A phase ii study of ifosfamide, Methotrexate, Etoposide, And prednisolone for previously untreated stage i/ii extranodal natural killer/t-cell lymphoma, Nasal type: A multicenter trial of the korean cancer study group

Tae Min Kim, Dong Wan Kim, Yoon Koo Kang, Jooseop Chung, Hong Suk Song, Hyo Jung Kim, Byung Soo Kim, Jong Seok Lee, Hawk Kim, Sung Hyun Yang, Young Jin Yuh, Sung Hwa Bae, Myung Soo Hyun, Yoon Kyung Jeon, Chul Woo Kim, Dae Seog Heo

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Abstract

Background. Combination chemotherapy consisting of ifosfa-mide, methotrexate, etoposide, and prednisolone (IMEP) was active as first-line and second-line treatment for extranodal natural killer/T-cell lymphoma (NTCL).

Methods. Forty-four patients with chemo-na¨ve stage I/IINTCL were enrolled in a prospective, multicenter, phase II study and received six cycles of IMEP (ifosfamide 1.5 g/m2 on days 1-3; methotrextate 30 mg/m2 on days 3 and 10; etoposide 100 mg/m2 on days 1-3; and prednisolone 60 mg/m2 per day on days 1-5) followed by involved field radiotherapy (IFRT).

Results. Overall response rates were 73% (complete remission [CR] in 11 of 41 evaluable patients [27%]) after IMEP chemotherapy and 78% (CR 18 of 27 evaluable patients [67%]) after IMEP followed by IFRT. Neutropenia and thrombocytopenia were documented in 33 patients (75%) and 7 patients (16%), respectively. Only 8 patients (18%) experienced febrile neutropenia. Three-year progression-free survival (PFS) and overall survival (OS) were 66% and 56%, respectively. High Ki-67 (>70%) and Ann Arbor stage II independently reduced PFS (p =.004) and OS (p =.001), respectively.

Conclusion. Due to the high rate of progression during IMEP chemotherapy, IFRT needs to be introduced earlier. Moreover, active chemotherapy including an L-asparaginase-based regimen should be use to reduce systemic treatment failure in stage I/II NTCL.

Original languageEnglish
Pages (from-to)1129-1130
Number of pages2
JournalOncologist
Volume19
Issue number11
DOIs
Publication statusPublished - 2014

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

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    Kim, T. M., Kim, D. W., Kang, Y. K., Chung, J., Song, H. S., Kim, H. J., Kim, B. S., Lee, J. S., Kim, H., Yang, S. H., Yuh, Y. J., Bae, S. H., Hyun, M. S., Jeon, Y. K., Kim, C. W., & Heo, D. S. (2014). A phase ii study of ifosfamide, Methotrexate, Etoposide, And prednisolone for previously untreated stage i/ii extranodal natural killer/t-cell lymphoma, Nasal type: A multicenter trial of the korean cancer study group. Oncologist, 19(11), 1129-1130. https://doi.org/10.1634/theoncologist.2014-0305