DA-EPOCH-R improves the outcome over that of R-CHOP regimen for DLBCL patients below 60 years, GCB phenotype, and those with high-risk IPI, but not for double expressor lymphoma.
Abstract | PURPOSE: METHODS: A total of 252 cases treated with R-CHOP and 146 cases who received DA-EPOCH-R were enrolled into this study. RESULTS: Overall, 162 (64.3%) and 105 patients (71.9%) achieved complete remission, 43 (17.1%) and 14 patients (9.6%) achieved partial remission following R-CHOP and DA-EPOCH-R regimen, respectively. After a median follow-up of 48 months, better progression-free survival (PFS) was seen in DA-EPOCH-R group, but no better overall survival (OS) was found in patients treated with DA-EPOCH-R compared to R-CHOP (P = 0.015 for PFS, P = 0.19 for OS). However, subgroup analysis according to cell of origin, international prognostic index (IPI), and age showed DA-EPOCH-R resulted in significantly better PFS and OS than R- CHOP regimen in patients with germinal center B-cell-like (GCB) phenotype (P = 0.002 for PFS, P = 0.007 for OS), high IPI (P = 0.002 for PFS; P = 0.03 for OS), and with a younger age (P = 0.002 for PFS, P = 0.045 for OS). We also compared two regimens in patients with double expressor lymphoma (DEL). The prognosis of DEL patients was significantly worse than non-DEL patients (P < 0.001 for PFS, P < 0.001 for OS), but DA-EPOCH-R regimen may not overcome the poor prognosis (P = 0.47 for PFS, P = 0.79 for OS). CONCLUSION: GCB DLBCL, younger patients, and high-risk patients, but not DEL patients, may benefit from continuous-infusion DA-EPOCH-R regimen.
|
Authors | Xin-Yu Zhang, Jin-Hua Liang, Li Wang, Hua-Yuan Zhu, Wei Wu, Lei Cao, Lei Fan, Jian-Yong Li, Wei Xu |
Journal | Journal of cancer research and clinical oncology
(J Cancer Res Clin Oncol)
Vol. 145
Issue 1
Pg. 117-127
(Jan 2019)
ISSN: 1432-1335 [Electronic] Germany |
PMID | 30327941
(Publication Type: Journal Article)
|
Chemical References |
- Antibodies, Monoclonal, Murine-Derived
- Proto-Oncogene Proteins c-bcl-2
- Proto-Oncogene Proteins c-myc
- R-CHOP protocol
- Rituximab
- Vincristine
- Etoposide
- Doxorubicin
- Cyclophosphamide
- Prednisone
|
Topics |
- Adolescent
- Adult
- Age Factors
- Aged
- Aged, 80 and over
- Antibodies, Monoclonal, Murine-Derived
(administration & dosage, adverse effects)
- Antineoplastic Combined Chemotherapy Protocols
(administration & dosage, adverse effects)
- Cyclophosphamide
(administration & dosage, adverse effects)
- Disease-Free Survival
- Doxorubicin
(administration & dosage, adverse effects)
- Etoposide
(administration & dosage, adverse effects)
- Female
- Humans
- Infusions, Intravenous
- Lymphoma, Large B-Cell, Diffuse
(drug therapy, metabolism)
- Male
- Middle Aged
- Phenotype
- Prednisone
(administration & dosage, adverse effects)
- Prognosis
- Proto-Oncogene Proteins c-bcl-2
(metabolism)
- Proto-Oncogene Proteins c-myc
(metabolism)
- Remission Induction
- Retrospective Studies
- Rituximab
- Treatment Outcome
- Vincristine
(administration & dosage, adverse effects)
|
|
Join CureHunter, for free Research Interface BASIC access!
Take advantage of free CureHunter research engine access to explore the best drug and treatment options for any disease.
Find out why thousands of doctors, pharma researchers and patient activists
around the world use CureHunter every day.
Realize the full power of the drug-disease research graph!
|