R-CHOP every 21 days for diffuse large B-cell lymphoma: still the standard of care?

Evaluation of: Cunningham D, Hawkes EA, Jack A et al. Rituximab plus cyclophosphamide, doxorubicin, vincristine, and prednisolone in patients with newly diagnosed diffuse large B-cell non-Hodgkin lymphoma: a Phase 3 comparison of dose intensification with 14-day versus 21-day cycles. Lancet 381(9880), 1817-1826 (2013). Therapy of newly diagnosed diffuse large B-cell lymphoma is largely unchanged for the past 30 years. Investigators have evaluated if modification of the schedule of drug administration may have a positive effect on outcomes. This article focuses on a recent Phase III clinical trial, which compared every 2- versus 3-week administration of chemotherapy in patients with newly diagnosed diffuse large B-cell lymphoma. The trial found that there was no significant difference between the two dosing schedules. We evaluate the data from this and other trials, and give our recommendations for future studies.