Long-term results of gemcitabine plus oxaliplatin with and without rituximab as salvage treatment for transplant-ineligible patients with refractory/relapsing B-cell lymphoma

Abstract

Both regimes showed good tolerability and appealing response rates. FFS was more prolonged in R-GEMOX, but patients continuously relapsed without a clear plateau on survival curves.

Rituximab plus gemcitabine and oxaliplatin in patients with refractory/relapsed diffuse large B-cell lymphoma who are not candidates for high-dose therapy. A phase II Lymphoma Study Association trial

“…They confirmed good response rates with an ORR of 78% and a complete response rate of 50% for patients treated with R-GemOx, with mainly hematologic toxicity. 9 As in the CORAL trial, the cell of origin was not found to be a prognostic marker for second-line treatment of DLBCL. In this series of the 35 evaluable cases, we did not evidence a prognostic impact of the cell of origin phenotype according to Hans' algorithm.…”

“…Eight cycles were planned if patients reached at least a partial response after four cycles. No dose adjustment was planned in the event of hematologic toxicity, but cycles were postponed until the absolute neutrophil count reached 1.0x10 9 /L and the platelet count reached 100x10 9 /L. The dose of oxaliplatin was adjusted in the event of peripheral neuropathy, as previously described.…”

How I treat elderly patients with diffuse large B-cell lymphoma

“…It has activity and is well tolerated in elderly patients, [64][65][66] but long-term results in patients with prior exposure to rituximab are not satisfactory. Therefore, whenever possible, I treat my elderly patients with relapsing DLBCL within prospective trials, which try to evaluate the role of new antibodies and small molecules in this setting.…”

Non-Hodgkin's Lymphomas

“…331 Rituximab with other regimens has also been effective in patients with relapsed or refractory DLBCL. [332][333][334][335][336][337][338] An international Intergroup study (CORAL study) compared R-ICE and DHAP (dexamethasone, cisplatin, and cytarabine; R-DHAP) followed by ASCR in patients with relapsed DLBCL. 339 No significant differences were seen in the 3-year eventfree (26% vs. 35%) and overall survival rates (47% vs. 51%) between R-ICE and R-DHAP.…”