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Cabanillas F, Liboy I, Rodriguez-Monge E, Pavia O, Robles N, Maldonado N, Rivera E, Torres I, Perdomo J, Acaba L. GROC (gemcitabine, rituximab, oxaliplatin combination) plus pegfilgrastim is less toxic and as active as DHAP and ESHAP for relapsed aggressive non-Hodgkin’s lymphoma (NHL). J Clin Oncol 2008. [DOI: 10.1200/jco.2008.26.15_suppl.8530] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Cabanillas F, Liboy I, Rodriguez-Monge E, Pavia O, Robles N, Maldonado N, Rivera E, Suau L. A dose dense low toxicity salvage regimen for histologically aggressive non-Hodgkin’s lymphoma (NHL): Gemcitabine, rituximab, oxaliplatin combination (GROC) plus pegfilgrastim. J Clin Oncol 2006. [DOI: 10.1200/jco.2006.24.18_suppl.17513] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
17513 High dose chemo/autologous stem cell transplant (ASCT) is standard treatment for relapsed aggressive NHL. However many are unable to receive ASCT because they are refractory to salvage therapy, too old or too sick. More effective, less toxic salvage regimens are needed prior to ASCT. Gemcitabine (G) and Oxaliplatin (O) are active agents in NHL and exhibit synergism so their combination is attractive to explore together with Rituximab (R). We hereby report the results of a phase I-II trial designed to explore the GROC regimen administered every 14 days with Pegfilgrastim support. After the first 6 pts were entered, the phase I portion was completed; recommended dose: R = 375 mg/m2 on day 1, G = 1,250 mg/M2 on day 2, O = 100 mg/m2 on day 2 and Neulasta 6 mg day 3. So far we have entered 21 pts of which 19 are currently evaluable. Median age = 58 (range = 27–88); 9 were refractory to 1st line therapy, 5 were on 1st relapse, 3 on 2nd and 2 >2 relapses, 12 had high LDH, 10 high Beta-2-M. Using IWG/PET criteria ORR = 79%, CR = 42%, PR = 37%. There was a correlation between response to preceding chemo regimen and response to GROC ( table ). In 6 the response to GROC was better than to preceding regimen while only in 2 was the response worse. At 1 year the projected OS is 49% and PFS 34%. So far, only 5 of 15 responders have relapsed. An intriguing finding is that in 6 of 15 responders, PFS has been longer with GROC than with preceding regimen and shorter in only 1. Grade 4 hematologic toxicity occurred only once. No neutropenic fevers seen. Most common toxicity was reversible transaminitis in 13 (grade 1–2 in 10, grade 3 in 3), neuropathy in 9 (grade 1–2 in 8, grade 3 in 1), diarrhea in 3 (grade 4 in 1). We could deliver courses at a median interval of 14 days. Conclusions: 1- GROC is an effective dose dense salvage regimen. 2- It appears effective even in pts with poor prognostic features including primary refractory disease. 3-Hematologic toxicity is very low and non-hematologic toxicity acceptable. [Table: see text] [Table: see text]
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Affiliation(s)
- F. Cabanillas
- Auxilio Mutuo Cancer Center, San Juan; Puerto Rico Oncology Consortium, San Juan, Puerto Rico; Auxilio Mutuo Cancer Center, San Juan, Puerto Rico; Puerto Rico Chemotherapy Consortium, San Juan, Puerto Rico
| | - I. Liboy
- Auxilio Mutuo Cancer Center, San Juan; Puerto Rico Oncology Consortium, San Juan, Puerto Rico; Auxilio Mutuo Cancer Center, San Juan, Puerto Rico; Puerto Rico Chemotherapy Consortium, San Juan, Puerto Rico
| | - E. Rodriguez-Monge
- Auxilio Mutuo Cancer Center, San Juan; Puerto Rico Oncology Consortium, San Juan, Puerto Rico; Auxilio Mutuo Cancer Center, San Juan, Puerto Rico; Puerto Rico Chemotherapy Consortium, San Juan, Puerto Rico
| | - O. Pavia
- Auxilio Mutuo Cancer Center, San Juan; Puerto Rico Oncology Consortium, San Juan, Puerto Rico; Auxilio Mutuo Cancer Center, San Juan, Puerto Rico; Puerto Rico Chemotherapy Consortium, San Juan, Puerto Rico
| | - N. Robles
- Auxilio Mutuo Cancer Center, San Juan; Puerto Rico Oncology Consortium, San Juan, Puerto Rico; Auxilio Mutuo Cancer Center, San Juan, Puerto Rico; Puerto Rico Chemotherapy Consortium, San Juan, Puerto Rico
| | - N. Maldonado
- Auxilio Mutuo Cancer Center, San Juan; Puerto Rico Oncology Consortium, San Juan, Puerto Rico; Auxilio Mutuo Cancer Center, San Juan, Puerto Rico; Puerto Rico Chemotherapy Consortium, San Juan, Puerto Rico
| | - E. Rivera
- Auxilio Mutuo Cancer Center, San Juan; Puerto Rico Oncology Consortium, San Juan, Puerto Rico; Auxilio Mutuo Cancer Center, San Juan, Puerto Rico; Puerto Rico Chemotherapy Consortium, San Juan, Puerto Rico
| | - L. Suau
- Auxilio Mutuo Cancer Center, San Juan; Puerto Rico Oncology Consortium, San Juan, Puerto Rico; Auxilio Mutuo Cancer Center, San Juan, Puerto Rico; Puerto Rico Chemotherapy Consortium, San Juan, Puerto Rico
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Diaz-Canton EA, Valero V, Rahman Z, Rodriguez-Monge E, Frye D, Smith T, Buzdar AU, Hortobagyi GN. Clinical course of breast cancer patients with metastases confined to the lungs treated with chemotherapy. The University of Texas M.D. Anderson Cancer Center experience and review of the literature. Ann Oncol 1998; 9:413-8. [PMID: 9636832 DOI: 10.1023/a:1008205522875] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
PURPOSE To evaluate the clinical course of patients with a metastatic breast cancer (MBC) confined to the lungs and treated with doxorubicin/cyclophosphamide-containing chemotherapy (DC-CT). PATIENTS AND METHODS Between 1973 and 1985, 1581 patients with MBC were treated with DC-CT at M.D. Anderson Cancer Center. Data for 88 patients (5.6%) with metastases confined to the lungs were reviewed to correlate various clinical characteristics with response to treatment and survival. RESULTS The overall response rate was 76% with 33% achieving complete response (CR). The median overall survival time was 22 months (range 1-210). The 10-year survival rate was 9%. The overall response and CR rates were higher for the patients with metastases confined to the lungs (76% and 33%. respectively) than for the remainder of MBC patients (64% and 14%; P < 0.01). The 10-year survival rate was also higher (9% versus 3%, P < 0.01), but there were no differences in median overall survival rate. CONCLUSIONS This retrospective analysis demonstrated that patients with metastases confined to the lungs treated with DC-CT had a high objective response rate, especially high CR rates, and a median survival comparable to that of our entire population of MBC patients. A small but clinically significant percentage of patients had prolonged survival. Therefore, not all visceral sites are indicators of poor prognosis.
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Affiliation(s)
- E A Diaz-Canton
- Department of Breast Medical Oncology, University of Texas M.D. Anderson Cancer Center, Houston, USA
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