Prospective and retrospective studies evaluating R-CHOP(like) and DA-EPOCHR chemotherapy in PMBCL
| PMBCL studies R-chemotherapy . | Study size, n; Median age, y (range) . | Study type . | PFS/EFS, % (y) . | OS, % (y) . | % RT . | Treatment comparison/study comment . |
|---|---|---|---|---|---|---|
| Prospective | ||||||
| R-CHOP14/ICE±R (MSKCC 01-142) Moskowitz et al (abstract), 201093 | 54 34 (19-59) | Prospective + per protocol | 78 (3) | 88 (3) | 0 | First 28 patients treated during the study and 26 treated per protocol.* Planned switch to ICE. |
| R-CHOP/R-CHOEP (MINT study group), Rieger et al, 201149 † | 44 36 (27-43) | Prospective subgroup | 78 (3) | 89 (3) | 73 | R-CHO(E)P vs CHO(E)P EFS P = .012 OS P = .158 0 or 1 aaIPI factor* |
| DA-EPOCHR (NCI) DA-EPOCHR (Stanford) Dunleavy et al, 201354 | 51 30 (23-51) 16 33 (23-68) | Prospective Retrospective | 93 (5) 100 | 97 (5) 100 | 4 0 | Subset with PMBCL within phase 2 study of aggressive BCLs.* Series of PMBCL treated with DA-EPOCHR at Stanford 2007-12 reported with phase 2 study. |
| R-MACOPB/R-VACOPB (84%) or R-CHOP IELSG-26 Martelli et al, 201468 | 125 33 (range, NR) | Prospective observational | 86 (5) | 92 (5) | 92 | Purpose was to evaluate CR by Deauville criteria.* |
| R-CHOP14/21 (NCI) Gleeson et al, 201694 ‡ | 50 38.5 (22-78) | Prospective subgroup | 80 (5) | 84 (5) | 58 | R-CHOP21 vs R-CHOP14 PFS P = .10; OS P = .06 Unadjusted analysis* |
| DA-EPOCH-R (pediatric) Burke et al, 202195 | 47 15 (range NR) | Prospective | 69 (2) | 82 (2) | 0 | No patients received consolidative RT.* |
| R-CHOP21/14 (UNFOLDER trial) Held et al (abstract), 202096 § | 131 34 (range NR) | Prospective subgroup | 93 (3) | 97 (3) | 62.5 | R-CHOP21 vs R-CHOP14 (no difference) Pooled 3-y event rates;* RT did not impact PFS (P = .25). |
| Retrospective | ||||||
| R-V/MACOPB Zinzani et al, 200951 | 45 38 (17-66) | Retrospective | 84 (5) | 80 (5) | 71 | No difference in R-V/MACOPB vs historical estimates without R.* |
| R-CHOP Ahn et al, 201097 | 21 30 (17-79) | Retrospective | 79 (2) | 83 (2) | 62 | R-CHOP vs CHOP PFS P = .043 OS P = .08 |
| R-CHOP Vassilakopoulos et al, 201248 | 76 31.5 (17-73) | Retrospective | 81 (5) | 89 (5) | 76 | R-CHOP vs CHOP FFP P < .0001 OS P = .003 Early treatment failure (<6 m), 9%* |
| R-CHOP Xu et al, 201350 | 39 29 (13-54) | Retrospective | 77 (5) | 84 (5) | 76 | R-CHOP vs CHOP PFS P = .012 OS P = .011 |
| R-CHOP Aoki et al, 201415 ǁ | 187 31.5 (17-77) | Retrospective | 71 (4) | 90 (4) | 34 | R-chemo all vs CHOP PFS P = .001 OS P = .001 DA-EPOCHR; 2nd/3rd generation HDC/SCT (vs R-CHOP no difference) Treatment selection criteria unknown.* |
| R-CHOP Soumerai et al, 201498 | 63 37 (20-82) | Retrospective | 68 (5) | 79 (5) | 77 | PD during R-CHOP 18%* Male predominance (60%)* |
| R-VACOPB Avigdor et al, 201452 | 40 33 (range NR) | Retrospective | 83 (5) | NR | 0 | R-VACOPB vs VACOPB PFS P = .06 OS P = .2 R-VACOPB vs R-CHOP P = .3 |
