Comparing R-Bendamustine vs. R-CHOP Plus Maintenance Therapy as First-Line Systemic Treatment in Follicular Lymphoma: A Multicenter Retrospective GELTAMO Study

Simple Summary The initial treatment for patients with advanced-stage follicular lymphoma is usually a combo of immunochemotherapy called R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone) or R-bendamustine (R-B, for short). After six cycles of R-CHOP, continuing with rit...

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Autores: Bastos-Oreiro, M, Gutierrez, A, Cabero, A, López, J, Villafuerte, P, Jiménez-Ubieto, A, de Oña, R, de la Fuente, A, Navarro, B, Peñalver, J, Martínez, P, Alonso, C, Infante, M, Córdoba, R, Perez-Montero, B, de Oteyza, JP, de Villambrosio, SG, Fernández-Caldas, P, del Campo, R, Belmonte, DG, Diaz-Gálvez, J, Salar, A, Sancho, JM
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2024
País:España
Institución:Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (FISABIO)
Repositorio:r-FISABIO. Repositorio Institucional de Producción Científica
OAI Identifier:oai:fisabio.fundanetsuite.com:p16984
Acceso en línea:https://fisabio.portalinvestigacion.com/publicaciones/16984
Access Level:acceso abierto
Palabra clave:follicular lymphoma
rituximab
R-bendamustine
R-CHOP
maintenance
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network_name_str España
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spelling Comparing R-Bendamustine vs. R-CHOP Plus Maintenance Therapy as First-Line Systemic Treatment in Follicular Lymphoma: A Multicenter Retrospective GELTAMO StudyBastos-Oreiro, MGutierrez, ACabero, ALópez, JVillafuerte, PJiménez-Ubieto, Ade Oña, Rde la Fuente, ANavarro, BPeñalver, JMartínez, PAlonso, CInfante, MCórdoba, RPerez-Montero, Bde Oteyza, JPde Villambrosio, SGFernández-Caldas, Pdel Campo, RBelmonte, DGDiaz-Gálvez, JSalar, ASancho, JMfollicular lymphomarituximabR-bendamustineR-CHOPmaintenanceSimple Summary The initial treatment for patients with advanced-stage follicular lymphoma is usually a combo of immunochemotherapy called R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone) or R-bendamustine (R-B, for short). After six cycles of R-CHOP, continuing with rituximab for two years (maintenance therapy) has demonstrated a reduction in relapses. However, determining if this approach works well after R-B has yet to be confirmed. Here, we collected data from 476 FL patients from 17 GELTAMO centers and evaluated the efficacy of both regimens followed by rituximab maintenance therapy in untreated follicular lymphoma patients. We found a better response with R-B and relapses were more frequent with R-CHOP. During the initial treatment, low blood counts were more frequent with R-CHOP but, during maintenance therapy, they were more frequent with R-B and so were infectious complications. After six years, 79% and 67% of R-B- and R-CHOP-treated patients, respectively, did not have evidence of the disease but the number of deaths was the same in both groups. In conclusion, R-B followed by rituximab maintenance therapy in patients with previously untreated follicular lymphoma showed better responses and fewer relapses, without any extra side effects in an elderly population. During maintenance, patients had more issues when using R-B but deaths were the same in both groups.Abstract Rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) and R-bendamustine (R-B) are the most common frontline treatment strategies for advanced-stage follicular lymphoma (FL). After R-CHOP induction therapy, using rituximab for maintenance therapy notably improves outcomes; however, whether this can be achieved by using the same approach after R-B therapy is still being determined. This retrospective analysis compared 476 FL patients from 17 GELTAMO centers who received R-based regimens followed by rituximab maintenance therapy for untreated advanced-stage FL. The complete response rate at the end