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Comparison of immunohistochemistry and gene expression profiling subtyping for diffuse large B-cell lymphoma in the phase III clinical trial of R-CHOP ± ibrutinib

Comparison of immunohistochemistry and gene expression profiling subtyping for diffuse large B-cell lymphoma in the phase III clinical trial of R-CHOP ± ibrutinib
Comparison of immunohistochemistry and gene expression profiling subtyping for diffuse large B-cell lymphoma in the phase III clinical trial of R-CHOP ± ibrutinib

We assessed the concordance between immunohistochemistry (IHC) and gene expression profiling (GEP) for determining diffuse large B-cell lymphoma (DLBCL) cell of origin (COO) in the phase III PHOENIX trial of rituximab plus cyclophosphamide, doxorubicin, vincristine and prednisone (R-CHOP) with or without ibrutinib. Among 910 of 1114 screened patients with non-germinal centre B cell-like (non-GCB) DLBCL by IHC, the concordance with GEP for non-GCB calls was 82·7%, with 691 (75·9%) identified as activated B cell-like (ABC), and 62 (6·8%) as unclassified. Among 746 of 837 enrolled patients with verified non-GCB DLBCL by IHC, the concordance with GEP was 82·8%, with 567 (76·0%) identified as ABC and 51 (6·8%) unclassified; survival outcomes were similar regardless of COO or treatment, whereas among patients with ABC DLBCL aged <60 years, the overall and event-free survival were substantially better with ibrutinib versus placebo plus R-CHOP [hazard ratio (HR) 0·365, 95% confidence interval (CI) 0·147-0·909, P = 0·0305; HR 0·561, 95% CI 0·326-0·967, P = 0·0348, respectively]. IHC and GEP showed high concordance and consistent survival outcomes among tested patients, indicating centralised IHC may be used to enrich populations for response to ibrutinib plus R-CHOP.

IHC, concordance, diffuse large B-cell lymphoma, gene expression profiling, subtyping
0007-1048
83-91
Balasubramanian, Sriram
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Wang, Songbai
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Major, Christopher
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Hodkinson, Brendan
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Schaffer, Michael
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Sehn, Laurie H
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Johnson, Peter
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Zinzani, Pier Luigi
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Carey, Jodi
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Shreeve, S Martin
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Sun, Steven
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Gerecitano, John
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Vermeulen, Jessica
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Staudt, Louis M
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Wilson, Wyndham
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Balasubramanian, Sriram
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Wang, Songbai
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Major, Christopher
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Hodkinson, Brendan
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Schaffer, Michael
e78b82cd-9bee-4036-a8d0-ce0bae067e0d
Sehn, Laurie H
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Johnson, Peter
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Zinzani, Pier Luigi
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Carey, Jodi
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Shreeve, S Martin
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Sun, Steven
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Gerecitano, John
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Vermeulen, Jessica
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Staudt, Louis M
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Wilson, Wyndham
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Balasubramanian, Sriram, Wang, Songbai, Major, Christopher, Hodkinson, Brendan, Schaffer, Michael, Sehn, Laurie H, Johnson, Peter, Zinzani, Pier Luigi, Carey, Jodi, Shreeve, S Martin, Sun, Steven, Gerecitano, John, Vermeulen, Jessica, Staudt, Louis M and Wilson, Wyndham (2021) Comparison of immunohistochemistry and gene expression profiling subtyping for diffuse large B-cell lymphoma in the phase III clinical trial of R-CHOP ± ibrutinib. British Journal of Haematology, 194 (1), 83-91. (doi:10.1111/bjh.17450).

Record type: Article

Abstract

We assessed the concordance between immunohistochemistry (IHC) and gene expression profiling (GEP) for determining diffuse large B-cell lymphoma (DLBCL) cell of origin (COO) in the phase III PHOENIX trial of rituximab plus cyclophosphamide, doxorubicin, vincristine and prednisone (R-CHOP) with or without ibrutinib. Among 910 of 1114 screened patients with non-germinal centre B cell-like (non-GCB) DLBCL by IHC, the concordance with GEP for non-GCB calls was 82·7%, with 691 (75·9%) identified as activated B cell-like (ABC), and 62 (6·8%) as unclassified. Among 746 of 837 enrolled patients with verified non-GCB DLBCL by IHC, the concordance with GEP was 82·8%, with 567 (76·0%) identified as ABC and 51 (6·8%) unclassified; survival outcomes were similar regardless of COO or treatment, whereas among patients with ABC DLBCL aged <60 years, the overall and event-free survival were substantially better with ibrutinib versus placebo plus R-CHOP [hazard ratio (HR) 0·365, 95% confidence interval (CI) 0·147-0·909, P = 0·0305; HR 0·561, 95% CI 0·326-0·967, P = 0·0348, respectively]. IHC and GEP showed high concordance and consistent survival outcomes among tested patients, indicating centralised IHC may be used to enrich populations for response to ibrutinib plus R-CHOP.

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Accepted/In Press date: 11 March 2021
e-pub ahead of print date: 3 May 2021
Published date: July 2021
Keywords: IHC, concordance, diffuse large B-cell lymphoma, gene expression profiling, subtyping

Identifiers

Local EPrints ID: 449555
URI: http://eprints.soton.ac.uk/id/eprint/449555
ISSN: 0007-1048
PURE UUID: 48c925bb-8a6a-46ed-b487-16ca6e871ba0
ORCID for Peter Johnson: ORCID iD orcid.org/0000-0003-2306-4974

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Date deposited: 07 Jun 2021 16:32
Last modified: 17 Mar 2024 06:36

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Contributors

Author: Sriram Balasubramanian
Author: Songbai Wang
Author: Christopher Major
Author: Brendan Hodkinson
Author: Michael Schaffer
Author: Laurie H Sehn
Author: Peter Johnson ORCID iD
Author: Pier Luigi Zinzani
Author: Jodi Carey
Author: S Martin Shreeve
Author: Steven Sun
Author: John Gerecitano
Author: Jessica Vermeulen
Author: Louis M Staudt
Author: Wyndham Wilson

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