Cancer Research and Treatment

Original Articles

Hematologic malignancy

Intensified First Cycle of Rituximab Plus Eight Cycles of Cyclophosphamide, Doxorubicin, Vincristine, and Prednisolone with Rituximab Chemotherapy for Advanced-Stage or Bulky Diffuse Large B-Cell Lymphoma: A Multicenter Phase II Consortium for Improving Survival of Lymphoma (CISL) Study: Yu Ri Kim, Jin Seok Kim, Won Seog Kim, Hyeon Seok Eom, Deok-Hwan Yang, Sung Hwa Bae, Hyo Jung Kim, Jae Hoon Lee, Suk-Joong Oh, Sung-Soo Yoon, Jae-Yong Kwak, Chul Won Choi, Min Kyoung Kim, Sung Young Oh, Hye Jin Kang, Seung Hyun Nam, Hyeok Shim, Joon Seong Park, Yeung-Chul Mun, Cheolwon Suh, the Korean Society of Hematology Lymphoma Working Party; Cancer Res Treat. 2023;55(4):1355-1362. Published online March 30, 2023; DOI: https://doi.org/10.4143/crt.2023.271

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Purpose
This phase II, open-label, multicenter study aimed to investigate the efficacy and safety of a rituximab intensification for the 1st cycle with every 21-day of rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisolone (R-CHOP-21) among patients with previously untreated advanced-stage or bulky diffuse large B-cell lymphoma (DLBCL).
Materials and Methods
Ninety-two patients with stage III/IV or bulky DLBCL from 21 institutions were administered 8 cycles of R-CHOP-21 with an additional one dose of rituximab intensification on day 0 of the 1st cycle (RR-CHOP). The primary endpoint was a complete response (CR) rate after 3 cycles of chemotherapy.
Results
Among the 92 DLBCL patients assessed herein, the response rate after 3 cycles of chemotherapy was 88.0% (38.0% CR+50.0% partial response [PR]). After the completion of 8 cycles of chemotherapy, the overall response rate was observed for 68.4% (58.7% CR+9.8% PR). The 3-year progression-free survival rate was 64.0%, and the 3-year overall survival rate was 70.4%. Febrile neutropenia was one of the most frequent grade 3 adverse events (40.0%) and 5 treatment-related deaths occurred. Compared with the clinical outcomes of patients who received R-CHOP chemotherapy as a historical control, the interim CR rate was higher in male patients with RR-CHOP (20.5% vs. 48.8%, p=0.016).
Conclusion
Rituximab intensification on days 0 to the 1st cycle of the standard 8 cycles R-CHOP-21 for advanced DLBCL yielded favorable response rates after the 3 cycles of chemotherapy and acceptable toxicities, especially for male patients. ClinicalTrials.gov ID: NCT01054781.

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Design, Conduct, and Analysis of Externally Controlled Trials
Jiali Liu, Minghong Yao, Mingqi Wang, Wan Jie, Yanmei Liu, Xiaochao Luo, Jiayidaer Huan, Kelin Deng, Ke Deng, Kang Zou, Ying Zhang, Ling Li, Xin Sun
JAMA Network Open.2025; 8(9): e2530277. CrossRef

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Predictive Factors of Event-Free Survival at 24 Months in Patients with Peripheral T-Cell Lymphoma: A Retrospective Study: Yu Ri Kim, Soo-Jeong Kim, Hye Sun Lee, Soyoung Jeon, Hyunsoo Cho, Haerim Chung, Ji Eun Jang, June-Won Cheong, Yoo Hong Min, Jin Seok Kim; Cancer Res Treat. 2022;54(2):613-620. Published online August 5, 2021; DOI: https://doi.org/10.4143/crt.2021.270

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Purpose
Event-free survival at 24 months (EFS24) is known to be a surrogate marker for overall survival (OS) for patients with peripheral T-cell lymphoma (PTCL). We examined the role of EFS24 in PTCL compared to diffuse large B-cell lymphoma (DLBCL), and then assessed the clinical predictive factors of achieving EFS24.
Materials and Methods
Patients with newly diagnosed PTCL treated with anthracycline-based chemotherapy were included. Subsequent OS was defined as the time elapsed from 24 months after diagnosis until death from any cause in those who achieved EFS24.
Results
Overall, 153 patients were evaluated, and 51 patients (33.3%) achieved EFS24. Patients who achieved EFS24 showed superior OS compared to patients who did not (p < 0.001). EFS24 could stratify the subsequent OS although it did not reach to that of the general population. After matching the PTCL group to the DLBCL group based on the international prognostic index, the subsequent OS in patients who achieved EFS24 was similar between the two groups (p=0.094). Advanced stage was a significant factor to predict the failing EFS24 by multivariable analysis (p < 0.001).
Conclusion
Patients with PTCL who achieve EFS24 could have a favorable subsequent OS. Since advanced disease stage is a predictor of EFS24 failure, future efforts should focus on developing novel therapeutic strategies for PTCL patients presenting with advanced disease.

