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Ikoma Y, Nakamura N, Kitagawa J, Miwa T, Takada E, Matsumoto T, Shibata Y, Nakamura H, Kanemura N, Kasahara S, Hara T, Sawada M, Tsurumi H, Shimizu M. A phase II study of gemcitabine, carboplatin, dexamethasone, and rituximab in patients with relapsed or refractory non-Hodgkin lymphoma. Hematol Oncol 2024; 42:e3236. [PMID: 37932900 DOI: 10.1002/hon.3236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2023] [Revised: 10/15/2023] [Accepted: 10/21/2023] [Indexed: 11/08/2023]
Abstract
This study evaluated the efficacy and safety of salvage chemotherapy with gemcitabine, carboplatin, dexamethasone, and rituximab (GCD ± R) for Japanese patients with relapsed or refractory non-Hodgkin lymphoma (NHL). A multicenter, phase II trial of GCD ± R administered every 3 weeks for up to 6 cycles was conducted. Rituximab was administered as a therapeutic strategy for CD20-positive lymphoma. The primary endpoint was the complete response (CR) rate. Secondary endpoints included the overall response (OR) rate, overall survival (OS), progression-free survival (PFS), toxicity, and success rate of peripheral blood stem cell collection for eligible transplant patients. A total of 25 patients (median age 66 years) were evaluated, with a median follow-up period of 66.7 months. CR and OR rates were 28% and 52%, respectively. Median PFS and OS were 8.7 and 32.2 months, respectively. The major toxicity was myelosuppression, but the regimen was generally well-tolerated, with a low incidence of febrile neutropenia (20%) and no treatment-related deaths. Of the 6 patients who were eligible for autologous stem cell transplantation and underwent peripheral blood stem cell mobilization, the required number of CD34-positive cells was collected in 5 (83%). All 6 proceeded to transplantation and achieved successful engraftment without recurrence. The present results suggest that GCD ± R may be effective and well-tolerated in Japanese patients with relapsed or refractory NHL. However, further investigation is needed to confirm these results.
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Affiliation(s)
- Yoshikazu Ikoma
- Department of Hematology and Infectious Disease, Gifu University Hospital, Gifu, Japan
| | - Nobuhiko Nakamura
- Department of Hematology and Infectious Disease, Gifu University Hospital, Gifu, Japan
| | | | - Takao Miwa
- Department of Hematology and Infectious Disease, Gifu University Hospital, Gifu, Japan
| | - Eri Takada
- Department of Hematology, Gifu-Seino Medical Center, Gihoku Kosei Hospital, Gifu, Japan
| | - Takuro Matsumoto
- Department of Hematology and Infectious Disease, Gifu University Hospital, Gifu, Japan
| | - Yuhei Shibata
- Department of Hematology, Gifu Municipal Hospital, Gifu, Japan
| | - Hiroshi Nakamura
- Department of Hematology and Infectious Disease, Gifu University Hospital, Gifu, Japan
| | - Nobuhiro Kanemura
- Department of Hematology and Infectious Disease, Gifu University Hospital, Gifu, Japan
- Department of Hematology, Chuno Kosei Hospital, Gifu, Japan
| | - Senji Kasahara
- Department of Hematology, Gifu Municipal Hospital, Gifu, Japan
- Laboratory of Pharmaceutical Health Care and Promotion, Gifu Pharmaceutical University, Gifu, Japan
| | - Takeshi Hara
- Department of Hematology, Matsunami General Hospital, Gifu, Japan
| | - Michio Sawada
- Department of Hematology, Gifu Red Cross Hospital, Gifu, Japan
| | - Hisashi Tsurumi
- Department of Hematology and Infectious Disease, Gifu University Hospital, Gifu, Japan
- Department of Hematology, Matsunami General Hospital, Gifu, Japan
| | - Masahito Shimizu
- Department of Hematology and Infectious Disease, Gifu University Hospital, Gifu, Japan
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Ping L, Gao Y, He Y, Bai B, Huang C, Shi L, Wang X, Huang H. PD-1 blockade combined with ICE regimen in relapsed/refractory diffuse large B-cell lymphoma. Ann Hematol 2023:10.1007/s00277-023-05292-5. [PMID: 37306710 DOI: 10.1007/s00277-023-05292-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Accepted: 05/22/2023] [Indexed: 06/13/2023]
Abstract
The prognosis of relapsed/refractory (R/R) diffuse large B-cell lymphoma (DLBCL) is poor. The efficacy of salvage therapy with ICE (ifosfamide, carboplatin, and etoposide) is limited. DLBCL can evade immune surveillance by upregulating programmed cell death ligand 1 (PD-L1). The purpose of this study was to explore the efficacy and safety of programmed cell death 1 (PD-1) blockade combined with ICE regimen (P-ICE) in the treatment of R/R DLBCL patients. In this study, we retrospectively explored efficacy and toxicity in R/R DLBCL patients treated with P-ICE. Prognostic biomarkers, including clinical features and molecular markers related to efficacy, were explored. From February 2019 to May 2020, a total of 67 patients treated with the P-ICE regimen were analyzed. The median follow-up time was 24.7 months (range: 1.4-39.6 months), with an objective response rate (ORR) of 62.7% and a complete response rate (CRR) of 43.3%. The 2-year progression-free survival (PFS) and overall survival (OS) rates were 41.1% (95% CI: 35.0-47.2%) and 65.6% (95% CI: 59.5-71.7%), respectively. Age, Ann Arbor stage, international prognostic index (IPI) score, and response to first-line chemotherapy were correlated with the ORR. Grade 3 and 4 adverse events (AEs) related to the P-ICE regimen were reported in 21.5% of patients. The most common AE was thrombocytopenia (9.0%). No treatment-related deaths occurred. In patients with R/R DLBCL, the P-ICE regimen has promising efficacy and mild toxicity.
