Combination atezolizumab with rituximab and cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) may improve the complete response (CR) rate among patients with previously untreated diffuse large B cell lymphoma (DLBCL), according to research published in Blood Advances.
The CR rate improvement vs historical controls does not, however, appear to be great enough to warrant further study, and a number of immune-related adverse events (AEs) were observed.
Previous, early-stage clinical research has suggested that adding atezolizumab — an immune checkpoint inhibitor — to R-CHOP may improve outcomes compared with R-CHOP alone. For this phase 1b/2 study (ClinicalTrials.gov Identifier: NCT02596971), researchers evaluated the safety and efficacy of adding atezolizumab to R-CHOP among patients with previously untreated DLBCL. The primary endpoint was CR rate at end of induction.
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Overall, 42 patients were enrolled and treated on this study. The median age was 65 years in the cohort, 62% of patients were male sex, 95% of patients had Ann Arbor stage III or IV at diagnosis, and 48% of patients had bulky disease.
The CR rate at end of induction was 77.5% (95% CI, 64-87.7) per review by an independent review committee. By investigator assessment, the 3-year progression-free survival and overall survival rates were 77.4% and 87.2%, respectively.
All patients had at least 1 AE, and 76.2% of patients had a grade 3 to 4 AE. One fatal event was observed, which was an unconfirmed progressive multifocal leukoencephalopathy and considered related to treatment.
“In conclusion, this study in patients with previously untreated DLBCL demonstrated that the [atezolizumab]-R-CHOP combination provided durable clinical activity, and the safety profile was consistent with the known toxicities of the individual drugs,” the authors wrote in their report.
Disclosures: This research was supported by F. Hoffmann-La Roche Ltd. Please see the original reference for a full list of disclosures.
Reference
Younes A, Burke JM, Cheson BD, et al. Safety and efficacy of atezolizumab with rituximab and CHOP in previously untreated diffuse large B-cell lymphoma. Blood Adv. 2023;7(8):1488-1495. doi:10.1182/bloodadvances.2022008344
