Abstract | BACKGROUND: METHODS: Patients with recurrent or refractory diffuse large B-cell NHL or variants (REAL classification), measurable disease, and one previous chemotherapy regimen were eligible. Treatment consisted of gemcitabine 1000 mg/m(2) intravenously (i.v.) on Days 1 and 8, dexamethasone 40 mg orally on Days 1-4, and cisplatin 75 mg/m(2) i.v. on Day 1 ( GDP), every 21 days as an outpatient. The primary end point was a response after two cycles. Patients could then proceed to stem cell transplantation (SCT) or receive up to six treatment cycles. RESULTS: Fifty-one eligible patients were evaluable for toxicity and response. The median age of the patients was 57 years (range, 18-84 years) and most had diffuse large-cell lymphoma. After 2 cycles, there were 8 complete responses (CR; 16%) and 17 partial responses (PR; 33%). There was an overall response rate (RR) of 49% (95% confidence interval = 37-63%). The RR afer completion of all protocol chemotherapy (including those who received > 2 cycles of GDP) was 53% (11 CR, 16 PR). Grade 3 and 4 neutropenia occurred in 33% and 39% of patients, respectively. Grade 3 and 4 thrombocytopenia occurred in 24% and 4% of patients, respectively. Seven patients (14%) experienced febrile neutropenia. Of the 35 patients < 66 years, 22 (63%) proceeded to SCT. CONCLUSIONS:
GDP is an active regimen in B-cell NHL and can be administered with acceptable toxicity to outpatients. A Phase III trial comparing GDP with standard cisplatin-based chemotherapy is now ongoing through the National Cancer Institute of Canada Clinical Trials Group.
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Authors | Michael Crump, Tara Baetz, Stephen Couban, Andrew Belch, Deborah Marcellus, Kang Howson-Jan, Kevin Imrie, Robert Myers, Grenfell Adams, Keyue Ding, Nancy Paul, Lois Shepherd, Jose Iglesias, Ralph Meyer |
Journal | Cancer
(Cancer)
Vol. 101
Issue 8
Pg. 1835-42
(Oct 15 2004)
ISSN: 0008-543X [Print] United States |
PMID | 15386331
(Publication Type: Clinical Trial, Clinical Trial, Phase II, Journal Article, Multicenter Study, Research Support, Non-U.S. Gov't)
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Chemical References |
- Deoxycytidine
- Dexamethasone
- Cisplatin
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Topics |
- Administration, Oral
- Adolescent
- Adult
- Aged
- Aged, 80 and over
- Antineoplastic Combined Chemotherapy Protocols
(therapeutic use)
- Cisplatin
(therapeutic use)
- Deoxycytidine
(analogs & derivatives, therapeutic use)
- Dexamethasone
(therapeutic use)
- Female
- Humans
- Infusions, Intravenous
- Lymphoma, Non-Hodgkin
(drug therapy)
- Male
- Middle Aged
- Neoplasm Recurrence, Local
(drug therapy)
- Salvage Therapy
- Stem Cell Transplantation
- Treatment Outcome
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