The role of topoisomerase-I inhibitors in the treatment of non-Hodgkin's lymphoma.
First-line chemotherapy and/or radiotherapy can achieve disease-free survival in 30% to 75% of patients with non-Hodgkin's lymphomas (NHL), a diverse group of hematologic malignancies, depending on disease stage. However, as many as 50% of patients with advanced-stage NHL either do not achieve an Initial clinical response or subsequently relapse. Topotecan, a topoisomerase-I inhibitor, is considered a potential treatment for NHL. The efficacy of topotecan, alone and in combination with paclitaxel, in the treatment of patients with relapsed NHL has recently been Investigated. In a clinical study of topotecan as a single agent, patients with aggressive NHL who had received only 1 prior chemotherapy regimen had a 43% response rate, and similar patients with Indolent NHL had a 40% response rate. A combination of paclitaxel and topotecan has been shown to have efficacy in a phase 11 trial, with overall response rates of 27% in patients with primary refractory NHL and 72% in patients with relapsed NHL. Based on these promising early results, further Investigation of topotecan in the treatment of NHL is warranted.
Cabanillas
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Department of Lymphoma/Myeloma, M.D. Anderson Cancer Center, Houston, TX 77030, USA.
D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D004791:Enzyme Inhibitors / Q000627:therapeutic use; D006801:Humans; D008228:Lymphoma, Non-Hodgkin / Q000188:drug therapy*; D017239:Paclitaxel / Q000627:therapeutic use; D016879:Salvage Therapy; D059004:Topoisomerase I Inhibitors; D019772:Topotecan / Q000627:therapeutic use
D004791:Enzyme Inhibitors; D059004:Topoisomerase I Inhibitors; D019772:Topotecan; D017239:Paclitaxel