Event-free Survival at 24 Months as a Surrogate Endpoint for DLBCL

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Patients with diffuse large B-cell lymphoma who achieved post-treatment event-free survival for 24 months had only a minimally lower life expectancy.
Patients with diffuse large B-cell lymphoma who achieved post-treatment event-free survival for 24 months had only a minimally lower life expectancy.

Patients with diffuse large B-cell lymphoma (DLBCL) who achieved post-treatment event-free survival for 24 months had only a minimally lower life expectancy compared with the general population, according to the results of a study published in the Journal of Clinical Oncology.1

Based on these results, researchers concluded that post-treatment event-free survival at 24 months could be a surrogate endpoint in clinical trials, but cautioned that it could “potentially miss the impact of late toxicities and other late adverse effects on patient outcomes.”

Prior research showed that patients with DLBCL who survived 2 years after treatment had survival equivalent to the general population. This study was designed to evaluate survival of these patients compared with a matched general population.

The study included 1621 patients from the Danish Lymphoma Registry. All patients were newly diagnosed with DLBCL between 2003 and 2011 and had achieved complete remission or complete remission unconfirmed after treatment with first-line rituximab plus cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) or a similar therapy.

Five-year post-treatment survival for patients with DLBCL was 78% compared with 87% for the general population (P < .0001). This finding was age dependent as data showed that patients aged younger than 50 who achieved 24-month event-free survival had their survival normalize to that of the general population. In comparison, there was a continuously increased mortality in middle-aged and elderly patients.

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With this normalization of mortality among patients younger than 50 years, the researchers suggested that achieving post-treatment event-free survival at 24 months may indicate that this subgroup of patients requires less-intensive disease surveillance.

Reference

  1. Jakobsen LH, Bogsted M, de Nully Brown P, et al. Minimal loss of lifetime for patients with diffuse large B-cell lymphoma in remission and event free 24 months after treatment: a Danish population-based study. J Clin Oncol. 2017 Jan 17. doi: 10.1200/JCO.2016.70.0765 [Epub ahead of print]

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