Revision as of 12:33, 29 October 2022

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Guidelines

ESMO

2015: d'Amore et al. Peripheral T-cell lymphomas: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up

"How I Treat"

Tse E, Kwong YL. How I treat NK/T-cell lymphomas. Blood. 2013 Jun 20;121(25):4997-5005. Epub 2013 May 7. link to original article PubMed

NCCN

NCCN Guidelines - T-cell Lymphomas

Untreated

Cisplatin & RT

Cisplatin & RT: Cisplatin & Radiation Therapy

Regimen

Study	Evidence	Efficacy
Kim et al. 2009 (CISL 2004-10-08)	Phase 2	ORR: 83%

Chemotherapy

Cisplatin (Platinol) 30 mg/m² IV once per day on days 1, 8, 15, 22

Radiotherapy

Concurrent radiation therapy to the primary tumor, 1.8 to 2 Gy fractions (median total dose: 40 Gy), given 5 times per week.

4-week course

Subsequent treatment

VIPD consolidation, 3 to 5 weeks after the last dose of cisplatin

References

CISL 2004-10-08: Kim SJ, Kim K, Kim BS, Kim CY, Suh C, Huh J, Lee SW, Kim JS, Cho J, Lee GW, Kang KM, Eom HS, Pyo HR, Ahn YC, Ko YH, Kim WS; Consortium for Improving Survival of Lymphoma. Phase II trial of concurrent radiation and weekly cisplatin followed by VIPD chemotherapy in newly diagnosed, stage IE to IIE, nasal, extranodal NK/T-Cell Lymphoma: Consortium for Improving Survival of Lymphoma study. J Clin Oncol. 2009 Dec 10;27(35):6027-32. link to original article contains dosing details in manuscript PubMed NCT00418535

DEP & RT

DEP & RT: Dexamethasone, Etoposide, Platinol (Cisplatin), Radiation Therapy

Regimen

Study	Evidence	Efficacy
Tsai et al. 2014 (T1405)	Phase 2	ORR: 81%

Dosing details not available in the abstract.

Glucocorticoid therapy

Dexamethasone (Decadron)

Chemotherapy

28-day cycle for 2 cycles

Radiotherapy

Concurrent radiation therapy to the primary tumor, 50.4 Gy in 28 fractions

5.5-week course

Subsequent treatment

VIPD consolidation

References

T1405: Tsai HJ, Lin SF, Chen CC, Chen TY, Su WC, Hwang WL, Lin JC, Chiou TJ, Kao WY, Chiu CF, Chang YF, Chang JS, Chang MC, Su IJ. Long-term results of a phase II trial with frontline concurrent chemoradiotherapy followed by consolidation chemotherapy for localized nasal natural killer/T-cell lymphoma. Eur J Haematol. 2015 Feb;94(2):130-7. Epub 2014 Oct 10. link to original article PubMed NCT00292695

DeVIC & RT

DeVIC & RT: Dexamethasone, VP-16 (Etoposide), Ifosfamide, Carboplatin, Radiation Therapy

Regimen

Study	Evidence	Efficacy
Yamaguchi et al. 2009 (JCOG0211)	Phase 2	ORR: 81%

Glucocorticoid therapy, Dose Level I

Dexamethasone (Decadron) 40 mg IV once per day on days 1 to 3

Chemotherapy, Dose Level I

Etoposide (Vepesid) 67 mg/m² IV over 2 hours once per day on days 1 to 3
Ifosfamide (Ifex) 1000 mg/m² IV over 3 hours once per day on days 1 to 3
Carboplatin (Paraplatin) 200 mg/m² IV over 30 minutes once on day 1

Glucocorticoid therapy, Dose Level II

Dexamethasone (Decadron) 40 mg IV once per day on days 1 to 3

Chemotherapy, Dose Level II

Etoposide (Vepesid) 100 mg/m² IV over 2 hours once per day on days 1 to 3
Ifosfamide (Ifex) 1500 mg/m² IV over 3 hours once per day on days 1 to 3
Carboplatin (Paraplatin) 300 mg/m² IV over 30 minutes once on day 1

Supportive therapy

Filgrastim (Neupogen) (dose/route/schedule not specified) started for WBC count less than 2 x 10⁹/L or ANC less than 1000/uL; discontinued if WBC count greater than 5 x 10⁹/L.

21-day cycle for 3 cycles

Radiotherapy

Started simultaneously with the beginning of cycle 1 of chemotherapy

Concurrent radiation therapy by the following stage-based criteria:
- Stage IE disease: 2 Gy fractions x 25 fractions (total dose: 50 Gy)
- Stage IIE disease: 1.8 Gy fractions x 28 fractions (total dose: 50.4 Gy)

5- to 6-week course

References

JCOG0211: Yamaguchi M, Tobinai K, Oguchi M, Ishizuka N, Kobayashi Y, Isobe Y, Ishizawa K, Maseki N, Itoh K, Usui N, Wasada I, Kinoshita T, Ohshima K, Matsuno Y, Terauchi T, Nawano S, Ishikura S, Kagami Y, Hotta T, Oshimi K. Phase I/II study of concurrent chemoradiotherapy for localized nasal natural killer/T-cell lymphoma: Japan Clinical Oncology Group Study JCOG0211. J Clin Oncol. 2009 Nov 20;27(33):5594-600. link to original article contains dosing details in manuscript PubMed
1. Update: Yamaguchi M, Tobinai K, Oguchi M, Ishizuka N, Kobayashi Y, Isobe Y, Ishizawa K, Maseki N, Itoh K, Usui N, Wasada I, Kinoshita T, Hotta T, Tsukasaki K, Oshimi K. Concurrent chemoradiotherapy for localized nasal natural killer/T-cell lymphoma: an updated analysis of the Japan clinical oncology group study JCOG0211. J Clin Oncol. 2012 Nov 10;30(32):4044-6. Epub 2012 Oct 8. link to original article PubMed

GELOX/RT

GELOX/RT: Gemcitabine, L-asparaginase, Oxaliplatin, alternating with Radiation Therapy

Protocol

Study	Evidence	Efficacy
Wang et al. 2012	Phase 2	ORR: 96%

Note: total number of chemotherapy cycles was limited to 6.

Chemotherapy, part 1

Gemcitabine (Gemzar) 1000 mg/m² IV once per day on days 1 & 8
Asparaginase (Elspar) 6000 units/m² IV once per day on days 1 to 7
Oxaliplatin (Eloxatin) 130 mg/m² IV once on day 1

21-day cycle for at least 2 cycles, followed by:

Radiotherapy

IFRT to 56 Gy in 28 fractions, 5 fractions per week

5.5-week course, followed within one week by:

Chemotherapy, part 2

Gemcitabine (Gemzar) 1000 mg/m² IV once per day on days 1 & 8
Asparaginase (Elspar) 6000 units/m² IV once per day on days 1 to 7
Oxaliplatin (Eloxatin) 130 mg/m² IV once on day 1

21-day cycle for up to 4 cycles

References

Wang L, Wang ZH, Chen XQ, Li YJ, Wang KF, Xia YF, Xia ZJ. First-line combination of gemcitabine, oxaliplatin, and L-asparaginase (GELOX) followed by involved-field radiation therapy for patients with stage IE/IIE extranodal natural killer/T-cell lymphoma. Cancer. 2013 Jan 15;119(2):348-55. Epub 2012 Jul 18. link to original article contains dosing details in manuscript PubMed

LVP "Sandwich"

LVP: L-asparaginase, Vincristine, Prednisolone

Protocol

Study	Evidence	Efficacy
Jiang et al. 2011	Phase 2	ORR: 84%

Chemotherapy, part 1

Asparaginase (Elspar) 6000 units/m² IV once per day on days 1 to 5
Vincristine (Oncovin) 1.4 mg/m² IV once on day 1

Glucocorticoid therapy, part 1

Prednisolone (Millipred) 100 mg PO once per day on days 1 to 5

21-day cycle for 2 cycles, followed by:

Radiotherapy

External beam radiotherapy to the nasal cavity and surrounding sinuses, 56 Gy in 28 fractions, once per day, five days per week

5.5-week course, followed in one week by:

Chemotherapy, part 2

Asparaginase (Elspar) 6000 units/m² IV once per day on days 1 to 5
Vincristine (Oncovin) 1.4 mg/m² IV once on day 1

Glucocorticoid therapy, part 2

Prednisolone (Millipred) 100 mg PO once per day on days 1 to 5

21-day cycle for up to 4 cycles

References

Jiang M, Zhang H, Jiang Y, Yang Q, Xie L, Liu W, Zhang W, Ji X, Li P, Chen N, Zhao S, Wang F, Zou L. Phase 2 trial of "sandwich" L-asparaginase, vincristine, and prednisone chemotherapy with radiotherapy in newly diagnosed, stage IE to IIE, nasal type, extranodal natural killer/T-cell lymphoma. Cancer. 2012 Jul 1;118(13):3294-301. Epub 2011 Dec 2. link to original article contains dosing details in manuscript PubMed

MESA/RT

MESA/RT: Methotrexate, Etoposide, Steroid (dexamethasone), PEG-A-sparaginase alternating with Radiation Ttherapy

Protocol

Study	Evidence	Efficacy
Liang et al. 2016	Phase 2	ORR: 87%

Note: this regimen also incorporates radiation, see text for details.

