Metronomic therapy for refractory/relapsed lymphoma: the PEP-C low-dose oral combination chemotherapy regimen

Hematology ◽  
2012 ◽  
Vol 17 (sup1) ◽  
pp. s90-s92 ◽  
Author(s):  
Morton Coleman ◽  
Gia Ruan ◽  
Elstrom Rebecca L. ◽  
Peter Martin ◽  
John P. Leonard
Keyword(s):  
Combination Chemotherapy ◽  
Low Dose ◽  
Chemotherapy Regimen ◽  
Dose Oral ◽  
Metronomic Therapy ◽  
Relapsed Lymphoma ◽  
Combination Chemotherapy Regimen

Low-dose metronomic, multidrug therapy with the PEP-C oral combination chemotherapy regimen for mantle cell lymphoma

2008 ◽  
Vol 49 (3) ◽  
pp. 447-450 ◽  
Author(s):  
Morton Coleman ◽  
Peter Martin ◽  
Jia Ruan ◽  
Richard Furman ◽  
Ruben Niesvizky ◽  
...  
Keyword(s):  
Mantle Cell Lymphoma ◽  
Combination Chemotherapy ◽  
Low Dose ◽  
Chemotherapy Regimen ◽  
Cell Lymphoma ◽  
Multidrug Therapy ◽  
Mantle Cell ◽  
Combination Chemotherapy Regimen

Oral combination chemotherapy for refractory/relapsed lymphoma with the PEP-C (C3) regimen (daily prednisone, etoposide, procarbazine, cyclophosphamide): Low-dose continuous metronomic multidrug therapy

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 8064-8064
Author(s):  
M. Coleman ◽  
J. Ruan ◽  
R. R. Furman ◽  
R. Niesvizky ◽  
P. Martin ◽  
...  
Keyword(s):  
Combination Chemotherapy ◽  
Hodgkin’S Lymphoma ◽  
Low Dose ◽  
Oral Prednisone ◽  
Hodgkin's Lymphoma ◽  
Mantle Cell ◽  
Metronomic Therapy ◽  
Relapsed Lymphoma ◽  
Daily Prednisone ◽  
Low Dose Chemotherapy

8064 Background: Oral daily low dose chemotherapy (metronomic therapy) may maintain continuous sequential drug levels to impact endothelial cell viability (anti-angiogenesis) or to overcome drug resistance. Methods: We retrospectively reviewed data on 97 patients with refractory/relapsed Hodgkin's and non-Hodgkin's lymphoma treated with the PEP-C (C3) regimen, which consists of oral prednisone (20 mg in am), cyclophosphamide (50 mg at noon), etoposide (50 mg at dinner) and procarbazine (50 mg at h.s.with an oral anti- emetic). Medications were administered daily until the white blood cell count fell to less than 3000/dl, when treatment was held until recovery from the nadir. Treatment was then reinstituted on a daily, alternate day, or fractionated weekly basis (e.g. 5 of 7 days) based on patient tolerance. Doses given per day were constant. Results: All patients had been previously treated, with 80% having received 2 or more prior therapies and 57% with 3 or more previous regimens. Overall, 69 patients (71%) achieved a response. Responses by histology were: follicular (n=26) 92%, mantle cell (n=22) 82%, marginal zone (n=14) 71%, small lymphocytic (n=12) 67%, Hodgkin's lymphoma (n=9) 44%, diffuse large B cell (n=9) 33%, and T cell (n=5) 40%. Time on therapy of responding patients ranged from 3 weeks to 48 months (median 9 months, mean 11 months). Toxicity was predominantly myelosuppression, with hospitalization for infection occurring in 10 patients. Five patients developed H. zoster. Gastrointestinal effects prompting cessation of therapy occurred in 6 subjects, and 2 patients developed hematuria. Conclusions: Low dose, continuous (metronomic) combination chemotherapy with PEP-C is an easily administered, generally well- tolerated and effective treatment for relapsed/refractory lymphoma, particularly in indolent and mantle cell histologies. No significant financial relationships to disclose.

The m-BACOD combination chemotherapy regimen in large-cell lymphoma: analysis of the completed trial and comparison with the M-BACOD regimen.

1990 ◽  
Vol 8 (1) ◽  
pp. 84-93 ◽  
Author(s):  
M A Shipp ◽  
B Y Yeap ◽  
D P Harrington ◽  
M M Klatt ◽  
G S Pinkus ◽  
...  
Keyword(s):  
Combination Chemotherapy ◽  
Chemotherapy Regimen ◽  
Cell Lymphoma ◽  
Large Cell ◽  
Stage Ii ◽  
Late Relapse ◽  
Dose Methotrexate ◽  
Large Cell Lymphoma ◽  
Combination Chemotherapy Regimen

