1
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Chang EWY, Tan YH, Chan JY. Novel clinical risk stratification and treatment strategies in relapsed/refractory peripheral T-cell lymphoma. J Hematol Oncol 2024; 17:38. [PMID: 38824603 PMCID: PMC11144347 DOI: 10.1186/s13045-024-01560-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2024] [Accepted: 05/26/2024] [Indexed: 06/03/2024] Open
Abstract
Peripheral T cell lymphoma (PTCL) represents a group of heterogeneous hematological malignancies, which are notoriously challenging to treat and outcomes are typically poor. Over the past two decades, clinical prognostic indices for patient risk stratification have evolved, while several targeted agents are now available to complement combination chemotherapy in the frontline setting or as a salvage strategy. With further understanding of the molecular pathobiology of PTCL, several innovative approaches incorporating immunomodulatory agents, epigenetic therapies, oncogenic kinase inhibitors and immunotherapeutics have come to the forefront. In this review, we provide a comprehensive overview of the progress in developing clinical prognostic indices for PTCL and describe the broad therapeutic landscape, emphasizing novel targetable pathways that have entered early phase clinical studies.
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Affiliation(s)
- Esther Wei Yin Chang
- Division of Medical Oncology, National Cancer Centre Singapore, Singapore, Singapore.
- Duke-NUS Medical School, Singapore, Singapore.
| | - Ya Hwee Tan
- Division of Medical Oncology, National Cancer Centre Singapore, Singapore, Singapore
- Duke-NUS Medical School, Singapore, Singapore
| | - Jason Yongsheng Chan
- Division of Medical Oncology, National Cancer Centre Singapore, Singapore, Singapore.
- Duke-NUS Medical School, Singapore, Singapore.
- Cancer Discovery Hub, National Cancer Centre Singapore, Singapore, Singapore.
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2
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Yamasaki S, Iida H, Saito A, Matsumoto M, Kuroda Y, Izumi T, Saito AM, Miyoshi H, Ohshima K, Nagai H, Iwasaki H. Phase II Trial of Romidepsin as Consolidation Therapy after Gemcitabine, Dexamethasone, and Cisplatin in Elderly Transplant-Ineligible Patients with Relapsed/Refractory Peripheral T-Cell Lymphoma. Hematol Rep 2024; 16:336-346. [PMID: 38921182 PMCID: PMC11204088 DOI: 10.3390/hematolrep16020034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2023] [Revised: 01/28/2024] [Accepted: 05/22/2024] [Indexed: 06/27/2024] Open
Abstract
Romidepsin is an important therapeutic option for patients with peripheral T-cell lymphoma (PTCL). However, the timing of romidepsin administration remains controversial. The objective of this study was to characterize the safety and efficacy of romidepsin as consolidation therapy after gemcitabine, dexamethasone, and cisplatin (GDP) therapy (GDPR). This study of patients treated between March 2019 and March 2021 was registered with the Japan Registry of Clinical Trials (registration number: jRCT0000000519). If complete response, partial response, or stable disease was confirmed after 2-4 GDP cycles, romidepsin was administered every 4 weeks for 1 year. Seven patients with relapsed/refractory (R/R) PTCL (T-follicular helper phenotype [n = 1] and angioimmunoblastic T-cell lymphoma [n = 6]) were included in this prospective study (PTCL-GDPR). After a median follow-up of 34 months of patients in PTCL-GDPR, the 2-year overall survival rate was 71%, and the overall response rate after treatment was 57%. Common adverse events in patients with PTCL-GDPR included hematological toxicities such as neutropenia, which improved with supportive treatment. There were no treatment-related mortalities. GDPR might be safe and effective in elderly transplant-ineligible patients with R/R PTCL; however, further investigation is required.
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Affiliation(s)
- Satoshi Yamasaki
- Department of Internal Medicine, Kyushu University Beppu Hospital, 4546 Tsurumihara, Tsurumi, Beppu 874-0838, Japan
- Department of Hematology, Clinical Research Institute, NHO Kyushu Medical Center, Fukuoka 810-0065, Japan;
| | - Hiroatsu Iida
- Department of Hematology and Oncology Research, NHO Nagoya Medical Center, Nagoya 460-0001, Japan; (H.I.); (A.M.S.); (H.N.)
| | - Akio Saito
- Department of Hematology, NHO Shibukawa Medical Center, Shibukawa 377-0204, Japan; (A.S.); (M.M.)
| | - Morio Matsumoto
- Department of Hematology, NHO Shibukawa Medical Center, Shibukawa 377-0204, Japan; (A.S.); (M.M.)
| | - Yoshiaki Kuroda
- Department of Hematology, NHO Hiroshimanishi Medical Center, Otake 739-0696, Japan;
| | - Tohru Izumi
- Department of Hematology, NHO Sendai Medical Center, Sendai 983-8520, Japan;
| | - Akiko M. Saito
- Department of Hematology and Oncology Research, NHO Nagoya Medical Center, Nagoya 460-0001, Japan; (H.I.); (A.M.S.); (H.N.)
| | - Hiroaki Miyoshi
- Department of Pathology, School of Medicine, Kurume University, Kurume 830-0011, Japan; (H.M.); (K.O.)
| | - Koichi Ohshima
- Department of Pathology, School of Medicine, Kurume University, Kurume 830-0011, Japan; (H.M.); (K.O.)
| | - Hirokazu Nagai
- Department of Hematology and Oncology Research, NHO Nagoya Medical Center, Nagoya 460-0001, Japan; (H.I.); (A.M.S.); (H.N.)
