Efficacy of vinorelbine, epirubicin and prednisone combination regimen in pretreated elderly patients with aggressive non-Hodgkin's lymphoma.
OBJECTIVE
To assess the efficacy and toxic profile of the NAEPP protocol, a regimen including vinorelbine, epirubicin and prednisone, in a particularly troublesome subset of patients: pretreated elderly patients with aggressive non-Hodgkin's lymphoma (NHL).


METHODS
From November 1998 to January 2000, 20 pretreated patients who had all relapsed after first-line VNCOP-B chemotherapy were enrolled in a phase II trial and treated with the NAEPP regimen: vinorelbine (25 mg/m(2) i.v. on days 1 and 8), epirubicin (40 mg/m(2) i.v. on days 1 and 8), and prednisone (40 mg/m(2) on days 1 and 8) with granulocyte colony-stimulating factor administered at 5 mg/kg/day on days 2-5 and days 9-12. Chemotherapy was repeated every 4 weeks for a total of 6 cycles.


RESULTS
Six (30%) patients achieved complete remission (CR) and 7 (35%) had partial responses (PR), giving an overall response rate of 65%. The response rate was not affected either by type of relapse presentation (nodal versus nodal plus extranodal), presence of bulky disease, or time of relapse. No major toxic effects were recorded.


CONCLUSIONS
These preliminary data suggest that the NAEPP regimen is an effective combination with a low toxicity profile in elderly pretreated patients with aggressive NHL. Further trials using NAEPP as a consolidation phase following first-line treatment are needed to establish the advantage in terms of CR rate and relapse-free survival in these patients.
Istituto di Ematologia e Oncologia Medica "Seràgnoli", Policlinico S.Orsola, via Massarenti 9, 40121 Bologna, Italy. plzinzo@med.unibo.it
P L
PL
Zinzani
M
M
Tani
V
V
Stefoni
P
P
Albertini
M
M
Bendandi
F
F
Gherlinzoni
L
L
Alinari
E
E
Vigna
S
S
Tura
D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000592:standards / Q000627:therapeutic use* / Q000633:toxicity; D015251:Epirubicin / Q000008:administration & dosage / Q000592:standards / Q000633:toxicity; D005260:Female; D006801:Humans; D008228:Lymphoma, Non-Hodgkin / Q000188:drug therapy*; D008297:Male; D011241:Prednisone / Q000008:administration & dosage / Q000592:standards / Q000633:toxicity; D013810:Therapeutic Equivalency; D016896:Treatment Outcome; D014747:Vinblastine / Q000008:administration & dosage / Q000031:analogs & derivatives / Q000592:standards / Q000633:toxicity; D000077235:Vinorelbine
D015251:Epirubicin; D014747:Vinblastine; D000077235:Vinorelbine; D011241:Prednisone