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Tanaka K, Yasuda M, Tachi T, Teshigawara Y, Inoue S, Ino Y, Kitagawa J, Noguchi Y, Yoshimura T, Teramachi H, Kasahara S. Quality of life assessment and cost‑utility analysis of initial chemotherapy for patients with non‑Hodgkin's lymphoma: A prospective analysis. Oncol Lett 2024; 28:430. [PMID: 39049984 PMCID: PMC11268091 DOI: 10.3892/ol.2024.14564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2024] [Accepted: 06/26/2024] [Indexed: 07/27/2024] Open
Abstract
Chemotherapy has helped prolong survival in patients with malignant lymphoma, enhancing their quality of life (QOL). Despite the eventual decline in the QOL of patients, the impact of initial chemotherapy remains poorly understood. A prospective patient-reported QOL survey among patients with malignant lymphoma receiving initial chemotherapy was conducted, targeting those treated at Gifu Municipal Hospital (Gifu, Japan) between January 2021 and December 2022. Surveys were conducted pre- and post-chemotherapy based on the EuroQol 5 dimensions. Drug costs were calculated using official prices and analyzed from the cost payer's perspective via cost-utility analysis. Among the 60 patients included in the present study, 28 had diffuse large B-cell lymphoma. Cyclophosphamide, doxorubicin, vincristine, prednisolone ± rituximab therapy was the most common treatment (38 patients) and demonstrated superior cost-effectiveness due to its lowest cost and change in utility value. Initial chemotherapy for patients with malignant lymphoma generally improved the QOL. Clinical trial registration: UMIN000042868 (registered on December 28, 2020).
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Affiliation(s)
- Kazuhide Tanaka
- Department of Pharmacy, Gifu Municipal Hospital, Gifu, Gifu 500-8513, Japan
- Laboratory of Pharmaceutical Health Care and Promotion, Gifu Pharmaceutical University, Gifu, Gifu 500-8513, Japan
| | - Masahiro Yasuda
- Department of Pharmacy, Gifu Municipal Hospital, Gifu, Gifu 500-8513, Japan
- Laboratory of Pharmaceutical Health Care and Promotion, Gifu Pharmaceutical University, Gifu, Gifu 500-8513, Japan
| | - Tomoya Tachi
- Department of Pharmacy, Gifu Municipal Hospital, Gifu, Gifu 500-8513, Japan
- Laboratory of Pharmaceutical Health Care and Promotion, Gifu Pharmaceutical University, Gifu, Gifu 500-8513, Japan
- Laboratory of Clinical Pharmacy, Gifu Pharmaceutical University, Gifu, Gifu 501-1196, Japan
- Department of Clinical Pharmacy, Graduate School of Pharmaceutical Sciences, Nagoya City University, Nagoya, Aichi 467-8603, Japan
| | - Yuta Teshigawara
- Laboratory of Clinical Pharmacy, Gifu Pharmaceutical University, Gifu, Gifu 501-1196, Japan
| | - Seiji Inoue
- Department of Pharmacy, Gifu Municipal Hospital, Gifu, Gifu 500-8513, Japan
| | - Yoko Ino
- Department of Pharmacy, Gifu Municipal Hospital, Gifu, Gifu 500-8513, Japan
- Laboratory of Pharmaceutical Health Care and Promotion, Gifu Pharmaceutical University, Gifu, Gifu 500-8513, Japan
| | - Junichi Kitagawa
- Department of Hematology, Gifu Municipal Hospital, Gifu, Gifu 500-8513, Japan
| | - Yoshihiro Noguchi
- Laboratory of Clinical Pharmacy, Gifu Pharmaceutical University, Gifu, Gifu 501-1196, Japan
| | - Tomoaki Yoshimura
- Laboratory of Clinical Pharmacy, Gifu Pharmaceutical University, Gifu, Gifu 501-1196, Japan
| | - Hitomi Teramachi
- Laboratory of Clinical Pharmacy, Gifu Pharmaceutical University, Gifu, Gifu 501-1196, Japan
| | - Senji Kasahara