| | - Hiromi Iwasaki
- Department of Hematology, Clinical Research Institute, NHO Kyushu Medical Center, Fukuoka 810-0065, Japan;
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3
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Aubrais R, Bouabdallah K, Chartier L, Herbaux C, Banos A, Brice P, Sibon D, Schiano JM, Cluzeau T, Laribi K, Le Calloch R, Bellal M, Delapierre B, Daguindau N, Amorim S, Agbetiafa K, Chauchet A, Besson C, Durot E, Bonnet C, Fouillet L, Bijou F, Tournilhac O, Gaulard P, Parrens MC, Damaj G. Salvage therapy with brentuximab-vedotin and bendamustine for patients with R/R PTCL: a retrospective study from the LYSA group. Blood Adv 2023; 7:5733-5742. [PMID: 36477770 PMCID: PMC10539874 DOI: 10.1182/bloodadvances.2022008524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Revised: 11/07/2022] [Accepted: 11/08/2022] [Indexed: 12/12/2022] Open
Abstract
Patients with relapsed or refractory (R/R) peripheral T-cell lymphomas (PTCL) have a poor prognosis. Bendamustine (B) and brentuximab-vedotin (Bv) have shown interesting results in this setting. However, little information is available about their efficacy in combination. This multicenter and retrospective study aimed to evaluate the efficacy and safety of the combination of BBv in patients with noncutaneous R/R PTCL among 21 LYSA centers in France and Belgium. The primary objective was the overall response rate. A total of 82 patients with R/R PTCL were included. The best overall response rate (ORR) was 68%, with 49% of patients in complete response (CR). In multivariable analysis, only the disease status after the last regimen (relapse vs refractory) was associated with the response with an ORR of 83% vs 57%. Median duration of response was 15.4 months for patients in CR. With a median follow-up of 22 months, the median progression free survival (PFS) and overall survival (OS) were 8.3 and 26.3 months respectively. Moreover, patients in CR, who underwent an allogeneic transplant, had a better outcome than patients who did not with a median PFS and OS of 19.3 vs 4.8 months and not reached vs 12.4 months, respectively. Fifty-nine percent of patients experienced grade 3/4 adverse events that were mainly hematologic. BBv is highly active in patients with R/R PTCL and should be considered as a one of the best options of immunochemotherapy salvage combination in this setting and particularly as a bridge to allogeneic transplant for eligible patients.
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Affiliation(s)
- Raphaelle Aubrais
- Department of Hematology, Bordeaux University Hospital, Pessac, France
| | - Krimo Bouabdallah
- Department of Hematology, Bordeaux University Hospital, Pessac, France
| | - Loic Chartier
- Department of Biostatistics, The Lymphoma Academic Research Organization, Pierre-Bénite, France
| | - Charles Herbaux
- Department of Hematology, Montpellier University Hospital, Montpellier, France
| | - Anne Banos
- Department of Hematology, Centre Hospitalier de la Cote Basque Bayonne, Bayonne, France
| | - Pauline Brice
- Department of Hematology, Hôpital Saint-Louis, Paris, France
| | - David Sibon
- Department of Hematology, Hôpital Necker-Enfants maladies, Paris, France
| | - Jean Marc Schiano
- Department of Hematology, Institut Paoli Calmettes, Marseille, France
| | - Thomas Cluzeau
- Department of Hematology, Nice University Hospital, Nice, France
| | - Kamel Laribi
- Department of Hematology, Centre Hospitalier du Mans, Le-Mans, France
| | - Ronan Le Calloch
- Department of Hematology, Centre Hospitalier de Cornouaille, Quimper, France
| | - Mathieu Bellal
- Hematology Institute, University Hospital, Normandy University, Caen, France
| | - Baptiste Delapierre
- Hematology Institute, University Hospital, Normandy University, Caen, France
| | - Nicolas Daguindau
- Department of Hematology, Centre Hospitalier Annecy Genevois, Annecy, France
| | - Sandy Amorim
- Department of Hematology, Hopital Saint-Vincent, Lille, France
| | | | - Adrien Chauchet
- Department of Hematology, Besançon University Hospital, Besançon, France
| | - Caroline Besson
- Department of Hematology, Centre Hospitalier de Versailles, Le Chesnay, France
| | - Eric Durot
- Department of Hematology, Reims University Hospital, Reims, France
| | - Christophe Bonnet
- Department of Hematology, Liège University Hospital, Liège, Belgique
| | - Ludovic Fouillet
- Department of Hematology, Institut de Cancérologie Lucien Neuwirth, Saint-Etienne, France
| | - Fontanet Bijou
- Department of Hematology, Institut Bergonie, Bordeaux, France
| | - Olivier Tournilhac
- Department of Hematology, Estaing University Hospital, Clermont-Ferrand, France
| | - Philippe Gaulard
- Department of Pathology, Henri Mondor Hospital, Université Paris-Est, Créteil, France
| | | | - Gandhi Damaj
- Hematology Institute, University Hospital, Normandy University, Caen, France
| | - Lymphoma Study Association
- Department of Hematology, Bordeaux University Hospital, Pessac, France
- Department of Biostatistics, The Lymphoma Academic Research Organization, Pierre-Bénite, France
- Department of Hematology, Montpellier University Hospital, Montpellier, France
- Department of Hematology, Centre Hospitalier de la Cote Basque Bayonne, Bayonne, France
- Department of Hematology, Hôpital Saint-Louis, Paris, France
- Department of Hematology, Hôpital Necker-Enfants maladies, Paris, France
- Department of Hematology, Institut Paoli Calmettes, Marseille, France
- Department of Hematology, Nice University Hospital, Nice, France
- Department of Hematology, Centre Hospitalier du Mans, Le-Mans, France
- Department of Hematology, Centre Hospitalier de Cornouaille, Quimper, France
- Hematology Institute, University Hospital, Normandy University, Caen, France
- Department of Hematology, Centre Hospitalier Annecy Genevois, Annecy, France