| R-MACOPB Zinzani et al, 201566 | 74 34 (18-63) | Retrospective | 88 (10) | 82 (10) | 69 | RT vs no RT P = .85 RT only in PET-positive (IHP).* |
| R-CHOP DA-EPOCHR Pinnix et al, 201599 ¶ | 50 35 (19-70) 25 | Retrospective | ∼90 (estimate) 83 | NR NR | 90 20 | R-CHOP vs DA-EPOCHR (and R-HCVAD) PFS P = .35 Treatment selection criteria unknown.* |
| R-CHOP-RICE Goldschmidt et al, 2016100 | 24 34 (18-60) | Retrospective | 87 (5) | 100 (5) | 12 | R-CHOP-RICE vs other protocols, R CHOP/R-M/ VACOPB/DA-EPOCHR PFS P = .35 OS P = .31 78% other protocols received RT.* |
| R-CHOP/R-CHOEP Lisenko et al, 201747 | 45 38 (19-64) | Retrospective | 95 | 92 | 91 | R-CHO(E)P vs CHOP PFS P = .001 OS P = .023 |
| DA-EPOCH-R (Adult) DA-EPOCHR (Pediatric) Giulino-Roth et al, 201714 | 118 34 (21-70) 38 16 (9-20) | Retrospective | 87 (3) 81 (3) | 97 (3) 91 (3) | 16 11 | Adult vs pediatric; EFS P = .34 |
| R-CHOP DA-EPOCHR Shah et al, 201858 | 56 37 (20-77) 76 34 (18-69) | Retrospective | 76 (2) 85 (2) | 89 (2) 91 (2) | 59 13 | R-CHOP vs DA-EPOCHR PFS P = .28 OS P = .83 Treatment selection criteria unknown.* |
| R-CHOP Malenda et al, 202059 | 25 37 (18-80) | Retrospective | 87 (1) | 100 (1) | 25 | R-CHOP vs DA-EPOCHR PFS P = .20 OS P = .66 Treatment selection criteria unknown.* |
| R-CHOP R-CHOP + RT Messmer et al, 2019101 | 16 36 (23-52) 10 40.5 (19-60) | Retrospective | 93 (3) 100 (3) | 100 (3) 100 (3) | 0 100 | RT vs no RT P = .85 RT criteria unknown.* |
| R-CHOP R-CHOP + RT DA-EPOCHR Chan et al, 2019102 | 41 28 (11-72) 37 26 (14-48) 46 27 (16-51) | Retrospective | 56.5(5) 88 (5) 90 (5) | 76 (5) 94 (5) 94 (5) | 0 100 6 | R-CHOP vs DA-EPOCHR PFS P = .012 OS P = .01 RT vs no RT with R-CHOP PFS P = .04 Treatment selection criteria unknown.* |
| R-CHOP Zhou et al, 202057 # | 89 33 (11-64) | Retrospective | ∼60 (5) estimate | ∼70 (5) estimate | 84 (5) | R-CHOP vs DA-EPOCHR/R-HCVAD PFS P = .048 OS P = .0067 Treatement selection criteria unknown.* |
| R-CHOP Hayden et al, 202013 | 159 36 (19-84) | Retrospective | 80 (5) | 89 (5) | 28 | PET-guided use of consolidative RT (no difference in outcome vs routine RT).* |
| R-CHOP14/21 R-CHOEP14 Wästerlid et al, 2021103 ** | 17 49 (18-83) 90 35 (18-74) | Registry | NR | 74 (5) RS 95 (5) RS | 14 18 | R-CHOEP14/R-HyperCVAD/DA-EPOCHR Treatment selection criteria unknown (not formally compared)* |
| PMBCL studies R-chemotherapy . | Study size, n; Median age, y (range) . | Study type . | PFS/EFS, % (y) . | OS, % (y) . | % RT . | Treatment comparison/study comment . |
|---|---|---|---|---|---|---|
| Prospective | ||||||
| R-CHOP14/ICE±R (MSKCC 01-142) Moskowitz et al (abstract), 201093 | 54 34 (19-59) | Prospective + per protocol | 78 (3) | 88 (3) | 0 | First 28 patients treated during the study and 26 treated per protocol.* Planned switch to ICE. |
