Gemcitabine, vinorelbine, and pegylated liposomal doxorubicin (GVD), a salvage regimen in relapsed Hodgkin's lymphoma: CALGB 59804

Bartlett, Nancy L.; Niedzwiecki, Donna; Jl, Johnson; Friedberg, JW; Johnson, KB; Besien, Koen van; Ad, Zelenetz; Bd, Cheson; Gp, Canellos

doi:10.1093/annonc/mdm090

Cited by 248 publications

(155 citation statements)

References 25 publications

Supporting

Mentioning

144

Contrasting

Unclassified

Order By: Relevance

“…[26][27][28][29][30][31] Combination regimens (e.g., gemcitabine, vinorelbine, and pegylated liposomal doxorubicin) have shown somewhat higher response rates but have been associated with substantial toxic effects. 32 However, complete remissions are rare in patients with drug-refractory Hodgkin's lymphoma or systemic ALCL, especially in those treated with single agents.…”

Section: Discussionmentioning

confidence: 99%

Brentuximab Vedotin (SGN-35) for Relapsed CD30-Positive Lymphomas

et al. 2010

View full text Add to dashboard Cite

Section: Discussionmentioning

confidence: 99%

Brentuximab Vedotin (SGN-35) for Relapsed CD30-Positive Lymphomas

et al. 2010

View full text Add to dashboard Cite

“…Thus etoposide with high-dose cytarabine and cisplatinum -ESHAP, ICE, mini-BCNU or etoposide, cytosine arabinoside, and melphalan -BEAM, have been used. Recently gemcitabine-containing regimens have shown high response rates with an acceptable side-effect profile [72] and [73].…”

Section: Relapsementioning

confidence: 99%

Human immunodeficiency and Hodgkin lymphoma

Sissolak

Jacobs

2010

Transfusion and Apheresis Science

View full text Add to dashboard Cite

Presentation of Hodgkin lymphoma (HL) is distinctive in the infected individual being more advanced, accompanied by B symptoms and the presence of extranodal disease particularly lymphadenopathy of the head and neck. Bone marrow involvement may be found in over 50% of cases. Virtually all co express gamma-herpesvirus. Phenotypically there is prominence of the mixed-cellularity and lymphocyte depleted histopathologic subtypes that define an aggressive clinical course in comparison to other variants. Prior to the induction of cART, median survival was only 1-2 years. Notably the first chemotherapy trial using ABVD (doxorubicin, bleomycin, vinblastine, and dacarbazine) in 21 patients, without treating the viral infection, resulted in a 43% complete remission rate accompanied by severe haematological toxicities but did not extend median survival with this being 1.5 years matching the negative cases.Significant change accompanied concomitant anti-retroviral therapy that could be given safely even with dose intensive regimens exemplified by BEACOPP (bleomycin, etoposide, doxorubicin, cyclophosphamide, vincristine, procarbazine, and prednisone) in 12 patients or the Stanford V regimen (doxorubicin, vinblastine, mechlorethamine, etoposide, vincristine, bleomycin, prednisone) coupled with involved-field radiation for bulky disease studied in 59 patients. BEACOPP extended overall survival (OS) to 83% at 2 years. A similar trend was seen 1 when using the Stanford V regimen with an OS rate of 51% at 3 years, disease-free survival (DFS) of 68% and freedom from progression (FFP) in 60%. Additional benefits accrued from supportive care with stimulatory peptides such as G-CSF and when combined with bacterial prophylaxis results approached that found in the uninfected reference group. Current consensus holds this particular lymphoma as still among the non-AIDS defining cancers being lung, stomach, liver or anal despite these having recently gained more attention as several of these neoplasms may be occurring more commonly in the era of cART.While the relative risk of developing a non-AIDS-defining neoplasm in HIV-infected persons on the average is 2-3 times, the risk for developing HL in HIV-infected cases impressively ranges between 5 and 25 times when compared to the general population. Based on the precedent in which Kaposi sarcoma and the non-Hodgkin lymphomas distinctively alter the course of this retroviral infection in a way indistinguishable from concurrent Hodgkin lymphoma we propose that this entity be similarly regarded and the hypothesis tested in large randomised prospective study.

show abstract

“…The Cancer and Leukemia Group B (CALGB) 59804 study evaluated a gemcitabine-based regimen in 91 (40 had undergone prior auto-HCT) patients with relapsed/refractory HL. 13 The ORR was 70% (CR ¼ 19%). Median EFS was not reached in the transplant-naïve group, and it was 8.5 months in previously autografted patients.…”

Section: Salvage Therapies For Relapsed Hl After Auto-hctmentioning

confidence: 97%

“…Median EFS was not reached in the transplant-naïve group, and it was 8.5 months in previously autografted patients. 13 Notably in patients who relapsed after an auto-HCT, despite high response rates, the median EFS was shorter with disease progression accounting for most deaths. 14 Other promising gemcitabine-based combinations are summarized (Table 1).…”

Section: Salvage Therapies For Relapsed Hl After Auto-hctmentioning

confidence: 99%

Managing Hodgkin lymphoma relapsing after autologous hematopoietic cell transplantation: a not-so-good cancer after all!

Kharfan‐Dabaja

Hamadani

Sibai

et al. 2014

Bone Marrow Transplant

View full text Add to dashboard Cite

Hodgkin lymphoma (HL) relapsing after an autologous hematopoietic cell transplant (HCT) poses a therapeutic challenge. In this setting, salvage chemotherapy (for example, gemcitabine-based, ifosfamide-containing and others) or immunotherapy (for example, brentuximab vedotin) is essential as a bridging-cytoreduction strategy to an allogeneic HCT. Myeloablative allogeneic hematopoietic cell transplantation in relapsed HL is associated with high rates of non-relapse mortality. In carefully selected patients with chemosensitive disease, allografting following lower-intensity conditioning regimens can provide durable disease control rates of about 25-35%. Promising early results with haploidentical and umbilical cord transplantation are noteworthy and are expanding this procedure to patients for whom HLA-matched related or unrelated donors are not available. Unfortunately, a significant number of HL patients relapsing after an autologous HCT are not candidates for allografting because of the presence of resistant disease, donor unavailability or comorbidities. Brentuximab vedotin is approved for HL relapsing after a prior autograft. Rituximab and bendamustine are also active in this setting, albeit with short durations of remission. Histone deacetylase inhibitors (for example, panobinostat, mocetinostat), mTOR inhibitors (for example, everolimus) and immunomodulatory agents (lenalidomide) have shown activity in phase II trials, but currently are not approved for this indication. Second autologous HCT are rarely performed but this approach should not be considered standard practice at this time. The need for effective agents for post autograft failures of HL largely remains unmet. Continuous efforts to ensure early referral of such patients for allogeneic HCT or investigational therapies are the key to improving outcomes of this not-so-good lymphoma.

show abstract

Gemcitabine, vinorelbine, and pegylated liposomal doxorubicin (GVD), a salvage regimen in relapsed Hodgkin's lymphoma: CALGB 59804

Cited by 248 publications

References 25 publications

Brentuximab Vedotin (SGN-35) for Relapsed CD30-Positive Lymphomas

Brentuximab Vedotin (SGN-35) for Relapsed CD30-Positive Lymphomas

Human immunodeficiency and Hodgkin lymphoma

Managing Hodgkin lymphoma relapsing after autologous hematopoietic cell transplantation: a not-so-good cancer after all!

Contact Info

Product

Resources

About