Key result
R-CEOP linked to ~38% lower 4-year progression-free survival vs R-CHOP in DLBCL.
Why the study?
R-CEOP is commonly used for DLBCL patients with cardiovascular comorbidities as an alternative to R-CHOP, but evidence supporting its use is limited.
Does R-CEOP improve survival outcomes compared to R-CHOP in patients with newly-diagnosed DLBCL and cardiovascular comorbidities?
Cohort (n=552)
Yes
Does R-CEOP improve survival outcomes compared to R-CHOP in patients with newly-diagnosed DLBCL and cardiovascular comorbidities?
R-CEOP yields significantly inferior survival outcomes compared to R-CHOP in DLBCL patients, suggesting R-CHOP should remain the preferred regimen unless patients are strictly ineligible for anthracyclines.
R-CEOP was associated with inferior PFS in DLBCL; leaves open optimal regimens for anthracycline-ineligible patients with comorbidities.
Anthracycline-based chemoimmunotherapy with R-CHOP is the standard treatment for diffuse large B-cell lymphoma (DLBCL) but is associated with increased risks of cardiotoxicity. The alternative regimen R-CEOP substitutes etoposide for doxorubicin and is commonly administered to DLBCL patients with cardiovascular comorbidities, although there is limited evidence supporting its use. This multicenter real-world study included 138 consecutive patients with newly-diagnosed DLBCL treated with R-CEOP and 414 patients treated with R-CHOP matched 1:3 for age and International Prognostic Index. With median follow-up time 4.6 years, R-CEOP was associated with significantly inferior 4-year progression-free survival (32 vs. 52%, p < 0.0001), overall survival (39 vs. 59%, p < 0.0001), and disease-specific survival (48 vs. 69%, p < 0.0001) compared to R-CHOP. R-CHOP should remain the preferred regimen for most patients with DLBCL. While R-CEOP may be a reasonable choice for patients strictly ineligible for anthracyclines, the inferior outcomes of this regimen suggest that this high-risk population requires novel therapeutic approaches.
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Puckrin et al. (2021) conducted a cohort in Diffuse large B-cell lymphoma (n=552). R-CEOP vs. R-CHOP was evaluated on 4-year progression-free survival (p=< 0.0001). R-CEOP was associated with significantly inferior 4-year progression-free survival (32% vs. 52%, p < 0.0001) compared to R-CHOP in patients with newly-diagnosed diffuse large B-cell lymphoma.
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