- Department of Hematology, Hopital Saint-Vincent, Lille, France
- Department of Hematology, Institut Curie, Paris, France
- Department of Hematology, Besançon University Hospital, Besançon, France
- Department of Hematology, Centre Hospitalier de Versailles, Le Chesnay, France
- Department of Hematology, Reims University Hospital, Reims, France
- Department of Hematology, Liège University Hospital, Liège, Belgique
- Department of Hematology, Institut de Cancérologie Lucien Neuwirth, Saint-Etienne, France
- Department of Hematology, Institut Bergonie, Bordeaux, France
- Department of Hematology, Estaing University Hospital, Clermont-Ferrand, France
- Department of Pathology, Henri Mondor Hospital, Université Paris-Est, Créteil, France
- Department of Pathology, Bordeaux University Hospital, Pessac, France
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4
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Fox CP, Ahearne MJ, Pettengell R, Dearden C, El-Sharkawi D, Kassam S, Cook L, Cwynarski K, Illidge T, Collins G. Guidelines for the management of mature T- and natural killer-cell lymphomas (excluding cutaneous T-cell lymphoma): a British Society for Haematology Guideline. Br J Haematol 2022; 196:507-522. [PMID: 34811725 DOI: 10.1111/bjh.17951] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
MESH Headings
- Humans
- Clinical Decision-Making
- Combined Modality Therapy/adverse effects
- Combined Modality Therapy/methods
- Diagnosis, Differential
- Disease Management
- Killer Cells, Natural/metabolism
- Killer Cells, Natural/pathology
- Leukemia, Prolymphocytic, T-Cell/diagnosis
- Leukemia, Prolymphocytic, T-Cell/etiology
- Leukemia, Prolymphocytic, T-Cell/therapy
- Lymphoma, T-Cell/diagnosis
- Lymphoma, T-Cell/epidemiology
- Lymphoma, T-Cell/etiology
- Lymphoma, T-Cell/therapy
- Prognosis
- Treatment Outcome
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Affiliation(s)
- Christopher P Fox
- Department of Clinical Haematology, Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - Matthew J Ahearne
- Department of Haematology, University Hospitals of Leicester NHS Trust, Lymphoid Malignancies Group, University of Leicester, Leicester, UK
| | - Ruth Pettengell
- Haematology and Medical Oncology, St. George's Healthcare NHS Trust, London, UK
| | - Claire Dearden
- Department of Haemato-Oncology, The Royal Marsden NHS Foundation Trust, Sutton, UK
| | - Dima El-Sharkawi
- Department of Haemato-Oncology, The Royal Marsden NHS Foundation Trust, Sutton, UK
| | - Shireen Kassam
- Department of Haematological Medicine, King's College Hospital, London, UK
| | - Lucy Cook
- Department of Haematology and National Centre for Human Retrovirology, Imperial College Healthcare NHS Trust, London, UK
| | - Kate Cwynarski
- Department of Haematology, University College Hospital, London, UK
| | - Tim Illidge
- Division of Cancer Sciences, University of Manchester, Manchester, UK
- The Christie NHS Foundation Trust, Manchester, UK
| | - Graham Collins
- Department of Clinical Haematology, Oxford Cancer and Haematology Centre, Oxford University Hospitals NHS Trust, Oxford, UK
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5
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Liu Z, Wang S, Guo W, Zhang D, Yu H, Song W, Tang Z, Bai O. Cisplatin Loaded Poly(L-glutamic acid)-g-Methoxy Polyethylene Glycol Complex Nanoparticles Combined with Gemcitabine Presents Improved Safety and Lasting Anti-Tumor Efficacy in a Murine Xenograft Model of Human Aggressive B Cell Lymphoma. J Biomed Nanotechnol 2021; 17:652-661. [PMID: 35057891 DOI: 10.1166/jbn.2021.3060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Cisplatin (CDDP) is a highly effective anti-tumor drug with a broad spectrum of activity. However, the clinical efficacy of CDDP-containing regimens is yet unsatisfactory due to the severe dose-related toxicity of CDDP. In a previous study, CDDP nanoparticles (L-CDDP) forms a complex
as CDDP with poly(L-glutamic acid)-g-methoxy poly(ethylene glycol) with improved safety compared to CDDP. Herein, a murine xenograft model of human aggressive B cell lymphoma (BCL) was established to explore anti-lymphoma efficiency of L-CDDP combined with GEM. BJAB cells represent an aggressive
BCL, which were utilized to explore the anti-proliferative effect, cell apoptosis via CCK-8 test and flow cytometry technology, respectively. Toxicity experiment and the maximum tolerated dose (MTD) test were conducted in Kunming mice. Tumor inhibition experiment was conducted at the dose
of MTD in SCID beige mice-bearing lymphoma. In this study, the loading capacity and encapsulating efficiency of CDDP in the L-CDDP was 18.3% and 89.7%, respectively, and the hydrodynamic diameter of the prepared L-CDDP was 20.6 nm. The CCK-8 data indicated that the anti-proliferative activity
of monodrug groups (GEM, CDDP, L-CDDP) was dose- and time-dependent in BJAB cells. The synergistic effects in anti-lymphoma were detected in these two groups (GEM+CDDP, GEM + L-CDDP). Compared to control group, the proportion of apoptotic cells in experimental groups in BJAB cells was significantly
higher at 48 h. Toxicity assays revealed that GEM + L-CDDP regimen had low hematological toxicity, hepatotoxicity, and nephrotoxicity. Tumor inhibition experiment demonstrated that GEM + L-CDDP group exhibited significant tumor-suppressing effects. Moreover, tumors continued to shrink in GEM
+ L-CDDP group, while these appeared to grow in the GEM + CDDP group. Finally, tumor necrosis was most prominent in the GEM + CDDP and GEM + L-CDDP groups, as assessed by hematoxylin-eosin staining. In conclusion, compared to CDDP, L-CDDP combined with GEM seriously induces BJAB cell apoptosis.
Also, GEM + L-CDDP exhibits low hematotoxicity, hepatotoxicity, and nephrotoxicity. Importantly, GEM + L-CDDP presents lasting anti-lymphoma efficacy in a SCID beige mice-bearing lymphoma.
