- Volume 15 Issue 11
DOI QR Code
Fotemustine, Teniposide and Dexamethasone in Treating Patients with CNS Lymphoma
- Wu, Jing-Jing (Institute of Clinical Medicine,The First Affiliated Hospital of Zhengzhou University) ;
- Wang, Xin-Hua (Institute of Clinical Medicine,The First Affiliated Hospital of Zhengzhou University) ;
- Li, Ling (Institute of Clinical Medicine,The First Affiliated Hospital of Zhengzhou University) ;
- Li, Xin (Institute of Clinical Medicine,The First Affiliated Hospital of Zhengzhou University) ;
- Zhang, Lei (Institute of Clinical Medicine,The First Affiliated Hospital of Zhengzhou University) ;
- Sun, Zhen-Chang (Institute of Clinical Medicine,The First Affiliated Hospital of Zhengzhou University) ;
- Fu, Xiao-Rui (Institute of Clinical Medicine,The First Affiliated Hospital of Zhengzhou University) ;
- Ma, Wang (Institute of Clinical Medicine,The First Affiliated Hospital of Zhengzhou University) ;
- Chang, Yu (Institute of Clinical Medicine,The First Affiliated Hospital of Zhengzhou University) ;
- Zhang, Xu-Dong (Institute of Clinical Medicine,The First Affiliated Hospital of Zhengzhou University) ;
- Han, Li-Juan (Institute of Clinical Medicine,The First Affiliated Hospital of Zhengzhou University) ;
- Zhang, Ming-Zhi (Institute of Clinical Medicine,The First Affiliated Hospital of Zhengzhou University)
- Published : 2014.06.15
Purpose: We developed and evaluated a regimen including fotemustine, teniposide and dexamethasone (FTD) for treating patients with central nervous system (CNS) lymphoma based on pharmacokinetic properties of individual agents and in combination. Patients and Methods: In a comparison study, 8 patients with primary CNS lymphoma (PCNSL) and 8 with secondary CNS lymphoma (SCNSL) were treated with FTD (comprising fotemustine 100 mg/m2, 1h infusion, day 1; teniposide 60 mg/m2, >0.5 h infusion, on day 2, 3, 4; dexamethasone 40 mg, 1h infusion, on day 1, 2, 3, 4 and 5; and methotrexate 12 mg, cytosine arabinoside 50 mg plus dexamethasone 5 mg intrathecally, on day 2 and 7). Cycles were repeated every 3 weeks. After response assessment, patients received whole brain radiotherapy. Results: Of the 8 PCNSL patients, 4 (50%) achieved CR and 3 (38%) PR, an overall response rate of 88%. Four patients (50%) were in continuing remission at the end of this study after a median follow-up of 30 months (range 10 to 56 months). Of the 8 SCNSL patients the overall response rate was 63% (CR+PR: 38%+25%). All responses were achievable with predictable toxicity mainly reflecting reversible myelosuppression. Conclusion: This study suggests that FTD could be an effective treatment for CNS lymphoma, and is worthy of further evaluation.
Supported by : Natural Science Foundation of China
- Abrey L, DeAngelis LE (2005). CNS lymphomas. Hematal Oncol Clin North Am, 14, 729-38.
- Abrey LE, Yahalom J, DeAngelis LM (2000). Treatment for primary CNS lymphoma: the next step. J Clin Oncol, 18, 3144-50.
- Andres J. M. Ferreri (2011). How I treat primary CNS lymphoma. Blood, 118, 510-22. https://doi.org/10.1182/blood-2011-03-321349
- Boehme V, Schmitz N, Zeynalova S, et al (2009). CNS events in elderly patients with aggressive lymphoma treated with modern chemotherapy (CHOP-14) with or without rituximab: an analysis of patients treated in the RICOVER-60 trial of the German High-Grade Non-Hodgkin Lymphoma Study Group (DSHNHL). Blood, 113, 3896-902. https://doi.org/10.1182/blood-2008-10-182253
- Batchelor T, Carson K, O'Neill A, et al (2003). Treatment of primary CNS lymphoma with methotrexate and deferred radiotherapy: a report of NABTT 96-07. J Clin Oncol, 21, 1044-9. https://doi.org/10.1200/JCO.2003.03.036
- Bierman P, Giglio P (2005). Diagnosis and treatment of central nervous system involvement in non-Hodgkin's lymphoma. Hematol Oncol Clin North Am, 19, 597-609. https://doi.org/10.1016/j.hoc.2005.05.003
- Boehme V, Zeynalova S, Kloess M, et al (2007). Incidence and risk factors of central nervous system recurrence in aggressive lymphoma--a survey of 1693 patients treated in protocols of the German High-Grade Non-Hodgkin's Lymphoma Study Group (DSHNHL). Ann Oncol, 18, 149-57.
