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This study compared four cycles versus six cycles of chemotherapy in non\u2010bulky low\u2010risk DLBCL patients with negative interim positron emission tomography with computed tomography (PET\u2010CT, Deauville 1\u20103), irrespective of age and other IPI risk factors (IPI 0\u20101).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p xml:lang=\"en\">This was an open\u2010label, randomized, phase III, non\u2010inferiority trial. Patients aged 14\u201075 years with newly diagnosed low\u2010risk DLBCL, according to IPI, achieving PET\u2010CT confirmed complete response (CR) after four cycles of R\u2010CHOP were randomized (1:1) between four cycles of rituximab (4R\u2010CHOP+4R arm) or two cycles of R\u2010CHOP plus two cycles of rituximab (6R\u2010CHOP+2R arm). The primary endpoint was 2\u2010year progression\u2010free survival (PFS), conducted in the intention\u2010to\u2010treat population. Safety was assessed in patients with at least one cycle of assigned treatment. The non\u2010inferiority margin was \u20108%.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p xml:lang=\"en\">A total of 287 patients were included in the intention\u2010to\u2010treat analysis, the median follow\u2010up was 47.3 months, and the 2\u2010year PFS rate was 95% (95% confidence interval [CI], 92% to 99%) and 94% (95% CI, 91% to 98%) for the 4R\u2010CHOP+4R and 6R\u2010CHOP+2R arm. The absolute difference in 2\u2010year PFS between the two arms was 1% (95% CI, \u20105% to 7%), supporting the non\u2010inferiority of 4R\u2010CHOP+4R. Grade 3\u20104 neutropenia was lower in the last four cycles of rituximab alone in the 4R\u2010CHOP+4R arm (16.7% versus 76.9%), with decreased risk of febrile neutropenia (0.0% versus 8.4%) and infection (2.1% versus 14.0%).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p xml:lang=\"en\">For newly diagnosed low\u2010risk DLBCL patients, interim PET\u2010CT after four cycles of R\u2010CHOP was effective in identifying patients with Deauville 1\u20103 who would have a good response and Deauville 4\u20105 patients who might have high\u2010risk biological features or develop resistance. Reducing the standard six cycles to four cycles of chemotherapy had comparable clinical efficacy and fewer adverse events in low\u2010risk, non\u2010bulky DLBCL with interim PET\u2010CT confirmed CR.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/cac2.12462","type":"journal-article","created":{"date-parts":[[2023,7,5]],"date-time":"2023-07-05T00:30:09Z","timestamp":1688517009000},"page":"896-908","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Positron emission tomography\u2010adapted therapy in low\u2010risk diffuse large B\u2010cell lymphoma: results of a randomized, phase III, non\u2010inferiority trial"],"prefix":"10.34133","volume":"43","author":[{"given":"Qing","family":"Shi","sequence":"first","affiliation":[{"name":"Shanghai Institute of Hematology","place":["Shanghai, P. R. China"]},{"name":"Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine","place":["Shanghai, P. 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China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qi","family":"Song","sequence":"additional","affiliation":[{"name":"Ruijin Hospital affiliated to Shanghai Jiao Tong University School of Medicine","place":["Shanghai, P. R. China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sai\u2010Juan","family":"Chen","sequence":"additional","affiliation":[{"name":"Shanghai Institute of Hematology","place":["Shanghai, P. R. China"]},{"name":"Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine","place":["Shanghai, P. R. China"]},{"name":"P\u00f4le de Recherches Sino\u2010Fran\u00e7ais en Science du Vivant et G\u00e9nomique","place":["Shanghai, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Li","family":"Wang","sequence":"additional","affiliation":[{"name":"Shanghai Institute of Hematology","place":["Shanghai, P. R. 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