First-line non–anthracycline-based chemotherapy for extranodal nasal-type NK/T-cell lymphoma: a retrospective analysis from the CLCG

Qi, S.; Yang, Yong; Song, Yinggai; Wang, Ying; He, Xia; Hu, Chen; Zhang, L.; Wu, Gang; Qu, Baolin; Li, Qian; Hou, Xuwei; Zhang, Fu Quan; Qiao, X.Y.; Wang, Hua; Li, Gao Feng; Huang, Hui Qiang; Zhang, Yu Jing; Zhu, Yuan; Cao, Jian; Wu, Jun; Wu, Tao; Zhu, Shijun; Shi, Mei; Xu, Li; Yuan, Zhi Yong; Su, Hang; Zhu, Jun; Li, Ye Xiong

doi:10.1182/bloodadvances.2020001852

Cited by 40 publications

(52 citation statements)

References 52 publications

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“…17 out of 19 ANT-based regimens included CHOP (cyclophosphamide, doxorubicin, vincristine, and prednisolone). Whereas the mainly used non-ANT-based regimens were asparaginase (ASP)-containing regimens, including ASP/ANT based (8.3%), ASP/gemcitabine (GEM) based (48.6%), ASP/methotrexate based (9.2%) and ASP/not otherwise specified based (2.8%) regimens, followed by platinum or other-containing regimens (13.8%) 37 (Table S1).…”

Section: Resultsmentioning

confidence: 99%

VISTA and PD-L1 synergistically predict poor prognosis in patients with extranodal natural killer/T-cell lymphoma

Gao

et al. 2021

OncoImmunology

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Although PD-1/PD-L1 blockade therapy confers salutary effects across cancer types, their efficacy in Extranodal Natural killer/T-cell lymphoma (ENKTCL) patients is limited and unpredictable. Here, we comprehensively evaluated the expression profile of a panel of immune-regulatory makers to identify novel prognostic biomarkers and/or therapeutic targets for this malignancy. Using immunohistochemistry and multiplex immunofluorescence, we found that the expression of VISTA (88.1%) was predominantly in CD68+ macrophages and much higher than PD-L1 expression (68.7%) in ENKTCL. B7-H4 and HHLA2 proteins were not detected in ENKTCL. B7-H3 was expressed in minority of ENKTCL patients (13.7%) and mainly colocalized with CD31. A close correlation was detected between VISTA and PD-L1, but they were not co-expressed in the same cells. High expressions of VISTA or PD-L1 were significantly associated with detrimental clinicopathological characteristics, dismal prognosis, and high density of CD8+ TILs, and high VISTA expression was also significantly associated with high density of Foxp3+ TILs. VISTA combined with PD-L1 was an independent prognostic factor for PFS and OS. Moreover, the patients with high VISTA showed a poor response to PD-1 blockades in ENKTCL. In conclusion, these findings provide a rationale for VISTA as an ideal immunotherapeutic target next to PD-L1 for ENKTCL.

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Section: Resultsmentioning

confidence: 99%

VISTA and PD-L1 synergistically predict poor prognosis in patients with extranodal natural killer/T-cell lymphoma

Gao

et al. 2021

OncoImmunology

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“…This finding suggests PFS24 as a dichotomous variable, providing a clear benchmark for evaluating the success of initial treatment and for designing clinical trials for ENKTCL. The introduction of asparaginase-or platinum-based chemotherapy regimens and early implementation of highdose E-ISRT for localized disease have been the most important advances in the treatment of ENKTCL [11][12][13][14][15][16][17][18][19][20][21]31]. Although phase I/II trials or retrospective studies have reported improved survival with the use of non-ANT-based chemotherapy, the optimal chemotherapy regimens remain to be identified by prospective trials.…”

Section: Discussionmentioning

confidence: 99%

“…The introduction of asparaginase- or platinum-based chemotherapy regimens and early implementation of high-dose E-ISRT for localized disease have been the most important advances in the treatment of ENKTCL [ 11 – 21 , 31 ]. Although phase I/II trials or retrospective studies have reported improved survival with the use of non-ANT-based chemotherapy, the optimal chemotherapy regimens remain to be identified by prospective trials.…”

Section: Discussionmentioning

confidence: 99%

“…Patients diagnosed with ENKTCL between 2008 and 2016 were retrospectively reviewed using information from the China Lymphoma Collaborative Group (CLCG) database [5,9,13,21]. The eligibility criteria in this study included patients who had received non-ANT-based chemotherapy and/or radiotherapy.…”

