Efficacy of R-COMP in comparison to R-CHOP in patients with DLBCL: A systematic review and single-arm metanalysis

Visco, Carlo; Pregnolato, Francesca; Ferrarini, Isacco; Marco, Beatrice De; Bonuomo, Valentina; Sbisà, Eugenio; Fraenza, Costanza; Bernardelli, Andrea; Tanasi, Ilaria; Quaglia, Francesca Maria; Krampera, Mauro

doi:10.1016/j.critrevonc.2021.103377

Cited by 14 publications

(19 citation statements)

References 39 publications

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“…The dosages of Myocet™ in the R-COMP-DI and MBVD-DI schemes were a personal extrapolation from published in vitro and in vivo data, as they were not previously established. [10][11][12][13][16][17][18] However, the Myocet™ administrations were well within the ceiling dose of 785 mg/m 2 (the median lifetime dose reported for NPLD at the onset of cardiotoxicity). 9 Patients with DLBCL were scheduled to receive the first three cycles of therapy with R-COMP-DI which consisted of 1-day outpatient intravenous (i.v.)…”

Section: Treatment Planmentioning

confidence: 62%

“…[10][11][12] The schemes resulted as a safe option, with activity profile comparable to historical R-CHOP and ABVD data. [10][11][12] Liposomal doxorubicin at increased dose may have some pharmacokinetic and pharmacodynamic advantages 13 : it rapidly accumulates at high levels within tumour-associated macrophages of the lymphadenopathy microenvironment, and within the reticuloendothelial system (RES) of the spleen, liver, lung, and bone. [14][15][16][17][18][19][20] In real-life, these effects might be perceived as a great benefit in those patients with DLBCL or c-HL with a high tumour burden, regardless of age or comorbidities.…”

Section: Introductionmentioning

confidence: 58%

“…The schedules of study treatments are shown in detail in Table 1. The dosages of Myocet™ in the R‐COMP‐DI and MBVD‐DI schemes were a personal extrapolation from published in vitro and in vivo data, as they were not previously established 10–13,16–18 . However, the Myocet™ administrations were well within the ceiling dose of 785 mg/m 2 (the median lifetime dose reported for NPLD at the onset of cardiotoxicity) 9 …”

Section: Methodsmentioning

confidence: 88%

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Liposomal doxorubicin supercharge‐containing front‐line treatment in patients with advanced‐stage diffuse large B‐cell lymphoma or classical Hodgkin lymphoma: Preliminary results of a single‐centre phase II study

et al. 2022

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Summary We evaluated the impact of liposomal doxorubicin (NPLD) supercharge‐containing therapy on interim fluorodeoxyglucose positron emission tomography (interim‐FDG‐PET) responses in high‐risk diffuse large B‐cell lymphoma (DLBCL) or classical Hodgkin lymphoma (c‐HL). In this phase II study (2016–2021), 81 adult patients with advanced‐stage DLBCL (n = 53) and c‐HL (n = 28) received front‐line treatment with R‐COMP‐dose‐intensified (DI) and MBVD‐DI. R‐COMP‐DI consisted of 70 mg/m2 of NPLD plus standard rituximab, cyclophosphamide, vincristine and prednisone for three cycles (followed by three cycles with NPLD de‐escalated at 50 mg/m2); MBVD‐DI consisted of 35 mg/m2 of NPLD plus standard bleomycin, vinblastine and dacarbazine for two cycles (followed by four cycles with NPLD de‐escalated at 25 mg/m2). Patients underwent R‐COMP‐DI and MBVD‐DI with a median dose intensity of 91% and 94% respectively. At interim‐FDG‐PET, 72/81 patients (one failed to undergo interim‐FDG‐PET due to early death) had a Deauville score of ≤3. At end of treatment, 90% of patients reached complete responses. In all, 20 patients had Grade ≥3 adverse events, and four of them required hospitalisation. At a median 21‐months of follow‐up, the progression‐free survival of the entire population was 77.3% (95% confidence interval 68%–88%). Our data suggest that the NPLD supercharge‐driven strategy in high‐risk DLBCL/c‐HL may be a promising option to test in phase III trials, for improving negative interim‐FDG‐PET cases incidence.

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Section: Treatment Planmentioning

confidence: 62%

Section: Introductionmentioning

confidence: 58%

Section: Methodsmentioning

confidence: 88%

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Liposomal doxorubicin supercharge‐containing front‐line treatment in patients with advanced‐stage diffuse large B‐cell lymphoma or classical Hodgkin lymphoma: Preliminary results of a single‐centre phase II study

et al. 2022

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“…Second, replacement of free doxorubicin with the liposomal nanodrug would decrease cardiotoxicity of free doxorubicin, thereby offering access to the standard of care to more patients including the elderly and comorbid ones. Importantly, in a large meta-analysis of patients with DLBCL treated with NPLD, Visco et al endorsed the value of NPLD both in terms of response and survival [80]. In contrast, although Sancho et al confirmed the noninferiority of NPLD to conventional doxorubicin as part of frontline immunochemotherapy in patients with so far untreated aggressive lymphomas, the substitution with NPLD was not associated with less early cardiotoxicity, although some reduced cardiac safety signals were observed [81].…”

