b'What Increases Survival Rates inOlder Veterans With DLBCL? By Brenda L. MooneySANANTONIOThemostcommonnon-Hodg- with age (10.2% vs. 7.5% vs. 2.3%, p0.001).kinlymphomaisdiffuselargeB-celllymphomaAcrossallagegroups,R-CHOPremainedthe (DLBCL), and its incidence steadily increases withcommonfirst-lineregimen(73.3%,67.9%,39.1%) age, according to recent research. with more proportion of the 80-years group receiv-The elderly population diagnosed with DLBCL are aing R-mini-CHOP (0.3% vs. 2.1% vs. 15.1%) when heterogenous group with no standardized age cut-off incompared to the other groups, the authors noted. In literature, wrote a study team led by researchers fromterms of completion of first-line treatment(R-CHOP or the South Texas Veterans Health Care System and theR-mini-CHOP), patients 65 years were more likely to University of Texas Health Cancer Center, both Sancomplete 6 cycles when compared to patients 65-79 Antonio. There is also a paucity of data regarding theand 80 years (73.9% vs. 67.8% vs. 59.8%, p0.001).treatment of elderly DLBCL patients due to lack of par- Still, they said that the overall median overall sur-ticipation and/or inclusion in clinical trials. vival decreased with as age increased: 63.7 months In a presentation at the most recent ASH Meetingin those younger than 65, 48.3 months in those 65-79 and Exposition in New Orleans, the authors pointedand 23.6 months in the older than 80 years age group. out that the VHA is one of the largest integrated pro- Patients of all age groups, who received 6 or more viders of cancer care in the United States and has acycles of first-line anthracycline-based regimen had population which, on average, is older than the gen- almost double the duration of 1-, 2- year and overall eral U.S. population. They added that gave them asurvival when compared to patients who received 5 unique advantage in exploring real-world outcomes incycles, according to the study. this elderly population. 1 Veterans older than 65 years who are diagnosed The retrospective chart review involved 5,199 ran- with DLBCL present with a higher stage of disease, domly selected patients with an ICD code for lym- higher IPI score and ABC phenotype, the authors phoma treated within the VHA between Jan. 1, 2011,concluded. Amongst them, the very elderly patients and Dec. 31, 2019. Data abstractors collected base- older than 80 years old had the shortest survival along line patient and disease characteristics and treatmentwithlowtreatmentinitiationandcompletionrates responses, and survival time was determined via elec- despite comparable functional status at diagnosis.tronic health record query on July 25, 2022. Yet, they added that those who were able to com-Of the 2,697 patients meeting the inclusion crite- plete six or more cycles of first line R-CHOP/R-mini-ria, two-thirds of the patients were 65 and older. OfCHOP reached nearly double the duration of median those, 51.5% were 65-79 years old, and 14.5% wereOS when compared to veterans receiving less than six older than 80. Though ECOG status decreased withcycles of chemo-immunotherapy. increasing age, more than 2/3rd of the patients withinGiven that the incidence of DLBCL has been increas-each of the above subgroups had a preserved ECOGing over the age of 65 years, therapeutic approaches score of 0-2, the authors advised, adding that acti- thatoptimizetreatmentefficacywhileminimizing vated B cell [ABC} phenotype was statistically moretoxicity are needed, the researchers explained.With common in patients older than 80 years when com- the advent of genomic profiling and identification of pared to those 65 and younger or 65-79. No differ- molecularabnormalitiesinDLBCL,novelantibod-ence was seen in the distribution of double or triple hitiesorsmallmoleculeswithrelativelylowtoxicity status between the three groups, they added. can increase tolerance in upfront setting leading more Theresearchersreportedthatthepercentageofelderly patients towards completion of necessary lines patients that did not receive any treatment increasedof treatment and improved overall survival.withage(3.2%vs.6%vs.20.7%in65,65-791Ananth S, Kaur S, Al-Abavechi A, Blaize JP, et. al. Treatment Patterns and80-yearsgroupsrespectively,p0.001). Alsoand Survival Outcomes in Elderly Veterans Diagnosed with Diffuse decreasingwithagewasthenumberofpatientsLarge B-Cell Lymphoma. Presented at the 64th Annual ASH Meeting receiving two or more lines of treatment decreasedand Exposition; December 2022; New Orleans, LA48'