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Ma J, Zhao D, Zhen B, Xia Y, Gong Q, Chen W. Cost-effectiveness of obinutuzumab plus bendamustine in Chinese patients with relapse and refractory follicular lymphoma. J Comp Eff Res 2023; 12:e230073. [PMID: 37916709 PMCID: PMC10734320 DOI: 10.57264/cer-2023-0073] [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: 05/11/2023] [Accepted: 10/20/2023] [Indexed: 11/03/2023] Open
Abstract
A decision analytic model was constructed to assess the cost-effectiveness of obinutuzumab plus bendamustine followed by obinutuzumab maintenance therapy (O-B-O) in Chinese patients with relapsed and refractory follicular lymphoma (rrFL). O-B-O was associated with a dominant or more favorable cost-effectiveness than the conventional therapies. Survival outcomes, quality of life of progression-free survival, and subsequent treatment costs for progressive disease were the main drivers of the cost-effectiveness of O-B-O. The cost-effectiveness proportions of O-B-O relative to conventional therapies under the recommended cost-effectiveness threshold ranged from 61.0% to 99.9%. Thus, O-B-O was highly cost-effective for treating patients with rrFL in China compared with conventional therapies.
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Affiliation(s)
- Jun Ma
- Harbin Institute of Hematology & Oncology, Harbin, China
| | - Donglu Zhao
- Harbin Institute of Hematology & Oncology, Harbin, China
| | - Bihong Zhen
- Shanghai Roche Pharmaceuticals Ltd, Shanghai, China
| | - Yan Xia
- Shanghai Roche Pharmaceuticals Ltd, Shanghai, China
| | - Qianyi Gong
- Changsha Normin Health Technology Ltd, Changsha, China
| | - Wendong Chen
- Changsha Normin Health Technology Ltd, Changsha, China
- Normin Health Consulting Ltd, Toronto, Canada
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2
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Zhao F, Cheng LL, Zheng Z, Zhang MC, Cheng S, Xu PP, Wang L, Zhao WL. [Analysis of clinical factors of bendamustine combined with rituximab in the treatment of recurrent follicular lymphoma]. ZHONGHUA XUE YE XUE ZA ZHI = ZHONGHUA XUEYEXUE ZAZHI 2022; 43:513-517. [PMID: 35968596 PMCID: PMC9800227 DOI: 10.3760/cma.j.issn.0253-2727.2022.06.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Received: 09/11/2021] [Indexed: 12/24/2022]
Affiliation(s)
- F Zhao
- Shanghai Institute of Hematology, State Key Laboratory of Medical Genomics, National Research Center for Translational Medicine at Shanghai, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China Zhao Fang is working at the Hematology Center, First Affiliated Hospital of Xinjiang Medical University, Xinjiang Institute of Hematology, Urumqi 830054, China
| | - L L Cheng
- Shanghai Institute of Hematology, State Key Laboratory of Medical Genomics, National Research Center for Translational Medicine at Shanghai, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
| | - Z Zheng
- Shanghai Institute of Hematology, State Key Laboratory of Medical Genomics, National Research Center for Translational Medicine at Shanghai, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
| | - M C Zhang
- Shanghai Institute of Hematology, State Key Laboratory of Medical Genomics, National Research Center for Translational Medicine at Shanghai, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
| | - S Cheng
- Shanghai Institute of Hematology, State Key Laboratory of Medical Genomics, National Research Center for Translational Medicine at Shanghai, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
| | - P P Xu
- Shanghai Institute of Hematology, State Key Laboratory of Medical Genomics, National Research Center for Translational Medicine at Shanghai, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
| | - L Wang
- Shanghai Institute of Hematology, State Key Laboratory of Medical Genomics, National Research Center for Translational Medicine at Shanghai, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
| | - W L Zhao
- Shanghai Institute of Hematology, State Key Laboratory of Medical Genomics, National Research Center for Translational Medicine at Shanghai, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
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Zoellner A, Herfarth K, Herold M, Klapper W, Skoetz N, Hiddemann W. Clinical Practice Guideline: Follicular Lymphoma—Diagnosis, Treatment, and Follow-up. DEUTSCHES ARZTEBLATT INTERNATIONAL 2021; 118:arztebl.m2021.0022. [PMID: 33632384 PMCID: PMC8295529 DOI: 10.3238/arztebl.m2021.0022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Accepted: 11/09/2020] [Indexed: 11/27/2022]