Chemotherapy, part 1

Methotrexate (MTX) 2000 mg/m² IV once on day 1
Etoposide (Vepesid) 100 mg/m² IV once per day on days 2 to 4
Pegaspargase (Oncaspar) 2500 IU/m² IM once on day 5

Glucocorticoid therapy, part 1

Dexamethasone (Decadron) 20 mg/m² IV once per day on days 2 to 5

21-day cycle for at least 3 cycles, followed by:

Radiotherapy

Radiation therapy, 45 to 50 Gy in 25 fractions

One course, followed by:

Chemotherapy, part 2

Methotrexate (MTX) 2000 mg/m² IV once on day 1
Etoposide (Vepesid) 100 mg/m² IV once per day on days 2 to 4
Pegaspargase (Oncaspar) 2500 IU/m² IM once on day 5

Glucocorticoid therapy, part 1

Dexamethasone (Decadron) 20 mg/m² IV once per day on days 2 to 5

21-day cycle for a maximum of 7 cycles

References

Liang R, Gao GX, Chen JP, Wang JS, Wang XM, Zeng Y, Bai QX, Zhang T, Yang L, Dong BX, Gu HT, Shu MM, Hao CX, Wang JH, Zhang N, Chen XQ. A phase 2 study of methotrexate, etoposide, dexamethasone, and pegaspargase chemotherapy for newly diagnosed, relapsed, or refractory extranodal natural killer/T-cell lymphoma, nasal type: a multicenter trial in Northwest China. Hematol Oncol. 2017 Dec;35(4):619-629. Epub 2016 Oct 10. link to original article link to PMC article contains dosing details in manuscript PubMed

SMILE

SMILE: Steroid (Dexamethasone), Methotrexate, Ifosfamide, L-asparaginase, Etoposide

Regimen

Study	Evidence	Efficacy
Yamaguchi et al. 2011	Phase 2	ORR: 79%

Glucocorticoid therapy

Dexamethasone (Decadron) 40 mg IV or PO once per day on days 2 to 4

Chemotherapy

Methotrexate (MTX) 2000 mg/m² IV over 6 hours once on day 1
Ifosfamide (Ifex) 1500 mg/m² IV once per day on days 2 to 4
Asparaginase (Elspar) 6000 units/m² IV once per day on days 8, 10, 12, 14, 16, 18, 20
Etoposide (Vepesid) 100 mg/m² IV once per day on days 2 to 4

Supportive therapy

Folinic acid (Leucovorin) 15 mg IV or PO every 6 hours on days 2 to 4, beginning 30 hours after completion of Methotrexate (MTX)
Mesna (Mesnex) 300 mg/m² IV three times per day on days 2 to 4; first dose given together with Ifosfamide (Ifex), second dose given at 4 hours after start of Ifosfamide (Ifex), and third dose given 8 hours after start of Ifosfamide (Ifex)
Filgrastim (Neupogen) (dose not specified) IV or SC once per day, starting on day 6, given until WBC count greater than 5 x 10⁹/L
Trimethoprim-Sulfamethoxazole (Bactrim DS) prophylaxis recommended

28-day cycle for 2 cycles After 2 cycles, patients could receive additional treatment with SMILE and/or other chemotherapy, with or without autologous/allogeneic stem cell transplant.

References

Phase 1: Yamaguchi M, Suzuki R, Kwong YL, Kim WS, Hasegawa Y, Izutsu K, Suzumiya J, Okamura T, Nakamura S, Kawa K, Oshimi K. Phase I study of dexamethasone, methotrexate, ifosfamide, L-asparaginase, and etoposide (SMILE) chemotherapy for advanced-stage, relapsed or refractory extranodal natural killer (NK)/T-cell lymphoma and leukemia. Cancer Sci. 2008 May;99(5):1016-20. Epub 2008 Feb 19. link to original article contains dosing details in manuscript PubMed content property of HemOnc.org
Yamaguchi M, Kwong YL, Kim WS, Maeda Y, Hashimoto C, Suh C, Izutsu K, Ishida F, Isobe Y, Sueoka E, Suzumiya J, Kodama T, Kimura H, Hyo R, Nakamura S, Oshimi K, Suzuki R; NK-Cell Tumor Study Group. Phase II study of SMILE chemotherapy for newly diagnosed stage IV, relapsed, or refractory extranodal natural killer (NK)/T-cell lymphoma, nasal type: the NK-Cell Tumor Study Group study. J Clin Oncol. 2011 Nov 20;29(33):4410-6. Epub 2011 Oct 11. link to original article contains dosing details in manuscript PubMed

Consolidation after upfront therapy

VIPD

VIPD: VP-16 (Etoposide), Ifosfamide, Platinol (Cisplatin), Dexamethasone

Regimen

Study	Evidence
Kim et al. 2009 (CISL 2004-10-08)	Phase 2
Tsai et al. 2014 (T1405)	Phase 2

Details here are from CISL 2004-10-08.

Preceding treatment

CISL 2004-10-08: Cisplatin & concurrent RT
T1405: DEP & concurrent RT

Chemotherapy

Etoposide (Vepesid) 100 mg/m² IV over 90 minutes once per day on days 1 to 3
Ifosfamide (Ifex) 1200 mg/m² IV over 60 minutes once per day on days 1 to 3
Cisplatin (Platinol) 33 mg/m² IV over 60 minutes once per day on days 1 to 3

Glucocorticoid therapy

Dexamethasone (Decadron) 40 mg IV or PO once per day on days 1 to 4

Supportive therapy

Mesna (Mesnex) 240 mg/m² IV over 15 minutes once per day on days 1 to 3
G-CSF given for grade 3 or 4 neutropenia

21-day cycle for up to 3 cycles

References

CISL 2004-10-08: Kim SJ, Kim K, Kim BS, Kim CY, Suh C, Huh J, Lee SW, Kim JS, Cho J, Lee GW, Kang KM, Eom HS, Pyo HR, Ahn YC, Ko YH, Kim WS; Consortium for Improving Survival of Lymphoma. Phase II trial of concurrent radiation and weekly cisplatin followed by VIPD chemotherapy in newly diagnosed, stage IE to IIE, nasal, extranodal NK/T-Cell Lymphoma: Consortium for Improving Survival of Lymphoma study. J Clin Oncol. 2009 Dec 10;27(35):6027-32. link to original article contains dosing details in manuscript PubMed NCT00418535
T1405: Tsai HJ, Lin SF, Chen CC, Chen TY, Su WC, Hwang WL, Lin JC, Chiou TJ, Kao WY, Chiu CF, Chang YF, Chang JS, Chang MC, Su IJ. Long-term results of a phase II trial with frontline concurrent chemoradiotherapy followed by consolidation chemotherapy for localized nasal natural killer/T-cell lymphoma. Eur J Haematol. 2015 Feb;94(2):130-7. Epub 2014 Oct 10. link to original article PubMed NCT00292695

Relapsed or refractory

AspaMetDex

AspaMetDex: Asparaginase, Methotrexate, Dexamethasone

Regimen

Study	Evidence	Efficacy
Jaccard et al. 2011 (I05009)	Phase 2	ORR: 78%

Chemotherapy

Asparaginase (Elspar) 6000 units/m² IM once per day on days 2, 4, 6, 8
Methotrexate (MTX) by the following age-based criteria:
- Age up to 70: 3000 mg/m² (route not specified) once on day 1
- Older than 70: 2000 mg/m² (route not specified) once on day 1

Glucocorticoid therapy

Dexamethasone (Decadron) by the following age-based criteria:
- Age up to 70: 40 mg PO once per day on days 1 to 4
- Older than 70: 20 mg PO once per day on days 1 to 4

Supportive therapy

Trimethoprim-Sulfamethoxazole (Bactrim DS) (dose/route/schedule not specified) prophylaxis, discontinued during Methotrexate (MTX) administration
Valacyclovir (Valtrex) (dose/route/schedule not specified) prophylaxis
For Methotrexate (MTX): alkaline hydration and Folinic acid (Leucovorin) rescue (dose/route/schedule not specified)

21-day cycle for 3 cycles

Subsequent treatment

See paper for details about further treatment

References

I05009: Jaccard A, Gachard N, Marin B, Rogez S, Audrain M, Suarez F, Tilly H, Morschhauser F, Thieblemont C, Ysebaert L, Devidas A, Petit B, de Leval L, Gaulard P, Feuillard J, Bordessoule D, Hermine O; GELA; GOELAMS. Efficacy of L-asparaginase with methotrexate and dexamethasone (AspaMetDex regimen) in patients with refractory or relapsing extranodal NK/T-cell lymphoma, a phase 2 study. Blood. 2011 Feb 10;117(6):1834-9. link to original article contains dosing details in manuscript PubMed NCT00283985

AspaMetDex (Erwinaze)

AspaMetDex: Asparaginase, Methotrexate, Dexamethasone

Regimen

Study	Evidence	Efficacy
Jaccard et al. 2011 (I05009)	Phase 2	ORR: 78%

Note: this regimen is for patients with allergies to asparaginase.

