A study presented at the American Society of Hematology meeting found that people aged 80 and older with diffuse large B-cell lymphoma (DLBCL) can often be cured or live much longer when given a lower chemotherapy dose. Senior investigator Paul Barr described the results to the meeting audience.
Investigators evaluated outcomes in a real-world group of patients treated at community cancer clinics across the US. Wallace and Barr partnered with COTA Healthcare to analyse one of the largest available datasets, which covered nearly 1,400 older people with DLBCL.
The standard treatment is the R-CHOP combination. In this study, older patients received a reduced regimen called mini-R-CHOP. The mini dose cured the same number of people as the full dose and had a lower rate of treatment stops for side effects. Researchers called it a "Goldilocks regimen" because it kept effectiveness while limiting toxicity.
At Wilmot, Wallace is enrolling older patients into a new trial that combines mini-R-CHOP with the immunotherapy drug mosunetzumab. The findings support adapting treatment by age and care setting to reduce harm while keeping the chance of cure.
Difficult words
- lymphoma — a cancer that starts in the lymph system
- chemotherapy — treatment that uses strong drugs to kill cancerchemotherapy dose
- regimen — a planned schedule of medical treatment
- toxicity — harmful effects of a drug or treatment
- side effect — an unwanted medical problem from treatmentside effects
- immunotherapy — treatment that uses the body's immune systemimmunotherapy drug
- dataset — a collection of related information or recordsdatasets
- cure — to make a sick person healthy againcured
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Discussion questions
- Do you think doctors should adapt cancer treatment by a patient’s age? Why or why not?
- What advantages and risks do you see in using a lower chemotherapy dose for older patients?
- How might combining mini-R-CHOP with an immunotherapy drug affect an older patient’s daily life and recovery?
