Phase II study of ifosfamide, etoposide, and oxaliplatin (IFETOx) chemotherapy for relapsed or refractory non-Hodgkin’s lymphoma

Abstract

As part of an effort to develop a more effective and safe treatment for relapsed or refractory non-Hodgkin's lymphoma (NHL), we conducted a phase II study of the oxaliplatin, etoposide, and ifosfamide (IFETOx) regimen. Patients with relapsed or refractory NHL and a performance status of 0-2 were eligible. The IFETOx consisted of etoposide at 100 mg/m(2) on days 1-3, oxaliplatin at 130 mg/m(2) on day 2, and ifosfamide 5,000 mg/m(2) on day 2, every 21 days. The primary endpoint was the overall response rate (ORR) for IFETOx regimen. A total of 23 eligible patients were enrolled. The median age was 58 years (range 19-76 years), and the male-to-female ratio was 15:8. The disease status was as follows: 15 patients had relapsed and 8 patients were refractory to treatment. The ORR for IFETOx chemotherapy was 65.2 %. In the 15 patients who responded to the protocol treatment, five underwent hematopoietic stem cell transplantation. The 2-year probability of progression-free survival and overall survival rates were 51.4 and 56.1 %, respectively. Grade 3/4 neutropenia was observed in 73.9 % of the patients. No significant renal impairment was observed. In conclusion, IFETOx chemotherapy shows a tolerable toxicity profile and efficacy as a salvage treatment regimen for relapsed or refractory NHL.

Long‐term follow‐up of chemoimmunotherapy with rituximab, oxaliplatin, cytosine arabinoside, dexamethasone (ROAD) in patients with relapsed CD20+ B–cell non‐Hodgkin lymphoma: Results of a study of the Mayo Clinic Cancer Center Research Consortium (MCCRC) MC0485 now known as academic and community cancer research united (ACCRU)

“…The ORR was only 18% in patients with a relapse within 12 months of NHL diagnosis. There has been only one study that tested the ICE regimen substituting oxaliplatin for carboplatin finding an ORR of 65% (15/23) . No significant renal impairment was observed and patients were able to proceed to transplant.…”

“…There has been only one study that tested the ICE regimen substituting oxaliplatin for carboplatin finding an ORR of 65% (15/23). 15 No significant renal impairment was observed and patients were able to proceed to transplant. A phase 2 trial treated 46 patients with up to eight cycles of rituximab with gemcitabine and oxaliplatin.…”

The Nitrogen Mustards

“…The gemcitabine, ifosfamide, dexamethasone, and oxaliplatin (GIDOX) combination has been used in relapsed DLBCL or mantel cell lymphoma, with a CR of 15% and a PR of 37% (Park et al, 2011). A phase 2 study of ifosfamide, etoposide, and oxaliplatin in patients with relapsed or refractory NHL resulted in an OR of 65.2% and a 2-year OS of 56.1% (Kim et al, 2013b). Bendamustine combined with rituximab (BR) has also been used in patients with relapsed or refractory DLBCL, with a CR of 15.3% and a PR of 30.5% (Vacirca et al, 2014).…”