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All-oral metronomic DEVEC schedule in elderly patients with peripheral T cell lymphoma

PURPOSE: Peripheral T cell lymphomas (PTCLs) have an overall poor prognosis. Indeed, registry data in elderly patients show that the median progression-free survival (mPFS) following first- and second-line therapies are only 6.7 and 3.1 months, respectively. The aim of the study is to show the activ...

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Autores principales: Cox, Maria Christina, Banchi, Marta, Pelliccia, Sabrina, Di Napoli, Arianna, Marcheselli, Luigi, Patti, Caterina, Anticoli Borza, Paola, Battistini, Roberta, Di Gregorio, Francesca, Orlandi, Paola, Bocci, Guido
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Berlin Heidelberg 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7568761/
https://www.ncbi.nlm.nih.gov/pubmed/33070248
http://dx.doi.org/10.1007/s00280-020-04172-3
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author Cox, Maria Christina
Banchi, Marta
Pelliccia, Sabrina
Di Napoli, Arianna
Marcheselli, Luigi
Patti, Caterina
Anticoli Borza, Paola
Battistini, Roberta
Di Gregorio, Francesca
Orlandi, Paola
Bocci, Guido
author_facet Cox, Maria Christina
Banchi, Marta
Pelliccia, Sabrina
Di Napoli, Arianna
Marcheselli, Luigi
Patti, Caterina
Anticoli Borza, Paola
Battistini, Roberta
Di Gregorio, Francesca
Orlandi, Paola
Bocci, Guido
author_sort Cox, Maria Christina
collection PubMed
description PURPOSE: Peripheral T cell lymphomas (PTCLs) have an overall poor prognosis. Indeed, registry data in elderly patients show that the median progression-free survival (mPFS) following first- and second-line therapies are only 6.7 and 3.1 months, respectively. The aim of the study is to show the activity of metronomic chemotherapy, a regular administration of low chemotherapeutic drug doses allowing a favourable toxicity profile, on elderly PTCL patients. METHODS: We report a series of 17 PTCL patients, treated with the all-oral metronomic schedule DEVEC (prednisolone–etoposide–vinorelbine–cyclophosphamide) in four Italian centres. Patients 5/17 (29.4%) were treatment-naïve (naïve) and 12/17 (70.6%) were relapsed-refractory (RR), respectively. The median age was 83 years (range 71–87) and 71.5 years (range 56–85) for naïve and RR, respectively. In vitro activity of metronomic vinorelbine (VNR), etoposide (ETO) and their concomitant combination on HH, a PTCL cell line, was also assessed. RESULTS: Histology: PTCL-not-otherwise-specified = 12; angioimmunoblastic = 2; NK/T nasal type = 1; adult-type leukaemia lymphoma = 1, transformed Mycosis Fungoides = 1. The overall response rate was 80 and 58% in naïve and RR, respectively; whereas the PFS was 20 in naïve (95% CI 0–43) and 11 months (95% CI 4.2–17.8) in RR. The occurrence of relevant adverse events was 23.5%, which was managed with ETO dose reduction. In vitro experiments showed that both metronomic VNR and ETO caused a significant inhibitory activity on HH cells and a strong synergism when administered concomitantly. CONCLUSION: All-oral DEVEC showed an encouraging activity and acceptable toxicity. This schedule deserves further studies in elderly PTCL also for assessing combinations with targeted drugs. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1007/s00280-020-04172-3) contains supplementary material, which is available to authorized users.
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spelling pubmed-75687612020-10-19 All-oral metronomic DEVEC schedule in elderly patients with peripheral T cell lymphoma Cox, Maria Christina Banchi, Marta Pelliccia, Sabrina Di Napoli, Arianna Marcheselli, Luigi Patti, Caterina Anticoli Borza, Paola Battistini, Roberta Di Gregorio, Francesca Orlandi, Paola Bocci, Guido Cancer Chemother Pharmacol Short Communication PURPOSE: Peripheral T cell lymphomas (PTCLs) have an overall poor prognosis. Indeed, registry data in elderly patients show that the median progression-free survival (mPFS) following first- and second-line therapies are only 6.7 and 3.1 months, respectively. The aim of the study is to show the activity of metronomic chemotherapy, a regular administration of low chemotherapeutic drug doses allowing a favourable toxicity profile, on elderly PTCL patients. METHODS: We report a series of 17 PTCL patients, treated with the all-oral metronomic schedule DEVEC (prednisolone–etoposide–vinorelbine–cyclophosphamide) in four Italian centres. Patients 5/17 (29.4%) were treatment-naïve (naïve) and 12/17 (70.6%) were relapsed-refractory (RR), respectively. The median age was 83 years (range 71–87) and 71.5 years (range 56–85) for naïve and RR, respectively. In vitro activity of metronomic vinorelbine (VNR), etoposide (ETO) and their concomitant combination on HH, a PTCL cell line, was also assessed. RESULTS: Histology: PTCL-not-otherwise-specified = 12; angioimmunoblastic = 2; NK/T nasal type = 1; adult-type leukaemia lymphoma = 1, transformed Mycosis Fungoides = 1. The overall response rate was 80 and 58% in naïve and RR, respectively; whereas the PFS was 20 in naïve (95% CI 0–43) and 11 months (95% CI 4.2–17.8) in RR. The occurrence of relevant adverse events was 23.5%, which was managed with ETO dose reduction. In vitro experiments showed that both metronomic VNR and ETO caused a significant inhibitory activity on HH cells and a strong synergism when administered concomitantly. CONCLUSION: All-oral DEVEC showed an encouraging activity and acceptable toxicity. This schedule deserves further studies in elderly PTCL also for assessing combinations with targeted drugs. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1007/s00280-020-04172-3) contains supplementary material, which is available to authorized users. Springer Berlin Heidelberg 2020-10-18 2020 /pmc/articles/PMC7568761/ /pubmed/33070248 http://dx.doi.org/10.1007/s00280-020-04172-3 Text en © Springer-Verlag GmbH Germany, part of Springer Nature 2020 This article is made available via the PMC Open Access Subset for unrestricted research re-use and secondary analysis in any form or by any means with acknowledgement of the original source. These permissions are granted for the duration of the World Health Organization (WHO) declaration of COVID-19 as a global pandemic.
spellingShingle Short Communication
Cox, Maria Christina
Banchi, Marta
Pelliccia, Sabrina
Di Napoli, Arianna
Marcheselli, Luigi
Patti, Caterina
Anticoli Borza, Paola
Battistini, Roberta
Di Gregorio, Francesca
Orlandi, Paola
Bocci, Guido
All-oral metronomic DEVEC schedule in elderly patients with peripheral T cell lymphoma
title All-oral metronomic DEVEC schedule in elderly patients with peripheral T cell lymphoma
title_full All-oral metronomic DEVEC schedule in elderly patients with peripheral T cell lymphoma
title_fullStr All-oral metronomic DEVEC schedule in elderly patients with peripheral T cell lymphoma
title_full_unstemmed All-oral metronomic DEVEC schedule in elderly patients with peripheral T cell lymphoma
title_short All-oral metronomic DEVEC schedule in elderly patients with peripheral T cell lymphoma
title_sort all-oral metronomic devec schedule in elderly patients with peripheral t cell lymphoma
topic Short Communication
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7568761/
https://www.ncbi.nlm.nih.gov/pubmed/33070248
http://dx.doi.org/10.1007/s00280-020-04172-3
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