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.
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.
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