title: Cyclophosphamide, doxorubicin, vincristine, prednisone and rituximab versus epirubicin, cyclophosphamide, vinblastine, prednisone and rituximab for the initial treatment of elderly "fit" patients with diffuse large B-cell lymphoma: results from the ANZINTER3 trial of the Intergruppo Italiano Linfomi.
abstract: We conducted a prospective study to compare epirubicin, cyclophosphamide, vinblastine, prednisone and rituximab (R-miniCEOP) with cyclophosphamide, doxorubicin, vincristine, prednisone and rituximab (R-CHOP) for the treatment of "fit" elderly patients with diffuse large B-cell lymphoma (DLBCL). Patients over the age of 65 with stage II-IV DLBCL were screened with a comprehensive geriatric assessment. Patients were randomized to receive six courses of R-miniCEOP (n = 114) or R-CHOP (n = 110). Overall, the rate of complete remission was 70% (p = 0.466). After a median follow-up of 42 months, 5-year event-free survival (EFS) rates were 46% and 48% for R-miniCEOP and R-CHOP, respectively (p = 0.538). Patients older than 72 years and with low-risk disease had a better outcome when treated with R-miniCEOP (p = 0.011). Overall R-CHOP and R-miniCEOP are similarly effective for elderly "fit" patients with DLBCL. The less intense R-miniCEOP may be an acceptable option for the treatment of relatively older patients with low-risk disease.
authors: Oncology Department, Azienda Ospedaliera Arcispedale Santa Maria Nuova-IRCCS, Reggio Emilia, Argentina. merli.francesco@asmn.re.it
authors: Francesco
authors: F
authors: Merli
authors: Stefano
authors: S
authors: Luminari
authors: Giuseppe
authors: G
authors: Rossi
authors: Caterina
authors: C
authors: Mammi
authors: Luigi
authors: L
authors: Marcheselli
authors: Alessandra
authors: A
authors: Tucci
authors: Fiorella
authors: F
authors: Ilariucci
authors: Annalisa
authors: A
authors: Chiappella
authors: Maurizio
authors: M
authors: Musso
authors: Alice
authors: A
authors: Di Rocco
authors: Caterina
authors: C
authors: Stelitano
authors: Isabel
authors: I
authors: Alvarez
authors: Luca
authors: L
authors: Baldini
authors: Patrizio
authors: P
authors: Mazza
authors: Flavia
authors: F
authors: Salvi
authors: Annalisa
authors: A
authors: Arcari
authors: Alberto
authors: A
authors: Fragasso
authors: Paolo G
authors: PG
authors: Gobbi
authors: Anna Marina
authors: AM
authors: Liberati
authors: Massimo
authors: M
authors: Federico
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000740:Anemia / Q000139:chemically induced; D058846:Antibodies, Monoclonal, Murine-Derived / Q000008:administration & dosage / Q000009:adverse effects; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D003520:Cyclophosphamide / Q000008:administration & dosage / Q000009:adverse effects; D018572:Disease-Free Survival; D004317:Doxorubicin / Q000008:administration & dosage / Q000009:adverse effects; D015251:Epirubicin / Q000008:administration & dosage / Q000009:adverse effects; D005260:Female; D005500:Follow-Up Studies; D015577:Geriatric Assessment / Q000379:methods / Q000706:statistics & numerical data; D006801:Humans; D053208:Kaplan-Meier Estimate; D016403:Lymphoma, Large B-Cell, Diffuse / Q000188:drug therapy* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009503:Neutropenia / Q000139:chemically induced; D011241:Prednisone / Q000008:administration & dosage / Q000009:adverse effects; D016016:Proportional Hazards Models; D011446:Prospective Studies; D000069283:Rituximab; D016896:Treatment Outcome; D014750:Vincristine / Q000008:administration & dosage / Q000009:adverse effects
chemical_list: D058846:Antibodies, Monoclonal, Murine-Derived; D015251:Epirubicin; D000069283:Rituximab; D014750:Vincristine; D004317:Doxorubicin; D003520:Cyclophosphamide; D011241:Prednisone