- Laboratory of Pharmaceutical Health Care and Promotion, Gifu Pharmaceutical University, Gifu, Gifu 500-8513, Japan
- Department of Hematology, Gifu Municipal Hospital, Gifu, Gifu 500-8513, Japan
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Kitahiro Y, Yamamoto K, Yakushijin K, Ioroi T, Tanda M, Itohara K, Omura T, Minami H, Yano I. The Efficacy of Bepotastine Besilate Compared With Hydroxyzine Pamoate for Preventing Infusion Reactions to the First Dose of Rituximab in Patients With Non-Hodgkin Lymphoma: Protocol for a Phase II, Double-Blind, Multicenter Randomized Trial. JMIR Res Protoc 2024; 13:e54882. [PMID: 38386393 PMCID: PMC10921330 DOI: 10.2196/54882] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Revised: 01/31/2024] [Accepted: 01/31/2024] [Indexed: 02/23/2024] Open
Abstract
BACKGROUND Rituximab, an anti-CD20 monoclonal antibody, can cause infusion reactions (IRs), especially during the initial rituximab infusion therapy. Generally, patients are administered a histamine H1-receptor antagonist before the rituximab infusion, along with an antipyretic analgesic, to prevent or reduce IRs. Multiple retrospective case-control studies indicate that the second generation of histamine H1-receptor antagonists might be more effective than the first generation in suppressing IRs caused by the rituximab infusion. OBJECTIVE This study aimed to assess the efficacy of first- and second-generation histamine H1-receptor antagonists for preventing IRs resulting from the initial infusion of rituximab in patients diagnosed with non-Hodgkin lymphoma. METHODS This is a phase II, double-blind, active-controlled randomized trial. It will be a multicenter study conducted across 3 facilities that aims to enroll a total of 40 patients diagnosed with non-Hodgkin lymphoma who will receive their initial rituximab infusion. Participating patients will be administered hydroxyzine pamoate or bepotastine besilate, representing first- or second-generation histamine H1-receptor antagonists, respectively. This will be combined with 400-mg acetaminophen tablets taken approximately 30 minutes before the first infusion of rituximab. The primary end point of this trial is to assess severe IRs, equivalent to grade 2 or higher as defined by the National Cancer Institute Common Terminology Criteria for Adverse Events, version 5.0, that occur within a 4-hour period after the initiation of rituximab infusion. The secondary end points include assessing the severity of the initial IR, the maximum severity of the IR, and the duration between rituximab infusion initiation and the onset of the first IR within a 4-hour period. Additionally, the trial will evaluate histamine H1-receptor antagonist-induced drowsiness using the visual analogue scale, with each patient providing their individual response. RESULTS This study began with patient recruitment in April 2023, with 17 participants enrolled as of November 12, 2023. The anticipated study completion is set for February 2026. CONCLUSIONS This study is the first randomized controlled trial comparing the effects of oral first- and second-generation histamine H1-receptor antagonists in preventing IRs induced by the initial administration of rituximab. The findings from this study hold the potential to establish the rationale for a phase III study aimed at determining the standard premedication protocol for rituximab infusion. TRIAL REGISTRATION Japan Registry of Clinical Trials jRCTs051220169; https://jrct.niph.go.jp/latest-detail/jRCTs051220169. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/54882.