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Prognostic impact of pre-treatment and post-treatment plasma Epstein-Barr virus DNA in peripheral T-cell lymphomas
Chu-Yi Chan, Tung-Liang Lin, Ming-Chung Kuo, Yu-Shin Hung, Hung Chang, Che-Wei Ou, Jin-Hou Wu, Hsuan-Jen Shih, Yi-Jiun Su, Lee-Yung Shih, Yuen-Chin Ong, Wen-Yu Chuang, Hsiao-Wen Kao
Annals of Medicine.2025;[Epub] CrossRef
Clinical significance and predictive risk factors for event-free survival at 24 months in patients with PTCL, NOS
Zheng Cao, Xiaojun Wang, Xuemin Xue, Xiaoli Feng
Annals of Hematology.2024; 103(3): 869. CrossRef
Validity of event-free survival as a surrogate endpoint in haematological malignancy: Review of the literature and health technology assessments
Sarit Assouline, Adriana Wiesinger, Clare Spooner, Jelena Jovanović, Max Schlueter
Critical Reviews in Oncology/Hematology.2022; 175: 103711. CrossRef

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Treatment Outcomes of Rituximab Plus Hyper-CVAD in Korean Patients with Sporadic Burkitt or Burkitt-like Lymphoma: Results of a Multicenter Analysis: Junshik Hong, Seok Jin Kim, Jae-Sook Ahn, Moo Kon Song, Yu Ri Kim, Ho Sup Lee, Ho-Young Yhim, Dok Hyun Yoon, Min Kyoung Kim, Sung Yong Oh, Yong Park, Yeung-Chul Mun, Young Rok Do, Hun-Mo Ryoo, Je-Jung Lee, Jae Hoon Lee, Won Seog Kim, Cheolwon Suh; Cancer Res Treat. 2015;47(2):173-181. Published online October 28, 2014; DOI: https://doi.org/10.4143/crt.2014.055

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Purpose
This study was conducted to evaluate outcomes in adult patients with Burkitt lymphoma (BL) or Burkitt-like lymphoma treated with an rituximab plus hyper-CVAD (R-hyper-CVAD) regimen by focusing on tolerability and actual delivered relative dose intensity (RDI).
Materials and Methods
Patients ≥ 20 years of age and pathologically diagnosed with BL or Burkitt-like lymphoma were treated with at least one cycle of R-hyper-CVAD as the first-line treatment in this study. Eligible patients’ case report forms were requested from their physicians to obtain clinical and laboratory data for this retrospective study.
Results
Forty-three patients (median age, 51 years) from 14 medical centers in Korea were analyzed, none of which were infected with human immunodeficiency virus. The majority of patients had advanced diseases, and 24 patients achieved a complete response (75.0%). After a median follow-up period of 20.0 months, 2-year event-free and overall survival rates were 70.9% and 81.4%, respectively. Eleven patients (25.6%) were unable to complete the R-hyper-CVAD regimen, including six patients due to early death. The RDIs of adriamycin, vincristine, methotrexate, and cytarabine were between 60% and 65%, which means less than 25% of patients received greater than 80% of the planned dose of each drug. Poor performance status was related to the lower RDIs of doxorubicin and methotrexate.
Conclusion
R-hyper-CVAD showed excellent treatment outcomes in patients who were suitable for dose-intense chemotherapy. However, management of patients who are intolerant to a dose-intense regimen remains problematic due to the frequent occurrence of treatmentrelated complications.

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Comparison of chemotherapy regimens plus rituximab in adult Burkitt lymphoma: A single-arm meta-analysis
Xiaoxuan Lu, Yu Liu, Ruyu Liu, Jiaxin Liu, Xiaojing Yan, Liren Qian
Frontiers in Oncology.2022;[Epub] CrossRef
Trends in survival of patients with stage I/II Burkitt lymphoma in the United States: A SEER database analysis
Ze‐Long Liu, Pan‐Pan Liu, Xi‐Wen Bi, De‐Xin Lei, Yu Wang, Zhi‐Ming Li, Wen‐Qi Jiang, Yi Xia
Cancer Medicine.2019; 8(3): 874. CrossRef
ERK-dependent IL-6 positive feedback loop mediates resistance against a combined treatment using danusertib and BKM120 in Burkitt lymphoma cell lines
Jun Liu, Junshik Hong, Kwang-Sung Ahn, Junhyeok Go, Heejoo Han, Jihyun Park, Dongchan Kim, Hyejoo Park, Youngil Koh, Dong-Yeop Shin, Sung-Soo Yoon
Leukemia & Lymphoma.2019; 60(10): 2532. CrossRef
Lymphoma epidemiology in Korea and the real clinical field including the Consortium for Improving Survival of Lymphoma (CISL) trial
Kwai Han Yoo, Hyewon Lee, Cheolwon Suh
International Journal of Hematology.2018; 107(4): 395. CrossRef
Recent advances in treating extra-ocular lymphomas
Lauge Hjorth Mikkelsen, Natacha Storm Würtz, Steffen Heegaard
Expert Review of Ophthalmology.2018; 13(4): 205. CrossRef
The Consortium for Improving Survival of Lymphoma (CISL): recent achievements and future perspective
Cheolwon Suh, Byeong-Bae Park, Won Seog Kim
Blood Research.2017; 52(1): 3. CrossRef
Primary lymphomas in the gastrointestinal tract
Jiang Chen Peng, Lu Zhong, Zhi Hua Ran
Journal of Digestive Diseases.2015; 16(4): 169. CrossRef

17,614 View
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