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Evaluating the Efficacy of R-Mini-CHOP With or Without Oral Azacytidine for Elderly Patients With DLBCL
Elizabeth Brem, MD, University of California, Irvine, discusses an ongoing clinical trial, titled S1918, that examines elderly patients with diffuse large B-cell lymphoma (DLBCL) who are treated with a regimen of rituximab and reduced dose cyclophosphamide, hydroxydaunorubicin, vincristine sulfate, and prednisone (R-mini-CHOP) with or without oral azacytidine.
“We've built in these different geriatric, functional assessments of what people can do kind of before, during, and after therapy to better understand our older patients, who should maybe get chemoimmunotherapy, and how treatment affects them in both the short and the long term,” explained Dr Brem.
Transcript:
My name is Liz Brem, associate clinical professor at the University of California, Irvine. I've had the privilege of working on a clinical trial called S1918, which is a SWOG study, for patient 75 and older with newly diagnosed diffuse large B cell lymphoma (DLBCL). [It is] looking at rituximab and reduced dose cyclophosphamide, hydroxydaunorubicin, vincristine sulfate, and prednisone (R-mini-CHOP), presuming that's the standard, with or without oral azacytidine. There's some reason to think that a hypomethylating agent could be particularly useful in our older patients.
This has been an interesting study to work on because in addition to that therapeutic question of: does the oral azacytidine help more patients get into remission and improve outcomes? We get a chance to learn a lot about our older patients with [DLBCL]. We know that DLBCL tends to be a disease of older patients.
If you look at the (Surveillance, Epidemiology, and End Results) SEER data, about a third of DLBCL happens in patients above the age of 75, and yet they're often underrepresented on clinical trials. In addition to, again, the therapeutic question, we've built in these different geriatric assessments, these functional assessments of what people can do kind of before, during, and after therapy to better understand our older patients, who should maybe get chemoimmunotherapy, and how treatment affects them in both the short and the long term.
It's been an interesting study to work on to help us really gather information just about these older patients with DLBCL.
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