Skip to main content
Erschienen in: Medical Oncology 1/2013

01.03.2013 | Original Paper

Promising long-term outcome of gemcitabine, vinorelbine, liposomal doxorubicin (GVD) in 14-day schedule as salvage regimen for patients with previously heavily treated Hodgkin’s lymphoma and aggressive non-Hodgkin’s lymphoma

verfasst von: Bing Bai, Hui-Qiang Huang, Qing-Qing Cai, Xiao-Xiao Wang, Qi-Chun Cai, Ze-Xiao Lin, Yan Gao, Yi Xia, Qing Bu, Ying Guo

Erschienen in: Medical Oncology | Ausgabe 1/2013

Einloggen, um Zugang zu erhalten

Abstract

The combination of gemcitabine (G), vinorelbine (V), and pegylated liposomal doxorubicin (D) has proved to be effective in relapsed Hodgkin’s lymphoma (HL). Its efficacy in non-Hodgkin’s lymphoma (NHL) remains to be discussed. We retrospectively evaluated the efficacy and toxicity of the dose-adjusted gemcitabine, vinorelbine, liposomal doxorubicin (GVD) in 14-day schedule in 35 heavily pretreated patients with relapsed and refractory aggressive NHL or HL. Treatment consisted of G: 800 mg/m2 intravenous (i.v.) on day 1, V: 15 mg/m2 i.v. on day 1; D: 20 mg/m2 i.v. on day 1, repeated for 14 days. Patients responded to GVD proceeded to subsequent autologous stem cell transplantation. The objective response rate (ORR) was 48.6 %, with 31.4 % complete remission. A higher ORR was observed in patients with HL than in patients with NHL (80.0 vs. 36.0 %, P = 0.023). With a median follow-up of 26 months, the estimated median progression-free survival and overall survival were 5 (range 1–73 months) and 36 months (range 2–73 months), respectively. The estimated 5-year survival rate was 44.6 % (95 % confidence interval 28.1–61.1 %). Toxicities were mild (grade 3/4 neutropenia 34.3 %, thrombocytopenia 5.7 %). Our results suggest that the dose-adjusted GVD in 14-day schedule is effective and well tolerated in patients with refractory and relapsed HL and aggressive NHL. The potential long-term survival in NHL is promising.
Literatur
1.
Zurück zum Zitat Brice P. Managing relapsed and refractory Hodgkin lymphoma. Br J Haematol. 2008;141(1):3–13.PubMedCrossRef Brice P. Managing relapsed and refractory Hodgkin lymphoma. Br J Haematol. 2008;141(1):3–13.PubMedCrossRef
2.
Zurück zum Zitat Appelbaum FR. Hematopoietic cell transplantation for non-Hodgkin’s lymphoma: yesterday, today, and tomorrow. J Clin Oncol. 2008;26(18):2927–9.PubMedCrossRef Appelbaum FR. Hematopoietic cell transplantation for non-Hodgkin’s lymphoma: yesterday, today, and tomorrow. J Clin Oncol. 2008;26(18):2927–9.PubMedCrossRef
3.
Zurück zum Zitat Bartlett NL, Niedzwiecki D, Johnson JL, et al. Gemcitabine, vinorelbine, and pegylated liposomal doxorubicin (GVD), a salvage regimen in relapsed Hodgkin’s lymphoma: CALGB 59804. Ann Oncol. 2007;18(6):1071–9.PubMedCrossRef Bartlett NL, Niedzwiecki D, Johnson JL, et al. Gemcitabine, vinorelbine, and pegylated liposomal doxorubicin (GVD), a salvage regimen in relapsed Hodgkin’s lymphoma: CALGB 59804. Ann Oncol. 2007;18(6):1071–9.PubMedCrossRef
4.
Zurück zum Zitat Cheson BD, Pfistner B, Juweid ME, et al. Revised response criteria for malignant lymphoma. J Clin Oncol. 2007;25(5):579–86.PubMedCrossRef Cheson BD, Pfistner B, Juweid ME, et al. Revised response criteria for malignant lymphoma. J Clin Oncol. 2007;25(5):579–86.PubMedCrossRef
5.
Zurück zum Zitat Lazarus HM, Loberiza FR Jr, Zhang MJ, et al. Autotransplants for Hodgkin’s disease in first relapse or second remission: a report from the autologous blood and marrow transplant registry (ABMTR). Bone Marrow Transplant. 2001;27(4):387–96.PubMedCrossRef Lazarus HM, Loberiza FR Jr, Zhang MJ, et al. Autotransplants for Hodgkin’s disease in first relapse or second remission: a report from the autologous blood and marrow transplant registry (ABMTR). Bone Marrow Transplant. 2001;27(4):387–96.PubMedCrossRef