Section: Eligibility Criteria and Study Populationmentioning

confidence: 99%

“…Extensive primary tumor invasion (PTI) is usually present, involving the upper aerodigestive tract (UADT) site, and extranodal failure is common [5][6][7]. Over the past decade, substantial treatment advances have been made with the introduction of novel prognostic models and risk stratifications [8][9][10], upfront radiotherapy [11][12][13][14], and non-anthracycline (ANT)-based chemotherapy [15][16][17][18][19][20][21]. The treatment outcome has improved, with 5-year overall survival (OS) rates of 60-90% reported for localized diseases, but only 10-40% for disseminated diseases [10,13,[22][23][24][25].…”

Section: Introductionmentioning

confidence: 99%

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Progression-free survival at 24 months and subsequent survival of patients with extranodal NK/T-cell lymphoma: a China Lymphoma Collaborative Group (CLCG) study

et al. 2020

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Limited evidence supports the use of early endpoints to evaluate the success of initial treatment of extranodal NK/T-cell lymphoma (ENKTCL) in the modern era. We aim to analyze progression-free survival at 24 months (PFS24) and subsequent overall survival (OS) in a large-scale multicenter cohort of patients. 1790 patients were included from the China Lymphoma Collaborative Group (CLCG) database. Subsequent OS was defined from the time of PFS24 or progression within 24 months to death. OS was compared with age- and sex-matched general Chinese population using expected survival and standardized mortality ratio (SMR). Patients who did not achieve PFS24 had a median OS of 5.3 months after progression, with 5-year OS rate of 19.2% and the SMR of 71.4 (95% CI, 62.9–81.1). In contrast, 74% patients achieved PFS24, and the SMR after achieving PFS24 was 1.77 (95% CI, 1.34–2.34). The observed OS rate after PFS24 versus expected OS rate at 5 years was 92.2% versus 94.3%. Similarly, superior outcomes following PFS24 were observed in early-stage patients (5-year OS rate, 92.9%). Patients achieving PFS24 had excellent outcome, whereas patients exhibiting earlier progression had a poor survival. These marked differences suggest that PFS24 may be used for study design and risk stratification in ENKTCL.

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Comparison of the clinical efficacies of two L‐asparaginase‐based chemotherapy regimens for newly diagnosed nasal‐type extranodal NK/T‐cell lymphoma

Ren

Chen

et al. 2023

Cancer Medicine

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Background Nasal‐type extranodal natural killer (NK)/T cell lymphoma (ENKTL) is a rare and aggressive type of lymphoma. The optimal chemotherapy regimen for ENKTL has not yet been established. In this study, we compared the LVDP (L‐asparaginase, etoposide, dexamethasone, and cisplatin) and GLIDE (gemcitabine, L‐asparaginase, ifosfamide, dexamethasone, and etoposide) chemotherapy regimens for the treatment of ENKTL. Methods A total of 267 patients with newly diagnosed ENKTL were included in this retrospective study. Propensity score matching (PSM) was used to adjust for confounders between the LVDP and GLIDE groups. Treatment responses, survival outcomes, and toxicities between the two groups were compared before and after PSM. Results At the end of therapy, the objective response rate (ORR) and complete response (CR) were 83.5% and 62.2%, respectively, for all patients. The ORR and CR were 85.5% and 62.2% for the LVDP group compared with 79.3% and 62.2% for the GLIDE group, respectively, and no differences between the two groups were found (ORR, p = 0.212; CR, p = 0.996). With a median 71 months follow‐up, the 5‐year progression‐free survival (PFS) and overall survival (OS) rates were 64.3% and 68.5%, respectively. The 5‐year PFS and OS were 65.6% and 70.1% for the LVDP group compared with 61.6% and 64.6% for the GLIDE group, respectively (PFS, p = 0.478; OS, p = 0162). After PSM, no significant differences in short‐term efficacy (ORR, p = 0.696; CR, p = 0.264) or long‐term efficacy (PFS, p = 0.794; OS, p = 0.867) between the two groups were identified. However, treatment‐related toxicities were milder in the LVDP group compared to the GLIDE group, even after adjusting for confounders via PSM. Conclusion In conclusion, both LVDP and GLIDE regimens are effective for the treatment of ENKTL. However, the LVDP regimen is safer than the GLIDE regimen, with milder treatment‐related toxicities. Therefore, the LVDP regimen could be a preferable option for patients with ENKTL.

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First-line non–anthracycline-based chemotherapy for extranodal nasal-type NK/T-cell lymphoma: a retrospective analysis from the CLCG

Cited by 40 publications

References 52 publications

VISTA and PD-L1 synergistically predict poor prognosis in patients with extranodal natural killer/T-cell lymphoma

VISTA and PD-L1 synergistically predict poor prognosis in patients with extranodal natural killer/T-cell lymphoma

Progression-free survival at 24 months and subsequent survival of patients with extranodal NK/T-cell lymphoma: a China Lymphoma Collaborative Group (CLCG) study

Comparison of the clinical efficacies of two L‐asparaginase‐based chemotherapy regimens for newly diagnosed nasal‐type extranodal NK/T‐cell lymphoma

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