Further Data Shows R-CHOP Improves Survival in Elderly Patients with Lymphoma
According to an early online publication in Lancet Oncology, the addition of Rituxan® (rituximab) to the chemotherapy combination referred to as CHOP improves survival compared with CHOP alone in the treatment of elderly patients with aggressive B-cell non-Hodgkin's lymphoma.
Non-Hodgkin's lymphoma (NHL) is a form of cancer that begins in the cells of the lymph system, which includes the spleen, thymus, tonsils, bone marrow, lymph nodes, and circulating immune cells. Lymphocytes are the main cells in the lymph system and exist in two forms: B and T-cells. Each of these cells serves a specific function in helping the body fight infection. B-cell NHL is the most common type of NHL; it involves cancer that originates in B-cells and affects their normal maturation.
CHOP (cyclophosphamide, doxorubicin, vincristine, and prednisone) is a commonly used treatment for NHL. More recently, the addition of Rituxan to CHOP (R-CHOP) has become a standard treatment option for NHL.
Although Rituxan has become an integral part of treatment for patients with B-cell NHL, the optimal way to incorporate Rituxan into the overall treatment strategy for individual patients is still being investigated.
To compare different approaches to administering CHOP with or without Rituxan in the treatment of elderly patients with diffuse large B-cell lymphoma, researchers in Germany conducted a study among more than 1,000 patients between the ages of 61 and 80 years. Patients were divided into four treatment groups: 1) six cycles of CHOP alone; 2) eight cycles of CHOP alone; 3) six cycles of CHOP with Rituxan (CHOP-R); 4) eight cycles of CHOP-R. Patients were treated with radiation therapy if they had sites of bulky disease.
- Six cycles of CHOP-R resulted in the best survival compared with the other three regimens.
- Eight cycles of CHOP alone did not improve survival compared with six cycles of CHOP alone.
- The addition of Rituxan to chemotherapy resulted in improved survival in both the six- and eight-cycle CHOP regimens.
The researchers concluded that six cycles of CHOP-R provides improved survival over eight cycles of CHOP-R or any regimen containing CHOP alone in elderly patients with aggressive B-cell NHL. These results confirm that six cycles of R-CHOP appears to be the optimal treatment regimen for these patients.
Elderly patients with NHL may wish to speak with their physician regarding their individual risks and benefits of all treatment options.
Reference: Pfreundschuh M, et al . Six versus eight cycles of bi-weekly CHOP-14 with or without rituximab in elderly patients with aggressive CD20+ B-cell lymphomas: a randomized controlled trial (RICOVER-60). Lancet Oncology.2008; DOI: 10.1016/S1470-2045(08)70002-0.
Related News: Six Cycles of Rituxan®-CHOP-14 Confirmed as Standard of Care for Elderly with Diffuse Large B-cell Lymphoma (01/16/2007)