Journal
CRITICAL REVIEWS IN ONCOLOGY HEMATOLOGY
Volume 163, Issue -, Pages -Publisher
ELSEVIER SCIENCE INC
DOI: 10.1016/j.critrevonc.2021.103377
Keywords
Lymphoma; Doxorubicin; Liposomal doxorubicin; Hearth failure; DLBCL; Diffuse large B-cell lymphoma
Categories
Funding
- AIL (Italian Association against Leukemia, Lymphoma and Myeloma) section of Verona
- Istituto Gentili
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Through a systematic review, it was found that combination therapy with NPLD (R-COMP) is comparable to standard treatment (R-CHOP) in terms of treatment response, overall survival, and progression-free survival in DLBCL patients. R-COMP may be a safe and effective option for elderly DLBCL patients or those with existing cardiac impairment.
Doxorubicin represents the mainstay in the upfront treatment of diffuse large B-cell lymphoma (DLBCL) patients. However, its administration is sometimes hampered by the coexistence of former comorbidities/cardiac issues, especially in the elderly population. Liposome encapsulated drug delivery systems have been adopted to reduce the exposure of normal tissues to the drug, both in solid cancers and lymphomas. Despite claims for lower toxicity, the efficacy of non-pegylated liposome doxorubicin (NPLD) in DLBCL, as compared to standard doxorubicin, has never been established. We systematically reviewed relevant literature of NPLD in lymphoma treatment. Adjusting for age/comorbidities, our metanalysis revealed that the use of combinations including NPLD (R-COMP) were non-inferior in terms of response, overall and progression-free survival to the standard of care (R-CHOP) in overlapping series of DLBCL patients. R-COMP may represent a safe and active option for elderly patients with DLBCL, or for those with some extent of cardiac impairment at baseline.
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