R-CHOP vs R-DA-EPOCH for Double-Expressor Lymphoma: A Meta-Analysis

Double-expressor lymphoma (DEL), a subtype of diffuse large B-cell lymphoma (DLBCL), presents a poor prognosis. The traditional R-CHOP regimen has been ineffective in treating DEL. The intensified dose-adjusted rituximab, etoposide, prednisone, vincristine, cyclophosphamide, and doxorubicin (R-DA-EPOCH) chemotherapy regimen is considered a potential treatment strategy for DEL. This research assesses the distinction between the R-CHOP regimen and the R-DA-EPOCH regimen in treating DEL. A systematic search was conducted in the Cochrane Library, PubMed, and Embase databases, including studies through April 2023. Following literature screening, data extraction, and evaluation of study quality, a meta-analysis was executed utilizing the RevMan v5.4 software. This study included five studies in total, involving 439 patients. The findings of the meta-analysis indicated no considerable variations in the progression-free survival (HR = 1.03; 95% confidence interval, CI: 0.67–1.60; P > 0.05), overall survival (HR = 0.90; 95% CI: 0.60–0.34; P > 0.05), and objective response rate (HR = 0.97; 95% CI: 0.89–1.06; P > 0.05) among individuals with DEL who underwent treatment with R-CHOP and R-DA-EPOCH. This meta-analysis suggests that R-DA-EPOCH does not significantly improve the long-term prognosis of individuals with DEL compared to the R-CHOP regimen.