Dose-adjusted EPOCH chemotherapy for untreated large B-cell lymphomas: a pharmacodynamic approach with high efficacy.

Blood
Wyndham H WilsonFrank Balis

Abstract

We hypothesized that incremental improvements in the cyclophosphamide-doxorubicin-vincristine-prednisone (CHOP) chemotherapy regimen through optimization of drug selection, schedule, and pharmacokinetics would improve outcome in patients with large B-cell lymphomas. A prospective multi-institutional study of administration of etoposide, vincristine, and doxorubicin for 96 hours with bolus doses of cyclophosphamide and oral prednisone (EPOCH therapy) was done in 50 patients with previously untreated large B-cell lymphomas. The doses of etoposide, doxorubicin, and cyclophosphamide were adjusted 20% each cycle to achieve a nadir absolute neutrophil count below 0.5 x 10(9)/L. The median age of the patients was 46 years (range, 20-88 years); 24% were older than 60 years; and 44% were at high-intermediate or high risk according to International Prognostic Index (IPI) criteria. There was a complete response in 92% of patients, and at the median follow-up time of 62 months, the progression-free survival (PFS) and overall survival (OS) rates were 70% and 73%, respectively. Neither IPI risk factors nor the index itself was associated with response, PFS, or OS. Doses were escalated in 58% of cycles, and toxicity levels were tolerable. Sig...Continue Reading

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References

Nov 11, 1991·International Journal of Cancer. Journal International Du Cancer·G M LaiS E Bates
Jul 1, 1990·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·M G ConlanD D Weisenburger
Jan 11, 1991·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·D L LongoR I Fisher
Feb 1, 1991·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·R M MeyerM D Goodyear
Jun 1, 1990·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·L W KwakS J Horning
May 1, 1985·Annals of Internal Medicine·P Klimo, J M Connors
Apr 1, 1989·Clinical Pharmacology and Therapeutics·S P AcklandJ A Sinkule
Nov 1, 1989·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·T A ListerM Tubiana
Feb 1, 1982·Annals of Internal Medicine·S S LeghaE J Freireich
Aug 1, 1995·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·W H WilsonJ Herdt
Sep 30, 1993·The New England Journal of Medicine·UNKNOWN International Non-Hodgkin's Lymphoma Prognostic Factors Project
Jun 1, 1994·British Journal of Cancer·R Simon, D G Altman
Dec 1, 1995·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·M A ShippL N Shulman
Apr 1, 1997·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·M LazzarinoP Möller
Jun 12, 1999·American Journal of Health-system Pharmacy : AJHP : Official Journal of the American Society of Health-System Pharmacists·J L WolfeG K Potti
Nov 24, 1999·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·B D ChesonG P Canellos
Nov 24, 1999·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·P C BishopP C Elwood
Jan 22, 2000·Annals of Oncology : Official Journal of the European Society for Medical Oncology·H M KhaledM S Moawad
Oct 31, 2000·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·M GutierrezW H Wilson
Feb 7, 2001·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·E R GaynorR I Fisher

❮ Previous
Next ❯

Citations

Dec 5, 2002·Pharmacoepidemiology and Drug Safety
May 3, 2013·Annals of Hematology·Igor AurerJosip Joachim Grah
Oct 23, 2012·International Journal of Hematology·Mark RoschewskiWyndham H Wilson
May 8, 2008·Nature Clinical Practice. Oncology·Beate Klimm, Andreas Engert
Apr 12, 2013·The New England Journal of Medicine·Kieron DunleavyWyndham H Wilson
Nov 15, 2013·The New England Journal of Medicine·Kieron DunleavyWyndham H Wilson
Feb 23, 2008·AIDS Patient Care and STDs·Victoria S BlinderJohn P Leonard
Mar 1, 2013·Annals of Oncology : Official Journal of the European Society for Medical Oncology·T WästerlidM Jerkeman
Sep 10, 2003·Current Opinion in Oncology·Joseph A Sparano
Aug 12, 2005·Current Opinion in Oncology·Lee Ratner
Dec 21, 2011·Clinical Cancer Research : an Official Journal of the American Association for Cancer Research·Kieron Dunleavy, Wyndham H Wilson
Dec 10, 2013·Hematology·Wyndham H Wilson
Oct 29, 2005·Blood·Deepak SudheendraBradford J Wood
Mar 16, 2007·Blood·James O Armitage
Apr 2, 2008·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Wyndham H WilsonJohn E Janik
Mar 10, 2010·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Craig H MoskowitzAndrew D Zelenetz
Feb 9, 2012·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Rachel B SalitMichael R Bishop
Feb 11, 2009·PloS One·Lee RatnerUNKNOWN AIDS Malignancy Consortium
Jan 14, 2005·International Journal of Hematology·Korenori OhtsuboMichio Sata
Jul 27, 2006·International Journal of Hematology·Wendy B BernsteinRobert Yarchoan
Sep 9, 2004·Frontiers in Bioscience : a Journal and Virtual Library·Lee Ratner
Jun 24, 2014·Leukemia Research Reports·Katherine DevittBenjamin J Chen
May 10, 2012·Advances in Hematology·Adam M PetrichSamir Parekh
Aug 16, 2005·Radiology·Athos D PatsalidesWyndham H Wilson
Jul 11, 2006·Ocular Immunology and Inflammation·Robert B NussenblattUNKNOWN CNS and Ocular Lymphoma Workshop Group
Oct 27, 2012·Leukemia & Lymphoma·Catherine Lai, Kieron Dunleavy
May 10, 2007·Leukemia & Lymphoma·Bruce A PetersonUNKNOWN Cancer and Leukemia Group B 9351
Jun 20, 2007·Leukemia & Lymphoma·Kieron DunleavyWyndham H Wilson
Nov 22, 2014·Molecules : a Journal of Synthetic Chemistry and Natural Product Chemistry·Martina GobecIrena Mlinarič-Raščan
Jun 6, 2009·Expert Review of Anticancer Therapy·Anne Sonet, André Bosly
Apr 15, 2009·Expert Opinion on Pharmacotherapy·Mark PrichardJohn J Densmore
Mar 26, 2014·Expert Opinion on Investigational Drugs·Alessandra DondiStefano Sacchi
Jun 10, 2008·Expert Opinion on Emerging Drugs·Shireen Kassam, Silvia Montoto
Mar 25, 2006·Expert Opinion on Pharmacotherapy·Luis Fayad, Anas Younes
Oct 13, 2014·Molecular Oncology·Richard K DzengErle S Robertson

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