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Favourable outcomes for high-risk diffuse large b-cell lymphoma (IPI 3-5) treated with front-line r-CODOX-M/R-IVAC chemotherapy: results of a phase 2 UK NCRI Trial
McMillan, A. K. Phillips E H Kirkwood, A. A. Barrans, S. Burton, C. Rule, S. Patmore, R. Pettengell, R. Ardeshna, K. M. Lawrie, A.
McMillan, A. K.
Phillips E H
Kirkwood, A. A.
Barrans, S.
Burton, C.
Rule, S.
Patmore, R.
Pettengell, R.
Ardeshna, K. M.
Lawrie, A.
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Abstract
BACKGROUND: Outcomes for patients with high-risk diffuse large B-cell lymphoma (DLBCL) treated with R-CHOP chemotherapy are suboptimal but, to date, no alternative regimen has been shown to improve survival rates. This phase 2 trial aimed to assess the efficacy of a Burkitt-like approach for high-risk DLBCL using the dose-intense R-CODOX-M/R-IVAC regimen. PATIENTS AND METHODS: Eligible pts were aged 18-65 years with stage II-IV untreated DLBCL and an International Prognostic Index (IPI) score of 3-5. Patients received alternating cycles of CODOX-M and IVAC (cyclophosphamide, vincristine, doxorubicin and high-dose methotrexate [CODOX-M] alternating with ifosfamide, etoposide and high-dose cytarabine [IVAC]) chemotherapy plus 8 doses of rituximab. Response was assessed by CT after completing all 4 cycles of chemotherapy. The primary endpoint was 2-year progression-free survival (PFS). RESULTS: 111 eligible patients were registered; median age was 50 years, IPI score was 3 (60.4%) or 4-5 (39.6%), 54% had a performance status /=2 and 9% had central nervous system involvement. 85 patients (76.6%) completed all 4 cycles of chemotherapy. There were 5 treatment-related deaths (4.3%)
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Date
2020
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A. K. McMillan, E. H. Phillips, A. A. Kirkwood et al. Favourable Outcomes for High-Risk Diffuse Large B-Cell Lymphoma (IPI 3-5) Treated with Front-Line R-CODOX-M/R-IVAC Chemotherapy: Results of a Phase 2 UK NCRI Trial. Ann Oncol. 2020.