Seniors with DLBCL may benefit from Ga101-miniCHOP combo

The combination obinutuzumab (Ga101) with the attenuated CHOP regimen (cyclophosphamide, doxorubicin, vincristine and prednisone; miniCHOP) is safe and effective for elderly patients with diffuse large B-cell lymphoma (DLBCL) who are unfit to receive the full-dose immunochemotherapy, a new study has found. However, the new regimen does not seem to be posed to challenge current treatment standards.

Thirty-three elderly patients with DLBCL (median age, 82 years; 55 percent male) were enrolled and given six courses of the Ga101-miniCHOP treatment regimen. Patients were deemed unfit for the complete course according to the simplified Comprehensive Geriatric Assessment. Treatment response rate was the primary outcome of the study, and safety was also assessed.

A total of 228 cycles were delivered, and 27 participants completed all six courses. Treatment interruptions were due to adverse events and lack of response.

Two patients suffered from infections, both leading to discontinuations. Hepatic toxicity and worsening performance status were other adverse events reported. After a median follow-up of 16 months, lymphoma had progressed in 18 patients. Ten patients died; nine were due to disease progression and one was because of an adverse event.

The 2-year progression-free and overall survival rates were 49 percent and 68 percent, respectively. A total of 14 patients showed complete treatment response, yielding a rate of 42 percent. Partial response was observed in eight participants (24 percent), while ten had stable or progressive disease (30 percent).

Despite decent response rates, “study accrual was interrupted due to the very low probability of demonstrating the initial study hypothesis that Ga101-miniCHOP could improve results of historical data obtained with rituximab-miniCHOP in this group of patients,” the researchers said.