Retreatment With R-CHOP-Like Therapy Yields Durable Remission in Late-Relapse DLBCL
Jean-Nicolas Champagne, MD, BC Cancer Vancouver, Canada, discusses results from a retrospective study that evaluated outcomes of patients treated with R-CHOP-like therapy for late-relapse diffuse large B-cell lymphoma (DLBCL) in British Columbia. The study found that retreatment with R-CHOP-like therapy was a reasonable option for this patient population and resulted in durable remission in a high proportion of patients.
Dr Champagne presented these results at the 66th ASH Annual Meeting in San Diego, California.
Transcript:
Hi, I'm Jean-Nicolas Champagne, I’m a hematologist and oncologist trained in Montreal. I just completed my fellowship at BC Cancer in lymphoma and I'm going to talk to you about the abstract I presented on late relapse DLBCL with a second round of R-CHOP-like therapy.
The premise of our retrospective study was that late relapse DLBCL really represents a distinct disease, distinct biology, and share very few mutations with the original diagnosis often and this makes it more of a chemosensitive disease. In British Columbia we know that R-CHOP or RCOP may be curable for some patients. In British Columbia that approach has been used for some patients and the purpose and the objective of our study was basically to retrospectively assess the outcomes of patients treated with a second round of R-CHOP or RCOP therapy.
Overall, we've identified 65 patients who met the inclusion criteria being a de novo DLBCL treated with the frontline R-CHOP-like therapy, late relapse defined as more than 24 months from the initial diagnosis and treated with a second round of R-CHOP-like therapy. These 65 patients, they were a bit older, a bit frailer, median age of 77, the median time from initial diagnosis to relapse was 7.4 years, and they had a high IPI score in two-thirds of the patients.
Quite frail population but despite that they've received a median of 5 cycles of R-CHOP-like therapy and the overall response rate was 72% with 57% of the patients achieving complete response. The primary outcome of our study was time-to-progression (TTP) and after a median follow-up of 31 months the 24-months TTP was 55%, giving some durable response to some patients who have received R-CHOP-like therapy in the past.
The interesting finding of our study is that the timing of relapse actually affected the outcomes, and we saw that patients who had relapsed between 2 to 5 years from their initial diagnosis actually did quite poorly with the R-CHOP-like retreatment strategy with a 24-months TTP of 9%. On the other hand, those who relapsed more than 5 years from their initial diagnosis had the TTP at two-year of 68%, for these patients that allowed the curative intent therapy that prevented them from going on higher intensity therapy and as I mentioned earlier it's a bit of a more frail population.
It's a very interesting treatment choice for our patients and we have to acknowledge the distinct biology from late relapsed DLBCL, and the possibility of curing them with a second round of R-CHOP-like therapy.
Source:
Champagne JN, Villa D, Gerrie A, et al. Retreatment with R-CHOP-like therapy in patients with late relapse of diffuse large b-cell lymphoma (DLBCL). Presented at 66th ASH Annual Meeting & Exposition; December 7-10, 2024; San Diego, California. Abstract 109.
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