Comparison of dose-adjusted EPOCH-R and R-CHOP in diffuse large B-cell lymphoma with high Ki67 expression: Results from a prospective observational study

by Wenxin Jiang, Peng Liu Objectives To compare the safety and efficacy of first-line dose-adjusted EPOCH-R (DA-EPOCH-R) versus R-CHOP treatment in diffuse large B-cell lymphoma (DLBCL) patients with high Ki67 expression. Methods A retrospective analysis of DLBCL patients receiving R-CHOP determined the threshold of high Ki67 expression predicting 2-year progression-free survival (PFS) events using receiver operating characteristic (ROC) curve.

Then we initiated a prospective, observational study evaluating DA-EPOCH-R therapy for DLBCL with high Ki67 expression, and selected a retrospective R-CHOP cohort to perform a propensity score-matched (PSM) analysis. Primary endpoints were PFS and overall survival (OS).

Results A Ki67 threshold of 82.5% was determined using ROC in the retrospective analysis of 376 DLBCL cases, thus the threshold was ultimately set at 80%. A total of 29 patients receiving DA-EPOCH-R were enrolled in the prospective study, the enrollment was terminated due to the conditional power and a slow accrual.