Long-term results of gemcitabine plus oxaliplatin with and without rituximab as salvage treatment for transplant-ineligible patients with refractory/relapsing B-cell lymphoma

Gaetano Corazzelli, Gaetana Capobianco, Manuela Arcamone, Pier Ferruccio Ballerini, Emilio Iannitto, Filippo Russo, Ferdinando Frigeri, Cristina Becchimanzi, Gianpaolo Marcacci, Annarosaria De Chiara, Antonio Pinto

Research output: Contribution to journalArticle

Abstract

Purpose: To determine the efficacy and safety of the combination of gemcitabine plus oxaliplatin, with and without rituximab, in patients with relapsed/refractory B-cell lymphoma unsuitable for high dose therapy. Methods: Patients were prospectively enrolled in two subsequent trials, GEMOX [gemcitabine (1200 mg/m2, days 1 and 8) and oxaliplatin (120 mg/m2, day 2), three-weekly] and R-GEMOX [rituximab (375 mg/m 2, day 1), gemcitabine (1200 mg/m2, day 1) and oxaliplatin (120 mg/m2, day 2), bi-weekly], up to six courses. Results: Sixty-two patients were enrolled: GEMOX [n = 30; median age, 66 years (range, 46-85); previous chemotherapy ≥2, 70%; PS ECOG ≥2, 57%]; R-GEMOX [n = 32; median age, 65 years (range 32-79); previous chemotherapy ≥2, 75%; PS ECOG ≥2, 47%]. Overall and complete response rates were 57 and 30% (95% CI, 15-49) for GEMOX and 78 and 50% (95% CI, 32-68) in R-GEMOX, respectively. Grade 3/4 neutropenia occurred in 57 and 47% of cycles and grade 3/4 thrombocytopenia in 26 and 17% of courses for GEMOX and R-GEMOX, respectively. At 42 months, the failure-free survival (FFS) was 7% (95% CI, 0-16) for GEMOX and 28% (95% CI, 9-47) for R-GEMOX (P = 0.014), with overall survivals of 7 (95% CI, 0-16) and 37% (95% CI, 20-55), respectively (P = 0.016). Conclusions: Both regimes showed good tolerability and appealing response rates. FFS was more prolonged in R-GEMOX, but patients continuously relapsed without a clear plateau on survival curves.

Original languageEnglish
Pages (from-to)907-916
Number of pages10
JournalCancer Chemotherapy and Pharmacology
Volume64
Issue number5
DOIs
Publication statusPublished - Oct 2009

Keywords

  • Gemcitabine
  • Non-Hodgkin lymphoma
  • Oxaliplatin
  • Rituximab
  • Salvage treatment

ASJC Scopus subject areas

  • Cancer Research
  • Oncology
  • Pharmacology
  • Pharmacology (medical)
  • Toxicology

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