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Improving eligibility criteria for first-line trials for patients with DLBCL using a US-based Delphi-method survey
Journal article   Open access   Peer reviewed

Improving eligibility criteria for first-line trials for patients with DLBCL using a US-based Delphi-method survey

R Andrew Harkins, Sharvil P Patel, Michelle J Lee, Jeffrey M Switchenko, Stephen M Ansell, Nancy L Bartlett, Kristie A Blum, Amanda F Cashen, Carla Casulo, Jonathan W Friedberg, …
Blood advances, Vol.6(9), pp.2745-2756
05/10/2022
DOI: 10.1182/bloodadvances.2021006504
PMCID: PMC9092417
PMID: 35100356
url
https://doi.org/10.1182/bloodadvances.2021006504View
Published (Version of record) Open Access

Abstract

Recent first-line randomized controlled trials (RCTs) for patients with diffuse large B-cell lymphoma (DLBCL) have shown negative results, which may be due in part to onerous eligibility criteria limiting enrollment of poor-risk patients who require immediate treatment. We conducted a Delphi-method survey with lymphoma experts in the United States to define recommendations for essential and potentially unnecessary enrollment criteria for modern first-line DLBCL RCTs aimed at increasing clinical diversity of ensuing study groups. We first tabulated enrollment criteria from 19 DLBCL RCTs spanning the rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) era to identify common eligibility criteria from prior DLBCL RCTs for inclusion in the Delphi-method survey. We tabulated 451 total eligibility criteria comprising 51 criterion categories across 19 first-line DLBCL RCTs in the R-CHOP era. We then surveyed lymphoma clinical trial experts representing 8 academic medical centers in the United States regarding essential and unnecessary eligibility criteria for modern DLBCL RCTs. Seventeen of 29 invited clinical investigators completed the round-1 questionnaire (response rate, of 58.6%), 15 of 17 round-1 participants (88.2%) completed the round-2 survey, and all round-1 participants reviewed finalized recommendations for eligibility criteria for modern first-line DLBCL RCTs. We defined consensus recommendations for 31 modernized eligibility criteria including threshold values for 10 quantitative eligibility criteria aimed at facilitating enrollment of a clinically diverse study population in first-line DLBCL RCTs designed to improve standard-of-care therapy.
Antineoplastic Combined Chemotherapy Protocols - adverse effects Cyclophosphamide Doxorubicin Humans Lymphoma, Large B-Cell, Diffuse - pathology Prednisone - adverse effects Prednisone - therapeutic use Rituximab Surveys and Questionnaires Vincristine

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