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Affiliation(s)
- Zhihe Liu
- Department of Hematology, The First Hospital of Jilin University, Changchun, 130021, China
| | - Shunan Wang
- Department of Hematology, The First Hospital of Jilin University, Changchun, 130021, China
| | - Wei Guo
- Department of Hematology, The First Hospital of Jilin University, Changchun, 130021, China
| | - Dawei Zhang
- Key Laboratory of Polymer Ecomaterials, Changchun Institute of Applied Chemistry, Chinese Academy of Sciences, Changchun 130022, China
| | - Haiyang Yu
- Key Laboratory of Polymer Ecomaterials, Changchun Institute of Applied Chemistry, Chinese Academy of Sciences, Changchun 130022, China
| | - Wantong Song
- Key Laboratory of Polymer Ecomaterials, Changchun Institute of Applied Chemistry, Chinese Academy of Sciences, Changchun 130022, China
| | - Zhaohui Tang
- Key Laboratory of Polymer Ecomaterials, Changchun Institute of Applied Chemistry, Chinese Academy of Sciences, Changchun 130022, China
| | - Ou Bai
- Department of Hematology, The First Hospital of Jilin University, Changchun, 130021, China
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6
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Shen QD, Wang L, Zhu HY, Liang JH, Xia Y, Wu JZ, Fan L, Li JY, Xu W. Gemcitabine, oxaliplatin and dexamethasone (GemDOx) as salvage therapy for relapsed or refractory diffuse large B-cell lymphoma and peripheral T-cell lymphoma. J Cancer 2021; 12:163-169. [PMID: 33391412 PMCID: PMC7738829 DOI: 10.7150/jca.47031] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Accepted: 10/13/2020] [Indexed: 01/21/2023] Open
Abstract
Background Outcomes of relapsed or refractory diffuse large B-cell lymphoma (DLBCL) and peripheral T-cell lymphoma (PTCL) remain poor. The objective of this study was to evaluate the efficacy and safety of gemcitabine, oxaliplatin and dexamethasone (GemDOx) with or without rituximab as salvage therapy in patients with relapsed or refractory DLBCL and PTCL. Materials and Methods: We retrospectively reviewed patients with relapsed or refractory DLBCL and PTCL receiving GemDOx as salvage therapy between Jul 1, 2011, and Aug 31, 2017. Results: Thirty-three (57.9%) patients with relapsed or refractory DLBCL and 24 (42.1%) with PTCL were included in this study. The median age was 57 years (inter-quartile range 46-67). The overall response rate (ORR) in DLBCL was 48.5% with 27.3% of complete remission (CR), and the 2-year progression-free survival (PFS) and 2-year overall survival (OS) was 21% and 44%. In patients with PTCL, ORR was 50.0% with CR rate of 29.2%; the 2-year PFS and 2-year OS was 28% and 49%, respectively. Common grade 3-4 hematological adverse events were thrombocytopenia (26.3%), anemia (15.7%) and neutropenia (15.7%). Conclusion: With acceptable efficacy and good tolerability, GemDOx might be a new therapeutic option for relapsed or refractory DLBCL and PTCL.
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Affiliation(s)
- Qiu-Dan Shen
- Department of Hematology, the First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing 210029, China; Key Laboratory of Hematology of Nanjing Medical University, Nanjing 210029, China; Collaborative Innovation Center for Cancer Personalized Medicine, Nanjing 210029, China
| | - Li Wang
- Department of Hematology, the First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing 210029, China; Key Laboratory of Hematology of Nanjing Medical University, Nanjing 210029, China; Collaborative Innovation Center for Cancer Personalized Medicine, Nanjing 210029, China
| | - Hua-Yuan Zhu
- Department of Hematology, the First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing 210029, China; Key Laboratory of Hematology of Nanjing Medical University, Nanjing 210029, China; Collaborative Innovation Center for Cancer Personalized Medicine, Nanjing 210029, China.,Pukou CLL Center, Nanjing 210000, China
| | - Jin-Hua Liang
- Department of Hematology, the First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing 210029, China; Key Laboratory of Hematology of Nanjing Medical University, Nanjing 210029, China; Collaborative Innovation Center for Cancer Personalized Medicine, Nanjing 210029, China
| | - Yi Xia
- Department of Hematology, the First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing 210029, China; Key Laboratory of Hematology of Nanjing Medical University, Nanjing 210029, China; Collaborative Innovation Center for Cancer Personalized Medicine, Nanjing 210029, China.,Pukou CLL Center, Nanjing 210000, China
| | - Jia-Zhu Wu
- Department of Hematology, the First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing 210029, China; Key Laboratory of Hematology of Nanjing Medical University, Nanjing 210029, China; Collaborative Innovation Center for Cancer Personalized Medicine, Nanjing 210029, China
| | - Lei Fan
- Department of Hematology, the First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing 210029, China; Key Laboratory of Hematology of Nanjing Medical University, Nanjing 210029, China; Collaborative Innovation Center for Cancer Personalized Medicine, Nanjing 210029, China.,Pukou CLL Center, Nanjing 210000, China
| | - Jian-Yong Li
- Department of Hematology, the First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing 210029, China; Key Laboratory of Hematology of Nanjing Medical University, Nanjing 210029, China; Collaborative Innovation Center for Cancer Personalized Medicine, Nanjing 210029, China.,Pukou CLL Center, Nanjing 210000, China
| | - Wei Xu
- Department of Hematology, the First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing 210029, China; Key Laboratory of Hematology of Nanjing Medical University, Nanjing 210029, China; Collaborative Innovation Center for Cancer Personalized Medicine, Nanjing 210029, China.,Pukou CLL Center, Nanjing 210000, China
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7
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Chen MT, Fu XH, Huang H, Wang Z, Fang XJ, Yao YY, Ren QG, Chen ZG, Lin TY. Combination of crizotinib and chemotherapy in patients with relapsed or refractory anaplastic lymphoma kinase (ALK)-positive anaplastic large cell lymphoma (ALCL). Leuk Lymphoma 2020; 62:571-580. [PMID: 33155495 DOI: 10.1080/10428194.2020.1839658] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Our aim was to explore the role of crizotinib, targeted anaplastic lymphoma kinase (ALK), on r/r systemic anaplastic large cell lymphoma (sALCL). The treated group prospectively screened 20 patients. After taking crizotinib in the first week, 16 patients who were tolerant and sensitive received the combination of crizotinib with chemotherapy. The control group included 27 patients receiving chemotherapy in the same hospital during the same period. The objective remission rates of the treated and control group were 81.3% and 74.1% (p = .869), respectively. The progression-free survival rates at two years in treated and control group were 68.7% and 45.0% (HR = 0.42, 95% CI 0.17-0.99, p < .05), respectively. The overall survival rates at two years in the treated and control group were 86.1% and 78.9% (p = .385, HR = 0.51, 95% CI 0.11-2.30), respectively. The main adverse events included elevated transaminase, diarrhea, and vision abnormalities. Thus, the combination of crizotinib with chemotherapy might be effective in ALK-positive and crizotinib sensitive r/r sALCL patients.
