R-da-EPOCH vs R-CHOP in patients with primary mediastinal large B-cell lymphoma: Results of randomised (prospective) multicenter study

Date

09 Oct 2016

Session

Haematological malignancies

Presenters

Iryna Kryachok

Citation

Annals of Oncology (2016) 27 (6): 313-327. 10.1093/annonc/mdw375

Authors

I. Kryachok1, I. Stepanishyna1, I. Tytorenko1, A.V. Martynchyk1, K. Filonenko2, O. Novosad1, T. Kadnikova1, I. Pastushenko1, Y. Kushchevyy1, T. Skrypets1, O. Aleksyk2, K. Ulianchenko1

Author affiliations

  • 1 Oncohematology, National Cancer Institute of the MPH Ukraine, 03022 - Kiev/UA
  • 2 Oncohematology With Adjuvant Chemotherapy, National Cancer Institute of the MPH Ukraine, 03022 - Kiev/UA
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Background

The standard frontline therapy of primary mediastinal large B-cell lymphoma (PMBL) does not exist. Different anthracycline–based regimens are applied. Therefore, the efforts to determine the most effective and well-tolerated treatment of such category of patients is reasonable. Aim To compare the treatment efficacy and toxicity of R-da-EPOCH and R-CHOP regimens in patients with PMBL.

Methods

69 patients with newly diagnosed PMBL from six Ukrainian centers were included into the study since Aug 2011 to Dec 2015. Median age was 27 years (range 17-45), 50 females (72,5%) and 19 males (27,5%). 68,1 % of patient had early stage (I-II) of disease, 78,3% of patients had greatest size of the tumor mass in mediastinum more than 10 cm. Patients were randomized in two groups to receive R-da-EPOCH (36 patients) or R-CHOP (33 patients). Primary and post treatment assessment of disease included PET-CT or CT of the whole body. The treatment efficacy in both groups was evaluated according to Cheson criteria 1999, 2007 and Deauville criteria. Toxicity rates were evaluated according to NCI-CTC V.3.0. All patients received 6 cycles of R-chemo ± mediastinal radiation therapy (30-36 Gy).

Results

The ORR was 100% in the group of R-da-EPOCH and 75,7% in group of R-CHOP, p 

Conclusions

The analysis of our study showed significantly higher efficacy of R-da-EPOCH regimen comparing to R-CHOP. Toxicity was tolerable in both groups, but the rate of neutropenia grade 3-4 was higher in the group of R-da-EPOCH than in the group of R-CHOP.

Clinical trial identification

Legal entity responsible for the study

I. Kryachok

Funding

N/A

Disclosure

All authors have declared no conflicts of interest.

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