One hundred thirty-four assessable patients with stage II-IV large-cell lymphoma (LCL) were treated with the combination chemotherapy regimen methotrexate with leucovorin, bleomycin, doxorubicin, cyclophosphamide, vincristine, and dexamethasone (m-BACOD) between July 1981 and May 1986. The m-BACOD regimen substituted moderate-dose methotrexate (200 mg/m2 x 2) for the high-dose methotrexate used in the preceding M-BACOD regimen; all other drugs were administered as with m-BACOD. Eighty-two patients (61%) in the completed m-BACOD trial achieved a complete response (CR). With a median follow-up of 3.6 years, 62 patients (76%) continue in CR. Predicted survivals of 1, 3, and 5 years for the entire m-BACOD group are 80%, 63%, and 60%, respectively, with a 5-year disease-free survival (DFS) of 74% for the patients who achieve CR. The results obtained with m-BACOD are comparable with those obtained in the preceding M-BACOD trial, which now has a median follow-up of 8.0 years. The reduction in methotrexate dosage in m-BACOD patients was not associated with an increased incidence of CNS relapse. Long-term follow-up of the 215 M/m-BACOD patients indicates that the regimens are not associated with an increased incidence of secondary malignancy. Prolonged follow-up also indicates that advanced-stage patients have a persistent rate of late relapse of about 7.0% per year for years 2 to 5 of their follow-up and that stage II patients have an approximate 2.1% per year rate of late relapse. Application of the previously described prognostic factor model to the 215 M/m-BACOD patients from the completed trials identifies a high-risk group of patients with a CR rate and predicted 5-year survival (38% and 24%, respectively) that are significantly worse than those of the group as a whole (65% and 57%, respectively).

scholarly journals Treatment of poor prognosis nonseminomatous testicular cancer with a “high-dose” platinum combination chemotherapy regimen

Cancer ◽  
1983 ◽  
Vol 51 (10) ◽  
pp. 1803-1807 ◽  
Author(s):  
Robert F. Ozols ◽  
Albert B. Deisseroth ◽  
Nasser Javadpour ◽  
Audrey Barlock ◽  
Gerald L. Messerschmidt ◽  
...  
Keyword(s):  
Testicular Cancer ◽  
Combination Chemotherapy ◽  
Poor Prognosis ◽  
Chemotherapy Regimen ◽  
High Dose ◽  
Combination Chemotherapy Regimen

Phase III randomized study of fluorouracil, epirubicin, and cyclophosphamide v fluorouracil, doxorubicin, and cyclophosphamide in advanced breast cancer: an Italian multicentre trial. Italian Multicentre Breast Study with Epirubicin.

1988 ◽  
Vol 6 (6) ◽  
pp. 976-982 ◽  
Keyword(s):  
Breast Cancer ◽  
Advanced Breast Cancer ◽  
Combination Chemotherapy ◽  
Chemotherapy Regimen ◽  
Performance Status ◽  
Randomized Study ◽  
Menopausal Status ◽  
Advanced Breast ◽  
Phase Iii ◽  
Combination Chemotherapy Regimen

From February 1983 to January 1985, 497 patients with advanced breast cancer were randomly allocated to receive either epirubicin or doxorubicin in the following combination chemotherapy regimen: fluorouracil (5-FU) 500 mg/m2 intravenous (IV) on days 1 and 8; epirubicin or doxorubicin 50 mg/m2 IV on day 1; cyclophosphamide 500 mg/m2 IV on day 1 (FEC or FAC). Cycles were repeated every 21 days until progression or to cumulative doses of 700 mg/m2 for epirubicin and 550 mg/m2 for doxorubicin. Dose reductions were applied according to the standard criteria. Activity was evaluated in 443 patients (222 in the FEC arm and 221 in the FAC arm). The two experimental groups were comparable in age, performance status, menopausal status, histology, previous treatments, and site of the disease. The overall response rate (complete response and partial response [CR + PR]) was not significantly different: 53.6% for FEC and 56.5% for FAC. The median time to progression was 273 days for FEC and 314 days for FAC; the median survival time was 591 and 613 days, respectively. Leukopenia, anemia, nausea, and vomiting were significantly lower in patients treated with FEC. As for cardiotoxicity, four cases of congestive heart failure (CHF) were recorded among patients treated with FAC while only one was observed in the FEC group. These results indicate that epirubicin in a combination chemotherapy regimen is as active as doxorubicin and is significantly less toxic.

Chemotherapy for diffuse large-cell lymphoma--rapidly responding patients have more durable remissions.

1986 ◽  
Vol 4 (2) ◽  
pp. 160-164 ◽  
Author(s):  
J O Armitage ◽  
D D Weisenburger ◽  
M Hutchins ◽  
D F Moravec ◽  
M Dowling ◽  
...  
Keyword(s):  
Complete Remission ◽  
Combination Chemotherapy ◽  
Chemotherapy Regimen ◽  
Cell Lymphoma ◽  
Large Cell ◽  
Diffuse Large Cell Lymphoma ◽  
Persistent Disease ◽  
Large Cell Lymphoma ◽  
Combination Chemotherapy Regimen ◽  
Better Than

Fifty-one patients with diffuse large-cell lymphoma (DLCL) were treated with a six-drug combination chemotherapy regimen including cyclophosphamide, doxorubicin, procarbazine, bleomycin, vincristine, and prednisone. The patients were restaged after three cycles of therapy, and restaging was repeated at 2-month intervals in patients who had persistent disease. Responding patients received two cycles of therapy after documentation of complete remission (CR). With all patients considered evaluable, 73% of the patients achieved a CR. Twenty-six of the 37 CRs (70%) achieved remission in the first three treatment cycles. The durability of remission in the rapidly responding patients was significantly better than for patients who required five cycles to achieve CR (80% v 40% at 2 years, P = .02) despite the latter patients having received two more cycles of therapy. Rapidly responding patients with DLCL do not require prolonged therapy and have a better prognosis than patients achieving a CR more slowly.

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