Spanish Lymphoma Group (GELTAMO) guidelines for the diagnosis, staging, treatment, and follow-up of diffuse large B-cell lymphoma

González‐Barca, Eva; Coronado, Mónica; Martı́n, Alejandro; Montalbán, Carlos; Montes‐Moreno, Santiago; Panizo, Carlos; Rodríguez, Guillermo; Sancho, Juan‐Manuel; López-Hernández, Andrés

doi:10.18632/oncotarget.25892

Cited by 11 publications

(10 citation statements)

References 107 publications

(134 reference statements)

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“…The combination of the monoclonal anti‐CD20 antibody rituximab plus chemotherapy with cyclophosphamide, doxorubicin, vincristine, and prednisone (R‐CHOP) still constitutes the standard first‐line regimen for patients with diffuse large B‐cell lymphoma (DLBCL) 1 . However, its use is limited especially in elderly patients due, among other reasons, to cardiotoxicity derived from doxorubicin.…”

Section: Introductionmentioning

confidence: 99%

R‐COMP versus R‐CHOP as first‐line therapy for diffuse large B‐cell lymphoma in patients ≥60 years: Results of a randomized phase 2 study from the Spanish GELTAMO group

et al. 2021

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The use of non‐pegylated liposomal doxorubicin (Myocet®) in diffuse large B‐cell lymphoma (DLBCL) has been investigated in retrospective and single‐arm prospective studies. This was a prospective phase 2 trial of DLBCL patients ≥60 years old with left ventricular ejection fraction (LVEF) ≥55% randomized to standard R‐CHOP or investigational R‐COMP (with Myocet® instead of conventional doxorubicin). The primary end point was to evaluate the differences in subclinical cardiotoxicity, defined as decrease in LVEF to <55% at the end of treatment. Secondary objectives were efficacy, safety, and variations of troponin and N‐terminal pro‐B‐type natriuretic peptide (NT‐proBNP) and LVEF along follow‐up. Ninety patients were included, 45 in each group. No differences were observed in the percentage of patients with LVEF <55% at end of treatment (11% in R‐CHOP arm vs. 7% in R‐COMP arm, p = 0.697) or at 4 months (10% vs. 6%, respectively, p = 0.667) and 12 months (8% vs. 7%, respectively, p = 1). However, a higher percentage of R‐CHOP compared with R‐COMP patients showed increased troponin levels in cycle 6 (100% vs. 63%, p = 0.001) and at 1 month after treatment (88% vs. 56%, respectively, p = 0.015). Cardiovascular adverse events were seen in five R‐CHOP patients (nine episodes, four grade ≥3) and in four R‐COMP patients (five episodes, all grade 1–2). No significant differences in efficacy were observed. In conclusion, R‐COMP is a feasible immunochemotherapy schedule for DLBCL patients ≥60 years, with similar efficacy to R‐CHOP. However, the use of non‐pegylated doxorubicin instead of conventional doxorubicin was not associated with less early cardiotoxicity, although some reduced cardiac safety signals were observed. Trial registration: ClinicalTrials.gov Identifier: NCT02012088.

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Section: Introductionmentioning

confidence: 99%

R‐COMP versus R‐CHOP as first‐line therapy for diffuse large B‐cell lymphoma in patients ≥60 years: Results of a randomized phase 2 study from the Spanish GELTAMO group

et al. 2021

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“…In Poland, the need is felt for collaboration within the European MCL network and development of common standards. At present, 102 Spanish hospitals collaborate with the Geltamo network for lymphoma, and there is at least one person responsible for lymphoma in each hospital [ 60 ]. Two general meetings are organized with all the delegates and several educational activities are performed each year, some of them addressed to young hematologists.…”

Section: Challenge-by-challenge Accountmentioning

confidence: 99%

Tackling Mantle Cell Lymphoma in Europe

Horgan¹,

Walewski

Aurer

et al. 2022

Healthcare

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An expert panel convened by the European Alliance for Personalized Medicine (EAPM) reflected on achievements and outstanding challenges in Europe in mantle cell lymphoma (MCL). Through the prism of member state experience, the panel noted advances in outcomes over the last decade, but highlighted issues constituting barriers to better care. The list notably included availability of newer treatments, infrastructure and funding for related testing, and shortages of relevant skills and of research support. The prospect of improvements was held to reside in closer coordination and cooperation within and between individual countries, and in changes in policy and scale of investment at both national and EU levels.