Abstract
BACKGROUND Follicular lymphoma (FL) occurs predominantly at advanced age, with an annual incidence of 3-5 cases per 100 000 inhabitants in Western countries. The clinical course is heterogeneous. METHODS For this new guideline, systematic literature searches were conducted in medical databases (MEDLINE, PubMed Central) (up to November 2017) and in the Guidelines International Network (G-I-N), and recent publications were added. RESULTS The results of 21 systematic reviews with meta-analyses, 75 randomized controlled trials, and 58 prospective and retrospective studies were evaluated. Lymph-node biopsy is necessary for initial diagnosis of FL. CT scanning of the neck, thorax, and abdomen should be performed to assess how far the disease has spread, together with bone marrow biopsy and, if required, PET/CT. In early FL (stages I and II; 10-15 %), potentially curative radiotherapy combined with an anti-CD 20 antibody is recommended. In advanced disease (stages III and IV), watchful waiting is indicated for patients who have no clinical symptoms and a low tumor burden. Patients with clinical symptoms and/or high tumor burden should receive chemotherapy in combination with an anti-CD 20 antibody, followed by 2 years' maintenance treatment with an anti-CD 20 antibody. CONCLUSION Given the good long-term prognosis of FL, the treatment must be chosen with care and thorough follow-up is necessary to ensure detection of late sequelae such as second malignancies or organ damage.
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Affiliation(s)
- Anna Zoellner
- Department of Medicine III, Hospital of the Ludwig-Maximilians-University (LMU), Munich, Germany
| | - Klaus Herfarth
- Department of Radiation Oncology, Heidelberg University Hospital, Heidelberg, Germany
| | - Michael Herold
- Department of Medicine III, Hospital of the Ludwig-Maximilians-University (LMU), Munich, Germany
| | - Wolfram Klapper
- Department of Pathology, Lymph Node Registry, Hematopathology Section, University Hospital Schleswig-Holstein, Kiel, Germany
| | - Nicole Skoetz
- Evidence-based Oncology Research Group, Department of Medicine I, University of Cologne, Cologne, Germany
| | - Wolfgang Hiddemann
- Department of Medicine III, Hospital of the Ludwig-Maximilians-University (LMU), Munich, Germany
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Karadurmus N, Paydas S, Esin E, Surmeli ZG, Yildiz B, Erturk I, Nayir E, Dogan M, Sumbul AT, Barista I, Gurkan E, Ocal R, Ferhanoglu B, Ozgur G, Karakas Y, Lacin S, Ozaydin S, Petekkaya HI, Uskent N. Effectiveness of bendamustine in relapsed or refractory lymphoma cases: a Turkish Oncology Group study. Arch Med Sci 2021; 17:920-927. [PMID: 34336021 PMCID: PMC8314394 DOI: 10.5114/aoms.2019.83000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2018] [Accepted: 08/07/2018] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION We aimed to investigate the efficacy and side effects of bendamustine in relapsed/refractory lymphoma patients in Turkey. MATERIAL AND METHODS In this retrospective study, we included relapsed/refractory Hodgkin lymphoma (HL) and non-Hodgkin lymphoma (NHL) patients who underwent multiple lines of chemotherapy. The primary endpoint was to determine the objective response and toxicity. RESULTS Ninety-nine patients with a median age of 59.8 years were included in the study. Eighty-one patients had NHL (follicular lymphoma: 10, diffuse large B-cell lymphoma: 27, mantle-cell lymphoma: 18, marginal zone lymphoma: 9, small lymphocytic lymphoma/chronic lymphocytic leukemia: 17) and 18 patients had HL. The patients had previously received a median of three lines of chemotherapy (range: 2-8) except autologous stem cell transplantation (ASCT); 19 patients (HL: 11, NHL: 8) had undergone ASCT. The objective response rate (ORR) was 74.3%, the complete response rate was 57% (= 53), and the partial response rate was 16.6% ( = 19). The overall survival (OS) rate at 1 year was 74.6%. The progression-free survival (PFS) rate at 1 year was 62.5%. The most common side effects were lymphopenia, anemia and neutropenia. Side effects which were observed as grade 3 and higher levels were lymphopenia (14.1%), neutropenia (10.1%) and fatigue (7.1%). CONCLUSIONS Objective response rate of bendamustine was found to be 74.3% in relapsed/refractory HL and NHL patients. It appears to be an effective option as a salvage treatment for patients who have previously received multiple lines of therapy.