6.
Zurück zum Zitat Sureda A, Constans M, Iriondo A, et al. Prognostic factors affecting long-term outcome after stem cell transplantation in Hodgkin’s lymphoma autografted after a first relapse. Ann Oncol. 2005;16(4):625–33.PubMedCrossRef Sureda A, Constans M, Iriondo A, et al. Prognostic factors affecting long-term outcome after stem cell transplantation in Hodgkin’s lymphoma autografted after a first relapse. Ann Oncol. 2005;16(4):625–33.PubMedCrossRef
7.
Zurück zum Zitat Brandwein JM, Callum J, Sutcliffe SB, et al. Evaluation of cytoreductive therapy prior to high dose treatment with autologous bone marrow transplantation in relapsed and refractory Hodgkin’s disease. Bone Marrow Transplant. 1990;5(2):99–103.PubMed Brandwein JM, Callum J, Sutcliffe SB, et al. Evaluation of cytoreductive therapy prior to high dose treatment with autologous bone marrow transplantation in relapsed and refractory Hodgkin’s disease. Bone Marrow Transplant. 1990;5(2):99–103.PubMed
8.
Zurück zum Zitat Schmitz N, Pfistner B, Sextro M, et al. Aggressive conventional chemotherapy compared with high-dose chemotherapy with autologous haemopoietic stem-cell transplantation for relapsed chemosensitive Hodgkin’s disease: a randomised trial. Lancet. 2002;359(9323):2065–71.PubMedCrossRef Schmitz N, Pfistner B, Sextro M, et al. Aggressive conventional chemotherapy compared with high-dose chemotherapy with autologous haemopoietic stem-cell transplantation for relapsed chemosensitive Hodgkin’s disease: a randomised trial. Lancet. 2002;359(9323):2065–71.PubMedCrossRef
9.
Zurück zum Zitat Velasquez WS, Cabanillas F, Salvador P, et al. Effective salvage therapy for lymphoma with cisplatin in combination with high-dose Ara-C and dexamethasone (DHAP). Blood. 1988;71(1):117–22.PubMed Velasquez WS, Cabanillas F, Salvador P, et al. Effective salvage therapy for lymphoma with cisplatin in combination with high-dose Ara-C and dexamethasone (DHAP). Blood. 1988;71(1):117–22.PubMed
10.
Zurück zum Zitat Moskowitz CH, Bertino JR, Glassman JR, et al. Ifosfamide, carboplatin, and etoposide: a highly effective cytoreduction and peripheral-blood progenitor-cell mobilization regimen for transplant-eligible patients with non-Hodgkin’s lymphoma. J Clin Oncol. 1999;17(12):3776–85.PubMed Moskowitz CH, Bertino JR, Glassman JR, et al. Ifosfamide, carboplatin, and etoposide: a highly effective cytoreduction and peripheral-blood progenitor-cell mobilization regimen for transplant-eligible patients with non-Hodgkin’s lymphoma. J Clin Oncol. 1999;17(12):3776–85.PubMed
11.
Zurück zum Zitat Velasquez WS, McLaughlin P, Tucker S, et al. ESHAP—an effective chemotherapy regimen in refractory and relapsing lymphoma: a 4-year follow-up study. J Clin Oncol. 1994;12(6):1169–76.PubMed Velasquez WS, McLaughlin P, Tucker S, et al. ESHAP—an effective chemotherapy regimen in refractory and relapsing lymphoma: a 4-year follow-up study. J Clin Oncol. 1994;12(6):1169–76.PubMed
12.
Zurück zum Zitat Rodriguez MA, Cabanillas FC, Hagemeister FB, et al. A phase II trial of mesna/ifosfamide, mitoxantrone and etoposide for refractory lymphomas. Ann Oncol. 1995;6(6):609–11.PubMed Rodriguez MA, Cabanillas FC, Hagemeister FB, et al. A phase II trial of mesna/ifosfamide, mitoxantrone and etoposide for refractory lymphomas. Ann Oncol. 1995;6(6):609–11.PubMed
13.