Chemotherapy

Asparaginase Erwinia chrysanthemi (Erwinaze) 20,000 units/m² IM once per day on days 2, 4, 6, 8
Methotrexate (MTX) by the following age-based criteria:
- Age up to 70: 3000 mg/m² (route not specified) once on day 1
- Older than 70: 2000 mg/m² (route not specified) once on day 1

Glucocorticoid therapy

Dexamethasone (Decadron) by the following age-based criteria:
- Age up to 70: 40 mg PO once per day on days 1 to 4
- Older than 70: 20 mg PO once per day on days 1 to 4

Supportive therapy

Trimethoprim-Sulfamethoxazole (Bactrim DS) (dose/route/schedule not specified) prophylaxis, discontinued during Methotrexate (MTX) administration
Valacyclovir (Valtrex) (dose/route/schedule not specified) prophylaxis
For Methotrexate (MTX): alkaline hydration and Folinic acid (Leucovorin) rescue (dose/route/schedule not specified)

21-day cycle for 3 cycles

Subsequent treatment

See paper for details about further treatment

References

I05009: Jaccard A, Gachard N, Marin B, Rogez S, Audrain M, Suarez F, Tilly H, Morschhauser F, Thieblemont C, Ysebaert L, Devidas A, Petit B, de Leval L, Gaulard P, Feuillard J, Bordessoule D, Hermine O; GELA; GOELAMS. Efficacy of L-asparaginase with methotrexate and dexamethasone (AspaMetDex regimen) in patients with refractory or relapsing extranodal NK/T-cell lymphoma, a phase 2 study. Blood. 2011 Feb 10;117(6):1834-9. link to original article contains dosing details in manuscript PubMed NCT00283985

L-Asparaginase, Vincristine, Prednisolone

LVP: L-asparaginase, Vincristine, Prednisolone

Regimen

Study	Evidence	Efficacy
Yong et al. 2003	Phase 2, <20 patients	ORR: 83%

Regimen details are from a review article; original article is not available through PubMed

Chemotherapy

Asparaginase (Elspar) 6000 units/m² IV once per day on days 1 to 5
Vincristine (Oncovin) 1.4 mg/m² IV once on day 1

Glucocorticoid therapy

Prednisolone (Millipred) 100 mg PO once per day on days 1 to 5

References

Yong W, Zheng W, Zhang Y, Zhu J, Wei Y, Zhu D, Li J. L-asparaginase-based regimen in the treatment of refractory midline nasal/nasal-type T/NK-cell lymphoma. Int J Hematol. 2003 Aug;78(2):163-7. link to original article PubMed

SMILE

SMILE: Steroid (Dexamethasone), Methotrexate, Ifosfamide, L-asparaginase, Etoposide

Regimen

Study	Evidence	Efficacy
Yamaguchi et al. 2011	Phase 2	ORR: 79%

Glucocorticoid therapy

Dexamethasone (Decadron) 40 mg IV or PO once per day on days 2 to 4

Chemotherapy

Methotrexate (MTX) 2000 mg/m² IV over 6 hours once on day 1
Ifosfamide (Ifex) 1500 mg/m² IV once per day on days 2 to 4
Asparaginase (Elspar) 6000 units/m² IV once per day on days 8, 10, 12, 14, 16, 18, 20
Etoposide (Vepesid) 100 mg/m² IV once per day on days 2 to 4

Supportive therapy

Folinic acid (Leucovorin) 15 mg IV or PO every 6 hours on days 2 to 4, beginning 30 hours after completion of Methotrexate (MTX)
Mesna (Mesnex) 300 mg/m² IV three times per day on days 2 to 4; first dose given together with Ifosfamide (Ifex), second dose given at 4 hours after start of Ifosfamide (Ifex), and third dose given 8 hours after start of Ifosfamide (Ifex)
Filgrastim (Neupogen) (dose not specified) IV or SC once per day, starting on day 6, given until WBC count greater than 5 x 10⁹/L
Trimethoprim-Sulfamethoxazole (Bactrim DS) prophylaxis recommended

28-day cycle for 2 cycles After 2 cycles, patients could receive additional treatment with SMILE and/or other chemotherapy, with or without autologous/allogeneic stem cell transplant.

References

Phase 1: Yamaguchi M, Suzuki R, Kwong YL, Kim WS, Hasegawa Y, Izutsu K, Suzumiya J, Okamura T, Nakamura S, Kawa K, Oshimi K. Phase I study of dexamethasone, methotrexate, ifosfamide, L-asparaginase, and etoposide (SMILE) chemotherapy for advanced-stage, relapsed or refractory extranodal natural killer (NK)/T-cell lymphoma and leukemia. Cancer Sci. 2008 May;99(5):1016-20. Epub 2008 Feb 19. link to original article contains dosing details in manuscript PubMed content property of HemOnc.org
Yamaguchi M, Kwong YL, Kim WS, Maeda Y, Hashimoto C, Suh C, Izutsu K, Ishida F, Isobe Y, Sueoka E, Suzumiya J, Kodama T, Kimura H, Hyo R, Nakamura S, Oshimi K, Suzuki R; NK-Cell Tumor Study Group. Phase II study of SMILE chemotherapy for newly diagnosed stage IV, relapsed, or refractory extranodal natural killer (NK)/T-cell lymphoma, nasal type: the NK-Cell Tumor Study Group study. J Clin Oncol. 2011 Nov 20;29(33):4410-6. Epub 2011 Oct 11. link to original article contains dosing details in manuscript PubMed