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Affiliation(s)
- Nuri Karadurmus
- Department of Medical Oncology, Health Sciences University, Gulhane Training and Research Hospital, Ankara, Turkey
| | - Semra Paydas
- Department of Medical Oncology, Faculty of Medicine, Cukurova University, Adana, Turkey
| | - Ece Esin
- Department of Medical Oncology, Health Sciences University, Dr. Abdurrahman Yurtaslan Training and Research Hospital, Ankara, Turkey
| | | | - Birol Yildiz
- Department of Medical Oncology, Health Sciences University, Gulhane Training and Research Hospital, Ankara, Turkey
| | - Ismail Erturk
- Department of Medical Oncology, Health Sciences University, Gulhane Training and Research Hospital, Ankara, Turkey
| | - Erdinc Nayir
- Department of Medical Oncology, Medicalpark Hospital, Ankara, Turkey
| | - Mutlu Dogan
- Department of Medical Oncology, Health Sciences University, Numune Training and Research Hospital, Ankara, Turkey
| | - Ahmet Taner Sumbul
- Department of Medical Oncology, Faculty of Medicine, Baskent University, Adana, Turkey
| | - Ibrahim Barista
- Department of Medical Oncology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Emel Gurkan
- Department of Haematology, Faculty of Medicine, Cukurova University, Adana, Turkey
| | - Ramazan Ocal
- Department of Haematology, Faculty of Medicine, Gazi University, Ankara, Turkey
| | - Burhan Ferhanoglu
- Department of Haematology, Faculty of Medicine, Koc University, Istanbul, Turkey
| | - Gokhan Ozgur
- Department of Haematology, Health Sciences University, Gulhane Training and Research Hospital, Ankara, Turkey
| | - Yusuf Karakas
- Department of Medical Oncology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Sahin Lacin
- Department of Medical Oncology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Sukru Ozaydin
- Department of Medical Oncology, Health Sciences University, Gulhane Training and Research Hospital, Ankara, Turkey
| | | | - Necdet Uskent
- Department of Medical Oncology, Anatolian Health Center, Istanbul, Turkey
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5
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Watanabe H, Uchida M, Masuda S. [Clinical Pharmacology Research for Promoting Individualized Cancer Chemotherapy]. YAKUGAKU ZASSHI 2019; 139:901-909. [PMID: 31155534 DOI: 10.1248/yakushi.18-00213-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Cancer chemotherapy has progressed remarkably with conventional and molecular-targeted anticancer drugs as well as immune checkpoint inhibitors. However, adverse drug reaction (ADR) management remains a challenge in cancer chemotherapy. Therefore, improving the quality of medical care through clinical pharmacology research is warranted. Intravenous injection of bendamustine in patients with follicular or mantle cell lymphoma frequently causes venous irritation. Because the underlying mechanisms are not clear, we investigated the factors responsible for bendamustine-induced venous irritation. Based on the results of our analysis, we altered the administration regimen and observed that the incidence of venous irritation, which manifested in a concentration-dependent manner following conventional approaches, significantly decreased when following the modified regimen. Guidelines on the management of chemotherapy-induced nausea and vomiting recommend aprepitant, a selective neurokinin-1 (NK-1) receptor antagonist, 5-hydroxytryptamine 3 (5-HT3) receptor antagonists, and dexamethasone as prophylactic antiemetics. Pretreatment with high-dose chemotherapy before hematopoietic stem cell transplantation has extremely high emetogenic potential. This can be countered by using aprepitant in combination with conventional antiemetics. However, the safety and efficacy of such combinations are unexplored. Upon evaluation, we observed improved antiemetic effects without an increase in ADRs. At this symposium, I highlight the significance of clinical pharmacology research for promoting individualized cancer chemotherapy.
