Young Patients with Non-Germinal B-cell-Like Lymphoma Benefit from Dose-Intensive R-ACVBP vs. R-CHOP

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According to new findings published in the Journal of Clinical Oncology, researchers have found that the Hans algorithm may be useful as a theragnostic biomarker for identifying young patients with non-germinal center B-cell-like (non-GCB) diffuse large B-cell lymphoma (DLBCL) who may benefit from dose-intensive rituximab, doxorubicin, cyclophophamide, vindesine, bleomycin, and prednisone (R-ACVBP) rather than being treated with standard rituximab, doxorubicin, cyclophosphamide, vincristine, and prednisone (R-CHOP).

For the analysis of data from the phase 3 trial LNH 03-2B, researchers sought to identify whether any biomarkers could predict which patients with DLBCL would experience a survival advantage when treated with dose-intensive R-ACVBP compared with R-CHOP. Researchers analyzed the interaction effects between various biomarkers and each treatment arm of the LNH 03-2B study on survival.

They used the Hans algorithm to classify tumors as GCB or non-GCB. They found that only the interaction between the Hans algorithm and the treatment arm was significantly associated with progression-free survival and overall survival (P = 0.01).

Progression-free survival and overall survival were similar between both regimens among patients with GCB tumors, but patients with non-GCB tumors had better outcomes when treated with dose-intensive R-ACVBP compared with R-CHOP.

For Chronic Lymphocytic Lymphoma (CLL) and Mantle Cell Lymphoma (MCL), Ibrutinib Plus ABT-199 may be
DLBCL may benefit from dose-intensive R-ACVBP.

This study aims to determine whether any tumor biomarkers could account for the survival advantage observed in the LNH 03–2B trial among patients with diffuse large B–cell lymphoma (DLBCL) and low–intermediate risk according to the International Prognostic Index when treated with dose–intensive rituximab, doxorubicin, cyclophosphamide, vindesine, bleomycin, and prednisone (R–ACVBP) compared with standard rituximab, doxorubicin, cyclophosphamide, vincristine, and prednisone (R–CHOP).

The survival benefit related to R–ACVBP over R–CHOP is at least partly linked to improved survival among patients with non–GCB DLBCL.


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