Efficacy of combined gemcitabine, oxaliplatin and pegaspargase (P-gemox regimen) in patients with newly diagnosed advanced-stage or relapsed/refractory extranodal NK/T-cell lymphoma
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Jing-hua Wang1,2,3,*, Liang Wang1,2,3,*, Cheng-cheng Liu1,2,3,*, Zhong-jun Xia1,2,3, Hui-qiang Huang2,3,4, Tong-yu Lin2,3,4, Wen-qi Jiang2,3,4, Yue Lu1,2,3
1Department of Hematologic Oncology, Sun Yat-Sen University Cancer Center, Guangzhou, 510060, People’s Republic of China
2State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, 510060, People’s Republic of China
3Collaborative Innovation Center for Cancer Medicine, Guangzhou, 510060, People’s Republic of China
4Department of Medical Oncology, Sun Yat-Sen University Cancer Center, Guangzhou, 510060, People’s Republic of China
*These authors contributed equally to this work
Yue Lu, email: [email protected]
Keywords: extranodal NK/T-cell lymphoma, gemcitabine, oxaliplatin, pegaspargase, adverse effects
Received: November 02, 2015 Accepted: March 18, 2016 Published: April 08, 2016
Extranodal natural killer/T-cell lymphoma (ENKTL) is an aggressive neoplasm with a poor outcome. Asparaginase-based regimens are recommended for patients with advanced-stage or relapsed/refractory ENKTL. We retrospectively investigated the efficacy and toxicity of combined gemcitabine, oxaliplatin, and pegaspargase (P-gemox) in these patients. A total of 35 patients with newly diagnosed stage III–IV, relapsed or refractory ENKTL were treated with 2 to 8 cycles of P-gemox: gemcitabine (1250 mg/m2) and oxaliplatin (85 mg/m2) injected intravenously and pegaspargase (2500 IU/m2) injected intramuscularly on day 1 and repeated every 2 weeks. Upon completion of treatment, the overall response rate was 80.0%, with a complete response in 51.4% of patients. The 1-, 2- and 3- year progression-free survival rates were 45.0%, 38.6% and 38.6%, and overall survival rates were 76.8%, 64.7% and 64.7%, respectively. Patients who attained a complete response showed better progression-free survival than those without a complete response (p = 0.01). The major adverse effects were hematologic toxicity and liver dysfunction. Grade 3/4 leucopenia and neutropenia occurred in 40.0% of patients. No treatment-related deaths occurred. These results indicate the P-gemox regimen is a safe and effective treatment for patients with newly diagnosed advanced-stage or relapsed/refractory ENKTL. We anticipate future prospective trials will confirm the efficacy.
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