Modified SMILE (mSMILE) is Active in the Treatment of Extranodal Natural Killer/T-Cell Lymphoma: A Single Center US Experience

Lunning, Matthew A.; Pamer, Eric G.; Maragulia, Jocelyn; Straus, David J.; Yahalom, Joachim; Moskowitz, Allison; Ad, Zelenetz; Horwitz, Steven M.

doi:10.1016/j.clml.2014.06.080

Cited by 5 publications

(1 citation statement)

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“…A large retrospective multicenter study analyzing sequential P-GEMOX (pegaspargase, gemcitabine and oxaliplatin) and radiotherapy for localized ENTKL, reported a complete response rate and objective response rate (ORR) of 83% and 96% with 3-year progression-free survival and overall survival of 75% and 85%, respectively, which was similar with historical cohorts; however, the incidences of severe hematological toxicities and radiation-induced mucositis were lower than reported for CCRT. Furthermore, a sequential modified SMILE (dexamethasone, methotrexate, ifosfamide, L-asparaginase, and etoposide) and radiotherapy [58], radiotherapy followed by GDP [59], P-GEMOX/GELOX (L-asparaginase plus gemcitabine and oxaliplatin) followed by radiotherapy [60], sequential DICEL (dexamethasone, ifosfamide, cisplatin, etoposide, and L-asparaginase) and radiotherapy [61], sequential DDGP (pegaspargase, gemcitabine, cisplatin and dexamethasone) and radiotherapy [62] were alternative therapeutic protocols. Efficacy and adverse events related to the regimens were listed in Table 2.…”

Section: For Patients With Early-stage Diseasementioning

confidence: 99%

EBV-associated NK and T-cell lymphoid neoplasms

Kimura

Leval

Cai

et al. 2022

Current Opinion in Oncology

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Purpose of reviewEpstein-Barr virus (EBV)-associated neoplasms derived from natural killer (NK) or T cells comprise a group of clinically and biologically heterogenous disorders affecting children and adults, which are overall rare but more prevalent in Asia and South America. This review focuses on neoplasms presenting in the adulthood, addressing recent genomic discoveries as well as therapeutic developments in these highly aggressive disorders. Recent findingsDistinct molecular subtypes of extranodal NK/T-cell lymphomas (ENKTCLs) have been described, with differences in cell of origin, EBV pattern, genomic alterations, clinical characteristics, response to asparaginase-based therapies and to more recent approaches targeting molecular aberrations of the lymphoma. For the last two decades, progress in the clinical management of ENKTCL was based on Lasapraginase containing combinations and the incoroperation of radiotherapy. A subset of cases with PDL1-2 structural alterations may be more responsive to treatment with immune checkpoint inhibitors. Primary nodal EBVþ lymphomas derived from T or NK cells have distinctive features separating them from both peripheral T-cell lymphoma not otherwise specified and ENKTCL. Treatment algorithms correspond to those for advanced ENKTCL.

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Section: For Patients With Early-stage Diseasementioning

confidence: 99%

EBV-associated NK and T-cell lymphoid neoplasms

Kimura

Leval

Cai

et al. 2022

Current Opinion in Oncology

View full text Add to dashboard Cite

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Sequential P‐GEMOX and radiotherapy for early‐stage extranodal natural killer/T‐cell lymphoma: A multicenter study

Zhang

Cai

et al. 2021

American J Hematol

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Extranodal natural killer/T‐cell lymphoma, nasal‐type (ENKTL) is a distinct subtype of non‐Hodgkin lymphoma and most of the patients presented localized disease. Combined modality therapy (CMT), namely chemotherapy combined with radiotherapy, has been recommended for patients with early‐stage ENKTL. However, the optimal CMT has not been fully clarified. This study reports the efficacy and toxicity of sequential P‐GEMOX (pegaspargase, gemcitabine and oxaliplatin) and radiotherapy in a large Chinese cohort comprising of 202 patients diagnosed with early‐stage ENKTL from six medical centers. The observed best overall response rate was 96.0% and 168 (83.2%) patients achieved complete remission. With a median follow‐up of 44.1 months, the 3‐year progression‐free survival (PFS) and overall survival (OS) were 74.6% and 85.2%, respectively. Multivariate analysis suggested that extensive primary tumor (PFS, hazard ratio [HR] 3.660, 95% CI 1.820–7.359, p < 0.001; OS, HR 3.825, 95% CI 1.442–10.148, p = 0.007) and Eastern Cooperative Oncology Group performance status ≥ 2 (PFS, 3.042, 95% CI 1.468–6.306, p = 0.003; OS, HR 3.983, 95% CI 1.678–9.457, p = 0.02) were independent prognostic factors for survival outcomes. Among the established prognostic models for ENKTL, the nomogram‐revised risk index model had optimal prognostic risk stratification ability (PFS, p < 0.001; OS, p < 0.001) and relatively balanced population distribution. The adverse events of this CMT were well‐tolerated and manageable. In conclusion, sequential P‐GEMOX and radiotherapy showed favorable efficacy with acceptable toxicity, and could be an effective treatment option for early‐stage ENKTL patients.

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