Key clinical point: R-CODOX-M/R-IVAC showed effectiveness for high-risk DLBCL and high-grade B-cell lymphoma.

Major finding: Two-year progression-free survival was 67.9% for the whole cohort.

Study details: A total of 111 eligible patients, median age 50 years,were assessed for their response to the regimen.

Disclosures: Cancer Research UK and the University College London Cancer Trials Centre supported the study. Several of the authors received funds from F.Hoffman-La Roche.

Commentary

“Drs. McMillan et al report the results of a phase II study of 111 patients with high risk diffuse large B-cell lymphoma (DLBCL) treated with the Burkitt lymphoma regimen R-CODOX-M/R-IVAC. The authors conclude that this treatment was effective and well tolerated. A key difference between this regimen compared to R-CHOP is the incorporation of methotrexate in both intravenous and intrathecal routes of administration. This study allowed patients with central nervous system (CNS) involvement to be enrolled, a population excluded from the majority of DLBCL clinical trials. Treatment of high risk DLBCL patients, including those with CNS involvement and with double hit lymphoma, is frequently based on data from retrospective studies. While the current prospective study does not incorporate a novel targeted strategy, the results are supportive of an intensive chemotherapy approach for high risk patients who are often ineligible for clinical trials.”

Sarah Rutherford, MD

Assistant Professor of Medicine, Weill Cornell Medicine