Therapy with gemcitabine in pretreated peripheral T-cell lymphoma patients

Zinzani, Pier Luigi; Magagnoli, Massimo; Bendandi, Maurizio; Orcioni, Giulio Fraternali; Gherlinzoni, Filíppo; Albertini, Patrizia; Pileri, Stefano; Tura, S

doi:10.1023/a:1008409601731

Cited by 110 publications

(58 citation statements)

References 9 publications

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“…Sallah et al reported an overall response rate of 60% with a 20% CR rate; our previous reports demonstrated a 70% overall response rate with a CR rate of 11%. 13,14 These findings led us to conclude that gemcitabine has the highest activity with acceptable toxicity in previously treated patients with CTCL. For this reason, we decided to use gemcitabine as the frontline treatment of CTCL to evaluate tumor response, as well as the safety and duration of response.…”

Section: Discussionmentioning

confidence: 96%

Gemcitabine as frontline treatment for cutaneous T‐cell lymphoma

Marchi

Alinari

Tani

et al. 2005

Cancer

143

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BACKGROUNDBased on the activity of gemcitabine in heavily pretreated patients with cutaneous T‐cell lymphoma (CTCL), the objective of the current study was to determine the role of gemcitabine in the treatment of patients with advanced, untreated CTCL.METHODSBetween June 2002 and February 2004, 32 untreated patients with mycosis fungoides (MF) (n = 26 patients); peripheral T‐cell lymphoma, unspecified (PTCLU) with exclusive skin involvement (n = 5 patients); and Sezary syndrome (SS) (n = 1 patient) were enrolled in a 7‐institution, Phase II trial and treated with gemcitabine. This drug was given on Days 1, 8, and 15 of a 28‐day schedule at a dose of 1200 mg/m2 intravenously over 30 minutes for a total of 6 cycles.RESULTSOf the 32 patients studied, 7 (22%) achieved a complete response (CR) and 17 (53%) achieved a partial response (PR), whereas the remaining 8 patients showed no benefit from the treatment. Five of the CRs were confirmed histologically. The CR and PR rates were found to be the same for patients with MF and PTCLU, respectively. The median duration of CR was 10 months (range, 4–22 mos). Treatment appeared to be well tolerated; hematologic toxicity was mild and no nausea/emesis or organ toxicity was noted.CONCLUSIONSThe results of the current Phase II study demonstrate the activity of gemcitabine as a single agent in untreated CTCL patients. Further studies using gemcitabine in combination, either contemporary or sequentially, with other drugs in patients with advanced stage, untreated CTCL are needed. Cancer 2005. © 2005 American Cancer Society.

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Section: Discussionmentioning

confidence: 96%

Gemcitabine as frontline treatment for cutaneous T‐cell lymphoma

Marchi

Alinari

Tani

et al. 2005

Cancer

143

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“…For example, overall response rates of 58-76% (and 41% complete response rate) have been observed in patients with MF/SS treated with low-dose, oral methotrexate [336][337][338][339]. In contrast, for patients with an adequate performance status, single-agent gemcitabine [340][341][342][343][344], pegylated liposomal doxorubicin [345][346][347][348] and pentostatin [349][350][351][352][353][354][355] are frequently utilized (Table VI). Gemcitabine, a pyrimidine nucleoside analog, is associated with overall and complete response rates of 50-70% and 10-20%, respectively, but is associated with neutropenia and nonhematologic toxicities [356].…”

Section: Systemic Chemotherapymentioning

confidence: 99%

Cutaneous T‐cell lymphoma: 2011 update on diagnosis, risk‐stratification, and management