@@ Line 4: / Line 4: @@
 </div>
 {{#lst:Section editor transclusions|tcl}}
-''Are you looking for a regimen, but can't find it here? It is possible that we've moved it to the [[Adult T-cell leukemia-lymphoma - historical|historical regimens page]].
 {| class="wikitable" style="float:right; margin-right: 5px;"
 |-
@@ Line 12: / Line 11: @@
 {{TOC limit|limit=3}}
 =Guidelines=
+==[http://www.esmo.org/ ESMO]==
+*'''2015:''' d'Amore et al. [https://www.esmo.org/Guidelines/Haematological-Malignancies/Peripheral-T-Cell-Lymphomas Peripheral T-cell lymphomas: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up]
 =="How I Treat"==
-*'''2021:''' Cook & Phillips [https://doi.org/10.1182/blood.2019004045 How I treat adult T-cell leukemia/lymphoma]
+* Tse E, Kwong YL. How I treat NK/T-cell lymphomas. Blood. 2013 Jun 20;121(25):4997-5005. Epub 2013 May 7. [http://www.bloodjournal.org/content/121/25/4997.long link to original article] [https://pubmed.ncbi.nlm.nih.gov/23652805 PubMed]
 ==[https://www.nccn.org/ NCCN]==
 *[https://www.nccn.org/professionals/physician_gls/pdf/t-cell.pdf NCCN Guidelines - T-cell Lymphomas]
 =Untreated=
-==CHOP-14 {{#subobject:3e53d9|Regimen=1}}==
+==Cisplatin & RT {{#subobject:544d0b|Regimen=1}}==
-CHOP-14: '''<u>C</u>'''yclophosphamide, '''<u>H</u>'''ydroxydaunorubicin (Doxorubicin), '''<u>O</u>'''ncovin (Vincristine), '''<u>P</u>'''redniso(lo)ne every '''<u>14</u>''' days
+Cisplatin & RT: Cisplatin & '''<u>R</u>'''adiation '''<u>T</u>'''herapy
-<br>CHOP-DI: '''<u>C</u>'''yclophosphamide, '''<u>H</u>'''ydroxydaunorubicin (Doxorubicin), '''<u>O</u>'''ncovin (Vincristine), '''<u>P</u>'''redniso(lo)ne, '''<u>D</u>'''ose-'''<u>I</u>'''ntense
-<br>I-CHOP: '''<u>I</u>'''ntensive '''<u>C</u>'''yclophosphamide, '''<u>H</u>'''ydroxydaunorubicin (Doxorubicin), '''<u>O</u>'''ncovin (Vincristine), '''<u>P</u>'''redniso(lo)ne
 <div class="toccolours" style="background-color:#eeeeee">
-===Regimen {{#subobject:ad2f7b|Variant=1}}===
+===Regimen {{#subobject:550baf|Variant=1}}===
-{| class="wikitable sortable" style="width: 100%; text-align:center;"
+{| class="wikitable" style="width: 60%; text-align:center;"
-!style="width: 17%"|Study
+!style="width: 33%"|Study
-!style="width: 15%"|Years of enrollment
+!style="width: 33%"|[[Levels_of_Evidence#Evidence|Evidence]]
-!style="width: 17%"|[[Levels_of_Evidence#Evidence|Evidence]]
+!style="width: 33%"|[[Levels_of_Evidence#Efficacy|Efficacy]]
-!style="width: 17%"|Comparator
+|-
-!style="width: 17%"|[[Levels_of_Evidence#Comparative_efficacy|Comparative Efficacy]]
+|[https://doi.org/10.1200/jco.2009.23.8592 Kim et al. 2009 (CISL 2004-10-08)]
-!style="width: 17%"|[[Levels_of_Evidence#Toxicity|Comparative Toxicity]]
+|style="background-color:#91cf61"|Phase 2
+| style="background-color:#e0ecf4" |ORR: 83%
+|-
+|}
+<div class="toccolours" style="background-color:#b3e2cd">
+====Chemotherapy====
+*[[Cisplatin (Platinol)]] 30 mg/m<sup>2</sup> IV once per day on days 1, 8, 15, 22
+====Radiotherapy====
+*Concurrent [[External_beam_radiotherapy|radiation therapy]] to the primary tumor, 1.8 to 2 Gy fractions (median total dose: 40 Gy), given 5 times per week.
+'''4-week course'''
+</div>
+<div class="toccolours" style="background-color:#cbd5e7">
+====Subsequent treatment====
+*[[#VIPD|VIPD]] consolidation, 3 to 5 weeks after the last dose of cisplatin
+</div></div>
+===References===
+#'''CISL 2004-10-08:''' Kim SJ, Kim K, Kim BS, Kim CY, Suh C, Huh J, Lee SW, Kim JS, Cho J, Lee GW, Kang KM, Eom HS, Pyo HR, Ahn YC, Ko YH, Kim WS; Consortium for Improving Survival of Lymphoma. Phase II trial of concurrent radiation and weekly cisplatin followed by VIPD chemotherapy in newly diagnosed,  stage IE to IIE, nasal, extranodal NK/T-Cell Lymphoma: Consortium for Improving Survival of Lymphoma study. J Clin Oncol. 2009 Dec 10;27(35):6027-32. [https://doi.org/10.1200/jco.2009.23.8592 link to original article] '''contains dosing details in manuscript''' [https://pubmed.ncbi.nlm.nih.gov/19884539 PubMed] NCT00418535
+==DEP & RT {{#subobject:d8a9eb|Regimen=1}}==
+DEP & RT: '''<u>D</u>'''examethasone, '''<u>E</u>'''toposide, '''<u>P</u>'''latinol (Cisplatin), '''<u>R</u>'''adiation '''<u>T</u>'''herapy
+<div class="toccolours" style="background-color:#eeeeee">
+===Regimen {{#subobject:f93f37|Variant=1}}===
+{| class="wikitable" style="width: 60%; text-align:center;"
+!style="width: 33%"|Study
+!style="width: 33%"|[[Levels_of_Evidence#Evidence|Evidence]]
+!style="width: 33%"|[[Levels_of_Evidence#Efficacy|Efficacy]]
+|-
+|[https://doi.org/10.1111/ejh.12405 Tsai et al. 2014 (T1405)]
+|style="background-color:#91cf61"|Phase 2
+| style="background-color:#e0ecf4" |ORR: 81%
+|-
+|}
+''Dosing details not available in the abstract.''
+====Glucocorticoid therapy====
+*[[Dexamethasone (Decadron)]]
+====Chemotherapy====
+*[[Etoposide (Vepesid)]]
+*[[Cisplatin (Platinol)]]
+'''28-day cycle for 2 cycles'''
+====Radiotherapy====
+*Concurrent [[External_beam_radiotherapy|radiation therapy]] to the primary tumor, 50.4 Gy in 28 fractions
+'''5.5-week course'''
+</div>
+<div class="toccolours" style="background-color:#cbd5e7">
+====Subsequent treatment====
+*[[#VIPD|VIPD]] consolidation
+</div></div>
+===References===
+#'''T1405:''' Tsai HJ, Lin SF, Chen CC, Chen TY, Su WC, Hwang WL, Lin JC, Chiou TJ, Kao WY, Chiu CF, Chang YF, Chang JS, Chang MC, Su IJ. Long-term results of a phase II trial with frontline concurrent chemoradiotherapy followed by consolidation chemotherapy for localized nasal natural killer/T-cell lymphoma. Eur J Haematol. 2015 Feb;94(2):130-7. Epub 2014 Oct 10. [https://doi.org/10.1111/ejh.12405 link to original article] [https://pubmed.ncbi.nlm.nih.gov/24957163 PubMed] NCT00292695
+==DeVIC & RT {{#subobject:4b25e6|Regimen=1}}==
+DeVIC & RT: '''<u>De</u>'''xamethasone, '''<u>V</u>'''P-16 (Etoposide), '''<u>I</u>'''fosfamide, '''<u>C</u>'''arboplatin, '''<u>R</u>'''adiation '''<u>T</u>'''herapy
+<div class="toccolours" style="background-color:#eeeeee">
+===Regimen {{#subobject:74ecfd|Variant=1}}===
+{| class="wikitable" style="width: 60%; text-align:center;"
+!style="width: 33%"|Study
+!style="width: 33%"|[[Levels_of_Evidence#Evidence|Evidence]]
+!style="width: 33%"|[[Levels_of_Evidence#Efficacy|Efficacy]]
+|-
+|[https://doi.org/10.1200/jco.2009.23.8295 Yamaguchi et al. 2009 (JCOG0211)]
+|style="background-color:#91cf61"|Phase 2
+| style="background-color:#e0ecf4" |ORR: 81%
+|-
+|}
+<div class="toccolours" style="background-color:#b3e2cd">
+====Glucocorticoid therapy, Dose Level I====
+*[[Dexamethasone (Decadron)]] 40 mg IV once per day on days 1 to 3
+====Chemotherapy, Dose Level I====
+*[[Etoposide (Vepesid)]] 67 mg/m<sup>2</sup> IV over 2 hours once per day on days 1 to 3
+*[[Ifosfamide (Ifex)]] 1000 mg/m<sup>2</sup> IV over 3 hours once per day on days 1 to 3
+*[[Carboplatin (Paraplatin)]] 200 mg/m<sup>2</sup> IV over 30 minutes once on day 1
+====Glucocorticoid therapy, Dose Level II====
+*[[Dexamethasone (Decadron)]] 40 mg IV once per day on days 1 to 3
+====Chemotherapy, Dose Level II====
+*[[Etoposide (Vepesid)]] 100 mg/m<sup>2</sup> IV over 2 hours once per day on days 1 to 3
+*[[Ifosfamide (Ifex)]] 1500 mg/m<sup>2</sup> IV over 3 hours once per day on days 1 to 3
+*[[Carboplatin (Paraplatin)]] 300 mg/m<sup>2</sup> IV over 30 minutes once on day 1
+====Supportive therapy====
+*[[Filgrastim (Neupogen)]] (dose/route/schedule not specified) started for WBC count less than 2 x 10<sup>9</sup>/L or ANC less than 1000/uL; discontinued if WBC count greater than 5 x 10<sup>9</sup>/L.
+'''21-day cycle for 3 cycles'''
+====Radiotherapy====
+''Started simultaneously with the beginning of cycle 1 of chemotherapy''
+*Concurrent [[External_beam_radiotherapy|radiation therapy]] by the following stage-based criteria:
+**Stage IE disease: 2 Gy fractions x 25 fractions (total dose: 50 Gy)
+**Stage IIE disease: 1.8 Gy fractions x 28 fractions (total dose: 50.4 Gy)
+'''5- to 6-week course'''
+</div></div>
+===References===
+# '''JCOG0211:''' Yamaguchi M, Tobinai K, Oguchi M, Ishizuka N, Kobayashi Y, Isobe Y, Ishizawa K, Maseki N, Itoh K, Usui N, Wasada I, Kinoshita T, Ohshima K, Matsuno Y, Terauchi T, Nawano S, Ishikura S, Kagami Y, Hotta T, Oshimi K. Phase I/II study of concurrent chemoradiotherapy for localized nasal natural killer/T-cell lymphoma: Japan Clinical Oncology Group Study JCOG0211. J Clin Oncol. 2009 Nov 20;27(33):5594-600. [https://doi.org/10.1200/jco.2009.23.8295 link to original article] '''contains dosing details in manuscript''' [https://pubmed.ncbi.nlm.nih.gov/19805668 PubMed]
