Format

Send to

Choose Destination
See comment in PubMed Commons below
Br J Haematol. 2016 Feb;172(4):535-44. doi: 10.1111/bjh.13855. Epub 2015 Dec 2.

A phase II study of cyclophosphamide, etoposide, vincristine and prednisone (CEOP) Alternating with Pralatrexate (P) as front line therapy for patients with peripheral T-cell lymphoma (PTCL): final results from the T- cell consortium trial.

Author information

1
Medical Oncology, Stanford Cancer Institute, Stanford, CA, USA.
2
Division of Hematology, Mayo Clinic, Rochester, MN, USA.
3
Winship Cancer Institute, Emory University School of Medicine, Atlanta, GA, USA.
4
Medicine-Oncology, Duke University Medical Center, Durham, NC, USA.
5
Division of Hematology/Oncology, University of Nebraska Medical Center, Omaha, NE, USA.
6
Division of Medical Oncology, Washington University School of Medicine, St. Louis, MO, USA.
7
Division of Hematology/Oncology, Tufts Medical Center, Boston, MA, USA.
8
Yale University Cancer Center, New Haven, CT, USA.
9
Hematology/Oncology, Memorial Sloan-Kettering Cancer Center, New York, NY, USA.
10
Medical Oncology, Jefferson University Hospital, Philadelphia, PA, USA.
11
Hematology/Oncology, UCLA Geffen School of Medicine, Los Angeles, CA, USA.
12
Center for Advanced Medicine, University of Chicago, Chicago, IL, USA.
13
Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA.
14
Centre for Lymphoid Cancer and Department of Medical Oncology, British Columbia Cancer Agency, Vancouver, BC, Canada.

Abstract

Peripheral T-cell lymphomas (PTCL) have suboptimal outcomes using conventional CHOP (cyclophosphamide, doxorubicin, vincristine, prednisone) chemotherapy. The anti-folate pralatrexate, the first drug approved for patients with relapsed/refractory PTCL, provided a rationale to incorporate it into the front-line setting. This phase 2 study evaluated a novel front-line combination whereby cyclophosphamide, etoposide, vincristine and prednisone (CEOP) alternated with pralatrexate (CEOP-P) in PTCL. Patients achieving a complete or partial remission (CR/PR) were eligible for consolidative stem cell transplantation (SCT) after 4 cycles. Thirty-three stage II-IV PTCL patients were treated: 21 PTCL-not otherwise specified (64%), 8 angioimmunoblastic T cell lymphoma (24%) and 4 anaplastic large cell lymphoma (12%). The majority (61%) had stage IV disease and 46% were International Prognostic Index high/intermediate or high risk. Grade 3-4 toxicities included anaemia (27%), thrombocytopenia (12%), febrile neutropenia (18%), mucositis (18%), sepsis (15%), increased creatinine (12%) and liver transaminases (12%). Seventeen patients (52%) achieved a CR. The 2-year progression-free survival and overall survival, were 39% (95% confidence interval 21-57) and 60% (95% confidence interval 39-76), respectively. Fifteen patients (45%) (12 CR) received SCT and all remained in CR at a median follow-up of 21·5 months. CEOP-P did not improve outcomes compared to historical data using CHOP. Defining optimal front line therapy in PTCL continues to be a challenge and an unmet need.

KEYWORDS:

T-cell lymphoma; clinical trials; therapy

PMID:
26627450
DOI:
10.1111/bjh.13855
[Indexed for MEDLINE]
PubMed Commons home

PubMed Commons

0 comments
How to join PubMed Commons

    Supplemental Content

    Full text links

    Icon for Wiley
    Loading ...
    Support Center