Efficacy of combined gemcitabine, oxaliplatin and pegaspargase (P-gemox regimen) in patients with newly diagnosed advanced-stage or relapsed/refractory extranodal NK/T-cell lymphoma.
Extranodal natural killer/T-cell lymphoma (ENKTL) is an aggressive neoplasm with a poor outcome. Asparaginase-based regimens are recommended for patients with advanced-stage or relapsed/refractory ENKTL. We retrospectively investigated the efficacy and toxicity of combined gemcitabine, oxaliplatin, and pegaspargase (P-gemox) in these patients. A total of 35 patients with newly diagnosed stage III-IV, relapsed or refractory ENKTL were treated with 2 to 8 cycles of P-gemox: gemcitabine (1250 mg/m2) and oxaliplatin (85 mg/m2) injected intravenously and pegaspargase (2500 IU/m2) injected intramuscularly on day 1 and repeated every 2 weeks. Upon completion of treatment, the overall response rate was 80.0%, with a complete response in 51.4% of patients. The 1-, 2- and 3- year progression-free survival rates were 45.0%, 38.6% and 38.6%, and overall survival rates were 76.8%, 64.7% and 64.7%, respectively. Patients who attained a complete response showed better progression-free survival than those without a complete response (p = 0.01). The major adverse effects were hematologic toxicity and liver dysfunction. Grade 3/4 leucopenia and neutropenia occurred in 40.0% of patients. No treatment-related deaths occurred. These results indicate the P-gemox regimen is a safe and effective treatment for patients with newly diagnosed advanced-stage or relapsed/refractory ENKTL. We anticipate future prospective trials will confirm the efficacy.
Department of Hematologic Oncology, Sun Yat-Sen University Cancer Center, Guangzhou, 510060, People's Republic of China.|State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, 510060, People's Republic of China.|Collaborative Innovation Center for Cancer Medicine, Guangzhou, 510060, People's Republic of China.
Jing-Hua
JH
Wang
Department of Hematologic Oncology, Sun Yat-Sen University Cancer Center, Guangzhou, 510060, People's Republic of China.|State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, 510060, People's Republic of China.|Collaborative Innovation Center for Cancer Medicine, Guangzhou, 510060, People's Republic of China.
Liang
L
Wang
Department of Hematologic Oncology, Sun Yat-Sen University Cancer Center, Guangzhou, 510060, People's Republic of China.|State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, 510060, People's Republic of China.|Collaborative Innovation Center for Cancer Medicine, Guangzhou, 510060, People's Republic of China.
Cheng-Cheng
CC
Liu
Department of Hematologic Oncology, Sun Yat-Sen University Cancer Center, Guangzhou, 510060, People's Republic of China.|State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, 510060, People's Republic of China.|Collaborative Innovation Center for Cancer Medicine, Guangzhou, 510060, People's Republic of China.
Zhong-Jun
ZJ
Xia
State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, 510060, People's Republic of China.|Collaborative Innovation Center for Cancer Medicine, Guangzhou, 510060, People's Republic of China.|Department of Medical Oncology, Sun Yat-Sen University Cancer Center, Guangzhou, 510060, People's Republic of China.
Hui-Qiang
HQ
Huang
State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, 510060, People's Republic of China.|Collaborative Innovation Center for Cancer Medicine, Guangzhou, 510060, People's Republic of China.|Department of Medical Oncology, Sun Yat-Sen University Cancer Center, Guangzhou, 510060, People's Republic of China.
Tong-Yu
TY
Lin
State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, 510060, People's Republic of China.|Collaborative Innovation Center for Cancer Medicine, Guangzhou, 510060, People's Republic of China.|Department of Medical Oncology, Sun Yat-Sen University Cancer Center, Guangzhou, 510060, People's Republic of China.
Wen-Qi
WQ
Jiang
Department of Hematologic Oncology, Sun Yat-Sen University Cancer Center, Guangzhou, 510060, People's Republic of China.|State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, 510060, People's Republic of China.|Collaborative Innovation Center for Cancer Medicine, Guangzhou, 510060, People's Republic of China.
Yue
Y
Lu
D000293:Adolescent; D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001215:Asparaginase / Q000008:administration & dosage / Q000009:adverse effects; D003841:Deoxycytidine / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D054391:Lymphoma, Extranodal NK-T-Cell / Q000188:drug therapy* / Q000401:mortality; D008297:Male; D008875:Middle Aged; D009944:Organoplatinum Compounds / Q000008:administration & dosage / Q000009:adverse effects; D000077150:Oxaliplatin; D011092:Polyethylene Glycols / Q000008:administration & dosage / Q000009:adverse effects; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult; D000093542:Gemcitabine
D009944:Organoplatinum Compounds; D000077150:Oxaliplatin; D003841:Deoxycytidine; D011092:Polyethylene Glycols; C042705:pegaspargase; D001215:Asparaginase; D000093542:Gemcitabine
adverse effects; extranodal NK/T-cell lymphoma; gemcitabine; oxaliplatin; pegaspargase