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Diffuse large B-cell lymphoma (DLBCL) patients with high Ki-67 expression receive limited benefits from R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone) therapy. This study aims to compare the R-EPOCH (etoposide, prednisone, vincristine, cyclophosphamide, and doxorubicin) and R-CHOP regimens as first-line therapy in DLBCL patients with high Ki-67 expression. Data from 44 untreated DLBCL patients with high Ki-67 expression receiving R-EPOCH therapy were matched with those from 132 untreated DLBCL patients with high Ki-67 expression receiving R-CHOP therapy based on the International Prognostic Index (IPI: age, Ann Arbor stage, performance status, LDH level, number of extranodal sites), gender, and Ki-67 expression. In the R-EPOCH group, 42/44 patients were eligible for response evaluation. A total of 35 patients (83.3%) achieved complete remission (CR); 6 patients (14.3%) achieved partial remission (PR); and one patient (2.4%) exhibited progressive disease (PD) after 2 cycles of therapy. Patients in the R-EPOCH group presented better survival outcomes than those in the R-CHOP group (3-year overall survival [OS]: 89.9% vs. 70.2%, p = 0.041; 3-year progression-free survival [PFS]: 86.6% vs. 59.7%, p = 0.024). The survival superiority of the R-EPOCH over the R-CHOP regimen persisted when considering only patients of low-to-intermediate IPI risk, but it was not observed in those of high IPI risk. Our data suggest that R-EPOCH could be superior to R-CHOP as a first-line regimen in DLBCL patients with high Ki-67 expression, especially in those of low-to-intermediate IPI risk.

// Xi Zhang 1, * , Jia-Jia Huang 1, * , Yi Xia 1, * , Chao-Feng Li 2 , Yu Wang 1 , Pan-Pan Liu 1 , Xi-Wen Bi 1 , Peng Sun 1 , Tong-Yu Lin 1 , Wen-Qi Jiang 1 , Zhi-Ming Li 1 1 State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Department of Medical Oncology, Sun Yat-sen University Cancer Center, 510060 Guangzhou, China 2 Department of Information, Sun Yat-sen University Cancer Center, 510060 Guangzhou, China * These authors contributed equally to this work Correspondence to: Zhi-Ming Li, email: lzmsysu@sysucc.org.cn Keywords: peripherally inserted central venous catheter (PICC), thrombosis, lymphoma Received: February 17, 2016 Accepted: March 28, 2016 Published: April 07, 2016 ABSTRACT Peripherally inserted central venous catheters (PICCs) are widely used in cancer patients. Although PICC is a convenient tool, its use is associated with an obvious increase in the incidence of venous thrombosis. The risk factors for deep vein thrombosis associated with the use of PICCs in cancer patients are largely unexplored. This study aimed to investigate the incidence of PICC-associated thrombosis in lymphoma compared with its incidences in other types of cancer. A total of 8028 adult cancer patients inserted with PICC between June 2007 and June 2015 were included in this study. A total of 249 of the 8028 included patients (3.1%) inserted with PICC developed upper extremity deep vein thrombosis (PICC-UEDVT). Patients with lymphoma were more likely to have PICC-UEDVT than those with other types of malignancies (7.1% vs. 2.80%; P < 0.001). Logistic analysis revealed that a lymphoma diagnosis was a risk factor for UEDVT in cancer patients inserted with PICC (OR: 3.849, 95% CI: 2.334–6.347). Patients with lymphoma may be more predisposed to developing PICC-UEDVT than those with other types of malignancies. Identifying the mechanism underlying the relationship between PICC-UEDVT and lymphoma requires further study.

// Hang Yang 1, 2, * , Yu Wang 1, 2, * , Jing Zhan 1, 3 , Yi Xia 1, 2 , Peng Sun 1, 2 , Xi-Wen Bi 1, 2 , Pan-Pan Liu 1, 2 , Zhi-Ming Li 1, 2 , Su Li 1, 3 , Ben-Yan Zou 1, 4 , Wen-Qi Jiang 1, 2 1 Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou 510060, China 2 Department of Medical Oncology, Sun Yat-sen University Cancer Center, Guangzhou 510060, China 3 Clinical Trial Center, Sun Yat-sen University Cancer Center, Guangzhou 510060, China 4 Nursing Department, Sun Yat-sen University Cancer Center, Guangzhou 510060, China * These authors have contributed equally to this work Correspondence to: Wen-Qi Jiang, e-mail: jiangwq_sysuucc@163.com Ben-Yan Zou, e-mail: zouby@sysucc.org.cn Keywords: XC-302, PI3K pathway, non-Hodgkin lymphoma, safety and efficacy, pharmacokinetics Received: July 20, 2015 Accepted: September 24, 2015 Published: October 17, 2015 ABSTRACT Objectives: To determine the safety of Puquitinib Mesylate (XC-302), an oral inhibitor of phosphatidylinositol 3-kinase, in treating relapsed or refractory non-Hodgkin’s lymphoma (NHL). Methods: Between October 2013 and July 2015, 21 patients from Sun Yat-sen University Cancer Center were treated twice daily on each day of a 28-day cycle (median number of cycles, 2; maximum, 20) with XC-302 at a post prandial dose of 25 mg, 37.5 mg, or 50 mg. Adverse events (AEs), AUC last and C max , response rates, and overall survival were assessed. Results: Patients had received a median (range) of 1 (1 to 3) previous cancer treatments. At the latest follow-up, two patients were still benefitting from the study. The most common drug-related AEs were elevations in alanine transaminase (ALT, 14 of 21 patients) and aspartate transaminase (AST, 7 of 21 patients). Four patients, both in the-50-mg group, had dose-limiting toxicities, and therapy was discontinued in a fifth because of persistent abnormal liver function. The overall response rate was 2 of19. Serum concentrations of XC-302 increased in a dose-dependent pattern. Median progression-free survival in all patients was 1.9 (95% CI, 1.7 to 2.0) months. Conclusion: XC-302 has an acceptable safety profile and offers potential therapeutic value to patients with relapsed or refractory non-Hodgkin lymphoma.