Section: Liposomal Formulations Of Doxorubicin In the Therapy Of Aggr...mentioning

confidence: 99%

Targeted Drug Delivery and Theranostic Strategies in Malignant Lymphomas

Etrych

Braunová

Zogala

et al. 2022

Cancers

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Malignant lymphomas represent the most common type of hematologic malignancies. The first clinically approved TDD modalities in lymphoma patients were anti-CD20 radioimmunoconjugates (RIT) 131I-tositumomab and 90Y-ibritumomab-tiuxetan. The later clinical success of the first approved antibody–drug conjugate (ADC) for the treatment of lymphomas, anti-CD30 brentuximab vedotin, paved the path for the preclinical development and clinical testing of several other ADCs, including polatuzumab vedotin and loncastuximab tesirine. Other modalities of TDD are based on new formulations of “old” cytostatic agents and their passive trapping in the lymphoma tissue by means of the enhanced permeability and retention (EPR) effect. Currently, the diagnostic and restaging procedures in aggressive lymphomas are based on nuclear imaging, namely PET. A theranostic approach that combines diagnostic or restaging lymphoma imaging with targeted treatment represents an appealing innovative strategy in personalized medicine. The future of theranostics will require not only the capability to provide suitable disease-specific molecular probes but also expertise on big data processing and evaluation. Here, we review the concept of targeted drug delivery in malignant lymphomas from RIT and ADC to a wide array of passively and actively targeted nano-sized investigational agents. We also discuss the future of molecular imaging with special focus on monoclonal antibody-based and monoclonal antibody-derived theranostic strategies.

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“…[9][10][11][12] In response to adverse effects, mainly cardiotoxicity, the replacement of doxorubicin with other anthracyclines was performed, which proved to be effective for alleviating cardiotoxicity and has no signi cant impact on the patient's curative effect. 13,14 In addition to cardiotoxicity, other common adverse reactions caused by standard R-CHOP regimen treatment, such as gastrointestinal reactions, bone marrow suppression, and neurological toxicity, still seriously affect patients' quality of life. How to minimize toxic and side effects while ensuring e cacy is a problem we need to solve.…”

Section: Introductionmentioning

confidence: 99%

Efficacy and safety of substitute vincristine with vindesine in R-CHOP- like regimen in the treatment of newly diagnosed DLBCL, a real-world study

Sun

Wan

Bai

et al. 2022

Preprint

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Background The replacement of doxorubicin with other anthracyclines like epirubicin, pirarubicin, or liposomal adriamycin in the R-CHOP regime showed non-inferiority for DLBCL. Replacing vincristine with vindesine (R-CHVP) in R-CHOP has rarely been compared in efficacy and safety. This study aimed to figure out whether R-CHVP was non-inferior to R-CHOP in both efficacy and toxic effects.Methods This is a retrospective study performed at The First Hospital of Lanzhou University, including all consecutive adult patients aged over 18 years with newly diagnosed DLBCL who received therapy with R-CHOP or R-CHVP from March 2008 to September 2020. We compared the efficacy and safety of the R-CHVP regimen with vincristine and the R-CHOP regimen with vindesine.Results We identified 56 patients with DLBCL, including 18 patients in R-CHOP, 7 in R-CTOP, 12 in R-CEOP, 17 in R-CEVP, 11 in R-CTVP. Complete response was achieved in 12(66.7%), 4(57.1%), 5(41.7%), 7(41.2%) and 4(36.4%) patients respectively. The ORR of the five different schemes is 83.3%, 85.7%, 66.7%，64.07%，and 81.8%, respectively. The most common hematological adverse events during induction were anemia and neutropenia, and the most common non-hematological toxicity are gastrointestinal symptoms and neurotoxicity. The comparison of adverse events between R-CEOP and R-CEVP groups is as follows: the toxicity of hematological adverse events was not statistically significant; among non-hematological toxicity, the R-CEVP group was superior to the R-CEOP group in peripheral neuropathy (p=0.026). The 2-year progression-free survival were 75.5%, 54.6%, 53.2%, 62.7% and 42.4% in R-CHOP, R-CTOP, RCEOP, R-CEVP and R-CTVP group respectively.Conclusion The R-CHVP, in which vincristine was substituted by vindesine, was not inferior to the standard R-CHOP regimen and showed less neurotoxicity. Treatment regimens composed of different anthracyclines have similar therapeutic benefits and adverse events in addition to cardiotoxicity.

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Efficacy of R-COMP in comparison to R-CHOP in patients with DLBCL: A systematic review and single-arm metanalysis

Cited by 14 publications

References 39 publications

Liposomal doxorubicin supercharge‐containing front‐line treatment in patients with advanced‐stage diffuse large B‐cell lymphoma or classical Hodgkin lymphoma: Preliminary results of a single‐centre phase II study

Liposomal doxorubicin supercharge‐containing front‐line treatment in patients with advanced‐stage diffuse large B‐cell lymphoma or classical Hodgkin lymphoma: Preliminary results of a single‐centre phase II study

Targeted Drug Delivery and Theranostic Strategies in Malignant Lymphomas

Efficacy and safety of substitute vincristine with vindesine in R-CHOP- like regimen in the treatment of newly diagnosed DLBCL, a real-world study

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