Abstract
Purpose: The pathogenic association between Chlamydophila psittaci (Cp) and ocular adnexal marginal zone lymphoma (OAMZL) and the efficacy of doxycycline monotherapy have been investigated in retrospective series with variations in stage, management, and follow-up duration. To our knowledge, this is the first international phase II trial aimed at clarifying Cp prevalence and activity of first-line doxycycline in a homogeneous series of consecutive patients with newly diagnosed stage I OAMZL. Patients and Methods: Forty-seven patients were registered. Tumor tissue, conjunctival swabs, and peripheral blood from 44 patients were assessed for seven Chlamydiaceae infections by three polymerase chain reaction protocols. Thirty-four patients with measurable or parametrable disease were treated with doxycycline and assessed for chlamydial eradication and lymphoma response (primary end point). Results: Cp DNA was detected in biopsies of 39 patients (89%); no other Chlamydiaceae were detected. Twenty-nine patients had Cp DNA in baseline swabs and/or blood samples and were evaluable for chlamydial eradication, which was achieved in 14 patients (48%). Lymphoma regression was complete in six patients and partial in 16 (overall response rate, 65%; 95% CI, 49% to 81%); 11 had stable disease, and one had progressive disease. At a median follow-up of 37 months (range, 15 to 62 months), 20 patients remained relapse free (5-year progression-free survival [PFS] ± standard deviation, 55% ± 9%). Cp eradication was associated with improved response rate (86% v 47%; P = .02) and 5-year PFS (68% v 47%; P = .11). Conclusion: Upfront doxycycline is a rational and active treatment for patients with stage I Cp-positive OAMZL. Lymphoma regression is consequent to Cp eradication, which can easily be monitored on conjunctival and blood samples. Prospective trials aimed at identifying more effective administration schedules for doxycycline are warranted.
| Original language | English |
|---|---|
| Pages (from-to) | 2988-2994 |
| Number of pages | 7 |
| Journal | Journal of Clinical Oncology |
| Volume | 30 |
| Issue number | 24 |
| DOIs | |
| Publication status | Published - Aug 20 2012 |
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ASJC Scopus subject areas
- Cancer Research
- Oncology
Cite this
Chlamydophila Psittaci eradication with doxycycline as first-line targeted therapy for ocular adnexae lymphoma : Final results of an international phase II trial. / Ferreri, Andrés J M; Govi, Silvia; Pasini, Elisa; Mappa, Silvia; Bertoni, Francesco; Zaja, Francesco; Montalbán, Carlos; Stelitano, Caterina; Cabrera, Maria Elena; Resti, Antonio Giordano; Politi, Letterio Salvatore; Doglioni, Claudio; Cavalli, Franco; Zucca, Emanuele; Ponzoni, Maurilio; Dolcetti, Riccardo.
