive diffuse large B-cell lymphoma
Comparison
Bevacizumab added to R-CHOP administered every… vs Placebo added to R-CHOP
Design
RCT, Randomized, Placebo-controlled
Follow-up
Median 23.7 months for R-CHOP and 23.6 months for RA-CHOP
Authors
Discussion
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Member takes
Implication
Adding bevacizumab to R-CHOP yields no PFS benefit and increases cardiotoxicity; confirms no role in frontline DLBCL.
Structured PICO
Does adding bevacizumab to R-CHOP improve progression-free survival in patients with previously untreated diffuse large B-cell lymphoma?
P
Population
787 patients with previously untreated CD20-positive diffuse large B-cell lymphoma
I
Intervention
Bevacizumab added to R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone) administered every 21 (8 cycles) or 14 days (6 cycles plus 2 rituximab cycles)
C
Comparator
Placebo added to R-CHOP
O
Outcome
Progression-free survivalhard clinical
Adding bevacizumab to R-CHOP in patients with diffuse large B-cell lymphoma does not improve progression-free survival but significantly increases the risk of cardiotoxicity, including heart failure.
Limitations
- Trial stopped early due to increased cardiotoxicity without efficacy benefit
Cite This Study
Seymour et al. (2014) studied this question.