Pola‐R‐CHP versus R‐CHOEP in young patients with high‐risk diffuse large B‐cell lymphoma
Notice bibliographique
Résumé
Introduction: The best treatment for young patients with high-risk diffuse large B-cell lymphoma (DLBCL) is still a matter of debate. Results of the phase 3 R-MegaCHOEP study showed promising results using etoposide in combination with R-CHOP (R-CHOEP). Progression-free (PFS) and overall survival (OS) rates for young patients (18–60 years) with high-risk (age-adjusted IPI 2, 3) DLBCL treated with R-CHOEP were among the best reported for such patients. Recently, the combination of polatuzumab vedotin and R-CHP (pola-R-CHP) was approved for the treatment of DLBCL patients based on the data of the POLARIX study that showed an improvement of PFS following treatment with pola-R-CHP compared to R-CHOP in DLBCL patients with an IPI 2–5. To obtain further insights into the optimal treatment of young (age ≤60 years), high-risk (aaIPI 2, 3) DLBCL patients we retrospectively compared outcomes of such patients treated with pola-R-CHP or R-CHOEP. Methods: Treatment consisted of 6 cycles pola-R-CHP followed by 2 cycles of rituximab (R) given every 3 weeks or 8 cycles of CHOEP given every two weeks plus 6 cycles of R. Event-free survival (EFS), PFS, and OS of DLBCL patients ≤60 years with aaIPI 2, 3 were calculated and major toxicities compared. The Kaplan-Meier method was used to estimate EFS, PFS, and OS in each group. Hazard ratios with 95% CI and log-rank tests comparing pola-R-CHP with R-CHOEP were calculated. P-values <0.05 were considered significant. Results: 113 patients treated with pola-R-CHP and 127 patients treated with R-CHOEP were analyzed. Major patient characteristics differed in aaIPI with more patients in the R-CHOEP group showing an aaIPI of 3 (28% vs. 12%). Two-year EFS-, PFS-, and OS-rates for patients treated with pola-R-CHP were 65.9% (CI: 56.7%, 74.8%), 74.8% (66.5%, 83.0%), and 88.3% (82.3%, 94.3%) as compared to 70.5% (62.5%, 78.5%), 74.9% (67.3%, 82.6%), and 84.6% (78.3%, 91.0%) for patients treated with R-CHOEP with no significant differences for any of these endpoints between treatment regimens. Patients treated with R-CHOEP experienced more hematological toxicity and infections (29.9% ≥ grade 3 infections in R-CHOEP-treated vs. 15.0% in pola-R-CHP treated patients) with 4 treatment-related deaths occurring in patients treated with R-CHOEP and 2 treatment-related deaths following pola-R-CHP, respectively. The research was funded by: This study was sponsored by F. Hoffmann-La Roche Ltd. Keywords: Aggressive B-cell non-Hodgkin lymphoma, Combination Therapies Conflicts of interests pertinent to the abstract. G. Lenz Consultant or advisory role: F. Hoffmann-La Roche Ltd., Gilead, Janssen, Bristol-Myers Squibb, Novartis, AbbVie, Incyte, Genmab, Constellation, ADC Therapeutics, Karyopharm, Miltenyi, PentixaPharm, Sobi, Immagene, Genase, Hexal/Sandoz, Lilly Research funding: Janssen, Bayer, AstraZeneca, MorphoSys Educational grants: AbbVie, Janssen, F. Hoffmann-La Roche Ltd. Other remuneration: F. Hoffmann-La Roche Ltd., Gilead, Novartis, Takeda, Bristol-Myers Squibb, AbbVie, Incyte, ADC Therapeutics, Sobi, Hexal/Sandoz (Speaker's Bureau). F. Hoffmann-La Roche Ltd. (Expert Testimony) H. Tilly Consultant or advisory role: F. Hoffmann-La Roche Ltd., Incyte, Celgene/Bristol-Myers Squibb Honoraria: Bristol-Myers Squibb, F. Hoffmann-La Roche Ltd. Research funding: F. Hoffmann-La Roche Ltd./Genentech, Inc. Educational grants: F. Hoffmann-La Roche Ltd., Janssen M. Ziepert Research funding: F. Hoffmann-La Roche Ltd. B. Altmann Research funding: F. Hoffmann-La Roche Ltd. V. Craine Employment or leadership position: F. Hoffmann-La Roche Ltd. M. Yan Employment or leadership position: Hoffmann-La Roche Ltd. Stock ownership: Hoffmann-La Roche Ltd. C. Herbaux Honoraria: F. Hoffmann-La Roche Ltd., Janssen-Cilag, AbbVie, Gilead Sciences Research funding: Takeda Educational grants: Janssen-Cilag, AbbVie, F. Hoffmann-La Roche Ltd. M. Nickelsen Consultant or advisory role: F. Hoffmann-La Roche Ltd. Honoraria: F. Hoffmann-La Roche Ltd. J. Hirata Employment or leadership position: Genentech, Inc. Stock ownership: F. Hoffmann-La Roche Ltd. D. Sahin Employment or leadership position: F. Hoffmann-La Roche Ltd. Stock ownership: F. Hoffmann-La Roche Ltd. C. Lee Employment or leadership position: F. Hoffmann-La Roche Ltd. Stock ownership: F. Hoffmann-La Roche Ltd. F. Morschhauser Consultant or advisory role: F. Hoffmann-La Roche Ltd./Genentech, Inc., Gilead, Celgene, Bristol-Myers Squibb, AbbVie, Epizyme, Servier, AstraZeneca, Novartis, Genmab Honoraria: F. Hoffmann-La Roche Ltd./Genentech, Inc., Chugai, Eisai Other remuneration: F. Hoffmann-La Roche Ltd./Genentech, Inc. (Expert Testimony) N. Schmitz Consultant or advisory role: Allogene, Miltenyi Stock ownership: Bristol-Myers Squibb Research funding: F. Hoffmann-La Roche Ltd., Janssen Educational grants: Miltenyi, Allogene
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,001 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,001 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».