Sequential DICE combined with<scp>l</scp>-asparaginase chemotherapy followed by involved field radiation in newly diagnosed, stage IE to IIE, nasal and extranodal NK/T-cell lymphoma

Dong, Lihua; Zhang, Lijuan; Wang, Wenjia; Lei, Wen; Sun, Xiaofeng; Du, Jiang; Gao, Xue; Li, Gang-Ping; Li, Yufu

doi:10.3109/10428194.2015.1108415

Cited by 42 publications

(29 citation statements)

References 29 publications

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“…61 The ORR was 100%, with CR achieved These data show that with the use of effective chemotherapy, there is no difference between concomitant or sequential radiotherapy and chemotherapy. For most institutes, sequential chemotherapy and radiotherapy is logistically easier to arrange.…”

Section: Sequential Chemotherapy and Radiotherapymentioning

confidence: 84%

Diagnosis and management of extranodal NK/T cell lymphoma nasal type

Tse

Kwong

2016

Expert Review of Hematology

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The diagnosis and management of NK/T-cell lymphoma is discussed, based on a literature search on PubMed. NK/T-cell lymphoma are typically positive for CD3 (cytoplasmic), CD56, cytotoxic markers (granzyme B, TIA1) and Epstein Barr virus (EBV). Plasma EBV DNA is an accurate surrogate biomarker for lymphoma load. For stage I/II nasal lymphoma, a combination of chemotherapy and radiotherapy yields the best results. Concomitant chemoradiotherapy and sequential chemotherapy and radiotherapy give similar response rates and survivals. For stage III/IV nasal lymphoma and non-nasal lymphomas, chemotherapy is the mainstay of treatment. Conventional anthracycline-based regimens are ineffective. Recommended chemotherapy protocols are based on the use of L-asparaginase combined with other effective drugs. Durable remission can be expected in at least 60% of patients irrespective of stage. Prognostically models based on clinicopathologic parameters and EBV DNA load are useful in stratification of patients for therapy. Expert commentary: Current treatment leads to long-term survival in a significant proportion of patients. For relapsed patients, novel strategies are needed.

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Section: Sequential Chemotherapy and Radiotherapymentioning

confidence: 84%

Diagnosis and management of extranodal NK/T cell lymphoma nasal type

Tse

Kwong

2016

Expert Review of Hematology

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“…VIPD is an effective and well-tolerated treatment regimen for early-stage ENKTCL patients [8,22]. A phase II study consisting of 30 stage I/II ENKTCL patients demonstrated that 100% of patients achieved a response to VIPD chemotherapy, with 3-year PFS and OS rates of 85.19% and 86.28%, respectively [22].…”

Section: Discussionmentioning

confidence: 99%

Clinical Significance of Circulating Exosomal PD-L1 and Soluble PD-L1 in Nasal-type NK/T-cell Lymphoma Patients Receiving VIPD Containing Chemotherapy

Wei

Guo

et al. 2020

Preprint

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Background: Several studies showed that circulating exosomal PD-L1 was associated with immunosuppression and prognosis in cancer patients. However, its prognostic value in extranodal NK/T cell lymphoma (ENKTCL) was poorly understood.Methods: We retrospectively evaluated the prognostic value of pretreatment circulating PD-L1+ exosomes and soluble PD-L1 in the plasma of ENKTCL patients treated with VIPD-containing chemotherapy. Results: A total of 107 ENKTCL patients, including 101 early stage and 6 advanced stage patients were enrolled in our study. Most patients were middle-aged and young male adults, with a male to female ratio of approximately 3.7:1. The 5-year progression-free survival (PFS) and 5-year overall survival (OS) rates were 65.2% and 85.7% for the whole cohort, respectively. For early-stage patients, the L/P-VIPD group had better 5-year PFS than the VIPD group (73.6% vs. 53.7%, P=0.031). Compared with the healthy individuals (n=16), the patients with ENKTCL exhibited significantly elevated exoPD-L1 and sPD-L1 levels in the blood. Five-year PFS and OS rates were significantly lower in the high exoPD-L1 and sPD-L1 group than in the low exoPD-L1 and sPD-L1group. However, no correlation was found between circulating exoPD-L1 and sPD-L1 levels (P=0.12, r=0.45).Conclusions: Our results demonstrated that VIPD-containing chemotherapy combined with radiotherapy was a promising regimen in ENKTCL patients. Circulating exoPD-L1 and sPD-L1 levels were significantly elevated in ENKTCL and might be potential biomarkers for predicting the survival outcomes of ENKTCL patients.

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“…With a median follow-up of 63.2 months, the 5-year OS and PFS were 85 and 74% [72]. In a retrospective analysis, 33 patients with stage I/II disease were treated with 4 cycles of DICE-L-asp (dexamethasone, ifosfamide, cisplatinum, etoposide, and L-asparaginase), followed by radiotherapy as consolidation [73]. The ORR was 100%, with CR achieved in 90.9%.…”

Section: Introductionmentioning

confidence: 99%

The diagnosis and management of NK/T-cell lymphomas

2017

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Extranodal natural killer (NK)/T-cell lymphoma is an aggressive malignancy of putative NK-cell origin, with a minority deriving from the T-cell lineage. Pathologically, the malignancy occurs in two forms, extranodal NK/T-cell lymphoma, nasal type; and aggressive NK-cell leukaemia. Lymphoma occur most commonly (80%) in the nose and upper aerodigestive tract, less commonly (20%) in non-nasal areas (skin, gastrointestinal tract, testis, salivary gland), and rarely as disseminated disease with a leukemic phase. Genetic analysis showed mutations of genes involved in the JAK/STAT pathway, RNA assembly, epigenetic regulation, and tumor suppression. In initial clinical evaluation, positron emission tomography computed tomography, and quantification of plasma EBV DNA are mandatory as they are useful for response monitoring and prognostication. In stage I/II diseases, combined chemotherapy and radiotherapy (sequentially or concurrently) is the best approach. Conventional anthracycline-containing regimens are ineffective and should be replaced by non-anthracycline-containing regimens, preferably including L-asparaginase. Radiotherapy alone is associated with high systemic relapse rates and should be avoided. In stage III/IV diseases, non-anthracycline-regimens-containing L-asparaginase are the standard. In relapsed/refractory cases, blockade of the programmed death protein 1 has recently shown promising results with high response rates. In the era of effective non-anthracycline-containing regimens, autologous haematopoietic stem cell transplantation (HSCT) has not been shown to be beneficial. However, allogeneic HSCT may be considered for high-risk or advanced-stage patients in remission or relapsed/refractory patients responding to salvage therapy. Prognostic models taking into account presentation, interim, and end-of-treatment parameters are useful in triaging patients to different treatment strategies.

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Sequential DICE combined withl-asparaginase chemotherapy followed by involved field radiation in newly diagnosed, stage IE to IIE, nasal and extranodal NK/T-cell lymphoma

Cited by 42 publications

References 29 publications

Diagnosis and management of extranodal NK/T cell lymphoma nasal type

Diagnosis and management of extranodal NK/T cell lymphoma nasal type

Clinical Significance of Circulating Exosomal PD-L1 and Soluble PD-L1 in Nasal-type NK/T-cell Lymphoma Patients Receiving VIPD Containing Chemotherapy

The diagnosis and management of NK/T-cell lymphomas

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