Dose-adjusted EPOCH-rituximab therapy in primary mediastinal B-cell lymphoma
Infusional dose-adjusted EPOCH with rituximab cured almost every patient with primary mediastinal B-cell lymphoma without any radiotherapy, sparing young patients the heart and breast cancer risks of chest irradiation.
Overview
Prospective single-centre phase 2 study of 51 patients with untreated primary mediastinal B-cell lymphoma treated with dose-adjusted EPOCH-rituximab for six to eight cycles without radiotherapy, with a retrospective validation cohort of 16 patients at Stanford.
At a median follow-up of 5 years, event-free survival was 93 percent and overall survival 97 percent; only two patients received radiotherapy, and PET scans after treatment had a low positive predictive value.
- Five-year event-free survival 93 percent; overall survival 97 percent.
- Radiotherapy avoided in 96 percent of patients.
Dose-adjusted EPOCH-R without radiotherapy became a standard for primary mediastinal B-cell lymphoma, particularly in the United States, and the IELSG37 trial later confirmed radiotherapy can be omitted after a negative PET.
- Single-arm study from one centre with a small validation cohort.
- Six-day infusional regimen is demanding; R-CHOP with PET-guided radiotherapy is an alternative.
Similar pages
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- TermR-CHOP (lymphoma chemoimmunotherapy)
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