People ages 80 and older with a common type of lymphoma can take a half-dose of chemotherapy and be cured or significantly extend their survivorship with fewer toxic side effects, a new study shows.
Senior investigator Paul Barr, a professor of medicine at the University of Rochester, presented the study at the American Society of Hematology (ASH) annual meeting.
It doesn’t make sense to give an 80-year-old cancer patient the same dose of chemotherapy as a younger person, the researchers say—and research has already proven this general approach is effective.
But their study evaluated whether the lower dose was valid in a “real world” group of patients treated at clinics across the US. The study did confirm the safety and effectiveness for millions of people seeking care in non-academic, community cancer clinics outside of National Cancer Institute-designated centers such as Wilmot.
Wallace and Barr partnered with COTA Healthcare, a company that collects data for cancer research, to analyze one of the largest datasets available and chart the outcomes for nearly 1,400 older people with diffuse large B-cell lymphoma (DLBCL).
The standard treatment for DLBCL is a chemotherapy cocktail known as R-CHOP, and in this case the older patients received “mini-R-CHOP.” The mini dose cured the same number of individuals.
“It also seemed like people who got mini-R-CHOP had a lower rate of stopping treatment because of side effects compared to full-dose R-CHOP,” Wallace says.
“We want people to get all their planned chemotherapy. In this study, it looks like a Goldilocks regimen—where it’s preserving effectiveness but limiting toxicity.”
Currently at Wilmot, Wallace is enrolling older patients with DLBCL into a new trial evaluating mini-R-CHOP plus an immunotherapy drug, mosunetzumab. The study is the third in a series of similar trials focused on refining treatments for the oldest patients and is supported by the Lymphoma Scientific Research Mentoring Program. Previous studies testing mosunetzumab in people with lymphoma, by Patrick Reagan, associate professor of medicine, served as the foundation for Wallace’s current trial.
Source: University of Rochester