- Chen TE (2006). Primary CNS lymphoma. Neurosurg Focus, 5, 21.
- DeAngelis LM, Seiferheld W, Schold SC, et al (2002). Combination chemotherapy and radiotherapy for primary central nervous system lymphoma: Radiation Therapy Oncology Group Study 93-10. J Clin Oncol, 20, 4643-8. https://doi.org/10.1200/JCO.2002.11.013
- FerreriAJ, Abrey LE, Blay JY, et al (2003). Summary statement on primary central nervous system lymphomas from the eighth international conference on malignant lymphoma, J Clin Oncol, 21, 2407-14. https://doi.org/10.1200/JCO.2003.01.135
- FerreriAJ, ReniM, ZoldanMC, et al (1996). Importance of complete staging in nonhodgkin's lymphoma presenting as a cerebral mass lesion. Cancer, 77, 827-33. https://doi.org/10.1002/(SICI)1097-0142(19960301)77:5<827::AID-CNCR4>3.0.CO;2-B
- FerreriAJ, Blay JY, Reni M, et al (2003). Prognostic scoring system for primary CNS lymphomas: the international extranodal lymphoma study group experience. J Clin Oncol, 21, 266-72. https://doi.org/10.1200/JCO.2003.09.139
- Jin J, Cai L, Liu ZM, et al (2013). miRNA-218 inhibits osteosarcoma cell migration and invasion by down-regulating of TIAM1, MMP2 and MMP9. Asian Pac J Cancer Prev, 14, 3681-4. https://doi.org/10.7314/APJCP.2013.14.6.3681
- G Vassal, I Boland, M J Terrier-Lacombe, et al (1998). Activity of fotemustine in medulloblastoma and malignant glioma xenografts in relation to O6-alkylguanine-DNA alkyltransferase and alkylpurine-DNA N-glycosylase activity. Clin Cancer Res, 4, 463-8.
- Hoang-Xuan K, Taillandier L, Chinot O, et al (2003). Chemotherapy alone as initial treatment for primary CNS lymphoma in patients older than 60 years: a multicenter phase II study (26952) of the European Organization for Research and Treatment of Cancer Brain Tumor Group. J Clin Oncol, 21, 2726-31. https://doi.org/10.1200/JCO.2003.11.036
- Jellinger KA, Paulus W (1992). Primary central nervous system lymphomas:An update. J Cancer Res Clin Oncol, 119, 7-27. https://doi.org/10.1007/BF01209483
- Korfel A (2011). Prevention of central nervous system relapses in diffuse large B-cell lymphoma: which patients and how? Curr Opin Oncol, 23, 436-40. https://doi.org/10.1097/CCO.0b013e3283499c7c
- Li Q, Yin J, Wang X, et al (2013). B-cell Lymphoma 2 rs17757541 C> G polymorphism was associated with an increased risk of gastric cardiac adenocarcinoma in a Chinese population. Asian Pac J Cancer Prev, 14, 4301-6. https://doi.org/10.7314/APJCP.2013.14.7.4301
- Li LF, Wang HQ, Liu XM, et al (2013). Epirubicin inhibits soluble CD25 secretion by Treg cells isolated from diffuse large B-cell lymphoma patients. Asian Pac J Cancer Prev, 14, 1721-4. https://doi.org/10.7314/APJCP.2013.14.3.1721
- McAllister LD, Doolittle ND, Guastadisegni PE, et al (2000). Cognitive outcomes and long-term follow-up results after enhanced chemotherapy delivery for primary central nervous system lymphoma. Neurosurgery, 46, 51-60.
- National Cancer Institute (1988): Guidelines for Reporting of Adverse Drug Reactions. Bethesda, MD, Division of Cancer Treatment, National Cancer Institute.
- Mead GM, Bleehen NM, Gregor A, et al (2000). Amedical research council randomized trial in patients with primary cerebral nonhodgkin lymphoma:cerebral radiotherapy with and without cyclophos-phamide, doxorubicin, vincristine, and prednisone chemotherapy. Cancer, 89, 1359-70. https://doi.org/10.1002/1097-0142(20000915)89:6<1359::AID-CNCR21>3.0.CO;2-9
- Miller DC, Hochberg FH, Harris NL, et al (1994). Pathology with clinical correlations of primary central nervous system non-Hodgkin's lymphoma. The Massachusetts General Hospital experience 1958-1989. Cancer, 74, 1383-97. https://doi.org/10.1002/1097-0142(19940815)74:4<1383::AID-CNCR2820740432>3.0.CO;2-1
- Muggia FM (1994). Teniposide: overview of its therapeutic potential in adult cancers. Cancer Chemother Pharmacol, 34, S127-33. https://doi.org/10.1007/BF00684876
- OBrien P, Roos D, Pratt G, et al (2000) . Phase II multicenter study of brief single-agent methotrexate followed by irradiation in primary CNS lymphoma. J Clin Oncol, 18, 519.
