Long-term outcome of patients in the LNH-98.5 trial, the first randomized study comparing rituximab-CHOP to standard CHOP chemotherapy in DLBCL patients: a study by the Groupe d'Etudes des Lymphomes de l'Adulte

Bertrand Coiffier(Université Claude Bernard Lyon 1), Catherine Thiéblemont(Institut Gustave Roussy), Éric Van Den Neste(Institut Gustave Roussy), G. Lepeu(Institut Gustave Roussy), Isabelle Plantier(Institut Gustave Roussy), Sylvie Castaigné(Institut Gustave Roussy), Sophie Lefort(Institut Gustave Roussy), Gérald Marit(Institut Gustave Roussy), Margaret Macro(Institut Gustave Roussy), Catherine Sebban(Institut Gustave Roussy), Karim Belhadj(Institut Gustave Roussy), Dominique Bordessoule(Institut Gustave Roussy), Christophe Fermé(Université Claude Bernard Lyon 1), Hervé Tilly(Institut Gustave Roussy)
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Abstract

We report the outcome of patients included in the LNH-98.5 study, which compared cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP) to rituximab plus CHOP (R-CHOP) therapy in 399 patients with diffuse large B-cell lymphoma (DLBCL) aged 60 to 80 years, with a median follow-up time of 10 years. Clinical event information was updated in all living patients (with the exception of 3 patients) in 2009. Survival end points were improved in patients treated with R-CHOP: the 10-year progression-free survival was 36.5%, compared with 20% with CHOP alone, and the 10-year overall survival was 43.5% compared with 27.6%. The same risk of death due to other diseases, secondary cancers, and late relapses was observed in both study arms. Relapses occurring after 5 years represented 7% of all disease progressions. The results from the 10-year analysis confirm the benefits and tolerability of the addition of rituximab to CHOP. Our findings underscore the need to treat elderly patients as young patients, with the use of curative chemotherapy.


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