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Affiliation(s)
- Mei-Ting Chen
- Department of Medical Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China
| | - Xiao-Hong Fu
- Department of Medical Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China.,Department of Medical Oncology, Shenzhen Nanshan People's Hospital, Shenzhen, China.,Department of Medical Oncology, Affiliated Shenzhen Sixth Hospital of Guangdong Medical University, Shenzhen, China
| | - He Huang
- Department of Medical Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China
| | - Zhao Wang
- Department of Medical Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China
| | - Xiao-Jie Fang
- Department of Medical Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China
| | - Yu-Yi Yao
- Department of Medical Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China
| | - Quan-Guang Ren
- Department of Medical Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China
| | - Ze-Geng Chen
- Department of Medical Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China
| | - Tong-Yu Lin
- Department of Medical Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China
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8
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Sun Y, Li L, Li X, Zhang L, Wang X, Fu X, Sun Z, Zhang X, Li Z, Wu J, Yu H, Chang Y, Yan J, Wu X, Zhou Z, Nan F, Tian L, Zhang M. Outcomes of GDPT (gemcitabine, cisplatin, prednisone, thalidomide) versus CHOP in newly diagnosed peripheral T-cell lymphoma patients. Ther Adv Med Oncol 2020; 12:1758835920923829. [PMID: 32550864 PMCID: PMC7278096 DOI: 10.1177/1758835920923829] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2019] [Accepted: 04/09/2020] [Indexed: 12/15/2022] Open
Abstract
AIM To compare the outcomes of GDPT [gemcitabine (G), cisplatin (D), prednisone (P), thalidomide (T)] versus CHOP (cyclophosphamide, doxorubicin, vincristine, prednisone) in treating newly diagnosed PTCL (peripheral T-cell lymphoma). METHODS An open-label prospective clinical trial with 153 newly diagnosed PTCL patients conducted between January 2010 and December 2018 was designed. Patients were randomly assigned to the GDPT (77 cases) and CHOP (76 cases) groups. Patients in each group were further divided into four subgroups: PTCL, not otherwise specified (PTCL-NOS); anaplastic large cell lymphoma (ALCL), angioimmunoblastic T cell lymphoma (AITL), and other types subgroup, in accordance with pathological patterns. Based on expression of RRM1, TOP2A, TUBB3, and ERCC1, patients were divided into groups with high and low gene expression levels. Clinical characteristics, side effects, efficacy, progression-free survival (PFS), and overall survival (OS) were compared. RESULTS There were no significant differences in the basic clinical features or side effects between the GDPT and CHOP groups. The overall response rate (ORR) of the GDPT group was better than that of the CHOP group (66.3% versus 50.0%, p = 0.042), as was the complete remission (CR) rate (42.9% versus 27.6%, p = 0.049). Patients in the GDPT group had a longer PFS and OS than the CHOP group. The 4-year PFS and OS rates in the GDPT group were both superior to those in the CHOP group (63.6% versus 53.0% for PFS, p = 0.035; 66.8% versus 53.6% for OS, p = 0.039). In the GDPT group, the difference in CR between the four subgroups was statistically significant (p = 0.046). In the CHOP group, differences in both CR and ORR among the four subgroups were statistically significant (p < 0.001 and p = 0.005, respectively). There were also statistically significant differences in CR between patients treated with CHOP and GDPT in the PTCL-NOS subgroup, AITL subgroup, and the other types subgroup (p = 0.015; p = 0.003; p = 0.005, respectively). The data also showed a significant difference in OS among the four subgroups within the GDPT group (p = 0.001). The OS of AITL was shorter than that of the other three subgroups. Four subgroups of CHOP showed a significant difference in PFS (p = 0.019). There was no statistical association between responses and the gene expression levels of RRM1, ERCC1, TUBB3, and TOP2A. CONCLUSION The GDPT group had better response rates and prolonged patient PFS and OS. As a promising new regimen, GDPT is expected to become the first-line therapy for PTCL. New agents should be applied to patients who do not achieve good responses with previous treatment, such as those diagnosed with angioimmunoblastic T cell lymphoma. TRIAL REGISTRATION This open randomized prospective clinical trial was registered at ClinicalTrials.gov (NCT01664975).
