We found a match
Your institution may have access to this item. Find your institution then sign in to continue.
- Title
The Impact of Sequence of Therapy for Older Patients With Follicular Lymphoma: SEER-Medicare Analysis.
- Authors
Xie, Can; Li, Ruosha; Huang, Xuelin; Chihara, Dai; Flowers, Christopher R.
- Abstract
There are limited data to address the preferred line of R-CHOP in the sequence of treatments among the elderly. Using the surveillance, epidemiology, and end results-medicare data, we analyzed 675 older patients (>65 years) with follicular lymphoma who received R-CHOP in the first or second line, and found that R-CHOP in first rather than second line was associated with longer survival in older patients. Background: One key clinical challenge remains in how to sequence treatments in follicular lymphoma (FL). The chemoimmunotherapy rituximab cyclophosphamide, doxorubicin, vincr istine (Oncovin), and prednisone (R-CHOP) has been a standard treatment option for two decades. However, there are limited data to suggest in which line R-CHOP should be used for older patients. Patients and Methods: We leveraged population-based surveillance, epidemiology, and end results-medicare data and identified 675 patients aged >65 years newly diagnosed with FL from 2000 to 2009 who received R-CHOP in either the first or second line. We estimated restricted mean survival time using Kaplan-Meier curves, propensity scores (PS), and regression models comparing patients who received R-CHOP as a first versus second line. Results: We found that patients who received R-CHOP as first line had significantly longer 9-year RMST than those who received R-CHOP in the second line using Kaplan-Meier curves (P = .01), PS stratification ( P = .002), PS matching (P = .005), and the inverse of PS as the treatment weight (P < .0001). The subgroup analyses using linear regression models showed that the 9-year restricted mean survival time of patients who received R-CHOP as the first line was longer in patients aged >80 years (P = .002) and with histological grade 1 or 2 (P = .02), compared to those who received R-CHOP as second line. Conclusion: R-CHOP given in the first line was associated with longer overall survival compared to R-CHOP given as second line for older patients with FL.
- Publication
Clinical Lymphoma, Myeloma & Leukemia, 2022, Vol 22, Issue 10, pe938
- ISSN
2152-2650
- Publication type
Article
- DOI
10.1016/j.clml.2022.06.014