P-VABEC: a prospective study of a new weekly chemotherapy regimen for elderly aggressive non-Hodgkin's lymphoma.

Martelli, Maurizio; Guglielmi, Cesare; Coluzzi, Serelina; Avvisati, Giuseppe; Amadori, Sergio; Giovannini, Marco; Torromeo, Concetta; Mandelli, Franco

doi:10.1200/jco.1993.11.12.2362

Cited by 64 publications

(13 citation statements)

References 23 publications

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“…Initiatives to improve cytotoxic delivery without compromising benefit have led investigators to develop weekly, multiagent chemotherapy regimens. [20][21][22][23]25,[36][37][38][39][40][41][42][43][44][45][46][47][48][49][50][51][52][53][54][55] Improvements in supportive care enable the delivery of chemotherapy at standard doses and intensity to deliver maximum benefit to patients. 56 The minimum age of entry of 60 was chosen because patients younger than this were eligible for high-dose regimens and because this age carried prognostic significance in the international prognostic index (IPI) analyses.…”

Section: Discussionmentioning

confidence: 99%

“…[14][15][16] During the 1980s, second-and third-generation combination chemotherapy regimens adapted for the elderly suggested similar outcomes with reduced toxicity in comparison to regimens for younger patients with similar histologies. [17][18][19][20][21][22][23][24][25] In the prednisolone, adriamycin, cyclophosphamide, etoposide, bleomycin, oncovin (vincristine), methotrexate (PACEBOM) alternating, weekly, combination chemotherapy regimen, the major toxicity problem was mucositis, which could be markedly reduced by the omission of methotrexate. 26 In this modified regimen, PAdriaCEBO, the greatest contributor to toxicity is adriamycin.…”

Section: Introductionmentioning

confidence: 99%

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Mitoxantrone is superior to doxorubicin in a multiagent weekly regimen for patients older than 60 with high-grade lymphoma: results of a BNLI randomized trial of PAdriaCEBO versus PMitCEBO

Mainwaring

Cunningham

Gregory

et al. 2001

Blood

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A prospective, multicenter, randomized trial was undertaken to compare the efficacy and toxicity of adriamycin with mitoxantrone within a 6-drug combination chemotherapy regimen for elderly patients (older than 60 years) with highgrade non-Hodgkin lymphoma (HGL) given for a minimum of 8 weeks. A total of 516 previously untreated patients aged older than 60 years were randomized to receive 1 of 2 anthracycline-containing regimens: adriamycin, 35 mg/m 2 intravenously (IV) on day 1 (n ‫؍‬ 259), or mitoxantrone, 7 mg/m 2 IV on day 1 (n ‫؍‬ 257); with prednisolone, 50 mg orally on days 1 to 14; cyclophosphamide, 300 mg/m 2 IV on day 1; etoposide, 150 mg/m 2 IV on day 1; vincristine, 1.4 mg/m 2 IV on day 8; and bleomycin, 10 mg/m 2 IV on day 8. Each 2-week cycle was administered for a minimum of 8 weeks in the absence of progression. Forty-three patients were ineligible for analysis. The overall and complete remission rates were 78% and 60% for patients receiving PMitCEBO and 69% and 52% for patients receiving PAdriaCEBO (P ‫؍‬ .05, P ‫؍‬ .12, respectively). Overall survival was significantly better with PMitCEBO than PAdriaCEBO (P ‫؍‬ .0067). However, relapse-free survival was not significantly different (P ‫؍‬ .16)

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Mitoxantrone is superior to doxorubicin in a multiagent weekly regimen for patients older than 60 with high-grade lymphoma: results of a BNLI randomized trial of PAdriaCEBO versus PMitCEBO

Mainwaring

Cunningham

Gregory

et al. 2001

Blood

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“…Grade III, IV toxicity was only reported for hematopoiesis (grade III and IV granulocytopenia and thrombocytopenia 12% each). Martelli et al [128] treated 60 chemonaive patients with the P-VAPEC protocol and reported a 75% CR rate, with no differences observed between patients treated for either 8 or 12 weeks. The 2-year overall survival was promising (64%), but currently awaits confirmation and comparison with, e.g.…”

Section: Pirarubicin (4)-o-tetrahydropyranyldoxorubicin Thpadriamycimentioning

confidence: 99%

Prognosis and Management Strategies of Lymphatic Neoplasias in the Elderly

Greil

1998

Oncology

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Lymphomas belong to the class of malignant diseases with the fastest increasing incidence. High-grade non-Hodgkin’s lymphomas (NHL) display a peak of incidence in the age group above 65. In the last few years, age has been recognized as a major risk factor for overall survival of high-grade NHL patients, and numerous attempts have been made to analyze the contribution of factors to the age-related worsening of prognosis in this disease, e.g. the biology of the disease on the one hand, and age-specific comorbidity or degree of cytotoxicity, reluctance in diagnosis and treatment and socioeconomic factors on the other. Furthermore, age-adapted treatment protocols have been designed and tested for their practicability and efficacy in the elderly. Very recently, large randomized prospective clinical trials have been carried out which support the idea that treatment with a curative intent is warranted even in the very elderly and that a successful attempt to cure requires the use of full-dose anthracycline-containing regimens closely similar to CHOP (cyclophosphamide, doxorubicin, vincristine, prednisone). In addition, progress has been made in systematically defining maximally tolerated doses of the cytotoxic drugs and in specifically testing anthracyclines with reduced cardiotoxicity with an efficacy similar to that of doxorubicin, and further in investigating the advantage of applying hematopoietic growth factors and/or cardioprotective drugs in this older population. In limited stages of disease, three cycles of CHOP chemotherapy followed by involved field irradiation may be superior to radiotherapy and prolonged chemotherapy and may produce highly satisfying cure rates.

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“…There were four treatment-related deaths. Martelli et al (26) evaluated the combination of doxorubicin, etoposide, cyclophosphamide, vincristine, bleomycin and prednisone (P-VABEC) in 60 elderly patients. The CR rate was 75% and the projected survival a t 2 years was 64%.…”

Section: Discussionmentioning

confidence: 99%