- Four cycles of R-CHOP (cyclophosphamide, doxorubicin, vincristine, and prednisone+rituximab)+2 cycles of rituximab (2R) is noninferior to 6 cycles of R-CHOP in patients with favorable prognosis diffuse large B-cell lymphoma (DLBCL).
Why this matters
- The current standard of treatment in low-risk DLBCL is 6 cycles of R-CHOP.
- Reducing CHOP cycles reduces toxicity.
- FLYER phase 3 international multicenter trial of 592 patients aged 18-60 years with nonbulky DLBCL, randomly assigned to 4 cycles of R-CHOP+2R or the standard 6 cycles of R-CHOP.
- Median follow-up, 66 months.
- Funding: Deutsche Krebshilfe.
- 3-year PFS rate was similar between groups (96% vs 94%; P=.797).
- 3-year OS rate was similar between groups (99% vs 98%; P=.671).
- Relapse rates were also similar (4% vs 5%).
- Limiting chemotherapy reduced the incidence of hematologic and nonhematologic events by about one-third.
- All patients had favorable prognostic characteristics.
- "For this well-defined subgroup of patients, it appears that we can make their treatment shorter and have less burden but equivalent efficacy," said David Steensma, MD, Dana-Farber Cancer Institute, Boston, Massachusetts. "I think this will immediately influence clinical practice."