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• W2996341323 abstract "Abstract Clinical trials comparing bendamustine/rituximab (BR) with cyclophosphamide‐based regimens (RCHOP/RCVP) have pooled various histologies of indolent B‐cell lymphomas. We examined real‐life outcomes of older patients with follicular (FL), mantle cell (MCL), or marginal zone/lymphoplasmacytic lymphoma (MZL/LPL), treated with these first‐line regimens. We identified Medicare beneficiaries with FL, MCL, or MZL/LPL, who received either first‐line BR or RCHOP/RCVP in 2009‐2016, and matched groups using a propensity score. Outcomes of claims‐based event‐free survival (EFS), overall survival (OS), toxicity, secondary cancers, and costs were compared in the aggregate cohort (N = 2736), and in separately matched histology‐specific subcohorts. In the aggregate cohort, EFS was better with BR than with RCHOP/RCVP (hazard ratio [HR], 0.78; 95% confidence interval [CI], 0.70‐0.87). Acute toxicity was lower with BR, including rates of hospitalizations (33% vs 45%), infections (21% vs 30%), cardiovascular events, and transfusions, yet OS did not differ (HR, 1.03; 95% CI, 0.91‐1.17) and Medicare spending was higher. There was no difference in the cumulative incidence of secondary cancers (subhazard ratio, 1.11; 95% CI, 0.83‐1.48). The EFS advantage of BR was pronounced in MCL (N = 690; HR, 0.64; 95% CI, 0.54‐0.76), but less so in FL (N = 1330; HR, 0.83; 95% CI, 0.69‐0.98) and absent in MZL/LPL (N = 574; HR, 0.92; 95% CI, 0.73‐1.17). Despite improved EFS and lower toxicity, the shift from RCHOP/RCVP to BR in clinical practice did not improve OS for older patients with indolent B‐cell lymphomas. Frequent infections and hospitalizations underscore the need for safer treatment approaches in this population. Secondary cancers do not appear to be increased after BR compared with RCHOP/RCVP." @default.
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• W2996341323 date "2020-01-02" @default.
• W2996341323 modified "2023-09-29" @default.
• W2996341323 title "Outcomes of bendamustine‐ or cyclophosphamide‐based first‐line chemotherapy in older patients with indolent B‐cell lymphoma" @default.
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• W2996341323 doi "https://doi.org/10.1002/ajh.25707" @default.
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