Integrating BTK inhibition into R-da-EPOCH for HIV-related DLBCL.

7001 Background: Human immunodeficiency virus (HIV)-related diffuse large B-cell lymphomas (DLBCL) are heterogeneous in nature, clinically, median cy of study therapy (tx) received = 5. At baseline median age was 52y (24-64) 9 pts had CD4 <100. 81% were male, 42% White 1CR, 5PR) during a median follow-up of 4.2y (95%CI = 2.3 to 4.87); median duration of response = 2.8y. 3y event-free (EFS) & overall survival (OS) were 83 & 81% respectively (GCB: 88 & 87%, non-GCB: 76 & 63%). Among 679 treatment-related adverse events (TRAE), the most frequent were (total, % grade (gr) 3+) anemia (105, 50%), thrombocytopenia (81, 41%), neutropenia (60, 88%) & lymphopenia (60, 68%). Non-hematologic AEs (total TRAE, # max gr) included diarrhea (22, 2 gr3), nausea (21, 1 g3), hypokalemia (20, 4 gr3), fatigue (17, 17 gr1), & sepsis (1 gr4). Reasons for tx discontinuation: 1 progression, 4 withdrawal, 4 TRAE, 1 lost to follow up. Conclusions: Incorporating ibrutinib 560mg daily with R-da-EPOCH in HIV-related DLBCL treatment resulted in manageable toxicities typical of R-da-EPOCH. Although lower confirmed CR, 3y EFS & OS are comparable or higher than prior studies of HIV+DLBCL R-da-EPOCH. Ongoing studies to be updated at the meeting include impact on T cell subsets, & correlations of response & survival with circulating tumor DNA & lymphoma features (EBV, MYC, BCL2, BCL6 & genomic determinations of COO). Clinical trial information: NCI-2017-01240 .