NDLI: Expression of p21 protein predicts clinical outcome in DLBCL patients older than 60 years treated with R-CHOP but not CHOP: a prospective ECOG and Southwest Oncology Group correlative study on E4494.

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Expression of p21 protein predicts clinical outcome in DLBCL patients older than 60 years treated with R-CHOP but not CHOP: a prospective ECOG and Southwest Oncology Group correlative study on E4494.

Content Provider	Semantic Scholar
Author	Winter, Jane N. Li, Shufeng Aurora, Vikas Variakojis, Daina Nelson, Beverly Anne Krajewska, Malgorzata Zhang, Lijun Habermann, Thomas Matthew Fisher, Richard I. Macon, William R. Chhanabhai, Mukesh Felgar, Raymond E. Hsi, E. D. Medeiros, L. Jeffrey Weick, James K. Weller, Edie A. Melnick, Ari Reed, John Christopher Horning, Sundya J. Gascoyne, Randy D.
Copyright Year	2010
Abstract	PURPOSE To prospectively investigate the prognostic significance of p21 and p53 expression in diffuse large B-cell lymphoma in the context of the U.S. Intergroup trial comparing conventional cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP) chemotherapy to rituximab-CHOP (R-CHOP) induction, with or without maintenance rituximab. EXPERIMENTAL DESIGN Immunohistochemical staining of 197 paraffin-embedded biopsy specimens was scored by an independent panel of experts. RESULTS The cyclin-dependent kinase inhibitor, p21, was expressed in 55% of cases examined. In a multivariable analysis adjusting for International Prognostic Index score and BCL2 status, p21 expression was a significant, independent, favorable predictive factor for failure-free survival (relative risk, 0.3; P = 0.001) and overall survival (relative risk, 0.3; P = 0.003) for patients treated with R-CHOP. Expression of p21 was not predictive of outcome for CHOP-treated patients. Only p21-positive cases benefited from the addition of rituximab to CHOP. Among p21-positive patients, treatment with R-CHOP was associated with a higher failure-free survival rate at 5 years compared with CHOP (61% versus 24%; P = 0.01). In contrast, no significant differences were detected in failure-free survival according to treatment arm for p21-negative patients. Expression of p53, alone or in combination with p21, did not predict for outcome in univariable or multivariable analyses. CONCLUSIONS In this study, p21 protein expression emerged as an important independent predictor of a favorable clinical outcome when rituximab was added to CHOP therapy. These data suggest that rituximab-related effects on lymphoma survival pathways may be functionally linked to p21 activity.
Starting Page	9267
Ending Page	9277
Page Count	11
File Format	PDF HTM / HTML
Alternate Webpage(s)	http://clincancerres.aacrjournals.org/content/clincanres/16/8/2435.full.pdf
PubMed reference number	20371683v1
Alternate Webpage(s)	https://doi.org/10.1158/1078-0432.CCR-09-1219
DOI	10.1158/1078-0432.ccr-09-1219
Journal	Clinical cancer research : an official journal of the American Association for Cancer Research
Volume Number	16
Issue Number	8
Language	English
Access Restriction	Open
Subject Keyword	B-Cell Lymphomas Body mass index CHOP protocol-cyclophosphamide/doxorubicin/prednisone/vincristine Chronic Lymphocytic Leukemia Cyclins Cyclophosphamide Diffuse Large B-Cell Lymphoma Doxorubicin Electrocorticogram Embedding Leukemia, B-Cell Overall Survival Patients Prednisone Specimen Staining method Vincristine cyclophosphamide/doxorubicin/prednisone/rituximab/vincristine predictive factor rituximab
Content Type	Text
Resource Type	Article

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Expression of p21 Protein Predicts Clinical Outcome in DLBCL Patients Over Age 60 Treated with R-CHOP but not CHOP: A prospective ECOG and SWOG correlative study of E4494

Expression of p21 protein predicts clinical outcome in DLBCL patients older than 60 years treated with R-CHOP but not CHOP: a prospective ECOG and Southwest Oncology Group correlative study on E4494.