of induction was higher with R-B and relapses were more frequent with R-CHOP. During induction, cytopenias were significantly more frequent with R-CHOP and so was the use of colony-stimulating factors. During maintenance therapy, R-B showed more neutropenia and infectious toxicity. After a median follow-up of 81 months (95% CI: 77-86), the 6-year rates of progression-free survival (PFS) were 79% (95% CI: 72-86) for R-bendamustine vs. 67% (95% CI: 61-73) for R-CHOP (p = 0.046), and 6-year overall survival (OS) values were 91% (95% CI: 86-96) for R-B vs. 91% (95% CI: 87-94) for R-CHOP (p = 0.49). In conclusion, R-B followed by rituximab maintenance therapy in patients with previously untreated FL resulted in significantly longer PFS than R-CHOP, with older patients also benefiting from this treatment without further toxicity. Adverse events during maintenance were more frequent with R-B without impacting mortality.MDPI2024info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionhttps://fisabio.portalinvestigacion.com/publicaciones/16984CancersISSN: 20726694reponame:r-FISABIO. Repositorio Institucional de Producción Científicainstname:Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (FISABIO)Inglésinfo:eu-repo/semantics/openAccessoai:fisabio.fundanetsuite.com:p169842026-06-11T12:45:17Z
dc.title.none.fl_str_mv Comparing R-Bendamustine vs. R-CHOP Plus Maintenance Therapy as First-Line Systemic Treatment in Follicular Lymphoma: A Multicenter Retrospective GELTAMO Study
title Comparing R-Bendamustine vs. R-CHOP Plus Maintenance Therapy as First-Line Systemic Treatment in Follicular Lymphoma: A Multicenter Retrospective GELTAMO Study
spellingShingle Comparing R-Bendamustine vs. R-CHOP Plus Maintenance Therapy as First-Line Systemic Treatment in Follicular Lymphoma: A Multicenter Retrospective GELTAMO Study
Bastos-Oreiro, M
follicular lymphoma
rituximab
R-bendamustine
R-CHOP
maintenance
title_short Comparing R-Bendamustine vs. R-CHOP Plus Maintenance Therapy as First-Line Systemic Treatment in Follicular Lymphoma: A Multicenter Retrospective GELTAMO Study
title_full Comparing R-Bendamustine vs. R-CHOP Plus Maintenance Therapy as First-Line Systemic Treatment in Follicular Lymphoma: A Multicenter Retrospective GELTAMO Study
title_fullStr Comparing R-Bendamustine vs. R-CHOP Plus Maintenance Therapy as First-Line Systemic Treatment in Follicular Lymphoma: A Multicenter Retrospective GELTAMO Study
title_full_unstemmed Comparing R-Bendamustine vs. R-CHOP Plus Maintenance Therapy as First-Line Systemic Treatment in Follicular Lymphoma: A Multicenter Retrospective GELTAMO Study
title_sort Comparing R-Bendamustine vs. R-CHOP Plus Maintenance Therapy as First-Line Systemic Treatment in Follicular Lymphoma: A Multicenter Retrospective GELTAMO Study
dc.creator.none.fl_str_mv Bastos-Oreiro, M
Gutierrez, A
Cabero, A
López, J
Villafuerte, P
Jiménez-Ubieto, A
de Oña, R
de la Fuente, A
Navarro, B
Peñalver, J
Martínez, P
Alonso, C
Infante, M
Córdoba, R
Perez-Montero, B
de Oteyza, JP
de Villambrosio, SG
Fernández-Caldas, P
del Campo, R
Belmonte, DG
Diaz-Gálvez, J
Salar, A
Sancho, JM
author Bastos-Oreiro, M
author_facet Bastos-Oreiro, M
Gutierrez, A
Cabero, A
López, J
Villafuerte, P
Jiménez-Ubieto, A
de Oña, R
de la Fuente, A
Navarro, B
Peñalver, J
Martínez, P
Alonso, C
Infante, M
Córdoba, R
Perez-Montero, B
de Oteyza, JP
de Villambrosio, SG
Fernández-Caldas, P
del Campo, R
Belmonte, DG
Diaz-Gálvez, J
Salar, A
Sancho, JM
author_role author
author2 Gutierrez, A
Cabero, A
López, J
Villafuerte, P
Jiménez-Ubieto, A
de Oña, R
de la Fuente, A
Navarro, B
Peñalver, J
Martínez, P
Alonso, C
Infante, M
Córdoba, R
Perez-Montero, B
de Oteyza, JP
de Villambrosio, SG
Fernández-Caldas, P
del Campo, R
Belmonte, DG
Diaz-Gálvez, J
Salar, A
Sancho, JM
author2_role author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
dc.subject.none.fl_str_mv follicular lymphoma
rituximab
R-bendamustine
R-CHOP
maintenance
