Purpose To assess the clinical outcome and the influence of biomarkers associated with apoptosis inhibition (Bcl-2), tumor proliferation (MIB-1), and cellular differentiation on the outcome with dose-adjusted (DA) EPOCH (etoposide, prednisone, vincristine, cyclophosphamide, and doxorubicin) plus rituximab (R) infusional therapy in diffuse large B-cell lymphoma (DLBCL) with analysis of germinal center B-cell (GCB) and post-GCB subtypes by immunohistochemistry. Patients and Methods Phase II study of 72 patients with untreated de novo DLBCL who were at least 18 years of age and stage II or higher. Radiation consolidation was not permitted. Results Patients had a median age of 50 years (range, 19 to 85) and 40% had a high-intermediate or high International Prognostic Index (IPI). At 5 years, progression-free survival (PFS) and overall survival (OS) were 79% and 80%, respectively, with a median potential follow-up of 54 months. PFS was 91%, 90%, 67%, and 47%, and OS was 100%, 90%, 74%, and 37%, for 0 to 1, 2, ...

/pdf/phase-ii-study-of-dose-adjusted-epoch-and-rituximab-in-3qqtei4b82.pdf

Phase II Study of Dose-Adjusted EPOCH and Rituximab in Untreated Diffuse Large B-Cell Lymphoma With Analysis of Germinal Center and Post-Germinal Center Biomarkers

Prognostic markers identify subgroups of patients with similar risk profiles, helping to guide clinical care. The addition of rituximab to conventional anthracycline-based chemotherapy has improved clinical outcomes for patients with diffuse large B-cell lymphoma (DLBCL). Studies suggest that rituximab eliminates or modulates the significance of some markers (eg, BCL6 or BCL2), whereas other previously unimportant markers may emerge as significant prognostic indicators in the setting of treatment that now includes rituximab. These changes in the prognostic profile are likely to reflect the impact of rituximab on survival pathways important to some groups of patients with DLBCL but not to other groups, and thereby may provide clues to the underlying biology of the disease. They also identify subgroups of patients likely to benefit most from rituximab therapy and those who seem to garner no advantage from its inclusion in their treatment. Studies of prognostic indicators in the context of modern therapy have the potential to identify new, rational therapeutic targets for this biologically diverse disease.

Prognostic markers in diffuse large B-cell lymphoma: Keys to the underlying biology.

8038 Background: P21 is a downstream effector protein of p53 that induces cell cycle arrest by inhibiting cyclin/cyclin dependent kinase (cdK) complexes. In this prospective correlative study, we i...

Prognostic significance of p53/p21 expression in DLBCL treated with CHOP or R-CHOP: A correlative study of E4494

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Prognostic significance of p53/p21 expression in DLBCL treated with CHOP or R-CHOP: A correlative study of E4494