Real World Data on Efficacy and Safety of EPOCH in T-Cell Lymphoma

Abstract

T-cell lymphomas are a heterogeneous group of lymphoid malignancies with poor outcomes. Frontline multi-agent chemotherapy options include CHOP (prednisone, vincristine, cyclophosphamide, and doxorubicin), brentuximab-CHP, CHOEP, and EPOCH (etoposide, prednisone, vincristine, cyclophosphamide, and doxorubicin) . We report our single institution data for safety and efficacy of EPOCH in 38 patients with aggressive T-cell lymphoma including both peripheral T cell lymphoma (PTCL) and cutaneous T-cell lymphoma (CTCL). Eighteen patients received EPOCH as first-line and 21 in the relapsed/refractory (R/R) setting. In 36 evaluable patients, the overall response rate (ORR) was 77% (95% CI: 61%-89%) with 19 (53%) patients achieving complete response (CR) (95% CI: 36%-69%). The ORR in first line and R/R settings were 80% (95% CI 46%-94%) and 75% (95%CI: 52% - 90%), respectively. Response rate was similar in African American vs Caucasian patients but was higher in CD30 negative vs positive patients. Most common grade 3 / 4 adverse events included cytopenias. Overall, EPOCH was well tolerated with high response rates in first line and R/R setting.Microabstract: T-cell lymphomas are a heterogeneous group of lymphoid malignancies with poor outcomes. Acceptable frontline treatment regimens include various combinations of prednisone, vincristine, cyclophosphamide, etoposide and doxorubicin with brentuximab included for CD30- positive disease especially anaplastic large cell lymphoma. We report that EPOCH is well tolerated with high response rates in aggressive T-cell lymphomas and can serve as a backbone for combination studies across subtypes.