SAN DIEGO — Dose-adjusted R-EPOCH chemotherapy did not appear superior to standard chemoimmunotherapy for the treatment of patients with diffuse large B-cell lymphoma, John P. Leonard, MD, of Weill Cornell Medicine and NewYork-Presbyterian Hospital told HemOnc Today at the ASH Annual Meeting and Exposition.
Chemoimmunotherapy with R-CHOP — rituximab (Rituxan, Genentech) plus cyclophosphamide, doxorubicin, vincristine and prednisone — has been the standard therapy for DLBCL for several years.
“There has been a modification to R-CHOP called dose-adjusted R-EPOCH that differs in three main ways,” Leonard said. “It’s given infusionally over 4 days, it adds a drug called etoposide, and it has some dose adjustments with each cycle depending on the treatment effect.”
Leonard and colleagues conducted a phase 3 multicenter study in which 524 patients with DLBCL to standard R-CHOP or the dose-adjusted R-EPOCH regimen.
Results showed R-CHOP and dose-adjusted R-EPOCH demonstrated similar efficacy, with no statistically significant differences in OS or PFS.
“There may be some subgroups where the regimens may differ, and those molecular and correlative analyses are ongoing,” Leonard said. “But at this point, it seems that most patients will continue to be treated with R-CHOP, because it is equally efficacious as dose-adjusted R-EPOCH ... and is obviously more user-friendly for the patient and the physician. It is an outpatient treatment and has a bit less toxicity, as well.” – by Kristie L. Kahl
Wilson WH, et al. Abstract 469. Presented at: ASH Annual Meeting and Exposition; Dec. 3-6, 2016; San Diego.
Disclosure: Leonard reports consultant roles with AbbVie, Biotest, Bristol-Myers Squibb, Celgene, Genmab, Gilead, Juno, Nanostring, Regeneron, Sunesis, Sutro and Teva.