Comparative Effectiveness of R‐miniCOMP Versus R‐miniCHOP in Older Non‐Fit Patients With Diffuse Large B‐Cell Lymphoma: Insights From a “Fondazione Italiana Linfomi” Cohort Study

作者：Alberto Bavieri, Sara Veronica Usai, Michele Merli, Alice Di Rocco, Federica Cavallo, Vittorio Ruggero Zilioli, Manuela Zanni, Flenghi Leonardo, Dario Marino, Annalisa Arcari, Emanuele Cencini, Guido Gini, Barbara Botto, Alessandra Tucci, Clara Deambrogi, Plenteda Caterina, Bianchi Maria Paola, Stefan Hohaus, Manuel Gotti, Benedetta Puccini, Daniela Dessì, Marta Coscia, Luigi Petrucci, Simone Ragaini, Emanuela Chimienti, Luigi Marcheselli, Caterina Mammi, Stefano Luminari, Michele Spina, Francesco Merli · 发表于：Hematological Oncology · 年份：2025 · DOI：10.1002/hon.70099 · 被引用次数：5 · 研究领域：Lymphoma Diagnosis and Treatment、CNS Lymphoma Diagnosis and Treatment、Viral-associated cancers and disorders

The R-miniCHOP regimen is the standard first-line treatment for diffuse large B-cell lymphoma (DLBCL) in older unfit or frail patients. Recent research suggests that replacing doxorubicin with non-PEGylated liposomal doxorubicin (NPLD) is safe and effective for DLBCL. However, the outcomes of DLBCL patients receiving NPLD as part of a reduced-intensity regimen approach have yet to be investigated. This study aimed to assess non-fit DLBCL patients enrolled in the Elderly Project (EP) conducted by the Fondazione Italiana Linfomi (FIL) who were treated with R-miniCHOP or R-miniCOMP. The primary and secondary endpoints were overall survival (OS) and progression-free survival (PFS), respectively. Of the 1163 cases within the EP cohort, we identified 176 patients (18%) who resulted unfit or frail at simplified geriatric assessment (sGA) and received either R-miniCHOP (89 cases; 51%) or R-miniCOMP (87 cases; 49%). Both cohorts exhibited similar clinical characteristics, a similar distribution of unfit and frail cases using the sGA and similar Elderly Prognostic Index (EPI) scores. After a median follow-up of 28 months, the 3-year OS and PFS rates were 61% and 54% respectively, with no significant difference between R-miniCHOP and R-miniCOMP. Notably, the therapeutic regimen had no significant impact on OS (HR 1.07, 95% CI: 0.63-1.82, p = 0.798) or PFS (HR 1.00, 95% CI: 0.62-1.6, p = 0.999) even after adjusting for propensity score (PS) and inverse probability weighting (IPW). A comp...