Dose-adjusted EPOCH-rituximab therapy in primary

mediastinal B-cell lymphoma.

Dunleavy K
1
, Pittaluga S, Maeda LS, Advani R, Chen CC, Hessler J, Steinberg SM, Grant
C, Wright G, ar!a G, Staudt LM, Ja"e #S, Wils$n WH%
Results: The patients had a median age of 30 years (range, 19 to 52) and a median tumor
diameter of 11 cm; 59% were women !uring a median of 5 years of fo""ow#up, the e$ent#
free sur$i$a" rate was 93%, and the o$era"" sur$i$a" rate was 9%% &mong the 1' patients
who were in$o"$ed in the retrospecti$e ana"ysis at another center, o$er a median of 3 years
of fo""ow#up, the e$ent#free sur$i$a" rate was 100%, and no patients recei$ed radiotherapy
(o "ate mor)idity or cardiac to*ic e+ects were found in any patients &fter fo""ow#up ranging
from 10 months to 1, years, a"" )ut 2 of the 51 patients (,%) who recei$ed !&#-./01#2
a"one were in comp"ete remission The 2 remaining patients recei$ed radiotherapy and were
disease#free at fo""ow#up
A Cancer and Leuemia !roup B multi-center study
o" DA-EPOCH-rituximab in untreated di#use lar$e B-
cell lymphoma %ith analysis o" outcome by molecular
subtype.
Wils$n WH
1
, Jung SH, P$r&u P, Hurd D, J$hns$n J, Martin S#, C'u&'!an M, Lai R, Said
J, Chadburn A, J$nes D, Dunleavy K, Canell$s G, (elenet' AD,Ches$n )D, Hsi #D* Can&er
Leu+e!ia Gr$u, )%
Results: 3ith a median fo""ow up of '2 months, time to progression and o$era"" sur$i$a"
were 41% and 4,%, respecti$e"y, and time to progression was 4%%, 92% and 5,% for
"ow5"ow#intermediate, high#intermediate and high 6nternationa" .rognostic 6nde* ris7 groups,
respecti$e"y, at 5#years and )eyond The time to progression and e$ent#free sur$i$a" of
germina" center 8#ce"" "ymphoma were 100% and 9,%, respecti$e"y, and non#germina"
center 8#ce"" 908 di+use "arge 8#ce"" "ymphoma were '%% and 54%, respecti$e"y, at '2
months (germina" center $s non#germina" center 8 ce"" .:0004) !&#-./01#2 was
to"erated without signi;cant grade , non#hemato"ogic to*icities
Dose-adjusted EPOCH plus rituximab is an e#ecti&e
re$imen in patients %ith poor-pro$nostic untreated
di#use lar$e B-cell lymphoma' results "rom a
prospecti&e obser&ational study.
Gar&-a.Su/re' J
1
, )a0as H, Arribas 1, De Miguel D, Pas&ual 2, )urgaleta C%
This study was designed to assess the e<cacy and safety of an infusiona" !&#-./01 (dose#
ad=usted etoposide5$incristine5do*oru)icin5)o"us cyc"ophosphamide5prednisone) and
ritu*ima) (!&#-./01#2) regimen for patients with poor prognosis di+use "arge 8#ce""
"ymphoma (!>80>) Thirty#three patients, aged 21#%' years, with an age#ad=usted
6nternationa" .rognostic 6nde* (6.6) of 2 or 3, were enro""ed, and 31533 patients were
e$a"ua)"e for response 0onso"idati$e radiation therapy was gi$en to eight patients with
)u"7y (? or :10 cm) disease at presentation /$era"", 2' patients (434%) achie$ed a
comp"ete remission (02), four patients (129%) achie$ed a partia" remission, and one patient
(32%) died during induction Two patients re"apsed (%'%) within 15 months 9rade 3#,
neutropenia de$e"oped in 52% of cyc"es and neutropenic fe$er in 1,% of cyc"es (51% of
patients) The estimates for e$ent#free sur$i$a" (-@A) and o$era"" sur$i$a" at 2 years were
'4% and %5% respecti$e"y The on"y factor re"ated to poor -@A was the presence of three
age#ad=usted 6.6#ris7 factors 3e conc"ude that !&#-./01#2 has c"inica""y signi;cant acti$ity
with a fa$oura)"e to*icity pro;"e for poor#prognostic !>80> patients The administration
of !&#-./01#2 as an outpatient regimen )y using a sing"e porta)"e infusion pump may )e a
feasi)"e a"ternati$e to impro$e the comp"iance and to reduce the tota" cost of this $ery
e+ecti$e regimen%
Phase (( study o" dose-adjusted EPOCH and rituximab
in untreated di#use lar$e B-cell lymphoma %ith
analysis o" $erminal center and post-$erminal center
biomarers.