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Affiliation(s)
- Yuanyuan Sun
- Department of Oncology, the First Affiliated
Hospital of Zhengzhou University, Zhengzhou, Henan Province, China
| | - Ling Li
- Department of Oncology, the First Affiliated
Hospital of Zhengzhou University, Zhengzhou, Henan Province, China
| | - Xin Li
- Department of Oncology, the First Affiliated
Hospital of Zhengzhou University, Zhengzhou, Henan Province, China
| | - Lei Zhang
- Department of Oncology, the First Affiliated
Hospital of Zhengzhou University, Zhengzhou, Henan Province, China
| | - Xinhua Wang
- Department of Oncology, the First Affiliated
Hospital of Zhengzhou University, Zhengzhou, Henan Province, China
| | - Xiaorui Fu
- Department of Oncology, the First Affiliated
Hospital of Zhengzhou University, Zhengzhou, Henan Province, China
| | - Zhenchang Sun
- Department of Oncology, the First Affiliated
Hospital of Zhengzhou University, Zhengzhou, Henan Province, China
| | - Xudong Zhang
- Department of Oncology, the First Affiliated
Hospital of Zhengzhou University, Zhengzhou, Henan Province, China
| | - Zhaoming Li
- Department of Oncology, the First Affiliated
Hospital of Zhengzhou University, Zhengzhou, Henan Province, China
| | - Jingjing Wu
- Department of Oncology, the First Affiliated
Hospital of Zhengzhou University, Zhengzhou, Henan Province, China
| | - Hui Yu
- Department of Oncology, the First Affiliated
Hospital of Zhengzhou University, Zhengzhou, Henan Province, China
| | - Yu Chang
- Department of Oncology, the First Affiliated
Hospital of Zhengzhou University, Zhengzhou, Henan Province, China
| | - Jiaqin Yan
- Department of Oncology, the First Affiliated
Hospital of Zhengzhou University, Zhengzhou, Henan Province, China
| | - Xiaolong Wu
- Department of Oncology, the First Affiliated
Hospital of Zhengzhou University, Zhengzhou, Henan Province, China
| | - Zhiyuan Zhou
- Department of Oncology, the First Affiliated
Hospital of Zhengzhou University, Zhengzhou, Henan Province, China
| | - Feifei Nan
- Department of Oncology, the First Affiliated
Hospital of Zhengzhou University, Zhengzhou, Henan Province, China
| | - Li Tian
- Department of Oncology, the First Affiliated
Hospital of Zhengzhou University, Zhengzhou, Henan Province, China
| | - Mingzhi Zhang
- Department of Oncology, the First Affiliated
Hospital of Zhengzhou University, 6th Floor, Building 10, No.1 Construction
East Road, Zhengzhou 450001, Henan Province, China
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Zhao WL, Cai MC. [How I diagnose and treat peripheral T cell lymphoma]. ZHONGHUA XUE YE XUE ZA ZHI = ZHONGHUA XUEYEXUE ZAZHI 2019; 40:363-367. [PMID: 31207698 PMCID: PMC7342239 DOI: 10.3760/cma.j.issn.0253-2727.2019.05.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/08/2019] [Indexed: 11/21/2022]
Affiliation(s)
- W L Zhao
- Shanghai Rui Jin Hospital, State Key Laboratory of Medical Genomics, Shanghai Institute of Hematology, Shanghai 200025, China
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Reiman T, Savage KJ, Crump M, Cheung MC, MacDonald D, Buckstein R, Couban S, Piliotis E, Imrie K, Spaner D, Shivakumar S, Kuruvilla J, Villa D, Shepherd LE, Skamene T, Winch C, Chen BE, Hay AE. A phase I study of romidepsin, gemcitabine, dexamethasone and cisplatin combination therapy in the treatment of peripheral T-cell and diffuse large B-cell lymphoma; the Canadian cancer trials group LY.15 study†. Leuk Lymphoma 2018; 60:912-919. [PMID: 30301414 DOI: 10.1080/10428194.2018.1515937] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
We investigated GDP (gemcitabine, 1000 mg/m2 IV d1, d8; dexamethasone, 40 mg po d1-4; cisplatin, 75 mg/m2 IV d1) combined with romidepsin on days 1 and 8 every 21 days to a maximum of six cycles in a standard 3 + 3, phase I dose escalation trial for patients with relapsed/refractory peripheral T-cell (PTCL) or diffuse large B-cell (DLBCL) lymphoma (NCT01846390). After treating four patients, gemcitabine and romidepsin were given on days 1 and 15 every 28 days. On the 21-day schedule at 6 mg/m2 romidepsin, there were three dose-limiting toxicities (DLTs) among four patients. On the 28-day schedule, there were no DLTs at the 6, 8, or 10 mg/m2 dose. At 12 mg/m2, there were four observed grade 3 DLTs among six evaluable patients. Full doses of GDP can be combined with a recommended phase II romidepsin dose of 10 mg/m2 if given on a day 1, 15 every 28 days schedule.
