New research shows that many people aged 80 and older with diffuse large B-cell lymphoma (DLBCL) can achieve similar cure rates with a lower chemotherapy dose, while experiencing fewer treatment-limiting side effects. Senior investigator Paul Barr presented the study at the American Society of Hematology annual meeting and highlighted the clinical relevance for older patients.
The investigators analysed outcomes in a real-world cohort treated at community cancer clinics across the US rather than only at major research centres. Wallace and Barr partnered with COTA Healthcare to study one of the largest available datasets, charting results for nearly 1,400 older people with DLBCL. This broader sample aimed to reflect everyday clinical practice outside National Cancer Institute–designated centres such as Wilmot.
The usual regimen for DLBCL is R-CHOP; in the study many older patients received a reduced plan called mini-R-CHOP. The mini dose cured the same number of individuals as the full dose and produced a lower rate of treatment discontinuation for side effects. Researchers described the reduced plan as a "Goldilocks regimen" because it preserved effectiveness while limiting toxicity.
Wilmot is now enrolling older patients into a new trial that combines mini-R-CHOP with the immunotherapy mosunetzumab. The trial is the third in a series focused on refining care for the oldest patients and is supported by the Lymphoma Scientific Research Mentoring Program; previous studies testing mosunetzumab by Patrick Reagan provided the foundation for the current trial. Overall, the study offers evidence that treatment plans can be adapted by age and setting to reduce harm while keeping the chance of cure.
Difficult words
- lymphoma — cancer that starts in lymphatic system
- cohort — group of people studied together
- regimen — planned schedule of medical treatment
- discontinuation — stopping a treatment before planned end
- toxicity — harmful side effects caused by treatment
- immunotherapy — treatment that boosts the immune system
Tip: hover, focus or tap highlighted words in the article to see quick definitions while you read or listen.
Discussion questions
- What are the main benefits and risks of giving older patients a reduced chemotherapy dose? Give reasons from the article.
- How does using data from community cancer clinics (not only major research centres) affect how we can apply the study results?
- If mini-R-CHOP plus mosunetzumab proves effective, how might that change treatment choices for the oldest patients?
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