Maribel Rodriguez-Torres.

Grasela, Pharm.D., Ph.D. For the AI444040 Study Group: Daclatasvir plus Sofosbuvir for Previously Treated or Untreated Chronic HCV Infection Persistent infection with hepatitis C virus affects approximately 170 million people worldwide and is a major cause of cirrhosis and hepatocellular carcinoma.1,2 HCV-related morbidity and mortality are increasing; since 2007, HCV-related deaths in the United States possess exceeded those from human being immunodeficiency virus infections.3,4 HCV is classified into six main genotypes.5,6 Genotypes 1, 2, and 3 are located worldwide, with subtype 1a predominating in the United States and subtype 1b predominating in Europe, Japan, and China.9,10 Adding telaprevir or boceprevir has been proven to improve the response in sufferers with genotype 1 infection.11,12 However, the addition of telaprevir or boceprevir is bound to HCV genotype 1 and is associated with adverse events, complicated dose regimens, and viral level of resistance.A limitation of our research is that rituximab maintenance therapy was not used; current recommendations4,6 were not established when the study began. The usage of VR-CAP with rituximab maintenance therapy could further prolong progression-free survival and possibly extend overall survival. The improved efficacy of VR-CAP over R-CHOP was accompanied by additional toxic effects. However, there is no significant effect on the amount of completed cycles, median dose intensity for medications common to both regimens, or prices of deaths or discontinuations related to adverse events. The VR-CAP basic safety profile was expected based on previous encounter with bortezomib plus R-CHOP in non-Hodgkin’s lymphomas25-27 and with single-agent bortezomib in relapsed or refractory mantle-cell lymphoma.9-11,28 Previous experience from a noncomparative phase 2 study of weekly or twice-weekly bortezomib plus R-CHOP suggested that weekly administration of bortezomib could be associated with reduced rates of some grade three or four 4 hematologic and nonhematologic toxic effects but also with a reduced rate of complete response.25 Rates of peripheral neuropathy, a known toxicity connected with vincristine and bortezomib,8-11,22,24,28,29 were similar in both groups, and events seemed to resolve quicker in the VR-CAP group.