Evidence map›Paper›PMID 38191715›Full record

SynthesisAnnals of hematology2024

How to improve RCHOP as frontline therapy for diffuse large B-cell lymphoma: a systematic review and meta-analysis of 21 randomized controlled trials.

Stergios Intzes, Marianthi Symeonidou, Konstantinos Zagoridis, Aikaterini Pentidou, Zoi Bezirgianidou, Menelaos Papoutselis, Christina Misidou, Christoforos Roumpakis, Athina Spanoudaki, Konstantinos Liapis and 1 more

Abstract readMeta-AnalysisSystematic Review
PubMed Publisher
In one paragraph

Synthesis in Annals of hematology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
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

2 citing papers in PubMed.

  1. Article
  2. 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

11 authors.

Stergios IntzesDepartment of Hematology, Medical School, Democritus University of Thrace, Area of Dragana, 68100, Alexandroupolis, PC, Greece.
Marianthi SymeonidouDepartment of Hematology, Medical School, Democritus University of Thrace, Area of Dragana, 68100, Alexandroupolis, PC, Greece.
Konstantinos ZagoridisDepartment of Hematology, Medical School, Democritus University of Thrace, Area of Dragana, 68100, Alexandroupolis, PC, Greece.
Aikaterini PentidouDepartment of Hematology, Medical School, Democritus University of Thrace, Area of Dragana, 68100, Alexandroupolis, PC, Greece.
Zoi BezirgianidouDepartment of Hematology, Medical School, Democritus University of Thrace, Area of Dragana, 68100, Alexandroupolis, PC, Greece.
Menelaos PapoutselisDepartment of Hematology, Medical School, Democritus University of Thrace, Area of Dragana, 68100, Alexandroupolis, PC, Greece.
Christina MisidouDepartment of Hematology, Medical School, Democritus University of Thrace, Area of Dragana, 68100, Alexandroupolis, PC, Greece.
Christoforos RoumpakisDepartment of Hematology, Medical School, Democritus University of Thrace, Area of Dragana, 68100, Alexandroupolis, PC, Greece.
Athina SpanoudakiDepartment of Hematology, Medical School, Democritus University of Thrace, Area of Dragana, 68100, Alexandroupolis, PC, Greece.
Konstantinos LiapisDepartment of Hematology, Medical School, Democritus University of Thrace, Area of Dragana, 68100, Alexandroupolis, PC, Greece.
Emmanouil SpanoudakisDepartment of Hematology, Medical School, Democritus University of Thrace, Area of Dragana, 68100, Alexandroupolis, PC, Greece. espanoud@med.duth.gr.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

RCHOP is the standard of care for patients with diffuse large b-cell lymphoma (DLBCL) but failures occur in approximately 40% of them. We performed a meta-analysis of 21 randomized controlled trials (RCTs) comparing experimental regimens with RCHOP. We searched the database of PubMed with proper criteria, and data of efficacy (Progression Free Survival-PFS) in the ITT population were extracted and analyzed. Cross comparisons of RCTs were performed by using the CINEMA software. Odds ratio (OR) and 95% confidence intervals (95%, CI) are reported. The literature search yielded 21 RCTs including 5785 patients in the RCHOP arm and 5648 patients in the experimental arm. Odds ratio (OR) for PFS in the total cohort was OR (95%, CI): 0.87 (0.76-0.99), p=0.02. Among different strategies to improve RCHOP, addition of a novel agent on RCHOP improved PFS. In total 1740 patients in the RCHOP arm were compared with 1755 in the RCHOP plus a novel agent arm, and the OR (95% CI) for PFS was 0.84 (0.71-0.97), p=0.02. Indirect comparisons of nine studies adding a novel agent on RCHOP does not give prominence to any agent. Subgroup analysis according to cell of origin was performed for non-GC DLBCL patients. In this subgroup, 1546 patients treated with RCHOP were compared with 1538 patients treated with experimental regimens. The OR (95% CI) for PFS was 0.86 (0.73-1.02), p=0.34. Overall survival data extracted from 18 studies showed no superiority of experimental regimens over RCHOP. Efficacy of RCHOP backbone is marginally improved when adding a novel anti-lymphoma agent.

Indexed as

Antineoplastic Combined Chemotherapy ProtocolsCyclophosphamideDoxorubicinLymphoma, Large B-Cell, DiffusePrednisoneRituximabVincristineDexamethasoneHumansProgression-Free SurvivalRandomized Controlled Trials as TopicCyclophosphamideDexamethasoneDoxorubicinPrednisoneR-CHOP protocolRituximabVincristineDLBCLNovel agentsPFSRCHOP

Identifiers

PMID38191715

What OpenQuestion holds

Textmetadata
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.