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Affiliation(s)
- Liqin Ping
- Department of Medical Oncology, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-Sen University Cancer Center, Guangzhou, Guangdong, People's Republic of China
| | - Yan Gao
- Department of Medical Oncology, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-Sen University Cancer Center, Guangzhou, Guangdong, People's Republic of China
| | - Yanxia He
- Department of Medical Oncology, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-Sen University Cancer Center, Guangzhou, Guangdong, People's Republic of China
| | - Bing Bai
- Department of Medical Oncology, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-Sen University Cancer Center, Guangzhou, Guangdong, People's Republic of China
| | - Cheng Huang
- Department of Medical Oncology, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-Sen University Cancer Center, Guangzhou, Guangdong, People's Republic of China
| | - Lina Shi
- Nanjing Geneseeq Technology Inc., Nanjing, Jiangsu, People's Republic of China
| | - Xiaoxiao Wang
- Department of Medical Oncology, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-Sen University Cancer Center, Guangzhou, Guangdong, People's Republic of China.
| | - Huiqiang Huang
- Department of Medical Oncology, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-Sen University Cancer Center, Guangzhou, Guangdong, People's Republic of China.
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Nakamura H, Hara T, Mabuchi R, Matsumoto T, Nakamura N, Ninomiya S, Kitagawa J, Kanemura N, Kito Y, Takami T, Miyazaki T, Takeuchi T, Shimizu M, Tsurumi H. Clinical significance of oxidative stress for untreated patients with diffuse large B-cell lymphoma. Mol Clin Oncol 2021; 16:4. [PMID: 34824844 DOI: 10.3892/mco.2021.2437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Accepted: 07/14/2021] [Indexed: 11/05/2022] Open
Abstract
Oxidative stress serves an important role in carcinogenesis. The present study investigated the clinical significance of oxidative stress as a prognostic factor for diffuse large B-cell lymphoma (DLBCL). The participants comprised 55 consecutive patients with DLBCL. A commercially available derivatives of reactive oxygen metabolites (d-ROMs) test kit was used to assess oxidant levels. Similarly, a commercially available biological antioxidant potential (BAP) test was used to assess antioxidant levels. The antioxidative/oxidative stress ratio was calculated as d-ROMs/BAP. The median serum concentration of d-ROMs was 425 µM. The levels of d-ROMs were significantly higher in patients with DLBCL than in healthy volunteers (P<0.01). The complete remission (CR) rates in patients with d-ROMs <425 and ≥425 µM were 81.5 and 85.7%, respectively [not significant (NS)]. The 3-year overall survival (OS) rates for patients with d-ROMs <425 and ≥425 µM were 67.2 and 72.0%, respectively (NS). The median BAP was 2,002 µM. The CR rates of patients with BAP <2,002 and ≥2,002 µM were 77.8 and 88.9%, respectively (NS). The 3-year OS rates of patients with BAP <2,002 and ≥2,002 µM were 60.9 and 75.9%, respectively (NS). No significant difference in the d-ROMs/BAP ratio was observed between groups. Multivariate analysis revealed that d-ROMs were an independent prognostic factor for progression-free survival.