topic follicular lymphoma
rituximab
R-bendamustine
R-CHOP
maintenance
description Simple Summary The initial treatment for patients with advanced-stage follicular lymphoma is usually a combo of immunochemotherapy called R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone) or R-bendamustine (R-B, for short). After six cycles of R-CHOP, continuing with rituximab for two years (maintenance therapy) has demonstrated a reduction in relapses. However, determining if this approach works well after R-B has yet to be confirmed. Here, we collected data from 476 FL patients from 17 GELTAMO centers and evaluated the efficacy of both regimens followed by rituximab maintenance therapy in untreated follicular lymphoma patients. We found a better response with R-B and relapses were more frequent with R-CHOP. During the initial treatment, low blood counts were more frequent with R-CHOP but, during maintenance therapy, they were more frequent with R-B and so were infectious complications. After six years, 79% and 67% of R-B- and R-CHOP-treated patients, respectively, did not have evidence of the disease but the number of deaths was the same in both groups. In conclusion, R-B followed by rituximab maintenance therapy in patients with previously untreated follicular lymphoma showed better responses and fewer relapses, without any extra side effects in an elderly population. During maintenance, patients had more issues when using R-B but deaths were the same in both groups.Abstract Rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) and R-bendamustine (R-B) are the most common frontline treatment strategies for advanced-stage follicular lymphoma (FL). After R-CHOP induction therapy, using rituximab for maintenance therapy notably improves outcomes; however, whether this can be achieved by using the same approach after R-B therapy is still being determined. This retrospective analysis compared 476 FL patients from 17 GELTAMO centers who received R-based regimens followed by rituximab maintenance therapy for untreated advanced-stage FL. The complete response rate at the end of induction was higher with R-B and relapses were more frequent with R-CHOP. During induction, cytopenias were significantly more frequent with R-CHOP and so was the use of colony-stimulating factors. During maintenance therapy, R-B showed more neutropenia and infectious toxicity. After a median follow-up of 81 months (95% CI: 77-86), the 6-year rates of progression-free survival (PFS) were 79% (95% CI: 72-86) for R-bendamustine vs. 67% (95% CI: 61-73) for R-CHOP (p = 0.046), and 6-year overall survival (OS) values were 91% (95% CI: 86-96) for R-B vs. 91% (95% CI: 87-94) for R-CHOP (p = 0.49). In conclusion, R-B followed by rituximab maintenance therapy in patients with previously untreated FL resulted in significantly longer PFS than R-CHOP, with older patients also benefiting from this treatment without further toxicity. Adverse events during maintenance were more frequent with R-B without impacting mortality.
publishDate 2024
dc.date.none.fl_str_mv 2024
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv https://fisabio.portalinvestigacion.com/publicaciones/16984
url https://fisabio.portalinvestigacion.com/publicaciones/16984
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.rights.none.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.publisher.none.fl_str_mv MDPI
publisher.none.fl_str_mv MDPI
dc.source.none.fl_str_mv Cancers
ISSN: 20726694
reponame:r-FISABIO. Repositorio Institucional de Producción Científica
instname:Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (FISABIO)
instname_str Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (FISABIO)
reponame_str r-FISABIO. Repositorio Institucional de Producción Científica
collection r-FISABIO. Repositorio Institucional de Producción Científica
repository.name.fl_str_mv
repository.mail.fl_str_mv
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