+## '''Update:''' Yamaguchi M, Tobinai K, Oguchi M, Ishizuka N, Kobayashi Y, Isobe Y, Ishizawa K, Maseki N, Itoh K, Usui N, Wasada I, Kinoshita T, Hotta T, Tsukasaki K, Oshimi K. Concurrent chemoradiotherapy for localized nasal natural killer/T-cell lymphoma: an updated analysis of the Japan clinical oncology group study JCOG0211. J Clin Oncol. 2012 Nov 10;30(32):4044-6. Epub 2012 Oct 8. [https://doi.org/10.1200/jco.2012.45.6541 link to original article] [https://pubmed.ncbi.nlm.nih.gov/23045573 PubMed]
+==GELOX/RT {{#subobject:e51517|Regimen=1}}==
+GELOX/RT: '''<u>G</u>'''emcitabine, '''<u>L</u>'''-asparaginase, '''<u>O</u>'''xaliplatin, alternating with '''<u>R</u>'''adiation '''<u>T</u>'''herapy
+<div class="toccolours" style="background-color:#eeeeee">
+===Protocol {{#subobject:ed4bb8|Variant=1}}===
+{| class="wikitable" style="width: 60%; text-align:center;"
+!style="width: 33%"|Study
+!style="width: 33%"|[[Levels_of_Evidence#Evidence|Evidence]]
+!style="width: 33%"|[[Levels_of_Evidence#Efficacy|Efficacy]]
+|-
+|[https://doi.org/10.1002/cncr.27752 Wang et al. 2012]
+|style="background-color:#91cf61"|Phase 2
+| style="background-color:#f7fcfd" |ORR: 96%
+|-
+|}
+''Note: total number of chemotherapy cycles was limited to 6.''
+<div class="toccolours" style="background-color:#b3e2cd">
+====Chemotherapy, part 1====
+*[[Gemcitabine (Gemzar)]] 1000 mg/m<sup>2</sup> IV once per day on days 1 & 8
+*[[Asparaginase (Elspar)]] 6000 units/m<sup>2</sup> IV once per day on days 1 to 7
+*[[Oxaliplatin (Eloxatin)]] 130 mg/m<sup>2</sup> IV once on day 1
+'''21-day cycle for at least 2 cycles, followed by:'''
+====Radiotherapy====
+*[[External_beam_radiotherapy|IFRT]] to 56 Gy in 28 fractions, 5 fractions per week
+'''5.5-week course, followed within one week by:'''
+====Chemotherapy, part 2====
+*[[Gemcitabine (Gemzar)]] 1000 mg/m<sup>2</sup> IV once per day on days 1 & 8
+*[[Asparaginase (Elspar)]] 6000 units/m<sup>2</sup> IV once per day on days 1 to 7
+*[[Oxaliplatin (Eloxatin)]] 130 mg/m<sup>2</sup> IV once on day 1
+'''21-day cycle for up to 4 cycles'''
+</div></div>
+===References===
+# Wang L, Wang ZH, Chen XQ, Li YJ, Wang KF, Xia YF, Xia ZJ. First-line combination of gemcitabine, oxaliplatin, and L-asparaginase (GELOX) followed by involved-field radiation therapy for patients with stage IE/IIE extranodal natural killer/T-cell lymphoma. Cancer. 2013 Jan 15;119(2):348-55. Epub 2012 Jul 18. [https://doi.org/10.1002/cncr.27752 link to original article] '''contains dosing details in manuscript''' [https://pubmed.ncbi.nlm.nih.gov/22811078 PubMed]
+==LVP "Sandwich" {{#subobject:b50432|Regimen=1}}==
+LVP: '''<u>L</u>'''-asparaginase, '''<u>V</u>'''incristine, '''<u>P</u>'''rednisolone
+<div class="toccolours" style="background-color:#eeeeee">
+===Protocol {{#subobject:5a27c1|Variant=1}}===
+{| class="wikitable" style="width: 60%; text-align:center;"
+!style="width: 33%"|Study
+!style="width: 33%"|[[Levels_of_Evidence#Evidence|Evidence]]
+!style="width: 33%"|[[Levels_of_Evidence#Efficacy|Efficacy]]
+|-
+|[https://doi.org/10.1002/cncr.26629 Jiang et al. 2011]
+|style="background-color:#91cf61"|Phase 2
+| style="background-color:#e0ecf4" |ORR: 84%
+|-
+|}
+<div class="toccolours" style="background-color:#b3e2cd">
+====Chemotherapy, part 1====
+*[[Asparaginase (Elspar)]] 6000 units/m<sup>2</sup> IV once per day on days 1 to 5
+*[[Vincristine (Oncovin)]] 1.4 mg/m<sup>2</sup> IV once on day 1
+====Glucocorticoid therapy, part 1====
+*[[Prednisolone (Millipred)]] 100 mg PO once per day on days 1 to 5
+'''21-day cycle for 2 cycles, followed by:'''
+====Radiotherapy====
+*[[External beam radiotherapy]] to the nasal cavity and surrounding sinuses, 56 Gy in 28 fractions, once per day, five days per week
+'''5.5-week course, followed in one week by:'''
+====Chemotherapy, part 2====
+*[[Asparaginase (Elspar)]] 6000 units/m<sup>2</sup> IV once per day on days 1 to 5
+*[[Vincristine (Oncovin)]] 1.4 mg/m<sup>2</sup> IV once on day 1
+====Glucocorticoid therapy, part 2====
+*[[Prednisolone (Millipred)]] 100 mg PO once per day on days 1 to 5
+'''21-day cycle for up to 4 cycles'''
+</div></div>
+===References===
+# Jiang M, Zhang H, Jiang Y, Yang Q, Xie L, Liu W, Zhang W, Ji X, Li P, Chen N, Zhao S, Wang F, Zou L. Phase 2 trial of "sandwich" L-asparaginase, vincristine, and prednisone chemotherapy with radiotherapy in newly diagnosed, stage IE to IIE, nasal type, extranodal natural killer/T-cell lymphoma. Cancer. 2012 Jul 1;118(13):3294-301. Epub 2011 Dec 2. [https://doi.org/10.1002/cncr.26629 link to original article] '''contains dosing details in manuscript''' [https://pubmed.ncbi.nlm.nih.gov/22139825 PubMed]
+==MESA/RT {{#subobject:54b89d|Regimen=1}}==
+MESA/RT: '''<u>M</u>'''ethotrexate, '''<u>E</u>'''toposide, '''<u>S</u>'''teroid (dexamethasone), PEG-'''<u>A</u>'''-sparaginase alternating with '''<u>R</u>'''adiation '''<u>T</u>'''therapy
+<div class="toccolours" style="background-color:#eeeeee">
+===Protocol {{#subobject:f98dcf|Variant=1}}===
+{| class="wikitable" style="width: 60%; text-align:center;"
+!style="width: 33%"|Study
+!style="width: 33%"|[[Levels_of_Evidence#Evidence|Evidence]]
+!style="width: 33%"|[[Levels_of_Evidence#Efficacy|Efficacy]]
+|-
+|[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5763273/ Liang et al. 2016]
+|style="background-color:#91cf61"|Phase 2
+|style="background-color:#e0ecf4"|ORR: 87%
 |-
-|[https://doi.org/10.1093/annonc/mdf287 Itoh et al. 2002 (JCOG 9505)]
+|}
-|1995-1998
+''Note: this regimen also incorporates radiation, see text for details.''
-|style="background-color:#1a9851"|Randomized Phase 2 (E-de-esc)
+<div class="toccolours" style="background-color:#b3e2cd">
-|[[#Dose-escalated_CHOP_99|dose-escalated CHOP]]
+====Chemotherapy, part 1====
-| style="background-color:#ffffbf" |Did not meet primary endpoint of CR rate
+*[[Methotrexate (MTX)]] 2000 mg/m<sup>2</sup> IV once on day 1
-| style="background-color:#1a9850" |Less toxic
+*[[Etoposide (Vepesid)]] 100 mg/m<sup>2</sup> IV once per day on days 2 to 4
+*[[Pegaspargase (Oncaspar)]] 2500 IU/m<sup>2</sup> IM once on day 5
+====Glucocorticoid therapy, part 1====
+*[[Dexamethasone (Decadron)]] 20 mg/m<sup>2</sup> IV once per day on days 2 to 5
+'''21-day cycle for at least 3 cycles, followed by:'''
+====Radiotherapy====
+*[[External_beam_radiotherapy|Radiation therapy]], 45 to 50 Gy in 25 fractions
+'''One course, followed by:'''
+====Chemotherapy, part 2====
+*[[Methotrexate (MTX)]] 2000 mg/m<sup>2</sup> IV once on day 1
+*[[Etoposide (Vepesid)]] 100 mg/m<sup>2</sup> IV once per day on days 2 to 4
+*[[Pegaspargase (Oncaspar)]] 2500 IU/m<sup>2</sup> IM once on day 5
+====Glucocorticoid therapy, part 1====
+*[[Dexamethasone (Decadron)]] 20 mg/m<sup>2</sup> IV once per day on days 2 to 5
+'''21-day cycle for a maximum of 7 cycles'''
+</div></div>
+===References===
+# Liang R, Gao GX, Chen JP, Wang JS, Wang XM, Zeng Y, Bai QX, Zhang T, Yang L, Dong BX, Gu HT, Shu MM, Hao CX, Wang JH, Zhang N, Chen XQ. A phase 2 study of methotrexate, etoposide, dexamethasone, and pegaspargase chemotherapy for newly diagnosed, relapsed, or refractory extranodal natural killer/T-cell lymphoma, nasal type: a multicenter trial in Northwest China. Hematol Oncol. 2017 Dec;35(4):619-629. Epub 2016 Oct 10. [https://doi.org/10.1002/hon.2325 link to original article] [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5763273/ link to PMC article] '''contains dosing details in manuscript''' [https://pubmed.ncbi.nlm.nih.gov/27723108 PubMed]
+==SMILE {{#subobject:eaf2e1|Regimen=1}}==
+SMILE: '''<u>S</u>'''teroid (Dexamethasone), '''<u>M</u>'''ethotrexate, '''<u>I</u>'''fosfamide, '''<u>L</u>'''-asparaginase, '''<u>E</u>'''toposide
+<div class="toccolours" style="background-color:#eeeeee">
+===Regimen {{#subobject:cfe666|Variant=1}}===
+{| class="wikitable" style="width: 60%; text-align:center;"
+!style="width: 33%"|Study
+!style="width: 33%"|[[Levels_of_Evidence#Evidence|Evidence]]
