Observational studyPloS one2026
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.
Observational study in PloS one, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Abstract
objectivesTo 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.
methodsA 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).
resultsA 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. Following 1:1 PSM, no PFS (HR 0.93, 95% CI: 0.47-1.84, p = 0.83) and OS (HR 1.28, 95% CI: 0.42-3.83, p = 0.66) benefit of DA-EPOCH-R versus R-CHOP was observed, with a nearly significantly higher frequency of grade ≥ 3 hematological adverse events (AEs) observed in the DA-EPOCH-R group (p = 0.052). Notably, only 37.9% (11/29) of patients executed dose escalation, which indicated a worse tolerance to this intensified regimen of the East Asians.
conclusionsNo significant survival benefit from DA-EPOCH-R treatment was observed for DLBCL with high Ki67 expression, which may be attributed to the poorer tolerance in the East Asian population.
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