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Matsumoto Y, Kobayashi T, Shimura Y, Kawata E, Nagoshi H, Ohshiro M, Sugitani M, Shimura K, Iwai T, Fuchida SI, Yoshida M, Kiyota M, Mizutani S, Chinen Y, Takimoto-Shimomura T, Nakao M, Kaneko H, Uchiyama H, Uoshima N, Nishigaki H, Kobayashi Y, Horiike S, Shimazaki C, Taniwaki M, Kuroda J. Combined rituximab, bendamustine, and dexamethasone chemotherapy for relapsed or refractory indolent B-cell non-Hodgkin lymphoma and mantle cell lymphoma: a multicenter phase II study. Int J Hematol 2019; 110:77-85. [PMID: 31127456 DOI: 10.1007/s12185-019-02650-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2018] [Revised: 04/05/2019] [Accepted: 04/11/2019] [Indexed: 10/26/2022]
Abstract
This multicenter phase II study (UMIN000008145) aims to investigate the efficacy and safety of six cycles of combination therapy (RBD) comprising rituximab, bendamustine, and dexamethasone (DEX) for relapsed or refractory (RR) indolent B-cell non-Hodgkin lymphoma (B-NHL) and mantle cell lymphoma (MCL). Although the initial study protocol comprised 20 mg/body DEX on days 1 and 2, and 10 mg/body on days 3-5 [high-dose (HD-) DEX group], the dose of DEX was later decreased to 8 mg/body on days 1 and 2 [low-dose (LD-) DEX group] due to frequent cytomegalovirus (CMV) antigenemia and recurrent retinitis. We enrolled 33 patients, and LD-DEX and HD-DEX were administered in 15 and 18 patients, respectively. The overall response and the 3-year progression-free survival rates were 88% and 75.5%, respectively. The leading adverse event was myelosuppression. Incidence of grade 3-4 leukocytopenia, neutropenia, and lymphocytopenia was 55%, 67%, and 91%, respectively. The most frequent nonhematological adverse events were CMV antigenemia and rash (33% and 30%, respectively). Incidence of CMV antigenemia over 10/100,000 white blood cells was significantly lower with LD-DEX than that with HD-DEX (P = 0.0127). In conclusion, RBD showed significant effectiveness for RR indolent B-NHL and MCL.
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Affiliation(s)
- Yosuke Matsumoto
- Department of Hematology, Japanese Red Cross Kyoto Daiichi Hospital, 15-749 Honmachi, Higashiyama-ku, Kyoto, 605-0981, Japan. .,Departments of Hematology and Laboratory Medicine, Aiseikai Yamashina Hospital, Kyoto, Japan.
| | - Tsutomu Kobayashi
- Division of Hematology and Oncology, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Yuji Shimura
- Division of Hematology and Oncology, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Eri Kawata
- Division of Hematology and Oncology, Kyoto Prefectural University of Medicine, Kyoto, Japan.,Department of Hematology, Japanese Red Cross Kyoto Daini Hospital, Kyoto, Japan
| | - Hisao Nagoshi
- Department of Hematology and Oncology, Hiroshima University, Hiroshima, Japan
| | - Muneo Ohshiro
- Department of Hematology, Japanese Red Cross Kyoto Daiichi Hospital, 15-749 Honmachi, Higashiyama-ku, Kyoto, 605-0981, Japan
| | - Mio Sugitani
- Department of Hematology, Matsushita Memorial Hospital, Moriguchi, Japan
| | - Kazuho Shimura
- Departments of Hematology and Laboratory Medicine, Aiseikai Yamashina Hospital, Kyoto, Japan
| | - Toshiki Iwai
- Department of Hematology, Japanese Red Cross Kyoto Daiichi Hospital, 15-749 Honmachi, Higashiyama-ku, Kyoto, 605-0981, Japan
| | - Shin-Ichi Fuchida
- Department of Hematology, Japan Community Health care Organization, Kyoto Kuramaguchi Medical Center, Kyoto, Japan
| | - Mihoko Yoshida
- Departments of Hematology and Laboratory Medicine, Aiseikai Yamashina Hospital, Kyoto, Japan
| | - Miki Kiyota
- Department of Hematology, Matsushita Memorial Hospital, Moriguchi, Japan
| | - Shinsuke Mizutani
- Division of Hematology and Oncology, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Yoshiaki Chinen
- Division of Hematology and Oncology, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | | | | | - Hiroto Kaneko
- Departments of Hematology and Laboratory Medicine, Aiseikai Yamashina Hospital, Kyoto, Japan
| | - Hitoji Uchiyama
- Department of Hematology, Japanese Red Cross Kyoto Daiichi Hospital, 15-749 Honmachi, Higashiyama-ku, Kyoto, 605-0981, Japan
| | - Nobuhiko Uoshima
- Department of Hematology, Japanese Red Cross Kyoto Daini Hospital, Kyoto, Japan
| | - Hikari Nishigaki
- Department of Hematology, Fukuchiyama City Hospital, Fukuchiyama, Japan
| | - Yutaka Kobayashi
- Department of Hematology, Japanese Red Cross Kyoto Daini Hospital, Kyoto, Japan
| | - Shigeo Horiike
- Division of Hematology and Oncology, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Chihiro Shimazaki