Wils$n WH
1
, Dunleavy K, Pittaluga S, Hegde 3, Grant 4, Steinberg SM, Ra"eld M, Gutierre'
M, Chabner )A, Staudt L, Ja"e #S, Jani+ J#%
.atients had a median age of 50 years (range, 19 to 45) and ,0% had a high#intermediate or
high 6nternationa" .rognostic 6nde* (6.6) &t 5 years, progression#free sur$i$a" (.@A) and
o$era"" sur$i$a" (/A) were %9% and 40%, respecti$e"y, with a median potentia" fo""ow#up of
5, months .@A was 91%, 90%, '%%, and ,%%, and /A was 100%, 90%, %,%, and 3%%, for
0 to 1, 2, 3, and , to 5 6.6 factors, respecti$e"y, at 5 years The 8c"#2 and B68#1 )iomar7ers
were not associated with .@A or /A 8ased on !&#-./01 historica" contro"s, ritu*ima) on"y
)ene;ted 8c"#2 positi$e tumors 8c"#' e*pression was associated with higher .@A whereas
908 e*hi)ited a margina""y signi;cant higher .@A compared with post#908 !>80>%
)Lon$-term *ollo%-+p "or ,- .e%ly Dia$nosed
Di#used Lar$e B-cell Lymphoma Patients /reated by
012-EPOCH3.
4an$ 54
6
7 8hai 4P
9
7 Liu H.
6
7 4u 4P
6
7 Li *
6
7 :on$ P
,
7 8hou 5!
6
7 An 8;
6
7 <an$ LP
6
.
The purpose of this study was to e$a"uate the e<cacy and safety of (2)#-./01 protoco" on
patients with di+use "arge 8#ce"" "ymphoma(!>80>) @rom @e)ruary 200, to &pri" 2009, a
tota" of 39 patients who su+ered from !>80> and recei$ed (2)#-./01 protoco" were
enro""ed in the study The median age of patients was 52 years o"d 2, patients were on
stage 6566, and 15 cases were on stage 66656C .atients with stage 6566 were administered with ,#
' cyc"es of (2)#-./01, whi"e other patients with stage 66656C recei$ed '#4 cyc"es of (2)#
-./01 !>80> patients with )u"7y disease recei$ed radiotherapy after comp"etion of
chemotherapy 39 patients recei$ed a tota" of 209 cyc"es of chemotherapy and the median
chemotherapy cyc"es was ' (range, 2#4 cyc"es) The resu"ts showed that the o$era""
response rate of 39 assessa)"e patients was 4%2%, inc"uding 24 patients (%14%) in
comp"ete remission (02) and ' patients (15,%) in partia" remission(.2) 3ith a median
fo""ow#up of 5%% months, the 1#year o$era"" sur$i$a" rate was 414%, whi"e %09% for 3#year
and 544% for 5#year The ma=or to*icity of (2)#-./01 potoco" was hemato"ogic to*icity and
the incidence of grade 666#6C neutropenia and anemia were 292% and 1,,%, respecti$e"y
/ther to*icities were mi"d, no treatment#re"ated deaths occurred &t the end of fo""ow#up,no
secondary tumors occurred 6t is conc"uded that (2)#-./01 protoco" is a e+ecti$e and safe
protoco" for the patients with !>80>