Evidence map›Paper›PMID 30686772›Full record

ArticleClinical lymphoma, myeloma & leukemia2019

Assessing the Effectiveness of Treatment Sequences for Older Patients With High-risk Follicular Lymphoma With a Multistate Model.

Çağlar Çağlayan, Hiromi Terawaki, Turgay Ayer, Jordan S Goldstein, Ashish Rai, Qiushi Chen, Christopher Flowers

Open access · greenAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Clinical lymphoma, myeloma & leukemia, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
0.8field-weighted citation impact, top 30% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 6 citations in OpenAlex.

  1. Article
  2. Article
  3. Article
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 4 institutions in 1 country.

Çağlar ÇağlayanH. Milton Stewart School of Industrial and Systems Engineering, Georgia Institute of Technology, Atlanta, GA. Electronic address: ccaglayan6@isye.gatech.edu.
Hiromi TerawakiWinship Cancer Institute of Emory University, Atlanta, GA.
Turgay AyerH. Milton Stewart School of Industrial and Systems Engineering, Georgia Institute of Technology, Atlanta, GA.
Jordan S GoldsteinWinship Cancer Institute of Emory University, Atlanta, GA.
Ashish RaiAmerican Cancer Society, Inc, Atlanta, GA.
Qiushi ChenInstitute for Technology Assessment, Massachusetts General Hospital, Boston, MA.
Christopher FlowersWinship Cancer Institute of Emory University, Atlanta, GA.
Emory University · USGeorgia Institute of Technology · USAmerican Cancer Society · USMassachusetts General Hospital · US

Funding

Winship Cancer Institute Cancer Center Support GrantP30CA138292 · NCI · EMORY UNIVERSITY · PI Suresh S Ramalingam · 2009 to 2026
$47.5M
Translational Physician-Scientist Training Program in OncologyT32CA160040 · NCI · EMORY UNIVERSITY · PI SHIN, DONG M · 2013 to 2017
$1.2M
Mentored Patient Oriented Research in LymphomaK24CA208132 · NCI · UNIVERSITY OF TX MD ANDERSON CAN CTR · PI FLOWERS, CHRISTOPHER R · 2016 to 2020
$822k
NCI NIH HHS K24 CA208132NCI NIH HHS P30 CA138292NCI NIH HHS T32 CA160040
6 · The paper itself

Abstract

backgroundDisease progression within < 2 years of initial chemoimmunotherapy and patient age > 60 years have been associated with poor overall survival (OS) in follicular lymphoma (FL). No standard treatment exists for these high-risk patients, and the effectiveness of sequential therapies remains unclear. PATIENTS AND

methodsWe studied the course of FL with first-, second-, and third-line treatment. Using large population-based data, we identified 5234 patients with FL diagnosed in 2000 to 2009. Of these patients, 71% had received second-line therapy < 2 years, and 29% had received no therapy after first-line therapy, with a median OS of < 3 years. Treatment included rituximab, R-CVP (rituximab, cyclophosphamide, vincristine), R-CHOP (rituximab, cyclophosphamide, hydroxydaunorubicin, vincristine), R-Other (other rituximab-containing), and other regimens. The Aalen-Johansen estimator and Cox proportional hazards models were used to quantify the outcomes and assess the effects of the clinical and sociodemographic factors.

resultsR-CHOP demonstrated the most favorable 5-year OS among first- (71%), second- (55%), and third-line (61%) therapies. First-line R-CHOP improved OS (hazard ratio [HR], 0.57; 95% confidence interval [CI], 0.50-0.64) and reduced the mortality risks after first-line (HR, 0.60; 95% CI, 0.47-0.77), second-line (HR, 0.40; 95% CI, 0.29-0.53), and third-line (HR, 0.63; 95% CI, 0.53-0.76) treatments. B-symptoms, being married, and histologic grade 1/2 were associated with the use of earlier second-line therapy. Early progression from second- to third-line therapy was associated with poor OS. The repeated use of R-CHOP or R-CVP as first- and second-line treatment yielded high 2-year mortality rates (R-CHOP + R-CHOP, 17.3%; R-CVP + R-CVP, 21.1%).

conclusionOur multistate approach assessed the effect of sequential therapy on the immediate and subsequent treatment-line outcomes. We found that R-CHOP in any line improved OS for patients with high-risk FL.

Indexed as

Models, BiologicalAgedAged, 80 and overAntineoplastic Combined Chemotherapy ProtocolsCyclophosphamideDisease ProgressionDoxorubicinFemaleFollow-Up StudiesHumansKaplan-Meier EstimateLymphoma, FollicularMaleMedicarePrednisonePrognosisCyclophosphamideDoxorubicinPrednisoneR-CHOP protocolRituximabVincristineFollicular lymphomaHigh-riskMultistate modelSurvival predictionTreatment-related mortality

Identifiers

PMID30686772
PMCPMC6555660
OpenAlexW2908320246

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.