+!style="width: 33%"|[[Levels_of_Evidence#Efficacy|Efficacy]]
 |-
-|[https://doi.org/10.1200/jco.2007.11.9958 Tsukasaki et al. 2007 (JCOG 9801)]
+|[https://doi.org/10.1200/jco.2011.35.6287 Yamaguchi et al. 2011]
-|1998-2003
+|style="background-color:#91cf61"|Phase 2
-|style="background-color:#1a9851"|Phase 3 (C)
+|style="background-color:#e0ecf4"|ORR: 79%
-|[[#mLSG15|mLSG15]]
-|style="background-color:#fc8d59"|Seems to have inferior CR rate
-| style="background-color:#1a9850" |Less toxic
 |-
 |}
 <div class="toccolours" style="background-color:#b3e2cd">
+====Glucocorticoid therapy====
+*[[Dexamethasone (Decadron)]] 40 mg IV or PO once per day on days 2 to 4
 ====Chemotherapy====
-*[[Cyclophosphamide (Cytoxan)]] 750 mg/m<sup>2</sup> IV once on day 1
+*[[Methotrexate (MTX)]] 2000 mg/m<sup>2</sup> IV over 6 hours once on day 1
-*[[Doxorubicin (Adriamycin)]] 50 mg/m<sup>2</sup> IV once on day 1
+*[[Ifosfamide (Ifex)]] 1500 mg/m<sup>2</sup> IV once per day on days 2 to 4
-*[[Vincristine (Oncovin)]] 1.4 mg/m<sup>2</sup> (maximum dose of 2 mg) IV once on day 1
+*[[Asparaginase (Elspar)]] 6000 units/m<sup>2</sup> IV once per day on days 8, 10, 12, 14, 16, 18, 20
-====Glucocorticoid therapy====
+*[[Etoposide (Vepesid)]] 100 mg/m<sup>2</sup> IV once per day on days 2 to 4
-*[[Prednisone (Sterapred)]] 100 mg PO once per day on days 1 to 5
 ====Supportive therapy====
-*[[Filgrastim (Neupogen)]] given once ANC decreased to less than 1000/uL and continued once per day until count increased to greater than 5000/uL
+*[[Folinic acid (Leucovorin)]] 15 mg IV or PO every 6 hours on days 2 to 4, beginning 30 hours after completion of [[Methotrexate (MTX)]]
-'''14-day cycle for 8 cycles'''
+*[[Mesna (Mesnex)]] 300 mg/m<sup>2</sup> IV three times per day on days 2 to 4; first dose given together with [[Ifosfamide (Ifex)]], second dose given at 4 hours after start of [[Ifosfamide (Ifex)]], and third dose given 8 hours after start of [[Ifosfamide (Ifex)]]
-====CNS therapy====
+*[[Filgrastim (Neupogen)]] (dose not specified) IV or SC once per day, starting on day 6, given until WBC count greater than 5 x 10<sup>9</sup>/L
-''Intrathecal triple-therapy was given during recovery phase of cycles 1, 3, and 5 after platelet count was greater than 70 × 10<sup>9</sup>/L.''
+*[[Trimethoprim-Sulfamethoxazole (Bactrim DS)]] prophylaxis recommended
-*[[Cytarabine (Ara-C)]] 40 mg IT
+'''28-day cycle for 2 cycles'''
-*[[Methotrexate (MTX)]] 15 mg IT
+''After 2 cycles, patients could receive additional treatment with SMILE and/or other chemotherapy, with or without autologous/allogeneic stem cell transplant.''
-*[[Prednisone (Sterapred)]] 10 mg IT
-'''3 doses, total'''
 </div></div>
 ===References===
-# '''JCOG 9505:''' Itoh K, Ohtsu T, Fukuda H, Sasaki Y, Ogura M, Morishima Y, Chou T, Aikawa K, Uike N, Mizorogi F, Ohno T, Ikeda S, Sai T, Taniwaki M, Kawano F, Niimi M, Hotta T, Shimoyama M, Tobinai K; [[Study_Groups#JCOG|JCOG]]. Randomized phase II study of biweekly CHOP and dose-escalated CHOP with prophylactic use of lenograstim (glycosylated G-CSF) in aggressive non-Hodgkin's lymphoma: Japan Clinical Oncology Group Study 9505. Ann Oncol. 2002 Sep;13(9):1347-55. [https://doi.org/10.1093/annonc/mdf287 link to original article] [https://pubmed.ncbi.nlm.nih.gov/12196359 PubMed]
+# '''Phase 1:''' Yamaguchi M, Suzuki R, Kwong YL, Kim WS, Hasegawa Y, Izutsu K, Suzumiya J, Okamura T, Nakamura S, Kawa K, Oshimi K. Phase I study of dexamethasone, methotrexate, ifosfamide, L-asparaginase, and etoposide (SMILE) chemotherapy for advanced-stage, relapsed or refractory extranodal natural killer (NK)/T-cell lymphoma and leukemia. Cancer Sci. 2008 May;99(5):1016-20. Epub 2008 Feb 19. [https://doi.org/10.1111/j.1349-7006.2008.00768.x link to original article] '''contains dosing details in manuscript''' [https://pubmed.ncbi.nlm.nih.gov/18294294 PubMed] content property of [http://hemonc.org HemOnc.org]
-<!-- Presented in part at the 47th Annual Meeting of the American Society of Hematology, December 10-13, 2005, Atlanta, GA. -->
+# Yamaguchi M, Kwong YL, Kim WS, Maeda Y, Hashimoto C, Suh C, Izutsu K, Ishida F, Isobe Y, Sueoka E, Suzumiya J, Kodama T, Kimura H, Hyo R, Nakamura S, Oshimi K, Suzuki R; NK-Cell Tumor Study Group. Phase II study of SMILE chemotherapy for newly diagnosed stage IV, relapsed, or refractory extranodal natural killer (NK)/T-cell lymphoma, nasal type: the NK-Cell Tumor Study Group study. J Clin Oncol. 2011 Nov 20;29(33):4410-6. Epub 2011 Oct 11. [https://doi.org/10.1200/jco.2011.35.6287 link to original article] '''contains dosing details in manuscript''' [https://pubmed.ncbi.nlm.nih.gov/21990393 PubMed]
-# '''JCOG 9801:''' Tsukasaki K, Utsunomiya A, Fukuda H, Shibata T, Fukushima T, Takatsuka Y, Ikeda S, Masuda M, Nagoshi H, Ueda R, Tamura K, Sano M, Momita S, Yamaguchi K, Kawano F, Hanada S, Tobinai K, Shimoyama M, Hotta T, Tomonaga M; [[Study_Groups#JCOG|JCOG]]. VCAP-AMP-VECP compared with biweekly CHOP for adult T-cell leukemia-lymphoma: Japan Clinical Oncology Group Study JCOG9801. J Clin Oncol. 2007 Dec 1;25(34):5458-64. Epub 2007 Oct 29. [https://doi.org/10.1200/jco.2007.11.9958 link to original article] '''contains dosing details in manuscript''' [https://pubmed.ncbi.nlm.nih.gov/17968021 PubMed] NCT00145002
+=Consolidation after upfront therapy=
-==mLSG15 {{#subobject:832886|Regimen=1}}==
+==VIPD {{#subobject:1de775|Regimen=1}}==
+VIPD: '''<u>V</u>'''P-16 (Etoposide), '''<u>I</u>'''fosfamide, '''<u>P</u>'''latinol (Cisplatin), '''<u>D</u>'''examethasone
 <div class="toccolours" style="background-color:#eeeeee">
-===Regimen {{#subobject:1dc050|Variant=1}}===
+===Regimen {{#subobject:76171b|Variant=1}}===
-{| class="wikitable sortable" style="width: 100%; text-align:center;"
+{| class="wikitable" style="width: 40%; text-align:center;"
-!style="width: 20%"|Study
+!style="width: 25%"|Study
-!style="width: 20%"|Years of enrollment
+!style="width: 25%"|[[Levels_of_Evidence#Evidence|Evidence]]
-!style="width: 20%"|[[Levels_of_Evidence#Evidence|Evidence]]
-!style="width: 20%"|Comparator
-!style="width: 20%"|[[Levels_of_Evidence#Comparative_efficacy|Comparative Efficacy]]
 |-
-|[https://doi.org/10.1200/jco.2007.11.9958 Tsukasaki et al. 2007 (JCOG 9801)]
+|[https://doi.org/10.1200/jco.2009.23.8592 Kim et al. 2009 (CISL 2004-10-08)]
-|1998-2003
+|style="background-color:#91cf61"|Phase 2
-|style="background-color:#1a9851"|Phase 3 (E-esc)
-|[[#CHOP-14|CHOP-14]]
-|style="background-color:#91cf60"|Seems to have superior CR rate
 |-
-|[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5024033/ Ishida et al. 2015 (Kyowa 0761-003)]
+|[https://doi.org/10.1111/ejh.12405 Tsai et al. 2014 (T1405)]
-|2010-2011
+|style="background-color:#91cf61"|Phase 2
-|style="background-color:#1a9851"|Randomized Phase 2 (C)
-|[[#mLSG15_.26_Mogamulizumab_99|mLSG15 & Mogamulizumab]]
-|style="background-color:#ffffbf"|Did not meet primary endpoint of CR rate
 |-
 |}
-''Ranimustine is not available in the United States and is approved only in Japan.''
+''Details here are from CISL 2004-10-08.''
+<div class="toccolours" style="background-color:#cbd5e8">
+====Preceding treatment====
+*CISL 2004-10-08: [[#Cisplatin_.26_RT|Cisplatin & concurrent RT]]
+*T1405: [[#DEP_.26_RT|DEP & concurrent RT]]
+</div>
+<div class="toccolours" style="background-color:#b3e2cd">
 ====Chemotherapy====
-*[[Vincristine (Oncovin)]] 1 mg/m<sup>2</sup> (maximum dose of 2 mg) IV once on day 1
+*[[Etoposide (Vepesid)]] 100 mg/m<sup>2</sup> IV over 90 minutes once per day on days 1 to 3
-*[[Cyclophosphamide (Cytoxan)]] 350 mg/m<sup>2</sup> IV once on day 1
+*[[Ifosfamide (Ifex)]] 1200 mg/m<sup>2</sup> IV over 60 minutes once per day on days 1 to 3
-*[[Doxorubicin (Adriamycin)]] 40 mg/m<sup>2</sup> IV once on day 1, then 30 mg/m<sup>2</sup> IV once on day 8
+*[[Cisplatin (Platinol)]] 33 mg/m<sup>2</sup> IV over 60 minutes once per day on days 1 to 3
-*[[Ranimustine (Cymerin)]] 60 mg/m<sup>2</sup> IV once on day 8
-*[[Vindesine (Eldisine)]] 2.4 mg/m<sup>2</sup> IV once on day 15
-*[[Etoposide (Vepesid)]] 100 mg/m<sup>2</sup> IV once per day on days 15 to 17
-*[[Carboplatin (Paraplatin)]] 250 mg/m<sup>2</sup> IV once on day 15
 ====Glucocorticoid therapy====
-*[[Prednisone (Sterapred)]] 40 mg/m<sup>2</sup> PO once per day on days 1, 8, 15 to 17
