Background
High‐dose cyclophosphamide to treat solid refractory tumors demonstrated meaningful activity, while data to treat lymphoma remain scarce. This study aims to assess high‐dose cyclophosphamide to treat relapsed or refractory lymphoma.
Methods
A phase II study included adult patients with relapsed or refractory B‐cell non‐Hodgkin's lymphoma, previously treated by ≥2 prior lines with no other available option of therapy. High‐dose cyclophosphamide was given intravenously 3 g/m2 over two consecutive days and repeated once at 28 days in responding patients. Rituximab 375 mg/m2 intravenously was added in patients not refractory to anti‐CD20 antibody.
Results
Forty‐two patients with median age 65 [56‐70] years were included. Patients had previously received a median of four lines of therapies. Tumor types were diffuse large B‐cell lymphoma (n = 26; 62%), indolent B‐cell non‐Hodgkin lymphoma (n = 10; 24%), or mantle lymphoma (n = 6; 14%). Hematologic and non‐hematologic grade 3‐5 toxicities occurred in 42 (100%) and 18 (43%) of patients, respectively. The overall response rate was 45%.
Conclusion
One to two cycles of high‐dose cyclophosphamide in hard‐to‐treat patients with relapsed or refractory B‐cell non‐Hodgkin lymphoma demonstrated a favorable safety and efficacy profile. This regimen could serve as a bridge to modern cellular therapy with CAR‐T cell.
Background In previous studies, patient-reported outcomes (PROs) have been shown to improve survival in cancer patients. The aim of the present study was to assess symptoms potentially related to adverse events experienced by cancer outpatients treated by oral anticancer agents (OAAs) using PROs. Methods Between September 2018 and May 2019, outpatients starting OAAs were included in a 12-week follow-up to assess 15 symptoms listed in the National Cancer Institute PRO Common Terminology Criteria for Adverse Events, using a 5-point scale of severity or frequency. Patients were requested to alert a referral nurse or pharmacist when they self-assessed high-level (level 3 or 4) symptoms. Results 407 questionnaires were completed by 63 patients in which 2333 symptoms were reported. Almost three-quarters (74.6%) reported at least one high-level symptom. The symptoms that were most commonly experienced were fatigue (>9 in 10 patients; 13.2% of symptoms declared), various psychological disorders (>9 in 10 patients; 28.6% of symptoms declared) and general pain (>8 in 10 patients; 9.4% of symptoms declared). Conclusion PROs are appropriate to detect potential adverse events in cancer outpatients treated by OAAs. This study is the first step for integrating the patient’s perspective in a digital e-health device in routine oncology care.
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