Impact of rituximab biosimilars on overall survival in diffuse large B-cell lymphoma: a Dutch population-based study

In 2017, the European Medicines Agency approved rituximab biosimilars (R-biosimilars) for treatment of diffuse large B-cell lymphoma (DLBCL). Thereafter, the Netherlands was one of the first countries to implement R-biosimilars, given lower costs compared with rituximab originator (R-originator). This study's objective was to investigate whether overall survival (OS) of patients with DLBCL receiving R-biosimilars is similar to patients treated with R-originator. DLBCL patients >18 years, diagnosed between 2014 and 2018, who received at least 1 cycle of rituximab combined with cyclophosphamide, doxorubicin, vincristine, and prednisolone (R-CHOP) were identified in the Netherlands Cancer Registry. Patients were categorized into R-originator or R-biosimilars groups based on data from a central repository of the Dutch medicinal drug market. The primary end point was 3-year OS, defined as the time between diagnosis and all-cause death. By the end of 2018, 91% of purchased rituximab were biosimilars. In total, 4429 patients were identified with 876 in the R-biosimilars group and 3553 in the R-originator group. Patients in the R-biosimilars group less frequently received >6 cycles of R-CHOP compared with patients treated with R-originator (24% vs 30%, P = .003). The 3-year OS did not differ between patients treated with R-originator or R-biosimilars (73% vs 73%, P = .855). This was confirmed with a multivariable Cox regression analysis accounting for sex, age, International Prognostic Index score, and number of R-CHOP cycles. In conclusion, the 3-year OS is similar for patients treated with CHOP in combination with R-originator or R-biosimilars and, therefore, favors the use of R-biosimilars in DLBCL treatment management.Immunobiology of allogeneic stem cell transplantation and immunotherapy of hematological disease

Health-related quality of life after chemotherapy with or without rituximab in primary central nervous system lymphoma patients

Background: The impact of rituximab on health-related quality of life (HRQoL) in primary central nervous system lymphoma patients is not well known. We determined the impact of rituximab added to standard high-dose methotrexate-based treatment on HRQoL in patients in a large randomised trial. Patients and methods: Patients from a large phase III trial (HOVON 105/ALLG NHL 24), randomly assigned to receive standard chemotherapy with or without rituximab and followed by 30 Gy whole brain radiotherapy (WBRT) in patients ≤60 years, completed the EORTC QLQ-C30 and QLQ-BN20 questionnaires before and during treatment, and up to 24 months of follow-up or progression. Differences between treatment arms over time in global health status, role functioning, social functioning, fatigue, and motor dysfunction were assessed. Differences ≥10 points were deemed clinically relevant. The effect of WBRT on HRQoL was analysed in irradiated patients. Results: A total of 160/175 patients eligible for the HRQoL study completed at least one questionnaire and were included. Over time, scores improved statistically significantly and were clinically relevant in both arms. Between arms, there were no differences on any scale (range: −3.8 to +4.0). Scores on all scales were improved to a clinically relevant extent at 12 and 24 months compared with baseline in both arms, except for fatigue and motor dysfunction at 12 months (−7.4 and −8.8, respectively). In irradiated patients (n = 59), scores in all preselected scales, except motor dysfunction, remained stable up to 24 months compared with shortly after WBRT, overall mean difference ranging between 0.02 and 4.570. Conclusion: Compared with baseline, treatment resulted in improved HRQoL scores. The addition of rituximab to standard chemotherapy did not impac

Rush hour commuting in the Netherlands : Gender-specific household activities and personal attitudes towards responsibility sharing.

Apart from work-hour commitments, rush hour commuting is dependent on household activities and responsibilities. It can also be gender specific when gender differences in performing household activities prevail. To that end, this study investigates gender differences in rush hour commuting in relation to daily household activities using data from TBO 2006 (Dutch Time Use Survey) and MON 2006 (National Travel Survey of the Netherlands). Two separate analyses were carried out, one for the morning rush hour and one for the afternoon rush hour. The analyses considered household activities such as childcare, child chauffeuring, household maintenance and shopping, and working from home. Additionally, we included personal attitudes towards sharing these activities between partners. We found that females in the Netherlands were more likely to commute during morning rush hours but less likely during afternoon rush hours. In terms of household activities, childcare and child chauffeuring before/after a commute led to a higher probability of commuting during morning rush hours. In the afternoon, only childcare activity was significant. As expected, working from home had a negative effect on rush hour commuting for both analyses. Furthermore, we found that personal attitudes regarding the sharing of household activities and responsibilities were of limited additional value

Rush hour commuting in the Netherlands : Gender-specific household activities and personal attitudes towards responsibility sharing.

Apart from work-hour commitments, rush hour commuting is dependent on household activities and responsibilities. It can also be gender specific when gender differences in performing household activities prevail. To that end, this study investigates gender differences in rush hour commuting in relation to daily household activities using data from TBO 2006 (Dutch Time Use Survey) and MON 2006 (National Travel Survey of the Netherlands). Two separate analyses were carried out, one for the morning rush hour and one for the afternoon rush hour. The analyses considered household activities such as childcare, child chauffeuring, household maintenance and shopping, and working from home. Additionally, we included personal attitudes towards sharing these activities between partners. We found that females in the Netherlands were more likely to commute during morning rush hours but less likely during afternoon rush hours. In terms of household activities, childcare and child chauffeuring before/after a commute led to a higher probability of commuting during morning rush hours. In the afternoon, only childcare activity was significant. As expected, working from home had a negative effect on rush hour commuting for both analyses. Furthermore, we found that personal attitudes regarding the sharing of household activities and responsibilities were of limited additional value