- Omuro AM, Taillandier L, Chinot O et al (2007), Temozolomide and methotrexate for primary central nervous system lymphoma in the elderly. J Neurooncol, 85, 207-11. https://doi.org/10.1007/s11060-007-9397-0
- Pels H, Schmidt-Wolf IG, Glasmacher A, et al (2003). Primary central nervous system lymphoma: results of a pilot and phase II study of systemic and intraventricular chemotherapy with deferred radiotherapy. J Clin Oncol, 21, 4489-95. https://doi.org/10.1200/JCO.2003.04.056
- Reni M, Ferreri AJ, Garancini MP, et al (1997). Therapeutic management of primary central nervous system lymphoma in immunocompetent patients:Results of a critical review of the literature. Ann Oncol, 8, 227-34. https://doi.org/10.1023/A:1008201717089
- Rubenstein J, FerreriAJ, Pittaluga S et al (2008). Primary lymphoma of the central nervous system: epidemiology, pathology and current approaches to diagnosis, prognosis and treatment. Leuk Lymphoma, 49, 43-51. https://doi.org/10.1080/10428190802311441
- Sutcliffe SB, Gospodarowicz MK, Bush RS, et al (1985). Role of radiation therapy in localized non-Hodgkin's lymphoma. Radiother Oncol, 4, 211-23. https://doi.org/10.1016/S0167-8140(85)80086-4
- Van Besien K, Ha CS, Murphy S, et al (1998). Risk factors, treatment, and outcome of central nervous system recurrence in adults with intermediate-grade and immunoblastic lymphoma. Blood, 91, 1178-84.
- Van Tellingen O, Boogerd W, Nooijen WJ, et al (1997). The vascular compartment hampers accurate determination of teniposide penetration into brain tumor tissue. Cancer Chemother Pharmacol, 40, 330-4. https://doi.org/10.1007/s002800050665
- Wang X, Song ZF, Xie RM, et al (2013). Analysis of death causes of in-patients with malignant tumors in Sichuan Cancer Hospital of China from 2002 to 2012. Asian Pac J Cancer Prev, 14, 4399-402. https://doi.org/10.7314/APJCP.2013.14.7.4399
- Wang XF, Wu YH, Wang MS, et al (2014). CEA, AFP, CA125, CA153 and CA199 in malignant pleural effusions predict the cause. Asian Pac J Cancer Prev, 15, 363-8. https://doi.org/10.7314/APJCP.2014.15.1.363
- Zhu WW, Kang L, Gao YP, et al (2013). Expression level of valosin containing protein is associated with prognosis of primary orbital MALT lymphoma. Asian Pac J Cancer Prev, 14, 6439-43. https://doi.org/10.7314/APJCP.2013.14.11.6439
- Zhang J, Zhu MY, Wang L, et al (2013). "Sandwich" chemotherapy (CT) with radiotherapy (RT) improves outcomes in patients with stage IE/IIE extranodal natural killer (NK)/T-cell Lymphomas. Asian Pac J Cancer Prev, 14, 4061-6. https://doi.org/10.7314/APJCP.2013.14.7.4061
- Zhang ZX, Shen CF, Zou WH, et al (2013). Exploration of molecular mechanisms of diffuse large B-cell lymphoma development using a microarray. Asian Pac J Cancer Prev, 14, 1731-5. https://doi.org/10.7314/APJCP.2013.14.3.1731
- Prediction of Deoxypodophyllotoxin Disposition in Mouse, Rat, Monkey, and Dog by Physiologically Based Pharmacokinetic Model and the Extrapolation to Human vol.7, pp.1663-9812, 2016, https://doi.org/10.3389/fphar.2016.00488
- Long-term remission of subcutaneous panniculitis-like T-cell lymphoma with central nervous system involvement: A case report vol.12, pp.1, 2016, https://doi.org/10.3892/ol.2016.4635
- Fotemustine, teniposide and dexamethasone versus high-dose methotrexate plus cytarabine in newly diagnosed primary CNS lymphoma: a randomised phase 2 trial pp.1573-7373, 2018, https://doi.org/10.1007/s11060-018-2970-x