- Department of Hematology, Japan Community Health care Organization, Kyoto Kuramaguchi Medical Center, Kyoto, Japan
| | - Masafumi Taniwaki
- Departments of Hematology and Laboratory Medicine, Aiseikai Yamashina Hospital, Kyoto, Japan.,Center for Molecular Diagnostics and Therapeutics, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Junya Kuroda
- Division of Hematology and Oncology, Kyoto Prefectural University of Medicine, Kyoto, Japan
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7
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Rueda A, Calvo V, Casanova M, Rodriguez-Abreu D, Aguiar D, Llanos M, Alvarez R, Martinez-Banaclocha N, Alfaro J, Quero C, Blasco A, de la Cruz Merino L, Herrero J, García-Arroyo FR, Provencio M. Efficacy of the combination of rituximab-bendamustine as a second-line treatment in patients with follicular lymphoma who progress after immunochemotherapy: a phase II trial of the Spanish Lymphoma Oncology Group. Leuk Lymphoma 2018; 60:1576-1579. [PMID: 30516082 DOI: 10.1080/10428194.2018.1542147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
| | - Virginia Calvo
- b Hospital Universitario Puerta de Hierro Majadahonda , Madrid , Spain
| | | | | | - David Aguiar
- d Hospital Dr. Negrín. Las Palmas de Gran Canaria , Las Palmas , Spain
| | - Marta Llanos
- e Hospital Universitario de Canarias. Santa Cruz de Tenerife , Spain
| | | | | | | | - Cristina Quero
- i Hospitales Universitarios General y Virgen de la Victoria , Málaga , Spain
| | - Ana Blasco
- j Hospital General Universitario. Valencia , Spain
| | | | - Joaquín Herrero
- l Hospital General Universitario de Alicante , Alicante , Spain
| | | | - Mariano Provencio
- b Hospital Universitario Puerta de Hierro Majadahonda , Madrid , Spain
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8
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Ye H, Desai A, Zeng D, Romaguera J, Wang ML. Frontline Treatment for Older Patients with Mantle Cell Lymphoma. Oncologist 2018; 23:1337-1348. [PMID: 29895632 PMCID: PMC6291324 DOI: 10.1634/theoncologist.2017-0470] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2017] [Accepted: 04/05/2018] [Indexed: 11/17/2022] Open
Abstract
The natural history of mantle cell lymphoma (MCL) undergoing chemotherapy is a cyclical pattern of remission followed by recurrence of disease due to acquired chemotherapy resistance. The median age of the occurrence of MCL is 65 years, so half of the newly diagnosed MCL patients are considered "elderly." The tolerance to long-term chemotherapy in elderly patients is decreased; hence, the response to frontline therapy used is of paramount importance. We hope that our review may guide clinicians in treating such populations in a more personalized and evidence-based manner.In the older patients with risk variables, frontline treatment is determined according to different body status of fit, unfit or compromised, and frail. In the fit patients, the pursuit of remission and prolongation of survival might currently justify the use of more intense and toxic therapies. For unfit or compromised older patients, disease control needs to be prioritized, maintaining a balance between the benefits and toxicities of the treatment. For frail patients, tolerance of treatment and minimizing myelotoxicity should be the primary focus. "Chemotherapy-free" regimens are likely to be considered as the first-line strategy for this population. On the other hand, in the older MCL population without risk variables, observation or "watch and wait" can prevent overtreatment. Furthermore, more clinical trials and research studies on novel agents and targeted therapies need to be translated into the general population to provide optimal treatment and to guide personalized treatment. IMPLICATIONS FOR PRACTICE: This review emphasizes the importance of frontline therapies for older MCL patients. MCL patients commonly experience a cyclical pattern of remission followed by recurrence of disease due to acquired chemotherapy resistance. As a special population, elderly patients have various comorbidities and decreased organ function, which may reduce the chances of undergoing treatment for recurrent disease. Thus, this older population of patients with MCL should be treated separately and exceptionally. So far, systematic reviews with regard to frontline treatment for older patients with MCL have not been encountered, but the hope is that this review may guide clinicians in treating such populations in a more personalized and evidence-based manner.
