Unknown

Dataset Information

0

Response-adapted therapy with infusional EPOCH chemotherapy plus rituximab in HIV-associated, B-cell non-Hodgkin's lymphoma.


ABSTRACT: Four cycles of rituximab plus CHOP chemotherapy is as effective as 6 cycles in low-risk diffuse large B-cell lymphoma (DLBCL). Here we report a post-hoc analysis of a prospective clinical trial in patients with HIV-associated DLBCL and high-grade lymphoma treated with 4-6 cycles of EPOCH plus rituximab based a response-adapted treatment strategy. 106 evaluable patients with HIV-associated DLBCL or high-grade CD20-positive non-Hodgkin's lymphoma were randomized to receive rituximab (375 mg/m2) given either concurrently prior to each infusional EPOCH cycle, or sequentially (weekly for 6 weeks) following completion of EPOCH. EPOCH consisted of a 96-hour IV infusion of etoposide, doxorubicin, and vincristine plus oral prednisone followed by IV bolus cyclophosphamide every 21 days for 4 to 6 cycles. Patients received 2 additional cycles of therapy after documentation of a complete response (CR) by computerized tomography after cycles 2 and 4. 64 of 106 evaluable patients (60%, 95% CI 50%, 70%) had a CR in both treatment arms. The 2-year event-free survival (EFS) rates were similar in the 24 patients with CR who received 4 or fewer EPOCH cycles (78%, 95% confidence intervals [55%, 90%]) due to achieving a CR after 2 cycles, compared with those who received 5-6 cycles of EPOCH (85%, 95% CI 70%, 93%) because a CR was first documented after cycle 4. A response-adapted strategy may permit a shorter treatment duration without compromising therapeutic efficacy in patients with HIV-associated lymphoma treated with EPOCH plus rituximab, which merits further evaluation in additional prospective trials. Clinical Trials.gov identifier NCT00049036.

SUBMITTER: Sparano JA 

PROVIDER: S-EPMC7927888 | BioStudies | 2021-01-01

SECONDARY ACCESSION(S): NCT00049036

REPOSITORIES: biostudies

Similar Datasets

2010-01-01 | S-EPMC2858478 | BioStudies
2012-01-01 | S-EPMC3310940 | BioStudies
2017-01-01 | S-EPMC5474506 | BioStudies
2021-01-01 | S-EPMC7869186 | BioStudies
2018-01-01 | S-EPMC5909762 | BioStudies
2021-01-01 | S-EPMC7948296 | BioStudies
2013-01-01 | S-EPMC3901044 | BioStudies
2018-01-01 | S-EPMC6314205 | BioStudies
2020-01-01 | S-EPMC7174964 | BioStudies
2019-01-01 | S-EPMC6553835 | BioStudies