文章：

比较R-苯达莫司汀与R-CHOP联合维持疗法作为滤泡性淋巴瘤一线系统治疗的疗效：一项GELTAMO多中心回顾性研究

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

原文发布日期：26 March 2024

DOI: 10.3390/cancers16071285

类型: Article

开放获取: 是

英文摘要：

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.

摘要翻译： 

利妥昔单抗、环磷酰胺、多柔比星、长春新碱和泼尼松（R-CHOP）以及利妥昔单抗联合苯达莫司汀（R-B）是晚期滤泡性淋巴瘤（FL）最常用的一线治疗策略。在R-CHOP诱导治疗后，使用利妥昔单抗进行维持治疗可显著改善预后；然而，在R-B治疗后采用相同方法是否也能达到这一效果，目前仍在探索中。本回顾性分析比较了来自17个GELTAMO中心的476例未经治疗的晚期FL患者，这些患者接受了以利妥昔单抗为基础的方案诱导治疗后，继以利妥昔单抗维持治疗。诱导治疗结束时的完全缓解率在R-B组更高，而R-CHOP组的复发更为频繁。在诱导治疗期间，R-CHOP组血细胞减少的发生率显著更高，集落刺激因子的使用也更为常见。在维持治疗期间，R-B组表现出更多的中性粒细胞减少和感染性毒性。中位随访81个月（95% CI：77-86）后，R-B组的6年无进展生存率（PFS）为79%（95% CI：72-86），而R-CHOP组为67%（95% CI：61-73）（p=0.046）；6年总生存率（OS）在R-B组为91%（95% CI：86-96），R-CHOP组为91%（95% CI：87-94）（p=0.49）。总之，在既往未经治疗的FL患者中，R-B继以利妥昔单抗维持治疗相较于R-CHOP方案，能显著延长PFS，且老年患者也能从该治疗中获益而未增加额外毒性。维持治疗期间的不良事件在R-B组更为常见，但未影响死亡率。

原文链接：

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