In: Journal of Clinical Oncology, Vol. 30, No. 24, 20.08.2012, p. 2988-2994.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Chlamydophila Psittaci eradication with doxycycline as first-line targeted therapy for ocular adnexae lymphoma
T2 - Final results of an international phase II trial
AU - Ferreri, Andrés J M
AU - Govi, Silvia
AU - Pasini, Elisa
AU - Mappa, Silvia
AU - Bertoni, Francesco
AU - Zaja, Francesco
AU - Montalbán, Carlos
AU - Stelitano, Caterina
AU - Cabrera, Maria Elena
AU - Resti, Antonio Giordano
AU - Politi, Letterio Salvatore
AU - Doglioni, Claudio
AU - Cavalli, Franco
AU - Zucca, Emanuele
AU - Ponzoni, Maurilio
AU - Dolcetti, Riccardo
PY - 2012/8/20
Y1 - 2012/8/20
N2 - Purpose: The pathogenic association between Chlamydophila psittaci (Cp) and ocular adnexal marginal zone lymphoma (OAMZL) and the efficacy of doxycycline monotherapy have been investigated in retrospective series with variations in stage, management, and follow-up duration. To our knowledge, this is the first international phase II trial aimed at clarifying Cp prevalence and activity of first-line doxycycline in a homogeneous series of consecutive patients with newly diagnosed stage I OAMZL. Patients and Methods: Forty-seven patients were registered. Tumor tissue, conjunctival swabs, and peripheral blood from 44 patients were assessed for seven Chlamydiaceae infections by three polymerase chain reaction protocols. Thirty-four patients with measurable or parametrable disease were treated with doxycycline and assessed for chlamydial eradication and lymphoma response (primary end point). Results: Cp DNA was detected in biopsies of 39 patients (89%); no other Chlamydiaceae were detected. Twenty-nine patients had Cp DNA in baseline swabs and/or blood samples and were evaluable for chlamydial eradication, which was achieved in 14 patients (48%). Lymphoma regression was complete in six patients and partial in 16 (overall response rate, 65%; 95% CI, 49% to 81%); 11 had stable disease, and one had progressive disease. At a median follow-up of 37 months (range, 15 to 62 months), 20 patients remained relapse free (5-year progression-free survival [PFS] ± standard deviation, 55% ± 9%). Cp eradication was associated with improved response rate (86% v 47%; P = .02) and 5-year PFS (68% v 47%; P = .11). Conclusion: Upfront doxycycline is a rational and active treatment for patients with stage I Cp-positive OAMZL. Lymphoma regression is consequent to Cp eradication, which can easily be monitored on conjunctival and blood samples. Prospective trials aimed at identifying more effective administration schedules for doxycycline are warranted.
AB - Purpose: The pathogenic association between Chlamydophila psittaci (Cp) and ocular adnexal marginal zone lymphoma (OAMZL) and the efficacy of doxycycline monotherapy have been investigated in retrospective series with variations in stage, management, and follow-up duration. To our knowledge, this is the first international phase II trial aimed at clarifying Cp prevalence and activity of first-line doxycycline in a homogeneous series of consecutive patients with newly diagnosed stage I OAMZL. Patients and Methods: Forty-seven patients were registered. Tumor tissue, conjunctival swabs, and peripheral blood from 44 patients were assessed for seven Chlamydiaceae infections by three polymerase chain reaction protocols. Thirty-four patients with measurable or parametrable disease were treated with doxycycline and assessed for chlamydial eradication and lymphoma response (primary end point). Results: Cp DNA was detected in biopsies of 39 patients (89%); no other Chlamydiaceae were detected. Twenty-nine patients had Cp DNA in baseline swabs and/or blood samples and were evaluable for chlamydial eradication, which was achieved in 14 patients (48%). Lymphoma regression was complete in six patients and partial in 16 (overall response rate, 65%; 95% CI, 49% to 81%); 11 had stable disease, and one had progressive disease. At a median follow-up of 37 months (range, 15 to 62 months), 20 patients remained relapse free (5-year progression-free survival [PFS] ± standard deviation, 55% ± 9%). Cp eradication was associated with improved response rate (86% v 47%; P = .02) and 5-year PFS (68% v 47%; P = .11). Conclusion: Upfront doxycycline is a rational and active treatment for patients with stage I Cp-positive OAMZL. Lymphoma regression is consequent to Cp eradication, which can easily be monitored on conjunctival and blood samples. Prospective trials aimed at identifying more effective administration schedules for doxycycline are warranted.
UR - http://www.scopus.com/inward/record.url?scp=84865190328&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84865190328&partnerID=8YFLogxK
U2 - 10.1200/JCO.2011.41.4466
DO - 10.1200/JCO.2011.41.4466
M3 - Article
C2 - 22802315
AN - SCOPUS:84865190328
VL - 30
SP - 2988
EP - 2994
JO - Journal of Clinical Oncology
JF - Journal of Clinical Oncology
SN - 0732-183X
IS - 24
ER -