+*[[Dexamethasone (Decadron)]] 40 mg IV or PO once per day on days 1 to 4
-'''28-day cycle for 6 cycles'''
+====Supportive therapy====
-====CNS therapy, prophylaxis====
+*[[Mesna (Mesnex)]] 240 mg/m<sup>2</sup> IV over 15 minutes once per day on days 1 to 3
-*[[Cytarabine (Ara-C)]] 40 mg IT, admixed with MTX & prednisone
+*[[:Category:Granulocyte colony-stimulating factors|G-CSF]] given for grade 3 or 4 neutropenia
-*[[Methotrexate (MTX)]] 15 mg IT, admixed with Ara-C & prednisone
+'''21-day cycle for up to 3 cycles'''
-*[[Prednisone (Sterapred)]] 10 mg IT, admixed with Ara-C & MTX
-'''Given after cycles 1, 3, and 5 after platelets greater than 70 × 10<sup>9</sup>/L and within 2 days before the next cycle'''
 </div></div>
 ===References===
-<!-- Presented in part at the 47th Annual Meeting of the American Society of Hematology, December 10-13, 2005, Atlanta, GA. -->
+# '''CISL 2004-10-08:''' Kim SJ, Kim K, Kim BS, Kim CY, Suh C, Huh J, Lee SW, Kim JS, Cho J, Lee GW, Kang KM, Eom HS, Pyo HR, Ahn YC, Ko YH, Kim WS; Consortium for Improving Survival of Lymphoma. Phase II trial of concurrent radiation and weekly cisplatin followed by VIPD chemotherapy in newly diagnosed,  stage IE to IIE, nasal, extranodal NK/T-Cell Lymphoma: Consortium for Improving Survival of Lymphoma study. J Clin Oncol. 2009 Dec 10;27(35):6027-32. [https://doi.org/10.1200/jco.2009.23.8592 link to original article] '''contains dosing details in manuscript''' [https://pubmed.ncbi.nlm.nih.gov/19884539 PubMed] NCT00418535
-#'''JCOG 9801:''' Tsukasaki K, Utsunomiya A, Fukuda H, Shibata T, Fukushima T, Takatsuka Y, Ikeda S, Masuda M, Nagoshi H, Ueda R, Tamura K, Sano M, Momita S, Yamaguchi K, Kawano F, Hanada S, Tobinai K, Shimoyama M, Hotta T, Tomonaga M; [[Study_Groups#JCOG|JCOG]]. VCAP-AMP-VECP compared with biweekly CHOP for adult T-cell leukemia-lymphoma: Japan Clinical Oncology Group Study JCOG9801. J Clin Oncol. 2007 Dec 1;25(34):5458-64. Epub 2007 Oct 29. [https://doi.org/10.1200/jco.2007.11.9958 link to original article] '''contains dosing details in manuscript''' [https://pubmed.ncbi.nlm.nih.gov/17968021 PubMed] NCT00145002
+#'''T1405:''' Tsai HJ, Lin SF, Chen CC, Chen TY, Su WC, Hwang WL, Lin JC, Chiou TJ, Kao WY, Chiu CF, Chang YF, Chang JS, Chang MC, Su IJ. Long-term results of a phase II trial with frontline concurrent chemoradiotherapy followed by consolidation chemotherapy for localized nasal natural killer/T-cell lymphoma. Eur J Haematol. 2015 Feb;94(2):130-7. Epub 2014 Oct 10. [https://doi.org/10.1111/ejh.12405 link to original article] [https://pubmed.ncbi.nlm.nih.gov/24957163 PubMed] NCT00292695
-#'''Kyowa 0761-003:''' Ishida T, Jo T, Takemoto S, Suzushima H, Uozumi K, Yamamoto K, Uike N, Saburi Y, Nosaka K, Utsunomiya A, Tobinai K, Fujiwara H, Ishitsuka K, Yoshida S, Taira N, Moriuchi Y, Imada K, Miyamoto T, Akinaga S, Tomonaga M, Ueda R. Dose-intensified chemotherapy alone or in combination with mogamulizumab in newly diagnosed aggressive adult T-cell leukaemia-lymphoma: a randomized phase II study. Br J Haematol. 2015 Jun;169(5):672-82. Epub 2015 Mar 2. [https://doi.org/10.1111/bjh.13338 link to original article] [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5024033/ link to PMC article] [https://pubmed.ncbi.nlm.nih.gov/25733162 PubMed] NCT01173887
 =Relapsed or refractory=
-==Alemtuzumab monotherapy {{#subobject:efc45a|Regimen=1}}==
+==AspaMetDex {{#subobject:407753|Regimen=1}}==
+AspaMetDex: '''<u>Aspa</u>'''raginase, '''<u>Met</u>'''hotrexate, '''<u>Dex</u>'''amethasone
 <div class="toccolours" style="background-color:#eeeeee">
-===Regimen {{#subobject:32e392|Variant=1}}===
+===Regimen {{#subobject:305a48|Variant=1}}===
-{| class="wikitable sortable" style="width: 60%; text-align:center;"
+{| class="wikitable" style="width: 60%; text-align:center;"
 !style="width: 33%"|Study
-!style="width: 33%"|Years of enrollment
 !style="width: 33%"|[[Levels_of_Evidence#Evidence|Evidence]]
+!style="width: 33%"|[[Levels_of_Evidence#Efficacy|Efficacy]]
 |-
-|[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5215752/ Sharma et al. 2016]
+|[http://www.bloodjournal.org/content/117/6/1834.long Jaccard et al. 2011 (I05009)]
-|2004-2009
 |style="background-color:#91cf61"|Phase 2
+| style="background-color:#e0ecf4" |ORR: 78%
 |-
 |}
 <div class="toccolours" style="background-color:#b3e2cd">
-====Targeted therapy====
+====Chemotherapy====
-*[[Alemtuzumab (Campath)]] 30 mg IV once per day on days 1, 3, 5 (three times per week)
+*[[Asparaginase (Elspar)]] 6000 units/m<sup>2</sup> IM once per day on days 2, 4, 6, 8
-'''7-day cycle for up to 7 cycles'''
+*[[Methotrexate (MTX)]] by the following age-based criteria:
+**Age up to 70: 3000 mg/m<sup>2</sup> (route not specified) once on day 1
+**Older than 70: 2000 mg/m<sup>2</sup> (route not specified) once on day 1
+====Glucocorticoid therapy====
+*[[Dexamethasone (Decadron)]] by the following age-based criteria:
+**Age up to 70: 40 mg PO once per day on days 1 to 4
+**Older than 70: 20 mg PO once per day on days 1 to 4
+====Supportive therapy====
+*[[Trimethoprim-Sulfamethoxazole (Bactrim DS)]] (dose/route/schedule not specified) prophylaxis, discontinued during [[Methotrexate (MTX)]] administration
+*[[Valacyclovir (Valtrex)]] (dose/route/schedule not specified) prophylaxis
+*For [[Methotrexate (MTX)]]: alkaline hydration and [[Folinic acid (Leucovorin)]] rescue (dose/route/schedule not specified)
+'''21-day cycle for 3 cycles'''
+</div>
+<div class="toccolours" style="background-color:#cbd5e7">
+====Subsequent treatment====
+*See paper for details about further treatment
 </div></div>
 ===References===
-<!-- Presented in abstract form at the 50th Annual Meeting of the American Society of Hematology, San Francisco, CA, December 6–9, 2008. -->
+# '''I05009:''' Jaccard A, Gachard N, Marin B, Rogez S, Audrain M, Suarez F, Tilly H, Morschhauser F, Thieblemont C, Ysebaert L, Devidas A, Petit B, de Leval L, Gaulard P, Feuillard J, Bordessoule D, Hermine O; GELA; GOELAMS. Efficacy of L-asparaginase with methotrexate and dexamethasone (AspaMetDex regimen) in patients with refractory or relapsing extranodal NK/T-cell lymphoma, a phase 2 study. Blood. 2011 Feb 10;117(6):1834-9. [http://www.bloodjournal.org/content/117/6/1834.long link to original article] '''contains dosing details in manuscript''' [https://pubmed.ncbi.nlm.nih.gov/21123825 PubMed] NCT00283985
-# Sharma K, Janik JE, O'Mahony D, Stewart D, Pittaluga S, Stetler-Stevenson M, Jaffe ES, Raffeld M, Fleisher TA, Lee CC, Steinberg SM, Waldmann TA, Morris JC. Phase II study of alemtuzumab (CAMPATH-1) in patients with HTLV-1-associated adult T-cell leukemia/lymphoma. Clin Cancer Res. 2017 Jan 1;23(1):35-42. Epub 2016 Aug 2. [http://clincancerres.aacrjournals.org/content/23/1/35.long link to original article] '''contain protocol''' [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5215752/ link to PMC article] [https://pubmed.ncbi.nlm.nih.gov/27486175 PubMed]
+==AspaMetDex (Erwinaze) {{#subobject:402253|Regimen=1}}==
-==Lenalidomide monotherapy {{#subobject:b2b90e|Regimen=1}}==
+AspaMetDex: '''<u>Aspa</u>'''raginase, '''<u>Met</u>'''hotrexate, '''<u>Dex</u>'''amethasone
 <div class="toccolours" style="background-color:#eeeeee">
-===Regimen {{#subobject:662944|Variant=1}}===
+===Regimen {{#subobject:308gy8|Variant=1}}===
-{| class="wikitable sortable" style="width: 80%; text-align:center;"
+{| class="wikitable" style="width: 60%; text-align:center;"
-!style="width: 25%"|Study
+!style="width: 33%"|Study
-!style="width: 25%"|Years of enrollment
+!style="width: 33%"|[[Levels_of_Evidence#Evidence|Evidence]]
-!style="width: 25%"|[[Levels_of_Evidence#Evidence|Evidence]]
+!style="width: 33%"|[[Levels_of_Evidence#Efficacy|Efficacy]]
-!style="width: 25%"|[[Levels_of_Evidence#Efficacy|Efficacy]]
+|-
+|[http://www.bloodjournal.org/content/117/6/1834.long Jaccard et al. 2011 (I05009)]
+|style="background-color:#91cf61"|Phase 2
+| style="background-color:#e0ecf4" |ORR: 78%
+|-
+|}
+''Note: this regimen is for patients with allergies to asparaginase.''
+<div class="toccolours" style="background-color:#b3e2cd">
+====Chemotherapy====
+*[[Asparaginase Erwinia chrysanthemi (Erwinaze)]] 20,000 units/m<sup>2</sup> IM once per day on days 2, 4, 6, 8