Wilcox

2011

American J Hematol

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Disease overview: Cutaneous T‐cell lymphomas are a heterogenous group of T‐cell lymphoproliferative disorders involving the skin, the majority of which may be classified as Mycosis fungoides (MF) or Sézary syndrome (SS).Diagnosis: The diagnosis of MF or SS requires the integration of clinical and histopathologic data.Risk‐adapted therapy: Tumor, node, metastasis, and blood (TNMB) staging remains the most important prognostic factor in MF/SS and forms the basis for a “risk‐adapted,” multidisciplinary approach to treatment. For patients with disease limited to the skin, expectant management or skin‐directed therapies is preferred, as both disease‐specific and overall survival for these patients is favorable. In contrast, patients with advanced‐stage disease with significant nodal, visceral, or blood involvement are generally approached with biologic‐response modifiers, denileukin diftitox, and histone deacetylase inhibitors before escalating therapy to include systemic, single‐agent chemotherapy. Multiagent chemotherapy may be used for those patients with extensive visceral involvement requiring rapid disease control. In highly‐selected patients with disease refractory to standard treatments, allogeneic stem‐cell transplantation may be considered. Am. J. Hematol., 2011. © 2011 Wiley‐Liss, Inc.

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“…There is a need to evaluate novel treatment modalities to improve the OS and PFS in the treatment of PTCL. Agents previously investigated include gemcitabine, 12 pralatrexate, 13 allogeneic stem cell transplantation, 14 monoclonal antibodies such as brentuximab, 15 and the histone deacetylase inhibitors (HDACi). 16 …”

Section: Relapsed/refractory Diseasementioning

confidence: 99%

Critical appraisal of belinostat in the management of T-cell lymphoma – patient considerations

Bodiford¹,

Talbott²,

Reddy³

2015

BLCTT

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Abstract:The histone deacetylase inhibitor (HDACi), belinostat, is an emerging and novel therapeutic option for patients diagnosed with relapsed/refractory peripheral T-cell lymphoma (PTCL). The PTCLs are comprised of multiple subtypes that occur in less than one per 100,000 cases in the USA. The incidence of these malignancies is rare, thus limited evidence is available. The most appropriate treatment modality has not been established. The most current recommended option is combination chemotherapy or enrollment in a clinical trial. T-cell lymphomas have emerged as a disease with marked epigenetic dysregulation. HDACi are an innovative and emerging medication class gaining increased attention in the treatment of T-cell lymphomas. There is a need to evaluate their potential place in the treatment of patients diagnosed with PTCL. Currently, the largest study evaluating belinostat use in this patient population is the BELIEF study. The BELIEF study is a single-arm, Phase II clinical trial, evaluating the use of belinostat in patients with refractory or relapsed PTCL. The primary outcome, objective response rate, was 26%, with 11% achieving a complete response and 15% a partial response. This study presents a potential novel therapeutic option in the treatment of these patients. In this paper, we review therapeutic options for PTCL and present the recent data on the role of HDACi, specifically belinostat, in the treatment of patients with relapsed/refractory PTCL.

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Therapy with gemcitabine in pretreated peripheral T-cell lymphoma patients

Abstract: In view of its significant activity and its modest toxicity profile, the role of gemcitabine deserves further evaluation in the management of pretreated patients with peripheral T-cell lymphoma.

Cited by 110 publications

References 9 publications

Gemcitabine as frontline treatment for cutaneous T‐cell lymphoma

Gemcitabine as frontline treatment for cutaneous T‐cell lymphoma

Cutaneous T‐cell lymphoma: 2011 update on diagnosis, risk‐stratification, and management

Critical appraisal of belinostat in the management of T-cell lymphoma – patient considerations

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Therapy with gemcitabine in pretreated peripheral T-cell lymphoma patients

Abstract: In view of its significant activity and its modest toxicity profile, the role of gemcitabine deserves further evaluation in the management of pretreated patients with peripheral T-cell lymphoma.

Cited by 110 publications

References 9 publications

Gemcitabine as frontline treatment for cutaneous T‐cell lymphoma

Gemcitabine as frontline treatment for cutaneous T‐cell lymphoma

Cutaneous T‐cell lymphoma: 2011 update on diagnosis, risk‐stratification, and management

Critical appraisal of belinostat in the management of T-cell lymphoma &ndash; patient considerations

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Critical appraisal of belinostat in the management of T-cell lymphoma – patient considerations