The Meta Analysis Of R2-CHOP In Diffuse Large B Cell Lymphoma

Objective: Additionnal molecular target drug to R-CHOP in newly diagnosis DLBCL is one of the major focus in recent years.Although this strategy is encouraging but the benefit is still controversial.Here we conduct a meta-analysis to investigate the benefit of additionnal lenalidomide to R-CHOP compare with R-CHOP in newly diagnosis DLBCL.Methods: We search the database of Pub Med,the Cochrane library,web of science,EMbase,china national knowledge internet and Wanfang for the literatures about lenalidomide in treatment of DLBCL before December 2022.Then we select the literatures witch meeting the eligibility criteria.And we assesse the risk of bias and extract datas.The Rev Men 5.3 software is used to process datas and conduct Meta-analysis.Fixed effect models or random effect model were used to estimate pooled hazard ratios(HRs)and odds ratios(ORs)with 95% confidence intervals(CI).Results: A total of six literatures was included 4 randomized controlled trials and 2 cohort studies.And a total of 1391 patients with DLBCL met the eligibility criteria.There were 683 patients in the R2-CHOP group,and 708 in the R-CHOP group.R2-CHOP has a higher ORR(OR=2.27,95%CI 1.16～4.46)and a higher CR rate(OR=1.32,95% CI 1.04～1.67).Between the two arms no differences were observed in PFS(HR=0.9,95%CI 0.74～1.10)and OS(HR=0.92,95%CI0.72～1.19).The most common grade 3/4 adverse events were seen in R2-CHOP group,esecially neutropenia(OR =1.25,95%CI 1.03～1.53)、thrombocytopenia(OR=2.25,95%CI 1.2～4.23)and febrile neutropenia(OR=1.79,95%CI 1.23～2.60),but grade 3/4 anemia(OR=1.37,95%CI 0.84～2.24)and grade 3/4 thromboembolic event(OR=2.8,95%CI 0.63～12.41)were no difference between two arms.Conclusions: Comparing with R-CHOP,R2-CHOP improved ORR and CR rate in newly diagnosis DLBCL,but no benefit in PFS and OS.Grade 3/4 adverse neutropenia,thrombocytopenia and febrile neutropenia were more common in R2-CHOP.