Germann N, Brienza S, Rotarski M, Emile J F, Di Palma M, Musset M, Reynes M, Soulié P, Cvitkovic E, Misset J L
Fédération des Maladies Sanguines, Immunitaires et Tumorales, Hôpital Paul Brousse, Villejuif, France.
Ann Oncol. 1999 Mar;10(3):351-4. doi: 10.1023/a:1008310708853.
Many patients with advanced NHL ultimately relapse and require salvage treatment. Oxaliplatin, a diaminocyclohexane (DACH) platinum, has shown a differential spectrum of cytotoxicity with cisplatin, with activity in primary or secondary cisplatin-resistant solid tumors (colon and ovarian cancer). We report the tolerance/activity of this platinum derivate in previously-treated NHL patients.
From July 1988 to February 1994, 22 patients (11 men, 11 women) with recurrent NHL received single-agent oxaliplatin (100-130 mg/m2 i.v. over two hours with antiemetic premedication, q three weeks). All had been previously treated (median number of prior chemotherapy regimens 2, range 1-7) > or = 1 alkylating agent: 22 patients, anthracyclines: 18 patients, cisplatin: four patients, and radiation: 11 patients. Fourteen patients (63%) had progressive disease as best response to their last chemotherapy, and were considered treatment-refractory. All histologies were centrally reviewed in accord with the R.E.A.L. Classification; they were: eight follicular, five MCL, three diffuse large cell, two MALT, one lymphoplasmocytoid, and three other.
A total of 144 cycles were administered for a median number of 6 (range 1-30) per patient. The objective response rate was 40% (95%, CI: 21-64), including one CR (MCL) and eight PRs (four follicular, two MCL, two MALT). The median response duration was 27 months (range 5-44). Treatment-related toxicity was limited to grade 1-2 nausea/vomiting and reversible grade 1-2 peripheral neuropathy in most of the patients.
Oxaliplatin is an active agent in relapsed/refractory NHL, including the MCL type. Its safety profile makes this agent a good candidate for the development of combined salvage regimens. Further phase II studies are needed to confirm these preliminary results.
许多晚期非霍奇金淋巴瘤（NHL）患者最终会复发，需要进行挽救性治疗。奥沙利铂是一种二氨基环己烷（DACH）铂类药物，其细胞毒性谱与顺铂不同，对原发性或继发性顺铂耐药的实体瘤（结肠癌和卵巢癌）具有活性。我们报告了这种铂类衍生物在先前接受过治疗的NHL患者中的耐受性/活性。
从1988年7月至1994年2月，22例复发性NHL患者（11例男性，11例女性）接受单药奥沙利铂治疗（100 - 130mg/m²静脉滴注2小时，用药前给予止吐药，每3周一次）。所有患者均曾接受过治疗（既往化疗方案中位数为2，范围1 - 7）：≥1种烷化剂治疗：22例患者，蒽环类药物治疗：18例患者，顺铂治疗：4例患者，放疗：11例患者。14例患者（63%）对其最后一次化疗的最佳反应为疾病进展，被认为是治疗难治性患者。所有组织学类型均根据修订的欧美淋巴瘤（REAL）分类进行集中审核；具体如下：8例滤泡性淋巴瘤，5例套细胞淋巴瘤（MCL），3例弥漫大B细胞淋巴瘤，2例黏膜相关淋巴组织淋巴瘤（MALT），1例淋巴浆细胞样淋巴瘤，以及3例其他类型。
共进行了144个周期的治疗，每位患者的中位数为6个周期（范围1 - 30）。客观缓解率为40%（95%置信区间：21 - 64），包括1例完全缓解（CR，MCL）和8例部分缓解（PR，4例滤泡性淋巴瘤，2例MCL，2例MALT）。中位缓解持续时间为27个月（范围5 - 44）。治疗相关毒性在大多数患者中仅限于1 - 2级恶心/呕吐以及可逆的1 - 2级周围神经病变。
奥沙利铂在复发/难治性NHL中是一种活性药物，包括MCL类型。其安全性使其成为联合挽救方案开发的良好候选药物。需要进一步的II期研究来证实这些初步结果。
