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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.
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.
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.
Shares Rituximab, New England Journal of Medicine.
Shares Rituximab, New England Journal of Medicine.
Shares Dose-adjusted EPOCH-R compared with R-CHOP as frontline therapy for diffuse large B-cell lymphoma: clinical outcomes of the phase III intergroup trial Alliance/CALGB 50303, Rituximab.
Shares Primary mediastinal (thymic) large B-cell lymphoma, Rituximab.
Shares Primary mediastinal (thymic) large B-cell lymphoma, Rituximab.
Shares Primary mediastinal (thymic) large B-cell lymphoma, Rituximab.
Shares Rituximab, New England Journal of Medicine.
Shares Rituximab, New England Journal of Medicine.
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