FIRST‐LINE TREATMENT OF INHL OR MCL PATIENTS WITH BR OR R‐CHOP/R‐CVP: RESULTS OF THE BRIGHT 5‐YEAR FOLLOW‐UP STUDY
Bibliographic record
Abstract
Introduction: BRIGHT, a phase 3, open-label, noninferiority study comparing efficacy and safety of bendamustine plus rituximab (BR) vs rituximab plus cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) or rituximab with cyclophosphamide, vincristine, and prednisone (R-CVP) in treatment-naive patients with indolent non-Hodgkin lymphoma (iNHL) or mantle cell lymphoma (MCL), showed that the complete response rate for first-line BR was statistically noninferior to R-CHOP/R-CVP (Blood 2014;123:2944-52). Patients were monitored for ≥5 years to assess the overall effect of BR or R-CHOP/R-CVP in a controlled clinical setting. This analysis reports the time-to-event variables of the 5-year follow-up study. Methods: Patients with iNHL or MCL randomized to 6-8 cycles of BR or R-CHOP/R-CVP underwent complete assessments at end of treatment, then were monitored regularly. Progression-free survival (PFS), event-free survival (EFS), duration of response (DOR), and overall survival (OS) were compared using a stratified log-rank test. Results: Of 447 randomized patients, 224 received BR, 104 R-CHOP, and 119 R-CVP; 419 entered the follow-up study. The median follow-up time was 65.0 and 64.1 months for BR and R-CHOP/R-CVP, respectively. The 5-year PFS rate was 65.5% (95% confidence interval [CI]: 58.5-71.6) and 55.8% (48.4-62.5), and OS was 81.7% (75.7-86.3) and 85% (79.3-89.3) for BR and R-CHOP/R-CVP, respectively. The hazard ratio (95% CI) for PFS was 0.61 (0.45-0.85; P = .0025), EFS 0.63 (0.46-0.84; P = .0020), DOR 0.66 (0.47-0.92; P = .0134), and OS 1.15 (0.72-1.84; P = .5461) comparing BR vs R-CHOP/R-CVP. Similar results were found in iNHL [PFS 0.70 (0.49-1.01; P = .0582)] and MCL [PFS 0.40 (0.21-0.75; P = .0035)], with the strongest treatment effect in MCL (Figure). Use of rituximab maintenance was similar, 43% in BR and 45% in R-CHOP/R-CVP. Bendamustine was included as second-line in 27 (36%) of the 75 patients requiring therapy who originally received R-CHOP/R-CVP. Comparable safety profiles with expected adverse events were observed in the follow-up study in BR vs R-CHOP/R-CVP. Conclusions: The long-term follow-up of the BRIGHT study has confirmed that PFS, EFS, and DOR were significantly better for BR, and OS was not statistically different between BR and R-CHOP/R-CVP. The safety profile was as previously reported. Keywords: bendamustine; mantle cell lymphoma (MCL); non-Hodgkin lymphoma (NHL).
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.004 | 0.002 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.002 | 0.002 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.001 | 0.002 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".