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“…Additional aggressive large B-cell lymphoma (LBCL) subtypes include high-grade B-cell lymphoma (HGBCL) with MYC and BCL2 and/or BCL6 rearrangements, follicular lymphoma grade 3B (FL3B), and primary mediastinal B-cell lymphoma (PMBCL). Although firstline standard of care (SOC) treatment with rituximab in combination with an anthracycline-based chemotherapy regimen is curative in [ 50% of patients with LBCL [3], 10-15% of patients are refractory and about one-third relapse after responding to their initial treatment [4][5][6][7]. Patients with relapsed or refractory (R/R) LBCL often have a poor clinical prognosis [8].…”

Section: Introductionmentioning

confidence: 99%

Indirect Treatment Comparison of Liso-Cel vs. Salvage Chemotherapy in Diffuse Large B-Cell Lymphoma: TRANSCEND vs. SCHOLAR-1

et al. 2021

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Most patients with relapsed/refractory (R/R) diffuse large B-cell lymphoma (DLBCL) have exhausted their treatment options and are deemed palliative. CD19-directed chimeric antigen receptor (CAR) T-cell therapy has recently been introduced as a new option for these patients. Lisocabtagene maraleucel (lisocel) is an investigational CAR T-cell therapy that has shown promising activity in this setting. We used an unanchored matching-adjusted indirect comparison (MAIC) methodology to compare liso-cel, using individual patient-level data from the TRANSCEND NHL 001 (TRANSCEND; NCT02631044) trial, to salvage chemotherapy, using summary-level data from the SCHOLAR-1 study, for the treatment of patients with R/R LBCL. Standardized mean differences were used to evaluate imbalances between the TRANS-CEND and SCHOLAR-1 studies. MAIC was conducted to determine the relative efficacy of liso-cel vs. salvage chemotherapy with regard to overall survival, complete response rate, and objective response rate. For all efficacy outcomes assessed, comparisons of clinical factors before MAIC showed that five of seven baseline characteristics were similar between the TRANSCEND and SCHOLAR-1 studies; however, age and R/R to last therapy status differed between studies, thus requiring matching and adjusting to ensure the validity of this analysis. The base case analyses demonstrated a significantly lower risk of mortality (hazard ratio, 0.5; 95% confidence interval [CI] 0.4-0.6; p \ 0.001) with significantly higher rates of complete response (odds ratio, 12.9; 95% CI 8.0-20.7) and objective response (odds ratio, 7.0; 95% CI 4.6-10.5) for patients treated with liso-cel than patients treated with salvage chemotherapy. MAIC comparisons demonstrated favorable efficacy for liso-cel compared with salvage chemotherapy in the treatment of patients with R/R LBCL.Trial Registration ClinicalTrials.gov identifier: NCT02631044. J. Garcia: Affiliation at the time the research was conducted.

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Spanish Lymphoma Group (GELTAMO) guidelines for the diagnosis, staging, treatment, and follow-up of diffuse large B-cell lymphoma

Cited by 11 publications

References 107 publications

R‐COMP versus R‐CHOP as first‐line therapy for diffuse large B‐cell lymphoma in patients ≥60 years: Results of a randomized phase 2 study from the Spanish GELTAMO group

R‐COMP versus R‐CHOP as first‐line therapy for diffuse large B‐cell lymphoma in patients ≥60 years: Results of a randomized phase 2 study from the Spanish GELTAMO group

Tackling Mantle Cell Lymphoma in Europe

Indirect Treatment Comparison of Liso-Cel vs. Salvage Chemotherapy in Diffuse Large B-Cell Lymphoma: TRANSCEND vs. SCHOLAR-1

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