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，阿霉素、长春新碱和依托泊苷以96小时持续输注的形式给药，环磷酰胺和泼尼松按剂量顺序给药。给药时间表的理由来自于实验室观察，即人类肿瘤细胞株，包括那些具有多药耐药表型的细胞株，对长期给予低浓度的细胞毒性天然产物比在较高浓度下短暂给予相同的药物更敏感。多项II期研究表明，它优于R-CHOP，可能是因为它抑制了肿瘤的增殖，增加了细胞对肿瘤细胞的杀伤力。若优于R-CHOP，则可提高DLBCL的治愈率。这项研究显示，两组患者的结果相似。然而，高危患者的DA-EPOCH-R预后有所改善。目前我们正在分析样品的分子特征。

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.