The Journal of Clinical Oncology has published updated results from the BRIGHT study, which compared Bendamustine+ Rituxan to R-CHOP and R-CVP.
In the last few years, B + R has become a popular choice as an immunochemotherapy treatment. It's not the only choice, by any means, but for certain FL patients who need something more aggressive, oncologists are choosing it over R-CHOP or R-CVP. Research has shown that it is as good, or even better, than those other choices, with fewer side effects.
The BRIGHT study has looked at how these treatments match up with each other. It looks specifically at patients who have not had treatment before. The article is an update, looking at how patients have done after 5 years of follow-up.
Results showed that B + R did better than the other two. Progression Free Survival (the time it took for the treatment to stop working) for 5 years was 65.5% for the B + R group and 55.8% for the CHOP/CVP group (the researchers combined the patients who received those two treatments into one group). Duration of response was better for B + R -- in the 5 year period, 26% of B + R patients needed a second treatment, vs. 39% for the other group.
As is often the case with these kinds of comparisons, there was no difference in the Overall Survival between the two groups (81.7% vs 85%). As for side effects, "The overall safety profiles of BR, R-CHOP, and R-CVP were as
expected; no new safety data were collected during long-term follow-up." This means that there were fewer side effects for the B + R group. However, there was a higher number of patients who developed another cancer (particularly certain skin cancers).
So what's the significance of all of this for patients?
Well, B + R remains a good choice, and I'm guessing it will remain a popular choice. Many patients seem to use B + R as a first treatment if their FL is on the aggressive side (with some other choices there if it's less aggressive). That will probably continue.
If anything, patients who are using the treatment can probably feel good about the choice.
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1 comment:
Good job Bob on pulling this treatment data together. Also on the CAR-T hospitalization, cost issue.
Yeah, it's been such a dilemma for years that no treatment has every been able to extend overall survival time. Now that the National Cancer Institute states that "cancer is a genetic disease" it's easy to see why the treatments that don't correct faulty gene activity can be effective other than for a short time. On a positive note however, biochemists and geneticists are slowly but gradually indicating ways that genetic remediation can occur for the better of us all.
Best in Health, Robert
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