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Limited efficacy of pixantrone in refractory diffuse large B-cell lymphoma

Relapsed or refractory diffuse large B-cell lymphoma (DLBCL) is an aggressive disease with poor outcomes in patients ineligible for autologous stem cell transplantation. In this setting, novel treatment approaches are urgently required and the innovative agent pixantrone has shown some promising res...

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Autores principales: Novakovic, Aleksander, Boltezar, Lucka, Novakovic, Barbara Jezersek
Formato: Online Artículo Texto
Lenguaje:English
Publicado: D.A. Spandidos 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7039066/
https://www.ncbi.nlm.nih.gov/pubmed/32194699
http://dx.doi.org/10.3892/ol.2020.11288
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author Novakovic, Aleksander
Boltezar, Lucka
Novakovic, Barbara Jezersek
author_facet Novakovic, Aleksander
Boltezar, Lucka
Novakovic, Barbara Jezersek
author_sort Novakovic, Aleksander
collection PubMed
description Relapsed or refractory diffuse large B-cell lymphoma (DLBCL) is an aggressive disease with poor outcomes in patients ineligible for autologous stem cell transplantation. In this setting, novel treatment approaches are urgently required and the innovative agent pixantrone has shown some promising results in terms of disease-free and overall survival (OS). The present study retrospectively analyzed 12 patients routinely treated with pixantrone in monotherapy or in combinations at the Institute of Oncology Ljubljana, Slovenia, between January 2016 and October 2018. All 12 patients had refractory lymphoma to last treatment and a large proportion of them had other high risk features (high proliferation index, high disease stage, high international prognostic index (IPI) score, high percentage of primary refractory disease and high percentage of refractoriness to anthracyclines) at initiation of pixantrone. All patients progressed during treatment and none of the patients were alive at the time of analysis due to progressive lymphoma. Pixantrone specific median OS was 3.5 months (range, 0.5–10 months). A somewhat superior median OS (P=0.065) was observed in patients primarily sensitive to anthracyclines. Pixantrone has shown only limited efficacy in the present real world study comparable to the results of another real world UK retrospective analysis and substantially worse than the efficacy observed in the PIX301 registration trial. Therefore, an appropriate selection of patients for this treatment is crucial. Despite the limited experience due to a small number of patients, it was recommended to consider only patients with relapsed (and not refractory) disease, patients with non-primary refractory disease and those with fewer lines of prior therapy.
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spelling pubmed-70390662020-03-19 Limited efficacy of pixantrone in refractory diffuse large B-cell lymphoma Novakovic, Aleksander Boltezar, Lucka Novakovic, Barbara Jezersek Oncol Lett Articles Relapsed or refractory diffuse large B-cell lymphoma (DLBCL) is an aggressive disease with poor outcomes in patients ineligible for autologous stem cell transplantation. In this setting, novel treatment approaches are urgently required and the innovative agent pixantrone has shown some promising results in terms of disease-free and overall survival (OS). The present study retrospectively analyzed 12 patients routinely treated with pixantrone in monotherapy or in combinations at the Institute of Oncology Ljubljana, Slovenia, between January 2016 and October 2018. All 12 patients had refractory lymphoma to last treatment and a large proportion of them had other high risk features (high proliferation index, high disease stage, high international prognostic index (IPI) score, high percentage of primary refractory disease and high percentage of refractoriness to anthracyclines) at initiation of pixantrone. All patients progressed during treatment and none of the patients were alive at the time of analysis due to progressive lymphoma. Pixantrone specific median OS was 3.5 months (range, 0.5–10 months). A somewhat superior median OS (P=0.065) was observed in patients primarily sensitive to anthracyclines. Pixantrone has shown only limited efficacy in the present real world study comparable to the results of another real world UK retrospective analysis and substantially worse than the efficacy observed in the PIX301 registration trial. Therefore, an appropriate selection of patients for this treatment is crucial. Despite the limited experience due to a small number of patients, it was recommended to consider only patients with relapsed (and not refractory) disease, patients with non-primary refractory disease and those with fewer lines of prior therapy. D.A. Spandidos 2020-03 2020-01-10 /pmc/articles/PMC7039066/ /pubmed/32194699 http://dx.doi.org/10.3892/ol.2020.11288 Text en Copyright: © Novakovic et al. This is an open access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, reproduction and adaptation in any medium and for any purpose provided that it is properly attributed. For attribution, the original author(s), title, publication source (PeerJ) and either DOI or URL of the article must be cited.
spellingShingle Articles
Novakovic, Aleksander
Boltezar, Lucka
Novakovic, Barbara Jezersek
Limited efficacy of pixantrone in refractory diffuse large B-cell lymphoma
title Limited efficacy of pixantrone in refractory diffuse large B-cell lymphoma
title_full Limited efficacy of pixantrone in refractory diffuse large B-cell lymphoma
title_fullStr Limited efficacy of pixantrone in refractory diffuse large B-cell lymphoma
title_full_unstemmed Limited efficacy of pixantrone in refractory diffuse large B-cell lymphoma
title_short Limited efficacy of pixantrone in refractory diffuse large B-cell lymphoma
title_sort limited efficacy of pixantrone in refractory diffuse large b-cell lymphoma
topic Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7039066/
https://www.ncbi.nlm.nih.gov/pubmed/32194699
http://dx.doi.org/10.3892/ol.2020.11288
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