Rituximab, gemcitabine and oxaliplatin: An effective regimen in patients with refractory and relapsing mantle cell lymphoma

Abstract

Mantle cell lymphoma constitutes one of the lymphomas with poorest prognosis at relapse with limited effective salvage regimens due to advanced age. We present results of a new salvage regimen, rituximab, gemcitabine and oxaliplatin (GEMOX-R), in 14 patients with relapsing (n = 9) or refractory (n = 5) mantle cell lymphoma. The median number of cycles was 5.5 for a total of 72 cycles evaluated in the current study. The median age was 69.5 years with high-risk features. Patients received a mean number of prior treatment lines of 1.79. Sixty-four percent achieved CR (total response rate of 85%). With a median follow-up of 11 months, OS and PFS were 58% and 45% at 12 months. The major toxicity was thrombopenia grade III-IV (35%). Factors related with overall survival were ECOG performance status and a-IPI at GEMOX-R. We conclude that GEMOX-R displays an outstanding efficacy with an excellent toxicity profile in a pretreated elderly population.

Efficacy and safety of gemcitabine, carboplatin, dexamethasone, and rituximab in patients with relapsed/refractory lymphoma: a prospective multi-center phase II study by the Puget Sound Oncology Consortium

“…Similar efficacy with GDP was observed by this group in HL with overall responses occurring in 70% of patients16. Though this trial was designed at a time when there was little published data on the efficacy of oxaliplatin in lymphoma, others have since evaluated the combination of gemcitabine and oxaliplatin, also demonstrating clinical activity in MCL and DLBCL 20,34. Our data contribute to this overall literature as the first multi-center prospective study to evaluate the safety and efficacy of a gemcitabine-carboplatin combination across a variety of relapsed lymphoid histologies.…”

Lifting the mantle: Unveiling new treatment approaches in relapsed or refractory mantle cell lymphoma

“…There are few large studies evaluating the role of salvage chemotherapy programs in relapsed/refractory MCL. Generally, short median progression-free survival (PFS) of 5 to 12 months has been associated with salvage regimens including rituximab-fludarabinecyclophosphamide-mitoxantrone (R-FCM), rituximab-gemcitabineoxaliplatin (R-GemOx) and rituximab-dexamethasone-cytarabinecisplatin (R-DHAP) [33][34][35]. The largest of these studies examined the efficacy of R-FCM with or without rituximab maintenance in patients with relapsed/refractory mantle cell lymphoma.…”

Mantle cell lymphoma: Frontline and salvage therapy

“…As mentioned, established drugs such as nucleoside analogs have activity in MCL. Rodriguez et al [ 38 ] reported on GEMOX-R, a new salvage regimen in which 375 mg/m 2 of rituximab, 1000 mg/m 2 of gemcitabine, and 100 mg/m 2 of oxaliplatin were all given on day 1 every 2 to 3 weeks (most patients could not tolerate a 14-day schedule). Sixty-four percent of patients achieved CR (total response rate, 85%).…”