961P - Intermediate results of treatment of primary mediastinal large B-cell lymphoma with DA-EPOCH-R regimen

Date 28 September 2014
Event ESMO 2014
Session Poster Display session
Topics Anti-Cancer Agents & Biologic Therapy
Lymphomas
Presenter Iana Stepanishyna
Citation Annals of Oncology (2014) 25 (suppl_4): iv327-iv339. 10.1093/annonc/mdu339
Authors I. Stepanishyna1, I. Kryachok2, I. Titorenko1, K. Filonenko2, A. Martynchyk2, O. Novosad2, V. Sokolov3, R. Vereschako3
  • 1Oncohematology, National cancer institute, 03022 - Kiev/UA
  • 2Oncohematology, National cancer institute, Kiev/UA
  • 3Thoracic Surgery, clinical hospital№17, Kiev/UA

Abstract

Aim

To estimate efficacy and toxicity of R-DA-EPOCH regimen in patients with primary mediastinal (thymic) large B-cell lymphoma (PMBL).

Methods

The studied group included 22 patients with newly diagnosed PMBL. Median age was 34 years, 16 were females (72,8%) and 6 were mails (27,2%). Primary and post treatment assessment of disease included PET/CT or CT of neck, chest, abdomen and pelvic. In 61,5% of patient was early stage (І-ІІ) of disease, 93,3% of patients had greatest size of the tumor mass in mediastinum more than 10 cm. The tumor pleurisy, pericarditis and lungs lesions were revealed in 46,5%, 52% and 30,7%, respectively. All patients received 6 cycles of R-DA-EPOCH regimen. Patients who achieved complete metabolic response received mediastinal radiation therapy (30 Gy) or were under observation.

Results

Response assessment performed after the completion of 6th cycles of chemotherapy. 19 patients have already completed treatment plan. 2 patients were exclude from study due to diseases progression (one of them had CNS lesion after 3rd cycle of chemotherapy, second patient had rapid increase of mediastinal mass after 6 cycle). Overall response rate was 89,4%. Complete response was achieved in 14 patients (73,6%). PET/CT was performed in 16 patients. Complete morphologic regression but with residual metabolic activity of residual mass was revealed in 5 patients (31,3%). Treatment was associated with moderate hematological toxicity: anemia grade 4 observed in one case (5,2%), febrile neutropenia requiring hospitalization in 2 patients (10,5%), and one of them had infection associated with venous port. Thrombocytopenia grade 3-4 was not observed. All detected cases of non-hematological toxicity were grade 1 or 2. Diarrhea, nausea, stomatitis, neuropathy were observed in 5,2%, 10,5%, 36,8% and in 31,6% of cases, respectively.

Conclusions

Our results indicate that R-DA-EPOCH has a high cure rate in patients with PMBL, which allows to achieve good response in 89,4% cases. Such treatment associated with moderate hematological and non-hematological toxicity. Further continuation of study is needed to estimate and analyze long-term results of therapy.

Disclosure

All authors have declared no conflicts of interest.