Zurück zum Zitat Baetz T, Belch A, Couban S, et al. Gemcitabine, dexamethasone and cisplatin is an active and non-toxic chemotherapy regimen in relapsed or refractory Hodgkin’s disease: a phase II study by the National Cancer Institute of Canada Clinical Trials Group. Ann Oncol. 2003;14(12):1762–7.PubMedCrossRef Baetz T, Belch A, Couban S, et al. Gemcitabine, dexamethasone and cisplatin is an active and non-toxic chemotherapy regimen in relapsed or refractory Hodgkin’s disease: a phase II study by the National Cancer Institute of Canada Clinical Trials Group. Ann Oncol. 2003;14(12):1762–7.PubMedCrossRef
14.
Zurück zum Zitat Fracasso PM, Blum KA, Tan BR, et al. Phase I study of pegylated liposomal doxorubicin and gemcitabine in patients with advanced malignancies. Cancer. 2002;95(10):2223–9.PubMedCrossRef Fracasso PM, Blum KA, Tan BR, et al. Phase I study of pegylated liposomal doxorubicin and gemcitabine in patients with advanced malignancies. Cancer. 2002;95(10):2223–9.PubMedCrossRef
15.
Zurück zum Zitat Gridelli C, Frontini L, Perrone F, et al. Gemcitabine plus vinorelbine in advanced non-small cell lung cancer: a phase II study of three different doses. Gem Vin Investig Br J Cancer. 2000;83(6):707–14.CrossRef Gridelli C, Frontini L, Perrone F, et al. Gemcitabine plus vinorelbine in advanced non-small cell lung cancer: a phase II study of three different doses. Gem Vin Investig Br J Cancer. 2000;83(6):707–14.CrossRef
16.
Zurück zum Zitat Gabizon AA. Pegylated liposomal doxorubicin: metamorphosis of an old drug into a new form of chemotherapy. Cancer Invest. 2001;19(4):424–36.PubMedCrossRef Gabizon AA. Pegylated liposomal doxorubicin: metamorphosis of an old drug into a new form of chemotherapy. Cancer Invest. 2001;19(4):424–36.PubMedCrossRef
17.
Zurück zum Zitat Orditura M, Quaglia F, Morgillo F, et al. Pegylated liposomal doxorubicin: pharmacologic and clinical evidence of potent antitumor activity with reduced anthracycline-induced cardiotoxicity (review). Oncol Rep. 2004;12(3):549–56.PubMed Orditura M, Quaglia F, Morgillo F, et al. Pegylated liposomal doxorubicin: pharmacologic and clinical evidence of potent antitumor activity with reduced anthracycline-induced cardiotoxicity (review). Oncol Rep. 2004;12(3):549–56.PubMed
18.
Zurück zum Zitat Martin A, Fernandez-Jimenez MC, Caballero MD, et al. Long-term follow-up in patients treated with mini-BEAM as salvage therapy for relapsed or refractory Hodgkin’s disease. Br J Haematol. 2001;113(1):161–71.PubMedCrossRef Martin A, Fernandez-Jimenez MC, Caballero MD, et al. Long-term follow-up in patients treated with mini-BEAM as salvage therapy for relapsed or refractory Hodgkin’s disease. Br J Haematol. 2001;113(1):161–71.PubMedCrossRef
19.
Zurück zum Zitat Philip T, Guglielmi C, Hagenbeek A, et al. Autologous bone marrow transplantation as compared with salvage chemotherapy in relapses of chemotherapy-sensitive non-Hodgkin’s lymphoma. N Engl J Med. 1995;333(23):1540–5.PubMedCrossRef Philip T, Guglielmi C, Hagenbeek A, et al. Autologous bone marrow transplantation as compared with salvage chemotherapy in relapses of chemotherapy-sensitive non-Hodgkin’s lymphoma. N Engl J Med. 1995;333(23):1540–5.PubMedCrossRef
Metadaten
Titel
Promising long-term outcome of gemcitabine, vinorelbine, liposomal doxorubicin (GVD) in 14-day schedule as salvage regimen for patients with previously heavily treated Hodgkin’s lymphoma and aggressive non-Hodgkin’s lymphoma
verfasst von
Bing Bai
Hui-Qiang Huang
Qing-Qing Cai
Xiao-Xiao Wang
Qi-Chun Cai
Ze-Xiao Lin
Yan Gao
Yi Xia
Qing Bu
Ying Guo
Publikationsdatum
01.03.2013
Verlag
Springer US
Erschienen in
Medical Oncology / Ausgabe 1/2013
Print ISSN: 1357-0560
Elektronische ISSN: 1559-131X
DOI
https://doi.org/10.1007/s12032-012-0350-5

Weitere Artikel der Ausgabe 1/2013

Medical Oncology 1/2013 Zur Ausgabe

Update Onkologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.