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Rituximab plus nonpegylated liposomal doxorubicin (R-NPLD) is an effective and safe combination in patients aged 80 years or older with diffuse large B cell lymphoma (DLBCL), according to study results presented at the European Society of Medical Oncology (ESMO) Congress 2021.
Investigators retrospectively and prospectively analyzed the data of patients aged 80 years or older with untreated histologically proven CD20-positive DLBCL. The participants received a combination treatment with R-NPLD, consisting of R 375 mg/sqm and NPLD 50 mg/sqm administered intravenously on cycle day 1, plus prednisone 50 mg orally on days 1 to 5, every 21 days for 6 courses.
The cohort included 50 patients (median age, 84 years [range 80-96]; 54% male) enrolled from May 2010 to April 2019. The median follow-up was 28 months (range, 10-104). The overall 3-year survival, cause-specific survival, and disease-free survival rates were 49.9% ± 7.6%, 55.5% ± 7.9%, and 48.5% ± 7.8%, respectively.
The treatment combination was well tolerated with only mild toxicities and no treatment-related hospitalization or toxic-related deaths. Patients who achieved event-free status (EFS)12 and EFS18 had an overall 3-year survival of 66% ± 13.0% and 67.9% ± 7.0%, respectively.
The results followed the researchers’ 2018 findings of the R-NPLD combination in patients in the same age group with DLBCL or grade 3 B follicular lymphoma. “Our results confirm that, in patients 80 years or older with DLBCL, R-NPDL is a very effective and safe combination,” they stated.
Among prognostic factors, only elevated lactate dehydrogenase (>1.25 upper limit) strongly correlated with overall survival and risk of relapse in univariate (P =.001; P =.003) and multivariate (P =.002; P =.005) analysis, respectively. In patients who achieved EFS18 the probability to survive 24 and 36 months was 90.5% and 67.9%, respectively.
“This analysis suggests that EFS18 will be useful in patient counseling and should be considered as a robust endpoint for future studies of newly diagnosed very elderly DLBCL patients,” the study authors said.
Cantò C, Pennese E, Di Nicola M, et al. Rituximab and nonpegylated liposomal doxorubicin (R-NPLD) treatment in patients 80 years of age and older affected by diffuse large B cell lymphoma (DLBCL): a 2020 update and implications of clinical and pathological factors. Presented at: European Society of Medical Oncology (ESMO) Congress 2021; September 16-21, 2021. Abstract 838P.