Is dose-adjusted EPOCH-R the new standard for high-risk Burkitt lymphoma?

Mené sur 89 patients atteints d'un lymphome de Burkitt récemment diagnostiqué (âge médian : 52 ans ; durée médiane de suivi : 28,5 mois), cet essai multicentrique de phase III compare l'efficacité, du point de vue de la survie sans progression, et la toxicité de deux stratégies d'immuno-chimiothérapie, l'une de haute intensité (type R-CODOX-M/R-IVAC) et l'autre de faible intensité (type DA-EPOCH-R)

Résumé en anglais

In the Lancet Haematology, Martine Chamuleau and colleagues 1 report on the first phase 3 study in Burkitt lymphoma since Ribrag and colleagues 2 showed that the addition of rituximab to a high-intensity chemotherapy backbone was associated with higher event-free survival in high-risk Burkitt lymphoma. The authors compared two regimens used to treat high-risk Burkitt lymphoma, as defined by Mead and colleagues. 3 Patients were randomly assigned to either two cycles of R-CODOX-M/IVAC-R (cyclophosphamide, vincristine, doxorubicin, methotrexate, iphosfamide, etoposide, and cytarabine) or six cycles of DA-EPOCH-R (dose-adjusted etoposide, prednisone, vincristine, cyclophosphamide, doxorubicin, and rituximab) using 2-year progression-free survival as the primary endpoint. Patients with sporadic Burkitt lymphoma or HIV-associated Burkitt lymphoma were eligible, but patients with CNS involvement were not.