{
  "abstract": "Background: Primary mediastinal large B-cell lymphoma (PMBCL) is a highly curable lymphoma in which first-line therapy must balance durable disease control with acute and late treatment toxicity.\n\nMethods: We retrospectively analyzed 98 patients with newly diagnosed PMBCL who received sintilimab plus R-CHOP (group 1, n = 42) or DA-EPOCH-R (group 2, n = 56). The primary endpoint was progression-free survival (PFS), and secondary endpoints included complete metabolic response (CMR) and safety. Propensity-score matching (PSM) and inverse probability of treatment weighting (IPTW) were used to adjust for baseline imbalances. Molecular profiling was performed in 75 diagnostic samples to characterize immune-escape features, including 9p24.1 alterations and PD-L1/PD-L2 expression.\n\nResults: Sintilimab plus R-CHOP produced numerically comparable response and PFS outcomes to DA-EPOCH-R, although equivalence or non-inferiority cannot be inferred from this retrospective, event-limited cohort. CMR rates were 85.7% versus 83.9% before matching (Fisher P = 1.000) and 83.3% versus 80.6% after PSM (P = 1.000; 36 pairs). Estimated 24-, 36-, and 60-month PFS rates were 81.0% versus 83.9% before matching (HR 1.19, 95% CI 0.46–3.09; log-rank P = 0.716), 83.3% versus 80.6% after matching (HR 0.84, 95% CI 0.28–2.51; P = 0.759), and 83.9% versus 84.6% after IPTW (HR 1.04, 95% CI 0.39–2.76; robust P = 0.942), respectively. These estimates were based on 17 PFS events in the full cohort and 13 events after matching. Grade 3–4 neutropenia was less frequent with sintilimab plus R-CHOP before matching (38.1% versus 66.1%; P = 0.008) and remained lower after matching (30.6% versus 61.1%; P = 0.017). In 75 profiled diagnostic samples, group-level molecular data confirmed the expected immune-escape architecture of PMBCL and showed broadly similar distributions of 9p24.1 alterations and PD-L1/PD-L2 expression between treatment groups.\n\nConclusion: In this real-world cohort, sintilimab plus R-CHOP produced overlapping response and PFS estimates relative to DA-EPOCH-R, together with less grade 3–4 neutropenia. The study cannot establish equivalence, non-inferiority, treatment replacement, or radiotherapy omission. These findings support the biological rationale for integrating PD-1 blockade into frontline chemoimmunotherapy and highlight the need for prospective studies to define its role within PET-adapted and immune-driven treatment strategies for PMBCL.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Lymphoma, the Affiliated Hospital of Qingdao University",
    "Department of Oncology, Gaomi People’s Hospital",
    "Department of Hematology, Linyi Central Hospital"
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 5,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Zhihe Liu"
    },
    {
      "affs": [
        1
      ],
      "name": "Jianxin Ren"
    },
    {
      "affs": [
        2
      ],
      "name": "Kaiqin Jiang"
    },
    {
      "affs": [
        0
      ],
      "name": "Hao Guan"
    },
    {
      "affs": [
        0
      ],
      "name": "Xia Zhao"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/a2x2dn8xn7rms.bib",
  "cited_by": 0,
  "doi": "10.3389/fimmu.2026.1924360",
  "fulltext_url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC13710370/",
  "id": "a2x2dn8xn7rms",
  "issns": [
    "1664-3224"
  ],
  "landing_url": "https://www.frontiersin.org/articles/10.3389/fimmu.2026.1924360/full",
  "language": "en",
  "licence": "CC-BY-4.0",
  "licence_label": "CC BY 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "Original Research"
    ],
    [
      "openalex",
      "2734|Lymphoma Diagnosis and Treatment"
    ]
  ],
  "openalex": "W7221727123",
  "pdf_url": "https://www.frontiersin.org/journals/immunology/articles/10.3389/fimmu.2026.1924360/pdf",
  "pmcid": "PMC13710370",
  "pmid": "42947919",
  "published": "2026-10-13",
  "publisher": "Frontiers Media SA",
  "ris": "https://research.draconitic.com/paper/a2x2dn8xn7rms.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:19:15Z",
      "native_id": "10.3389/fimmu.2026.1924360",
      "source": "crossref",
      "url": "https://www.frontiersin.org/articles/10.3389/fimmu.2026.1924360/full"
    },
    {
      "first_seen": "2026-10-31T12:21:21Z",
      "native_id": "PMC13710370",
      "source": "pmc",
      "url": "https://doi.org/10.3389/fimmu.2026.1924360"
    }
  ],
  "subjects": [
    {
      "field": "biology",
      "origin": "issn:1664-3224",
      "subfield": "immunology"
    }
  ],
  "title": "Sintilimab plus R-CHOP versus DA-EPOCH-R as first-line therapy for primary mediastinal large B-cell lymphoma: a real-world comparative cohort study",
  "title_text": "Sintilimab plus R-CHOP versus DA-EPOCH-R as first-line therapy for primary mediastinal large B-cell lymphoma: a real-world comparative cohort study",
  "type": "peer-reviewed",
  "updated_at": "2026-10-31T12:21:21Z",
  "url": "https://research.draconitic.com/paper/a2x2dn8xn7rms",
  "venue": "Frontiers in Immunology",
  "versions": []
}