Impact of Achieving Progression‐Free Survival 24 on Subsequent Overall Survival in Diffuse Large B‐Cell Lymphoma Patients

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Abstract
The impact of achieving progression‐free survival at 24 months (PFS24) on subsequent survival in patients with diffuse large B‐cell lymphoma (DLBCL) relative to the general population remains debatable. We assessed the impact of achieving PFS24 in newly diagnosed DLBCL patients using data from JCOG0601, a prospective study of DLBCL patients treated with R‐CHOP. Among 409 eligible patients (median follow‐up: 5.3 years), 334 (82%) achieved PFS24, whereas 66 (16%) did not. Patients who achieved PFS24 had significantly better overall survival (OS) than those who did not (median OS, not reached vs. 1.3 years; p < 0.001). Similar results were observed for PFS12 and PFS60. The OS for patients after achieving PFS24 or PFS60 was not markedly different from that of the age‐, sex‐, and calendar period‐matched Japanese general population (PFS24: standardized mortality ratio [SMR] 1.29, 95% confidence interval [CI] 0.72–2.12, p = 0.39; PFS60: SMR 1.43, 95% CI 0.47–3.33, p = 0.55). Conversely, the OS for patients after achieving PFS12 was significantly worse than that of the general population (SMR 2.30, 95% CI 1.59–3.22, p < 0.001). The primary cause of death among patients who achieved PFS12 was DLBCL, whereas the mortality rate from DLBCL among those who achieved PFS24 or PFS60 was less than 5%. Multivariable analysis showed that having two or more extranodal involvements (OR 2.76 [95% CI 1.39–5.46], p = 0.004) was the only significant risk factor for failing to achieve PFS24. Our findings suggest that PFS24 can serve as an early endpoint of OS in patients with DLBCL.
Funding Information
  • National Cancer Center Japan (23‐A‐16,23‐A‐17,26‐A‐4,29‐A‐3,2020‐J‐3,2023‐J‐03)

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