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Affiliation(s)
- Hiroshi Nakamura
- First Department of Internal Medicine, Gifu University Graduate School of Medicine, Gifu 501-1194, Japan
| | - Takeshi Hara
- First Department of Internal Medicine, Gifu University Graduate School of Medicine, Gifu 501-1194, Japan.,Department of Hematology, Matsunami General Hospital, Kasamatsu-cho, Hashima-gun, Gifu 501-6062, Japan
| | - Ryoko Mabuchi
- First Department of Internal Medicine, Gifu University Graduate School of Medicine, Gifu 501-1194, Japan
| | - Takuro Matsumoto
- First Department of Internal Medicine, Gifu University Graduate School of Medicine, Gifu 501-1194, Japan
| | - Nobuhiko Nakamura
- First Department of Internal Medicine, Gifu University Graduate School of Medicine, Gifu 501-1194, Japan
| | - Soranobu Ninomiya
- First Department of Internal Medicine, Gifu University Graduate School of Medicine, Gifu 501-1194, Japan
| | - Junichi Kitagawa
- First Department of Internal Medicine, Gifu University Graduate School of Medicine, Gifu 501-1194, Japan
| | - Nobuhiro Kanemura
- First Department of Internal Medicine, Gifu University Graduate School of Medicine, Gifu 501-1194, Japan
| | - Yusuke Kito
- Department of Pathology and Translational Research, Gifu University Graduate School of Medicine, Gifu 501-1194, Japan
| | - Tsuyoshi Takami
- Department of Pathology and Translational Research, Gifu University Graduate School of Medicine, Gifu 501-1194, Japan
| | | | - Tamotsu Takeuchi
- Department of Pathology and Translational Research, Gifu University Graduate School of Medicine, Gifu 501-1194, Japan
| | - Masahito Shimizu
- First Department of Internal Medicine, Gifu University Graduate School of Medicine, Gifu 501-1194, Japan
| | - Hisashi Tsurumi
- First Department of Internal Medicine, Gifu University Graduate School of Medicine, Gifu 501-1194, Japan.,Department of Hematology, Matsunami General Hospital, Kasamatsu-cho, Hashima-gun, Gifu 501-6062, Japan
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Follicular lymphoma suggested to transform into EBV-negative plasmablastic lymphoma. Int J Hematol 2019; 109:723-730. [DOI: 10.1007/s12185-019-02591-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2017] [Revised: 01/04/2019] [Accepted: 01/16/2019] [Indexed: 12/31/2022]
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Hara T, Yoshikawa T, Goto H, Sawada M, Yamada T, Fukuno K, Kasahara S, Shibata Y, Matsumoto T, Mabuchi R, Nakamura N, Nakamura H, Ninomiya S, Kitagawa J, Kanemura N, Nannya Y, Katsumura N, Takahashi T, Kito Y, Takami T, Miyazaki T, Takeuchi T, Shimizu M, Tsurumi H. R-THP-COP versus R-CHOP in patients younger than 70 years with untreated diffuse large B cell lymphoma: A randomized, open-label, noninferiority phase 3 trial. Hematol Oncol 2018; 36:638-644. [DOI: 10.1002/hon.2524] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2017] [Revised: 04/19/2018] [Accepted: 04/21/2018] [Indexed: 11/08/2022]
Affiliation(s)
- Takeshi Hara
- First Department of Internal Medicine; Gifu University Graduate School of Medicine; Gifu Japan
- Department of Hematology; Matsunami General Hospital; Kasamatsu Japan
| | - Takeshi Yoshikawa
- First Department of Internal Medicine; Gifu University Graduate School of Medicine; Gifu Japan
| | - Hideko Goto
- Division of Hematology; Gifu Municipal Hospital; Gifu Japan
| | - Michio Sawada
- Department of Hematology; Gifu Red-Cross Hospital; Gifu Japan
| | - Toshiki Yamada
- Department of Hematology; Gifu Prefectural General Medical Center; Gifu Japan
| | - Kenji Fukuno
- First Department of Internal Medicine; Gifu University Graduate School of Medicine; Gifu Japan
| | - Senji Kasahara
- Division of Hematology; Gifu Municipal Hospital; Gifu Japan
| | - Yuhei Shibata
- First Department of Internal Medicine; Gifu University Graduate School of Medicine; Gifu Japan
| | - Takuro Matsumoto
- First Department of Internal Medicine; Gifu University Graduate School of Medicine; Gifu Japan
| | - Ryoko Mabuchi
- Department of Internal Medicine; Kisogawa Municipal Hospital; Kisogawa Japan
| | - Nobuhiko Nakamura
- First Department of Internal Medicine; Gifu University Graduate School of Medicine; Gifu Japan
| | - Hiroshi Nakamura
- First Department of Internal Medicine; Gifu University Graduate School of Medicine; Gifu Japan
| | - Soranobu Ninomiya
- First Department of Internal Medicine; Gifu University Graduate School of Medicine; Gifu Japan
| | - Junichi Kitagawa
- First Department of Internal Medicine; Gifu University Graduate School of Medicine; Gifu Japan
| | - Nobuhiro Kanemura
- First Department of Internal Medicine; Gifu University Graduate School of Medicine; Gifu Japan
| | - Yasuhito Nannya
- First Department of Internal Medicine; Gifu University Graduate School of Medicine; Gifu Japan
| | - Naoki Katsumura
- Department of Internal Medicine; Chuno Kosei Hospital; Seki Japan
| | - Takeshi Takahashi
- Department of Hematology; Matsunami General Hospital; Kasamatsu Japan
| | - Yusuke Kito
- Department of Pathology and Translational Research; Gifu University Graduate School of Medicine; Gifu Japan
| | - Tsuyoshi Takami
- Department of Pathology and Translational Research; Gifu University Graduate School of Medicine; Gifu Japan
| | | | - Tamotsu Takeuchi
- Department of Pathology and Translational Research; Gifu University Graduate School of Medicine; Gifu Japan
| | - Masahito Shimizu
- First Department of Internal Medicine; Gifu University Graduate School of Medicine; Gifu Japan
| | - Hisashi Tsurumi
- First Department of Internal Medicine; Gifu University Graduate School of Medicine; Gifu Japan
- Department of Hematology; Matsunami General Hospital; Kasamatsu Japan
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