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Affiliation(s)
- Tony Reiman
- a Department of oncology, Saint John Regional Hospital , Dalhousie University, and University of New Brunswick , Saint John , Canada
| | | | - Michael Crump
- c Department of Medical Oncology and Hematology, Princess Margaret Cancer Centre , Toronto , Canada
| | - Matthew C Cheung
- d Division of Hematology, Sunnybrook Health Services Centre , Toronto , Canada
| | - David MacDonald
- e Department of Hematology, QEII Health Sciences Centre , Halifax , Canada
| | - Rena Buckstein
- d Division of Hematology, Sunnybrook Health Services Centre , Toronto , Canada
| | - Stephen Couban
- e Department of Hematology, QEII Health Sciences Centre , Halifax , Canada
| | - Eugenia Piliotis
- d Division of Hematology, Sunnybrook Health Services Centre , Toronto , Canada
| | - Kevin Imrie
- f Department of Hematology, Sunnybrook Health Services Centre , Toronto , Canada
| | - David Spaner
- d Division of Hematology, Sunnybrook Health Services Centre , Toronto , Canada
| | - Sudeep Shivakumar
- e Department of Hematology, QEII Health Sciences Centre , Halifax , Canada
| | - John Kuruvilla
- c Department of Medical Oncology and Hematology, Princess Margaret Cancer Centre , Toronto , Canada
| | - Diego Villa
- g Canadian Cancer Trials Group, Cancer Research Institute , Queen's University , Kingston , Canada
| | - Lois E Shepherd
- g Canadian Cancer Trials Group, Cancer Research Institute , Queen's University , Kingston , Canada
| | - Tanya Skamene
- g Canadian Cancer Trials Group, Cancer Research Institute , Queen's University , Kingston , Canada
| | - Chad Winch
- g Canadian Cancer Trials Group, Cancer Research Institute , Queen's University , Kingston , Canada
| | - Bingshu E Chen
- g Canadian Cancer Trials Group, Cancer Research Institute , Queen's University , Kingston , Canada
| | - Annette E Hay
- g Canadian Cancer Trials Group, Cancer Research Institute , Queen's University , Kingston , Canada
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Zhang Y, Zhang W, Li J, Duan M, Han B, Zhu T, Zhuang J, Cai H, Cao X, Chen M, Zhou D. Gemcitabine, cisplatin, and dexamethasone (GDP) in combination with methotrexate and pegaspargase is active in newly diagnosed peripheral T cell lymphoma patients: a phase 2, single-center, open-label study in China. Ann Hematol 2018; 98:143-150. [PMID: 30209556 DOI: 10.1007/s00277-018-3488-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2018] [Accepted: 08/25/2018] [Indexed: 01/08/2023]
Abstract
Peripheral T cell lymphomas (PTCL) are less responsive to anthracycline-containing regimen such as CHOP and carry a poor prognosis. In this prospective study, we investigated gemcitabine, cisplatin, and dexamethasone (GDP) combined with methotrexate (MTX) and pegaspargase (PEG-L) as front-line treatment in PTCL. Eligible newly diagnosed PTCL patients received 4 cycles of the GDP-ML chemotherapy every 28 days. After 4 cycles, responding patients continued to receive either autologous stem cell transplantation or the MTX/cytarabine (MA) regimen for consolidation. This trial is registered with www.chictr.org.cn (ChiCTR-ONC-12002055). A total of 65 patients were enrolled with a median follow-up of 38.5 months. The overall response rate (ORR) was 55.4%, and complete remission rate (CR) was 33.8%. The median overall survival (OS) was 16 months, and the 1-year and 2-year OS were 59.1% and 38.2%, respectively. The median PFS was only 8 months. The main adverse event was hematologic toxicity: 50% patients showed grade III/IV neutropenia. GDP-ML for the first-line treatment of PTCL patients is an effective induction regimen compared with standard CHOP, and the toxicity was more significant but acceptable. However, future studies exploring new drug combinations are warranted to overcome relapse after remission. ClinicalTrials.gov Identifier: NCT02987244.
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Affiliation(s)
- Yan Zhang
- Department of Hematology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, People's Republic of China
| | - Wei Zhang
- Department of Hematology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, People's Republic of China
| | - Jian Li
- Department of Hematology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, People's Republic of China
| | - Minghui Duan
- Department of Hematology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, People's Republic of China
| | - Bing Han
- Department of Hematology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, People's Republic of China
| | - Tienan Zhu
- Department of Hematology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, People's Republic of China
| | - Junling Zhuang
- Department of Hematology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, People's Republic of China
| | - Huacong Cai
- Department of Hematology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, People's Republic of China
| | - Xinxin Cao
- Department of Hematology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, People's Republic of China
| | - Miao Chen
- Department of Hematology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, People's Republic of China
| | - Daobin Zhou
- Department of Hematology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, People's Republic of China.
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12
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Phase 2 Study of First-line Intensity Modulated Radiation Therapy Followed by Gemcitabine, Dexamethasone, and Cisplatin for High-Risk, Early Stage Extranodal Nasal-Type NK/T-Cell Lymphoma: The GREEN Study. Int J Radiat Oncol Biol Phys 2018; 102:61-70. [DOI: 10.1016/j.ijrobp.2018.05.046] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2018] [Revised: 05/03/2018] [Accepted: 05/09/2018] [Indexed: 12/13/2022]
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13
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Gleeson M, Peckitt C, To YM, Edwards L, Oates J, Wotherspoon A, Attygalle AD, Zerizer I, Sharma B, Chua S, Begum R, Chau I, Johnson P, Ardeshna KM, Hawkes EA, Macheta MP, Collins GP, Radford J, Forbes A, Hart A, Montoto S, McKay P, Benstead K, Morley N, Kalakonda N, Hasan Y, Turner D, Cunningham D. CHOP versus GEM-P in previously untreated patients with peripheral T-cell lymphoma (CHEMO-T): a phase 2, multicentre, randomised, open-label trial. Lancet Haematol 2018; 5:e190-e200. [PMID: 29703335 PMCID: PMC5946805 DOI: 10.1016/s2352-3026(18)30039-5] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2018] [Revised: 03/09/2018] [Accepted: 03/11/2018] [Indexed: 02/06/2023]
Abstract