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Affiliation(s)
- Yumi Kitahiro
- Department of Pharmacy, Kobe University Hospital, Kobe, Japan
| | | | - Kimikazu Yakushijin
- Division of Medical Oncology/Hematology, Department of Medicine, Kobe University Hospital and Graduate School of Medicine, Kobe, Japan
| | - Takeshi Ioroi
- Department of Pharmacy, Kobe University Hospital, Kobe, Japan
| | - Masaaki Tanda
- Department of Pharmacy, Kobe University Hospital, Kobe, Japan
| | - Kotaro Itohara
- Department of Pharmacy, Kobe University Hospital, Kobe, Japan
| | - Tomohiro Omura
- Department of Pharmacy, Kobe University Hospital, Kobe, Japan
| | - Hironobu Minami
- Division of Medical Oncology/Hematology, Department of Medicine, Kobe University Hospital and Graduate School of Medicine, Kobe, Japan
| | - Ikuko Yano
- Department of Pharmacy, Kobe University Hospital, Kobe, Japan
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Fukuta T, Nishimura N, Shirouchi Y, Inoue N, Uryu H, Kusano Y, Mishima Y, Yokoyama M, Tsuyama N, Takeuchi K, Terui Y. Insignificance of surveillance imaging in patients with diffuse large B-cell lymphoma who achieved first complete remission: a retrospective cohort study. Int J Hematol 2020; 111:567-573. [PMID: 31939076 DOI: 10.1007/s12185-020-02819-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2019] [Revised: 01/02/2020] [Accepted: 01/07/2020] [Indexed: 11/30/2022]
Abstract
The aim of this study was to evaluate the value of scheduled imaging for patients who achieved first complete remission after CHOP-like chemotherapy plus rituximab. In this retrospective cohort study, we included 759 patients newly diagnosed with de novo diffuse large B-cell lymphoma (DLBCL) at the Cancer Institute, Japanese Foundation for Cancer Research. Relapsed patients were divided into two groups based on method of diagnosis: clinical symptoms (symptom group, n = 57) or scheduled imaging (imaging group, n = 27). Our primary goal was to compare overall survival and relapse-free survival between the two groups. No significant difference in outcomes was found between the symptom and imaging groups. Median overall survival [7.5 years; 95% confidence interval (CI) 4.0-9.7 vs. 9.1 years; 95% CI 2.7 to not reached; P = 0.747), and median relapse-free survival (1.8 years; 95% CI 1.4-2.5 vs. 2.4 years; 95% CI 1.2-4.4; P = 0.108). Surveillance imaging in patients with DLBCL who achieved first complete remission did not demonstrate an advantage in terms of overall survival or relapse-free survival.
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Affiliation(s)
- Takanori Fukuta
- Department of Hematology and Oncology, The Cancer Institute, Japanese Foundation for Cancer Research, 3-8-31, Ariake, Koto, Tokyo, 135-8550, Japan.
| | - Noriko Nishimura
- Department of Hematology and Oncology, The Cancer Institute, Japanese Foundation for Cancer Research, 3-8-31, Ariake, Koto, Tokyo, 135-8550, Japan
| | - Yuko Shirouchi
- Department of Hematology and Oncology, The Cancer Institute, Japanese Foundation for Cancer Research, 3-8-31, Ariake, Koto, Tokyo, 135-8550, Japan
| | - Norihito Inoue
- Department of Hematology and Oncology, The Cancer Institute, Japanese Foundation for Cancer Research, 3-8-31, Ariake, Koto, Tokyo, 135-8550, Japan
| | - Hideki Uryu
- Department of Hematology and Oncology, The Cancer Institute, Japanese Foundation for Cancer Research, 3-8-31, Ariake, Koto, Tokyo, 135-8550, Japan
| | - Yoshiharu Kusano
- Department of Hematology and Oncology, The Cancer Institute, Japanese Foundation for Cancer Research, 3-8-31, Ariake, Koto, Tokyo, 135-8550, Japan
| | - Yuko Mishima
- Department of Hematology and Oncology, The Cancer Institute, Japanese Foundation for Cancer Research, 3-8-31, Ariake, Koto, Tokyo, 135-8550, Japan
| | - Masahiro Yokoyama
- Department of Hematology and Oncology, The Cancer Institute, Japanese Foundation for Cancer Research, 3-8-31, Ariake, Koto, Tokyo, 135-8550, Japan
| | - Naoko Tsuyama
- Division of Pathology, The Cancer Institute, Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Kengo Takeuchi
- Division of Pathology, The Cancer Institute, Japanese Foundation for Cancer Research, Tokyo, Japan.,Pathology Project for Molecular Targets, The Cancer Institute, Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Yasuhito Terui
- Department of Hematology and Oncology, The Cancer Institute, Japanese Foundation for Cancer Research, 3-8-31, Ariake, Koto, Tokyo, 135-8550, Japan
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