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Affiliation(s)
- Haige Ye
- Department of Hematology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, People's Republic of China
- The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Aakash Desai
- The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
- The University of Texas Health Science Center, Houston, Texas, USA
| | - Dongfeng Zeng
- The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Jorge Romaguera
- The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Michael L Wang
- The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
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9
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An Evidence-based Review of Anti-CD20 Antibody-containing Regimens for the Treatment of Patients With Relapsed or Refractory Chronic Lymphocytic Leukemia, Diffuse Large B-cell Lymphoma, or Follicular Lymphoma. CLINICAL LYMPHOMA MYELOMA & LEUKEMIA 2018; 18:508-518.e14. [DOI: 10.1016/j.clml.2018.05.009] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/02/2018] [Revised: 04/30/2018] [Accepted: 05/14/2018] [Indexed: 12/11/2022]
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10
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Soumerai JD, Zelenetz AD, Moskowitz CH, Palomba ML, Hamlin PA, Noy A, Straus DJ, Moskowitz AJ, Younes A, Matasar MJ, Horwitz SM, Portlock CS, Konner JA, Gounder MM, Hyman DM, Voss MH, Fury MG, Gajria D, Carvajal RD, Ho AL, Beumer JH, Kiesel B, Zhang Z, Chen A, Little RF, Jarjies C, Dang TO, France F, Mishra N, Gerecitano JF. The PARP Inhibitor Veliparib Can Be Safely Added to Bendamustine and Rituximab and Has Preliminary Evidence of Activity in B-Cell Lymphoma. Clin Cancer Res 2017; 23:4119-4126. [PMID: 28314788 DOI: 10.1158/1078-0432.ccr-16-3068] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2016] [Revised: 01/06/2017] [Accepted: 03/08/2017] [Indexed: 11/16/2022]
Abstract
Purpose: The PARP inhibitor veliparib enhances the cytotoxicity of alkylating agents. This phase I study evaluated veliparib with the bifunctional alkylator bendamustine (VB) in patients with relapsed/refractory lymphoma, multiple myeloma, and solid malignancies, with a cohort expansion of VB with rituximab (VBR) in patients with B-cell lymphomas.Experimental Design: This dose-escalation study evaluated safety, pharmacokinetics, and preliminary efficacy of veliparib (20-400 mg twice a day, days 1-7 of 28-day cycle) and bendamustine (70 and 90 mg/m2 intravenously, days 1 and 2). A cohort expansion was conducted, which combined veliparib and bendamustine at the maximum tolerated dose (MTD) with rituximab (375 mg/m2, day 1) in patients with B-cell lymphomas. Thirty-four patients were treated in seven dose-escalation cohorts and seven patients in the dose-expansion cohort.Results: The MTD was veliparib 300 mg twice daily plus bendamustine 90 mg/m2 Dose-limiting toxicities (DLT) were anemia, nausea, hypertension, and hyperhidrosis. Grade ≥3 toxicities included lymphopenia (87.8%), anemia (19.5%), neutropenia (12.2%), thrombocytopenia (9.8%), leukopenia (9.8%), nausea (7.3%), and hypophosphatemia (7.3%). Apparent veliparib clearance was slightly lower than previously reported. Of 14 patients with lymphoma evaluable for response, five of seven (71%) on VB and six of seven (86%) on VBR achieved objective response. One patient with multiple myeloma achieved partial response.Conclusions: VB and VBR were generally well-tolerated. VBR had preliminary clinical activity in patients with B-cell lymphoma, which warrants further investigation in a phase II trial. This trial was registered at www.clinicaltrials.gov as NCT01326702 Clin Cancer Res; 23(15); 4119-26. ©2017 AACR.