BACKGROUND Outcomes with CHOP (cyclophosphamide, doxorubicin, vincristine, and prednisolone) or CHOP-like chemotherapy in peripheral T-cell lymphoma are poor. We investigated whether the regimen of gemcitabine, cisplatin, and methylprednisolone (GEM-P) was superior to CHOP as front-line therapy in previously untreated patients. METHODS We did a phase 2, parallel-group, multicentre, open-label randomised trial in 47 hospitals: 46 in the UK and one in Australia. Participants were patients aged 18 years and older with bulky (tumour mass diameter >10 cm) stage I to stage IV disease (WHO performance status 0-3), previously untreated peripheral T-cell lymphoma not otherwise specified, angioimmunoblastic T-cell lymphoma, anaplastic lymphoma kinase-negative anaplastic large cell lymphoma, enteropathy-associated T-cell lymphoma, or hepatosplenic γδ T-cell lymphoma. We randomly assigned patients (1:1) stratified by subtype of peripheral T-cell lymphoma and international prognostic index to either CHOP (intravenous cyclophosphamide 750 mg/m2, doxorubicin 50 mg/m2, and vincristine 1·4 mg/m2 [maximum 2 mg] on day 1, and oral prednisolone 100 mg on days 1-5) every 21 days for six cycles; or GEM-P (intravenous gemcitabine 1000 mg/m2 on days 1, 8, and 15, cisplatin 100 mg/m2 on day 15, and oral or intravenous methylprednisolone 1000 mg on days 1-5) every 28 days for four cycles. The primary endpoint was the proportion of patients with a CT-based complete response or unconfirmed complete response on completion of study chemotherapy, to detect a 20% superiority of GEM-P compared with CHOP, assessed in all patients who received at least one cycle of treatment and had an end-of-treatment CT scan or reported clinical progression as the reason for stopping trial treatment. Safety was assessed in all patients who received at least one dose of study medication. This trial is registered with ClinicalTrials.gov (NCT01719835) and the European Clinical Trials Database (EudraCT 2011-004146-18). FINDINGS Between June 18, 2012, and Nov 16, 2016, we randomly assigned 87 patients to treatment, 43 to CHOP and 44 to GEM-P. A planned unmasked review of efficacy data by the independent data monitoring committee in November, 2016, showed that the number of patients with a confirmed or unconfirmed complete response with GEM-P was non-significantly inferior compared with CHOP and the trial was closed early. At a median follow-up of 27·4 months (IQR 16·6-38·4), 23 patients (62%) of 37 assessable patients assigned to CHOP had achieved a complete response or unconfirmed complete response compared with 17 (46%) of 37 assigned to GEM-P (odds ratio 0·52, 95% CI 0·21-1·31; p=0·164). The most common adverse events of grade 3 or worse in both groups were neutropenia (17 [40%] with CHOP and nine [20%] with GEM-P), thrombocytopenia (4 [10%] with CHOP and 13 [30%] with GEM-P, and febrile neutropenia (12 [29%] with CHOP and 3 [7%] with GEM-P). Two patients (5%) died during the study, both in the GEM-P group, from lung infections. INTERPRETATION The number of patients with a complete response or unconfirmed complete response did not differ between the groups, indicating that GEM-P was not superior for this outcome. CHOP should therefore remain the reference regimen for previously untreated peripheral T-cell lymphoma. FUNDING Bloodwise and the UK National Institute of Health Research.
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Affiliation(s)
- Mary Gleeson
- The Royal Marsden NHS Foundation Trust, London and Surrey, UK
| | - Clare Peckitt
- The Royal Marsden NHS Foundation Trust, London and Surrey, UK
| | - Ye Mong To
- The Royal Marsden NHS Foundation Trust, London and Surrey, UK
| | - Laurice Edwards
- The Royal Marsden NHS Foundation Trust, London and Surrey, UK
| | | | | | | | - Imene Zerizer
- The Royal Marsden NHS Foundation Trust, London and Surrey, UK
| | | | - Sue Chua
- The Royal Marsden NHS Foundation Trust, London and Surrey, UK
| | - Ruwaida Begum
- The Royal Marsden NHS Foundation Trust, London and Surrey, UK
| | - Ian Chau
- The Royal Marsden NHS Foundation Trust, London and Surrey, UK
| | - Peter Johnson
- Cancer Research UK Centre, University of Southampton, Southampton, UK
| | | | - Eliza A Hawkes
- Olivia Newton John Cancer Research Institute, Austin Health, Melbourne, VA, Australia; Eastern Health, Melbourne, VA, Australia
| | | | - Graham P Collins
- Oxford Cancer and Haematology Centre, Churchill Hospital, Oxford, UK
| | - John Radford
- University of Manchester and the Christie NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK
| | | | | | | | - Pamela McKay
- Beatson West of Scotland Cancer Centre, Glasgow, UK
| | - Kim Benstead
- Gloucestershire Hospitals NHS Foundation Trust, Gloucestershire, UK
| | - Nicholas Morley
- Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
| | | | - Yasmin Hasan
- Sandwell and West Birmingham Hospitals NHS Trust, Birmingham, UK
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Shao Y, Bai C, Sun J, Gao X. T-cell lymphoma with abundant CD20 expression showing a good response to rituximab with gemcitabine, oxiplatin, and L-asparaginase (R-pGEMOX): A case report. Medicine (Baltimore) 2018; 97:e0199. [PMID: 29561444 PMCID: PMC5895354 DOI: 10.1097/md.0000000000010199] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
RATIONALE T-cell lymphoma is a neoplasm that expresses markers of T-cell or natural killer cell (NK)-origin but not those of B-cell origin. Although B-cell lymphoma with abundant expression of T-cell markers exist, the opposite is very rare. Therefore, little is known about this subtype of lymphoma, including its treatment and prognosis. CASE REPORT A 65-year-old man was diagnosed with T-cell lymphoma with abundant CD20 expression. He was refractory to cyclophosphamide + epirubicin + vincristine + prednisone + etoposide (CHOPE), ifosfamide + cisplatin + etoposide + dexamethasone (DICE), and hyper-cyclophosphamide + vincristine + epirubicin + dexamethasone (CVAD) chemotherapy. The patient was also treated with prednisone + thalidomide + chidamide, which was also not effective. Upon admission to our department, he was administered a rituximab + gemcitabine + oxiplatin + L-asparaginase (R-pGEMOX) regimen and achieved partial remission. LESSONS CD20-positive T-cell lymphoma is a very rare type of lymphoma that is refractory to CHOP-like regimens alone. Rituximab may be effective in patients showing abundant CD20 expression, and an R-pGEMOX regimen will likely be effective, even in refractory/recurrent patients.
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Affiliation(s)
| | | | | | - Xin Gao
- Department of Radiological, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China
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