{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T12:20:19Z","timestamp":1787314819080,"version":"build-2736575974"},"reference-count":29,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2018,6,8]],"date-time":"2018-06-08T00:00:00Z","timestamp":1528416000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Hematological Oncology"],"published-print":{"date-parts":[[2018,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    Pirarubicin (tetrahydropyranyl adriamycin [THP]) is an anthracyclin with less cardiotoxicity than doxorubicin (DOX). We previously reported the efficacy and safety of R\u2010THP\u2010COP consisting of rituximab (R), THP, cyclophosphamide (CPA), vincristine (VCR), and prednisolone (PSL) for diffuse large B cell lymphoma (DLBCL) in phase 2 studies. Here, we prospectively compared the efficacy and safety of the R\u2010THP\u2010COP and standard R\u2010CHOP regimen (consisting of R, CPA, DOX, VCR, and PSL) in a noninferiority phase 3 trial. This prospective, randomized phase 3 study included patients younger than 70\u00a0years of age with previously untreated DLBCL. The regimen consisted of R (day 1), DOX, or THP (day 3), CPA (day 3), VCR (day 3), and PSL for 5\u00a0days every 3\u00a0weeks for 6 to 8\u00a0cycles. Between July 5, 2006 and June 11, 2013, 81 patients were randomly assigned to the treatment groups (R\u2010CHOP group, 40 patients; R\u2010THP\u2010COP group, 41 patients). R\u2010THP\u2010COP was noninferior to R\u2010CHOP, as assessed by the primary endpoint of complete response rate (85% vs 85% respectively). With a median follow\u2010up of 75.2\u00a0months, the 5\u2010year overall survival was 87% in the R\u2010CHOP group and 82% in the R\u2010THP\u2010COP group (hazard ratio [HR]: 0.89, 95% confidence interval [CI]: 0.31\u20102.49;\n                    <jats:italic>P<\/jats:italic>\n                    \u00a0=\u00a0.82). The 5\u2010year progression\u2010free survival was 74% in the R\u2010CHOP group and 79% in the R\u2010THP\u2010COP group (HR: 1.37, 95% CI: 0.56\u20103.55;\n                    <jats:italic>P<\/jats:italic>\n                    \u00a0=\u00a0.49). No grade 3 cardiac side effects were observed in either group. No serious late adverse reactions were observed in either group, with the exception of therapy\u2010related acute myeloid leukemia in the R\u2010THP\u2010COP group. These data indicate that R\u2010THP\u2010COP is noninferior to R\u2010CHOP with regard to clinical response, and has an acceptable safety profile. Thus, this regimen may be an alternative therapy to R\u2010CHOP.\n                  <\/jats:p>","DOI":"10.1002\/hon.2524","type":"journal-article","created":{"date-parts":[[2018,6,8]],"date-time":"2018-06-08T04:12:42Z","timestamp":1528431162000},"page":"638-644","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":35,"title":["R\u2010THP\u2010COP versus R\u2010CHOP in patients younger than 70 years with untreated diffuse large B cell lymphoma: A randomized, open\u2010label, noninferiority phase 3 trial"],"prefix":"10.1002","volume":"36","author":[{"given":"Takeshi","family":"Hara","sequence":"first","affiliation":[{"name":"First Department of Internal Medicine Gifu University Graduate School of Medicine  Gifu Japan"},{"name":"Department of Hematology Matsunami General Hospital  Kasamatsu 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