Phase III Study of R-CHOP v DA-EPOCH-R with microarray

剂量调整的EPOCH方案是基于体外和药效学原理开发的，以帮助克服耐药性。在该方案中，多柔比星、长春新碱和依托泊苷以96小时连续输注给药，环磷酰胺和泼尼松以推注时间表给药。给药时间表的依据来自实验室观察结果，即人肿瘤细胞系（包括具有多药耐药表型的细胞）对低浓度长期给药的细胞毒性天然产物比对高浓度短期给药的相同药物更敏感。多项II期研究表明，其上级于R-CHOP，可能是由于克服了肿瘤增殖并增加了细胞肿瘤细胞杀伤。如果上级R-CHOP，将提高DLBCL的治愈率。该研究显示两组的结局相似。然而，高风险患者显示DA-EPOCH-R的结局改善。目前，我们正在分析样本的分子特征。

The dose-adjusted EPOCH regimen was developed based on in vitro and pharmacodynamic principals to help overcome drug resistance. In this regimen, doxorubicin, vincristine, and etoposide are administered as a 96-hour continuous infusion, and cyclophosphamide and prednisone are administered on a bolus schedule. The rationale for the administration schedule derived from the laboratory observation that human tumor cell lines, including those with a multi-drug resistance phenotype, are more sensitive to cytotoxic natural products given for prolonged periods at low concentrations than to the same agents given for brief periods at higher concentrations. Multiple phase II studies suggests it is superior to R-CHOP, possibly due to overcoming tumor proliferation and increasing cell tumor cell kill. If superior to R-CHOP, it will increase the cure of DLBCL. This study showed similar outcome in both arms. However, high risk patients showed an improved outcome with DA-EPOCH-R. Currently we are analyzing the molecular characteristics of the samples.