High rates of freedom from disease, overall survival for standard-dose, lower-dose EPOCH-R treatment
THURSDAY, Nov. 14 (HealthDay News) -- For patients with Burkitt's lymphoma, a low-intensity treatment consisting of infused etoposide, doxorubicin, and cyclophosphamide with vincristine, prednisone, and rituximab (EPOCH-R) is highly effective, according to a study published in the Nov. 13 issue of the New England Journal of Medicine.
Kieron Dunleavy, M.D., from the National Cancer Institute in Bethesda, Md., and colleagues studied two EPOCH-R regimens in patients with Burkitt's lymphoma: a standard dose-adjusted combination in HIV-negative patients (DA-EPOCH-R group; 19 patients) and a lower-dose short-course combination with double dose of rituximab in HIV-positive patients (SC-EPOCH-RR group; 11 patients).
The researchers found that the main toxic events of fever and neutropenia were noted during 22 and 10 percent of DA-EPOCH-R and SC-EPOCH-RR cycles, respectively. In one patient, tumor lysis syndrome developed; there were no treatment-related deaths. Compared with the median cumulative doses in the DA-EPOCH-R group, those of doxorubicin-etoposide and cyclophosphamide were 47 and 57 percent lower, respectively, in the SC-EPOCH-RR group. The rates of freedom from progression of disease and overall survival were 95 and 100 percent, respectively, with DA-EPOCH-R over a median follow-up of 86 months. For the SC-EPOCH-RR group, the rates were 100 and 90 percent, respectively, over a median follow-up of 73 months. There were no cases of Burkitt's lymphoma death.
"In this uncontrolled prospective study, low-intensity EPOCH-R-based treatment was highly effective in adults with sporadic or immunodeficiency-associated Burkitt's lymphoma," the authors write.
Full Text (subscription or payment may be required) (http://www.nejm.org/doi/full/10.1056/NEJMoa1308392 )