ASH 2024 | Long-term follow-up of patients aged 80 or older with DLBCL treated with mini-CHOP plus anti-CD20

We present at the ASH meeting an update about the long-term follow-up of two clinical trials already published and reported for patients treated with anti-CD20 plus mini-CHOP, which is attenuated chemotherapy for patients and they are not eligible for full R-CHOP. So it’s patient populations of more than 80 years and rituximab or anti-CD20 plus mini-CHOP is a standard of care but we have no idea and no study or check the long-term follow-up of this population of patients. Of course there is a [inaudible] which is normal in such a population but we would like to check if the long-term follow-up is safe for the treatment proposed by anti-cd20 plus mini-CHOP. So we complete a study with long-term follow-up in LNH 037B and LNH 097B, so two Phase II studies with R mini-CHOP or ofatumumab mini-CHOP two studies so evaluated anti-CD20 plus mini-CHOP. 149 patients in 037B and 120 for the 097B studies, so in total 269 patients were included in the long-term follow-up analysis and we check the PFS OS and cause of death and also we check for secondary primary malignancy. And we then we compare the outcome of the patients with general population healthy based on alpha based study. and we could say that the PFS median was 2.4 years and the overall survival median was 4.1 years. So it is very satisfactory in such elderly populations and we do not see any significant difference between the two studies. interestingly the second study with ofatumumab mini-CHOP included a pre-phase to control the disease before to start the full R mini-CHOP or anti-CD20 mini-CHOP and then we could see there is no death related to the treatment in the second study with the pre-phase and we think it should be a standard of care to give a pre-phase of treatment with just one dose of chemotherapy plus anti-CD20 before to start the full completion of anti-CD20 plus mini-CHOP to avoid toxicity, especially for the first cycle of treatment. So it was interesting to see the main cause of death was related to lymphoma we do not see any significant elevated cause of toxicity with this treatment. So the treatment was well tolerated in general with this regimen in such a population. And we see secondary malignancy could arrive with a rate of 6.3% of the total population. So it’s not very high and it means that there is no specific signals of long-term toxicity with anti-CD20 plus mini-CHOP. And this remains the standard of care for this population. Interestingly, we also check the outcome of patients as compared with the general population at the same age, same sex. And we do not see any difference between patients treated with anti-CD20 plus mini-CHOP as compared with the general population. As you know, the mean age of expectancy to life in the country, France, is near 83 years. So the mean age for the inclusion was the same, and it means that the patient treated with this regimen is very similar to the expectancy of life of the general population, we do not see any difference so it means that this type of population eligible for anti-CD20 plus mini-CHOP should be treated with any issue, any complaints as the objective of the treatment is still to be cure of the patient even if the patient is very old.

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