Ofatumumab versus rituximab salvage chemoimmunotherapy in relapsed or refractory diffuse large B-cell lymphoma: The ORCHARRD Study Journal Article


Authors: van Imhoff, G. W.; McMillan, A.; Matasar, M. J.; Radford, J.; Ardeshna, K. M.; Kuliczkowski, K.; Kim, W.; Hong, X.; Goerloev, J. S.; Davies, A.; Barrigón, M. D. C.; Ogura, M.; Leppä, S.; Fennessy, M.; Liao, Q.; Van Der Holt, B.; Lisby, S.; Hagenbeek, A.
Article Title: Ofatumumab versus rituximab salvage chemoimmunotherapy in relapsed or refractory diffuse large B-cell lymphoma: The ORCHARRD Study
Abstract: Purpose We compared the efficacy of ofatumumab (O) versus rituximab (R) in combination with cisplatin, cytarabine, and dexamethasone (DHAP) salvage treatment, followed by autologous stem-cell transplantation (ASCT) in patients with relapsed or refractory diffuse large B-cell lymphoma (DLBCL). Patients and Methods Patients with CD201 DLBCL age≥18 years who had experienced their first relapse or who were refractory to first-line R-CHOP (cyclophosphamide, doxorubicin, vincristine, prednisone)-like treatment were randomly assigned between three cycles of R-DHAP or O-DHAP. Either O 1,000 mg or R 375 mg/m2 was administered for a total of four infusions (days 1 and 8 of cycle 1; day 1 of cycles 2 and 3 of DHAP). Patients who experienced a response after two cycles of treatment received the third cycle, followed by high-dose therapy and ASCT. Primary end point was progression-free survival (PFS), with failure to achieve a response after cycle 2 included as an event. Results Between March 2010 and December 2013, 447 patients were randomly assigned. Median age was 57 years (range, 18 to 83 years); 17% were age≥65 years; 63% had stage III and IV disease; 71% did not achieve complete response (CR) or experience response for , 1 year on first-line R-CHOP. Response rate for O-DHAP was 38% (CR, 15%) versus 42% (CR, 22%) for R-DHAP. ASCT on protocol was completed by 74 patients (33%) in the O arm and 83 patients (37%) in the R arm. PFS, event-free survival, and overall survival were not significantly different between O-DHAP versus R-DHAP: PFS at 2 years was 24% versus 26% (hazard ratio [HR], 1.12; 95% CI, 0.89 to 1.42; P 5 .33); event-free survival at 2 years was 16% versus 18% (HR, 1.10; P 5 .35); and overall survival at 2 years was 41% versus 38% (HR, 0.90; P 5 .38). Positron emission tomography negativity before ASCT was highly predictive for superior outcome. Conclusion No difference in efficacy was found between O-DHAP and R-DHAP as salvage treatment of relapsed or refractory DLBCL. © 2016 by American Society of Clinical Oncology.
Journal Title: Journal of Clinical Oncology
Volume: 35
Issue: 5
ISSN: 0732-183X
Publisher: American Society of Clinical Oncology  
Date Published: 2017-02-10
Start Page: 544
End Page: 551
Language: English
DOI: 10.1200/jco.2016.69.0198
PROVIDER: scopus
PUBMED: 28029326
DOI/URL:
Notes: Article -- Presented in part at the 56th Annual Meeting of the American Society of Hematology, which took place December 6-9, 2014 in San Francisco, CA -- Export Date: 2 March 2017 -- Source: Scopus
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  1. Matthew J Matasar
    284 Matasar