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Results of a phase II study of vorinostat in combination with intravenous fludarabine, mitoxantrone, and dexamethasone in patients with relapsed or refractory mantle cell lymphoma: an interim analysis.
- Source :
-
Cancer chemotherapy and pharmacology [Cancer Chemother Pharmacol] 2016 Apr; Vol. 77 (4), pp. 865-73. Date of Electronic Publication: 2016 Mar 16. - Publication Year :
- 2016
-
Abstract
- Purpose: Mantle cell lymphoma (MCL) is a disease that frequently relapses and primarily affects elderly people. We performed an open-label, multi-center, phase II study to investigate the effect and quality of life (QoL) of treatment with vorinostat in combination with fludarabine, mitoxantrone and dexamethasone (V-FND) for relapsed or refractory MCL.<br />Methods: The treatment schedule was composed of four cycles of induction treatment with V-FND and subsequent consolidation therapy involving autologous hematopoietic stem cell transplantation or six cycles of vorinostat maintenance. QoL was assessed using EORTC Core Quality of Life questionnaire (EORTC QLQ-C30) every 2 cycles.<br />Results: Data from a total of 20 patients were collected for an interim analysis. The median age was 67 years (range 49-75), and 14 or the patients (70 %) were male. The full course of V-FND induction treatment was completed in 11 patients, but only three completed all six cycles of maintenance therapy. Response to V-FND was not available in two patients. Among the other 18 patients, the objective response rate was 77.8 % (complete response in five patients + partial response in nine patients). Median progression-free survival was 9.3 months [95 % confidence interval (CI) 4.0-12.3]. Fifteen patients (75 %) experienced grade 3/4 toxicities. Analysis of QoL demonstrated significant deterioration of social functioning (p = 0.01), and significant aggravation of fatigue and nausea/vomiting (p = 0.04 and 0.01, respectively) after two cycles of V-FND induction.<br />Conclusions: V-FND is effective in patients with relapsed or refractory MCL. However, significant toxicities were hurdles to sustained V-FND therapy.
- Subjects :
- Aged
Antineoplastic Combined Chemotherapy Protocols adverse effects
Dexamethasone administration & dosage
Female
Humans
Hydroxamic Acids administration & dosage
Infusions, Intravenous
Lymphoma, Mantle-Cell mortality
Lymphoma, Mantle-Cell psychology
Male
Middle Aged
Mitoxantrone administration & dosage
Quality of Life
Recurrence
Vidarabine administration & dosage
Vidarabine analogs & derivatives
Vorinostat
Antineoplastic Combined Chemotherapy Protocols therapeutic use
Lymphoma, Mantle-Cell drug therapy
Subjects
Details
- Language :
- English
- ISSN :
- 1432-0843
- Volume :
- 77
- Issue :
- 4
- Database :
- MEDLINE
- Journal :
- Cancer chemotherapy and pharmacology
- Publication Type :
- Academic Journal
- Accession number :
- 26984211
- Full Text :
- https://doi.org/10.1007/s00280-016-3005-y