DA-EPOCH-R No More Effective Than R-CODOX-M/R-IVAC in Burkitt Lymphoma


Two first-line chemoimmunotherapy regimens produce similar efficacy outcomes in patients with high-risk Burkitt lymphoma, according to research presented at the EHA 2022 Hybrid Congress.

In the phase 3 HOVON/SAKK trial, researchers compared R-CODOX-M/R-IVAC (rituximab, cyclophosphamide, doxorubicin, vincristine, methotrexate/rituximab, ifosfamide, etoposide, and high-dose cytarabine) with DA-EPOCH-R (dose-adjusted etoposide, prednisone, vincristine, cyclophosphamide, hydroxydaunorubicin, and rituximab).

The 2 regimens produced similar complete metabolic remission rates, progression-free survival (PFS), and overall survival, but R-CODOX-M/R-IVAC was associated with more adverse events (AEs).


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The trial included 84 patients with high-risk, sporadic and HIV-associated Burkitt lymphoma. The patients were randomly assigned to receive R-CODOX-M/R-IVAC (n=43) or DA-EPOCH-R (n=41). Baseline characteristics were well balanced between the treatment arms.

The study was stopped prematurely, and the median follow-up was 19.1 months.

The rate of complete metabolic remission was 65% in the R-CODOX-M/R-IVAC arm and 66% in the DA-EPOCH-R arm.

There were 10 PFS events in the R-CODOX-M/R-IVAC arm and 14 PFS events in the DA-EPOCH-R arm (P =.38). There were 10 deaths in the R-CODOX-M/R-IVAC arm and 11 in the DA-EPOCH-R arm (P =.85).

Grade 3-5 AEs were more common with R-CODOX-M/R-IVAC (129 events) than with DA-EPOCH-R (84 events). There was 1 grade 5 AE in each arm, 1 due to sepsis in the R-CODOX-M/R-IVAC arm and 1 due to COVID-19 in the DA-EPOCH-R arm.

There were 30 serious AEs in the R-CODOX-M/R-IVAC arm and 28 serious AEs in the DA-EPOCH-R arm. Infections and febrile neutropenia were significantly more common in the R-CODOX-M/R-IVAC arm than in the DA-EPOCH-R arm (P =.04).

Disclosures: The presenter declared affiliations with Bristol Myers Squibb/Celgene, Gilead, GenMab, AbbVie, Novartis, and Roche.

Reference

Chamuleau M, Stenner F, Chitu D, et al. R-CODOX-M/R-IVAC versus dose-adjusted (DA)-EPOCH-R in patients with newly diagnosed high-risk Burkitt lymphoma: First results of a multi-center randomized HOVON/SAKK trial. Presented at EHA 2022; June 9-12, 2022. Abstract LB2370.



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