Comparison of pixantrone-based regimen (CPOP-R) with doxorubicin-based therapy (CHOP-R) for treatment of diffuse large B-cell lymphoma

Herbrecht, Raoul; Cernohous, Paul; Engert, Andreas; Gouill, Steven Le; MacDonald, David; Machida, Chûji; Han, Mei; Saleh, Alfred; Singer, Jack W.; Wilhelm, Martin; Jagt, Richard van der

doi:10.1093/annonc/mdt289

Cited by 49 publications

(44 citation statements)

References 11 publications

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“…Later, Herbrecht et al [32] reported a randomized Phase II in an upfront setting where Pixantrone was combined with Cyclophosphamide, Vincristine and prednisolone (R-CPOP) and compared to standard R-CHOP. The CR rate (75 vs 84%) and duration was noninferior to R-CHOP.…”

Section: Combination Therapymentioning

confidence: 99%

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Pixantrone: a novel anthracycline-like drug for the treatment of non-Hodgkin lymphoma

Boyle

Morschhauser

2015

Expert Opinion on Drug Safety

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Section: Combination Therapymentioning

confidence: 99%

“…While Pixantrone cannot replace Doxorubicin in the upfront setting for all patients, the major reduction in cardiac side effects observed in the upfront trial [32] suggests this drug could offer an interesting alternative to Doxorubicin when anthracyclines are contra indicated. This is typically the case in the frail-elderly population.…”

Section: Expert Opinionmentioning

confidence: 99%

Pixantrone: a novel anthracycline-like drug for the treatment of non-Hodgkin lymphoma

Boyle

Morschhauser

2015

Expert Opinion on Drug Safety

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“…The problem of cardiotoxic agents in the treatment of comorbid patients with DLBCL is addressed by several recently published trials. The R-BL regimen might be an alternative treatment option, in addition to regimens with low-dose anthracyclines (Peyrade et al, 2011;Merli et al, 2012), regimens with less cardiotoxic agents, such as pixantrone, or the combination regimen with rituximab, cyclophosphamide, vincristine, gemcitabine and prednisone in patients with coexisting cardiac disease (Luminari et al, 2010;Herbrecht et al, 2013;Fields et al, 2014).…”

Section: Discussionmentioning

confidence: 99%

Rituximab, bendamustine and lenalidomide in patients with aggressive B‐cell lymphoma not eligible for anthracycline‐based therapy or intensive salvage chemotherapy – SAKK 38/08

et al. 2016

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An increasing number of older patients are suffering from aggressive lymphoma. Effective and more tolerable treatment regimens are urgently needed for this growing patient population. Patients with aggressive lymphoma not eligible for anthracycline-based first-line therapy or intensive salvage regimens were treated with the rituximab-bendamustine-lenalidomide (R-BL) regimen (rituximab 375 mg/m(2) day 1, bendamustine 70 mg/m(2) d 1, 2, lenalidomide 10 mg d 1-21) for six cycles every 4 weeks. Forty-one patients with a median age of 75 (range 40-94) years were enrolled: 33 patients had substantial co-morbidities. 13 patients were not eligible for anthracycline-based first-line chemotherapy, 28 patients had relapsed/refractory disease. The primary endpoint, overall response, was achieved by 25 (61%) patients (95% confidence interval 45-76%). Grade ≥ 3 toxicity comprised haematological (59%), skin (15%), constitutional (15%) and neurological (12%) events. 9 patients died during trial treatment: 5 from lymphoma progression, 2 from toxicity, 2 with sudden death. After a median follow-up of 25·9 (interquartile range 20·4-31·6) months, 13 patients were still alive. Median overall survival was 14·5 months. In conclusion, R-BL can be considered a treatment option for elderly patients with treatment naïve or relapsed/refractory aggressive lymphoma not eligible for standard aggressive regimens.

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“…Unfortunately, both of these drugs are approved for use only under limited conditions, and comprehensive clinical comparisons with DOX or other anthracyclines are limited [1]. Pixantrone was less cardiotoxic than DOX in a phase II study on patients with newly diagnosed non-Hodgkin lymphoma [29]. Pixantrone was also reasonably cardiac-tolerable in patients with refractory/relapsed non-Hodgkin lymphoma that had been previously treated with DOX [30].…”

Section: Primary Prevention Of Anthracycline Cardiotoxicitymentioning

confidence: 99%

Primary Prevention Strategies for Anthracycline Cardiotoxicity: A Brief Overview

Menna¹,

Salvatorelli

2017

Chemotherapy

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The clinical use of doxorubicin and other antitumor anthracyclines is limited by a dose-related risk of cardiomyopathy and heart failure which may occur “on treatment” or any time, from months to years, after completing chemotherapy. Dose reductions diminish the incidence of cardiac events attributable to anthracyclines, but heart failure still occurs in some patients exposed to low or moderate anthracycline doses. Because anthracyclines improve the life expectancy of patients with, for example, breast cancer or lymphomas, preventing or diminishing the risk of early or delayed cardiotoxicity is of obvious clinical importance. Here, we briefly review some potential strategies of primary prevention that are based on what we know about the molecular mechanisms of cardiotoxicity, and what can be done, or might be done, to interfere with the pharmacokinetic, pharmacodynamic, and genetic determinants of cardiotoxicity.

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Comparison of pixantrone-based regimen (CPOP-R) with doxorubicin-based therapy (CHOP-R) for treatment of diffuse large B-cell lymphoma

Abstract: CPOP-R is an active regimen with modestly lower response rates than CHOP-R but similar PFS and event-free survival. This study demonstrates a substantially lower cardiotoxicity of pixantrone compared with doxorubicin when used as first-line therapy in DLBCL.

Cited by 49 publications

References 11 publications

Pixantrone: a novel anthracycline-like drug for the treatment of non-Hodgkin lymphoma

Pixantrone: a novel anthracycline-like drug for the treatment of non-Hodgkin lymphoma

Rituximab, bendamustine and lenalidomide in patients with aggressive B‐cell lymphoma not eligible for anthracycline‐based therapy or intensive salvage chemotherapy – SAKK 38/08

Primary Prevention Strategies for Anthracycline Cardiotoxicity: A Brief Overview

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