| R-CHOP/R-CHOEP (MINT study group), Rieger et al, 201149 † | 44 36 (27-43) | Prospective subgroup | 78 (3) | 89 (3) | 73 | R-CHO(E)P vs CHO(E)P EFS P = .012 OS P = .158 0 or 1 aaIPI factor* |
| DA-EPOCHR (NCI) DA-EPOCHR (Stanford) Dunleavy et al, 201354 | 51 30 (23-51) 16 33 (23-68) | Prospective Retrospective | 93 (5) 100 | 97 (5) 100 | 4 0 | Subset with PMBCL within phase 2 study of aggressive BCLs.* Series of PMBCL treated with DA-EPOCHR at Stanford 2007-12 reported with phase 2 study. |
| R-MACOPB/R-VACOPB (84%) or R-CHOP IELSG-26 Martelli et al, 201468 | 125 33 (range, NR) | Prospective observational | 86 (5) | 92 (5) | 92 | Purpose was to evaluate CR by Deauville criteria.* |
| R-CHOP14/21 (NCI) Gleeson et al, 201694 ‡ | 50 38.5 (22-78) | Prospective subgroup | 80 (5) | 84 (5) | 58 | R-CHOP21 vs R-CHOP14 PFS P = .10; OS P = .06 Unadjusted analysis* |
| DA-EPOCH-R (pediatric) Burke et al, 202195 | 47 15 (range NR) | Prospective | 69 (2) | 82 (2) | 0 | No patients received consolidative RT.* |
| R-CHOP21/14 (UNFOLDER trial) Held et al (abstract), 202096 § | 131 34 (range NR) | Prospective subgroup | 93 (3) | 97 (3) | 62.5 | R-CHOP21 vs R-CHOP14 (no difference) Pooled 3-y event rates;* RT did not impact PFS (P = .25). |
| Retrospective | ||||||
| R-V/MACOPB Zinzani et al, 200951 | 45 38 (17-66) | Retrospective | 84 (5) | 80 (5) | 71 | No difference in R-V/MACOPB vs historical estimates without R.* |
| R-CHOP Ahn et al, 201097 | 21 30 (17-79) | Retrospective | 79 (2) | 83 (2) | 62 | R-CHOP vs CHOP PFS P = .043 OS P = .08 |
| R-CHOP Vassilakopoulos et al, 201248 | 76 31.5 (17-73) | Retrospective | 81 (5) | 89 (5) | 76 | R-CHOP vs CHOP FFP P < .0001 OS P = .003 Early treatment failure (<6 m), 9%* |
| R-CHOP Xu et al, 201350 | 39 29 (13-54) | Retrospective | 77 (5) | 84 (5) | 76 | R-CHOP vs CHOP PFS P = .012 OS P = .011 |
| R-CHOP Aoki et al, 201415 ǁ | 187 31.5 (17-77) | Retrospective | 71 (4) | 90 (4) | 34 | R-chemo all vs CHOP PFS P = .001 OS P = .001 DA-EPOCHR; 2nd/3rd generation HDC/SCT (vs R-CHOP no difference) Treatment selection criteria unknown.* |
| R-CHOP Soumerai et al, 201498 | 63 37 (20-82) | Retrospective | 68 (5) | 79 (5) | 77 | PD during R-CHOP 18%* Male predominance (60%)* |
| R-VACOPB Avigdor et al, 201452 | 40 33 (range NR) | Retrospective | 83 (5) | NR | 0 | R-VACOPB vs VACOPB PFS P = .06 OS P = .2 R-VACOPB vs R-CHOP P = .3 |
| R-MACOPB Zinzani et al, 201566 | 74 34 (18-63) | Retrospective | 88 (10) | 82 (10) | 69 | RT vs no RT P = .85 RT only in PET-positive (IHP).* |
| R-CHOP DA-EPOCHR Pinnix et al, 201599 ¶ | 50 35 (19-70) 25 | Retrospective | ∼90 (estimate) 83 | NR NR | 90 20 | R-CHOP vs DA-EPOCHR (and R-HCVAD) PFS P = .35 Treatment selection criteria unknown.* |
| R-CHOP-RICE Goldschmidt et al, 2016100 | 24 34 (18-60) | Retrospective | 87 (5) | 100 (5) | 12 | R-CHOP-RICE vs other protocols, R CHOP/R-M/ VACOPB/DA-EPOCHR PFS P = .35 OS P = .31 78% other protocols received RT.* |
