Efficacy and Safety Profile of Lenalidomide vs Lenalidomide + R-CHOP in patients with Diffuse Large B Cell Lymphoma: A Systematic Review

Abstract

The most frequent cause of non-Hodgkin lymphoma, which accounts for around one-third of cases, is diffuse large B cell lymphoma (DLBCL). Immune chemotherapy combined with rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) is the standard therapy for DLBCL. Objective: To analysing the utilization of Lenalidomide versus Lenalidomide R-CHOP regimen in treatment of DLBCL in terms of treatment efficacy and safety. Methods: PRISMA guidelines were followed for conducting this study. A thorough literature search was done from November 15 to November 25, 2022. A variety of databases, including PubMed, Google Scholar, and other, were used to conduct the literature search. Finally, for this systematic review, 10 studies were chosen. Results: In our study the monotherapy with Lenalidomide was found less significant in terms of improvement in Overall response rate, complete response among patients with DLBCL. However; Lenalidomide + R-CHOP was more effective in improving overall response rate (ORR) with ORR of 92.89% vs 30.58% and complete response rate (CRR) of 80.20% vs 12.53%. The partial response rate (PR) was comparable between two therapies.  similarly, the Progression free survival was also better in combination therapy. Haematological and Non-Hematological adverse effects of grade >3 were found higher among patients with combination therapy and Neutropenia was commonly observed adverse effect. Conclusions: Combination therapy was associated with significant improvement in disease outcome, however; the adverse effects were reported high in combination therapy vs monotherapy.