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Affiliation(s)
- Jacob D Soumerai
- Department of Medicine, Lymphoma Service, Memorial Sloan Kettering Cancer Center, New York, New York.
| | - Andrew D Zelenetz
- Department of Medicine, Lymphoma Service, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Craig H Moskowitz
- Department of Medicine, Lymphoma Service, Memorial Sloan Kettering Cancer Center, New York, New York.,Department of Medicine, Adult Bone Marrow Transplant Service, Memorial Sloan Kettering Cancer Center, New York, New York
| | - M Lia Palomba
- Department of Medicine, Lymphoma Service, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Paul A Hamlin
- Department of Medicine, Lymphoma Service, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Ariela Noy
- Department of Medicine, Lymphoma Service, Memorial Sloan Kettering Cancer Center, New York, New York
| | - David J Straus
- Department of Medicine, Lymphoma Service, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Alison J Moskowitz
- Department of Medicine, Lymphoma Service, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Anas Younes
- Department of Medicine, Lymphoma Service, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Matthew J Matasar
- Department of Medicine, Lymphoma Service, Memorial Sloan Kettering Cancer Center, New York, New York.,Department of Medicine, Adult Bone Marrow Transplant Service, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Steven M Horwitz
- Department of Medicine, Lymphoma Service, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Carol S Portlock
- Department of Medicine, Lymphoma Service, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Jason A Konner
- Department of Medicine, Center for Developmental Therapeutics, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Mrinal M Gounder
- Department of Medicine, Center for Developmental Therapeutics, Memorial Sloan Kettering Cancer Center, New York, New York
| | - David M Hyman
- Department of Medicine, Center for Developmental Therapeutics, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Martin H Voss
- Department of Medicine, Center for Developmental Therapeutics, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Matthew G Fury
- Department of Medicine, Center for Developmental Therapeutics, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Devika Gajria
- Department of Medicine, Center for Developmental Therapeutics, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Richard D Carvajal
- Department of Medicine, Center for Developmental Therapeutics, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Alan L Ho
- Department of Medicine, Center for Developmental Therapeutics, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Jan H Beumer
- Cancer Therapeutics Program, University of Pittsburgh Cancer Institute, Pittsburgh, Pennsylvania.,Department of Pharmaceutical Sciences, University of Pittsburgh School of Pharmacy, Pittsburgh, Pennsylvania.,Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Brian Kiesel
- Cancer Therapeutics Program, University of Pittsburgh Cancer Institute, Pittsburgh, Pennsylvania
| | - Zhigang Zhang
- Department of Biostatistics, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Alice Chen
- Cancer Therapy Evaluation Program, National Cancer Institute, Rockville, Maryland
| | - Richard F Little
- Cancer Therapy Evaluation Program, National Cancer Institute, Rockville, Maryland
| | | | - Thu O Dang
- Memorial Sloan Kettering Cancer Center, New York, New York
| | - Fallon France
- Memorial Sloan Kettering Cancer Center, New York, New York
| | - Nishant Mishra
- Memorial Sloan Kettering Cancer Center, New York, New York
| | - John F Gerecitano
- Department of Medicine, Lymphoma Service, Memorial Sloan Kettering Cancer Center, New York, New York.,Department of Medicine, Center for Developmental Therapeutics, Memorial Sloan Kettering Cancer Center, New York, New York
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Zhu H, Xu W, Li J. [Progress of bendamustine in the treatment of B cell non-Hodgkin lymphoma]. ZHONGHUA XUE YE XUE ZA ZHI = ZHONGHUA XUEYEXUE ZAZHI 2015; 36:972-6. [PMID: 26632476 PMCID: PMC7342420 DOI: 10.3760/cma.j.issn.0253-2727.2015.11.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- Huayuan Zhu
- Department of Hematology, the First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing 210029, China
| | - Wei Xu
- Department of Hematology, the First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing 210029, China
| | - Jianyong Li
- Department of Hematology, the First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing 210029, China
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Oh SY, Kim WS, Kim JS, Chae YS, Lee GW, Eom HS, Ryoo HM, Lee S, Kim SJ, Yoon DH, Won JH, Hong J, Park J, Lee SM, Hong JY, Park E, Kim HJ, Yang DH, Kim HJ, Suh C. A phase II study of oxaliplatin and prednisone for patients with relapsed or refractory marginal zone lymphoma: Consortium for Improving Survival of Lymphoma trial. Leuk Lymphoma 2015; 57:1406-12. [DOI: 10.3109/10428194.2015.1099650] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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