| R-CHOP/R-CHOEP Lisenko et al, 201747 | 45 38 (19-64) | Retrospective | 95 | 92 | 91 | R-CHO(E)P vs CHOP PFS P = .001 OS P = .023 |
| DA-EPOCH-R (Adult) DA-EPOCHR (Pediatric) Giulino-Roth et al, 201714 | 118 34 (21-70) 38 16 (9-20) | Retrospective | 87 (3) 81 (3) | 97 (3) 91 (3) | 16 11 | Adult vs pediatric; EFS P = .34 |
| R-CHOP DA-EPOCHR Shah et al, 201858 | 56 37 (20-77) 76 34 (18-69) | Retrospective | 76 (2) 85 (2) | 89 (2) 91 (2) | 59 13 | R-CHOP vs DA-EPOCHR PFS P = .28 OS P = .83 Treatment selection criteria unknown.* |
| R-CHOP Malenda et al, 202059 | 25 37 (18-80) | Retrospective | 87 (1) | 100 (1) | 25 | R-CHOP vs DA-EPOCHR PFS P = .20 OS P = .66 Treatment selection criteria unknown.* |
| R-CHOP R-CHOP + RT Messmer et al, 2019101 | 16 36 (23-52) 10 40.5 (19-60) | Retrospective | 93 (3) 100 (3) | 100 (3) 100 (3) | 0 100 | RT vs no RT P = .85 RT criteria unknown.* |
| R-CHOP R-CHOP + RT DA-EPOCHR Chan et al, 2019102 | 41 28 (11-72) 37 26 (14-48) 46 27 (16-51) | Retrospective | 56.5(5) 88 (5) 90 (5) | 76 (5) 94 (5) 94 (5) | 0 100 6 | R-CHOP vs DA-EPOCHR PFS P = .012 OS P = .01 RT vs no RT with R-CHOP PFS P = .04 Treatment selection criteria unknown.* |
| R-CHOP Zhou et al, 202057 # | 89 33 (11-64) | Retrospective | ∼60 (5) estimate | ∼70 (5) estimate | 84 (5) | R-CHOP vs DA-EPOCHR/R-HCVAD PFS P = .048 OS P = .0067 Treatement selection criteria unknown.* |
| R-CHOP Hayden et al, 202013 | 159 36 (19-84) | Retrospective | 80 (5) | 89 (5) | 28 | PET-guided use of consolidative RT (no difference in outcome vs routine RT).* |
| R-CHOP14/21 R-CHOEP14 Wästerlid et al, 2021103 ** | 17 49 (18-83) 90 35 (18-74) | Registry | NR | 74 (5) RS 95 (5) RS | 14 18 | R-CHOEP14/R-HyperCVAD/DA-EPOCHR Treatment selection criteria unknown (not formally compared)* |
Estimates are rounded; complete remission.
aaIPI, age-adjusted International Prognostic Index; CVAD, cyclophosphamide, vincristine, doxorubicin, dexamethasone; HCVAD hyper-CVAD; ICE, ifosfamide, carboplatin, and etoposide; IHP International Harmonization Project; NCI, National Cancer Institute; NR not reported; RS, relative survival; Tx, treatment.
Comment on treatment comparison.
R-CHOP (n=21), RCHOEP (n=23), RCHOP/RCHOEP (n=1).
Median age for all patients.
Abstract only; P-values not provided.
The study included 345 patients (CHOP [n = 47]; R-CHOP [n = 187]; DA-EPOCHR [n = 9]; second/third generation [n = 45]; high-dose chemotherapy/ASCT [n = 57]).
Median age for all patients; outcome for cohort: 5-year PFS 91%, 5-year OS 99%; PFS estimated for R-CHOP.
Median age for all patients; 19 patients were treated with HCVAD (vs R-CHOP PFS, P = .0088; OS, P = .095).
R-CHOP (n = 3); R-CHOP14 (n = 14); not shown DA-EPOCHR (n = 11); 5-year RS, 82%; R-HCVAD (n = 16), 5-year RS 100%.