+*[[Methotrexate (MTX)]] by the following age-based criteria:
+**Age up to 70: 3000 mg/m<sup>2</sup> (route not specified) once on day 1
+**Older than 70: 2000 mg/m<sup>2</sup> (route not specified) once on day 1
+====Glucocorticoid therapy====
+*[[Dexamethasone (Decadron)]] by the following age-based criteria:
+**Age up to 70: 40 mg PO once per day on days 1 to 4
+**Older than 70: 20 mg PO once per day on days 1 to 4
+====Supportive therapy====
+*[[Trimethoprim-Sulfamethoxazole (Bactrim DS)]] (dose/route/schedule not specified) prophylaxis, discontinued during [[Methotrexate (MTX)]] administration
+*[[Valacyclovir (Valtrex)]] (dose/route/schedule not specified) prophylaxis
+*For [[Methotrexate (MTX)]]: alkaline hydration and [[Folinic acid (Leucovorin)]] rescue (dose/route/schedule not specified)
+'''21-day cycle for 3 cycles'''
+</div>
+<div class="toccolours" style="background-color:#cbd5e7">
+====Subsequent treatment====
+*See paper for details about further treatment
+</div></div>
+===References===
+# '''I05009:''' Jaccard A, Gachard N, Marin B, Rogez S, Audrain M, Suarez F, Tilly H, Morschhauser F, Thieblemont C, Ysebaert L, Devidas A, Petit B, de Leval L, Gaulard P, Feuillard J, Bordessoule D, Hermine O; GELA; GOELAMS. Efficacy of L-asparaginase with methotrexate and dexamethasone (AspaMetDex regimen) in patients with refractory or relapsing extranodal NK/T-cell lymphoma, a phase 2 study. Blood. 2011 Feb 10;117(6):1834-9. [http://www.bloodjournal.org/content/117/6/1834.long link to original article] '''contains dosing details in manuscript''' [https://pubmed.ncbi.nlm.nih.gov/21123825 PubMed] NCT00283985
+==L-Asparaginase, Vincristine, Prednisolone {{#subobject:1ba9b6|Regimen=1}}==
+LVP: '''<u>L</u>'''-asparaginase, '''<u>V</u>'''incristine, '''<u>P</u>'''rednisolone
+<div class="toccolours" style="background-color:#eeeeee">
+===Regimen {{#subobject:651a7|Variant=1}}===
+{| class="wikitable" style="width: 60%; text-align:center;"
+!style="width: 33%"|Study
+!style="width: 33%"|[[Levels_of_Evidence#Evidence|Evidence]]
+!style="width: 33%"|[[Levels_of_Evidence#Efficacy|Efficacy]]
+|-
+|[https://doi.org/10.1007/bf02983387 Yong et al. 2003]
+|style="background-color:#ffffbe"|Phase 2, <20 patients
+| style="background-color:#e0ecf4" |ORR: 83%
+|-
+|}
+''Regimen details are from a review article; original article is not available through PubMed''
+====Chemotherapy====
+*[[Asparaginase (Elspar)]] 6000 units/m<sup>2</sup> IV once per day on days 1 to 5
+*[[Vincristine (Oncovin)]] 1.4 mg/m<sup>2</sup> IV once on day 1
+====Glucocorticoid therapy====
+*[[Prednisolone (Millipred)]] 100 mg PO once per day on days 1 to 5
+</div></div>
+===References===
+# Yong W, Zheng W, Zhang Y, Zhu J, Wei Y, Zhu D, Li J. L-asparaginase-based regimen in the treatment of refractory midline nasal/nasal-type T/NK-cell lymphoma. Int J Hematol. 2003 Aug;78(2):163-7. [https://doi.org/10.1007/bf02983387 link to original article] [https://pubmed.ncbi.nlm.nih.gov/12953813 PubMed]
+==SMILE {{#subobject:924b1a|Regimen=1}}==
+SMILE: '''<u>S</u>'''teroid (Dexamethasone), '''<u>M</u>'''ethotrexate, '''<u>I</u>'''fosfamide, '''<u>L</u>'''-asparaginase, '''<u>E</u>'''toposide
+<div class="toccolours" style="background-color:#eeeeee">
+===Regimen {{#subobject:aa2ac|Variant=1}}===
+{| class="wikitable" style="width: 60%; text-align:center;"
+!style="width: 33%"|Study
+!style="width: 33%"|[[Levels_of_Evidence#Evidence|Evidence]]
+!style="width: 33%"|[[Levels_of_Evidence#Efficacy|Efficacy]]
 |-
-|[https://doi.org/10.1200/JCO.2016.67.7732 Ishida et al. 2016 (ATLL-002)]
+|[https://doi.org/10.1200/jco.2011.35.6287 Yamaguchi et al. 2011]
-|2012-2014
 |style="background-color:#91cf61"|Phase 2
-|ORR: 42% (95% CI 23-63)
+| style="background-color:#e0ecf4" |ORR: 79%
 |-
 |}
 <div class="toccolours" style="background-color:#b3e2cd">
-====Targeted therapy====
+====Glucocorticoid therapy====
-*[[Lenalidomide (Revlimid)]] 25 mg PO once per day
+*[[Dexamethasone (Decadron)]] 40 mg IV or PO once per day on days 2 to 4
-'''Continued indefinitely'''
+====Chemotherapy====
+*[[Methotrexate (MTX)]] 2000 mg/m<sup>2</sup> IV over 6 hours once on day 1
+*[[Ifosfamide (Ifex)]] 1500 mg/m<sup>2</sup> IV once per day on days 2 to 4
+*[[Asparaginase (Elspar)]] 6000 units/m<sup>2</sup> IV once per day on days 8, 10, 12, 14, 16, 18, 20
+*[[Etoposide (Vepesid)]] 100 mg/m<sup>2</sup> IV once per day on days 2 to 4
+====Supportive therapy====
+*[[Folinic acid (Leucovorin)]] 15 mg IV or PO every 6 hours on days 2 to 4, beginning 30 hours after completion of [[Methotrexate (MTX)]]
+*[[Mesna (Mesnex)]] 300 mg/m<sup>2</sup> IV three times per day on days 2 to 4; first dose given together with [[Ifosfamide (Ifex)]], second dose given at 4 hours after start of [[Ifosfamide (Ifex)]], and third dose given 8 hours after start of [[Ifosfamide (Ifex)]]
+*[[Filgrastim (Neupogen)]] (dose not specified) IV or SC once per day, starting on day 6, given until WBC count greater than 5 x 10<sup>9</sup>/L
+*[[Trimethoprim-Sulfamethoxazole (Bactrim DS)]] prophylaxis recommended
+'''28-day cycle for 2 cycles'''
+''After 2 cycles, patients could receive additional treatment with SMILE and/or other chemotherapy, with or without autologous/allogeneic stem cell transplant.''
 </div></div>
 ===References===
-# '''ATLL-002:''' Ishida T, Fujiwara H, Nosaka K, Taira N, Abe Y, Imaizumi Y, Moriuchi Y, Jo T, Ishizawa K, Tobinai K, Tsukasaki K, Ito S, Yoshimitsu M, Otsuka M, Ogura M, Midorikawa S, Ruiz W, Ohtsu T. Multicenter phase II study of lenalidomide in relapsed or recurrent adult T-cell leukemia/lymphoma: ATLL-002. J Clin Oncol. 2016 Dec;34(34):4086-4093. [https://doi.org/10.1200/JCO.2016.67.7732 link to original article] [https://pubmed.ncbi.nlm.nih.gov/27621400 PubMed] NCT01724177
+# '''Phase 1:''' Yamaguchi M, Suzuki R, Kwong YL, Kim WS, Hasegawa Y, Izutsu K, Suzumiya J, Okamura T, Nakamura S, Kawa K, Oshimi K. Phase I study of dexamethasone, methotrexate, ifosfamide, L-asparaginase, and etoposide (SMILE) chemotherapy for advanced-stage, relapsed or refractory extranodal natural killer (NK)/T-cell lymphoma and leukemia. Cancer Sci. 2008 May;99(5):1016-20. Epub 2008 Feb 19. [https://doi.org/10.1111/j.1349-7006.2008.00768.x link to original article] '''contains dosing details in manuscript''' [https://pubmed.ncbi.nlm.nih.gov/18294294 PubMed] content property of [http://hemonc.org HemOnc.org]
-[[Category:Adult T-cell leukemia-lymphoma regimens]]
+# Yamaguchi M, Kwong YL, Kim WS, Maeda Y, Hashimoto C, Suh C, Izutsu K, Ishida F, Isobe Y, Sueoka E, Suzumiya J, Kodama T, Kimura H, Hyo R, Nakamura S, Oshimi K, Suzuki R; NK-Cell Tumor Study Group. Phase II study of SMILE chemotherapy for newly diagnosed stage IV, relapsed, or refractory extranodal natural killer (NK)/T-cell lymphoma, nasal type: the NK-Cell Tumor Study Group study. J Clin Oncol. 2011 Nov 20;29(33):4410-6. Epub 2011 Oct 11. [https://doi.org/10.1200/jco.2011.35.6287 link to original article] '''contains dosing details in manuscript''' [https://pubmed.ncbi.nlm.nih.gov/21990393 PubMed]
+[[Category:Extranodal NK- and T-cell lymphoma, nasal type regimens]]
 [[Category:Disease-specific pages]]
-[[Category:Acute leukemias]]
 [[Category:T-cell lymphomas]]
-[[Category:T-cell leukemias]]

Difference between revisions of "Staging page"

Revision as of 12:33, 29 October 2022

Guidelines

ESMO

"How I Treat"

NCCN

Untreated

Cisplatin & RT

Regimen

Chemotherapy

Radiotherapy

Subsequent treatment

References

DEP & RT

Regimen

Glucocorticoid therapy

Chemotherapy

Radiotherapy

Subsequent treatment

References

DeVIC & RT

Regimen

Glucocorticoid therapy, Dose Level I

Chemotherapy, Dose Level I

Glucocorticoid therapy, Dose Level II

Chemotherapy, Dose Level II

Supportive therapy

Radiotherapy

References

GELOX/RT

Protocol

Chemotherapy, part 1

Radiotherapy

Chemotherapy, part 2

References

LVP "Sandwich"

Protocol

Chemotherapy, part 1

Glucocorticoid therapy, part 1

Radiotherapy

Chemotherapy, part 2

Glucocorticoid therapy, part 2

References

MESA/RT

Protocol

Chemotherapy, part 1

Glucocorticoid therapy, part 1

Radiotherapy

Chemotherapy, part 2

Glucocorticoid therapy, part 1

References

SMILE

Regimen

Glucocorticoid therapy

Chemotherapy

Supportive therapy

References

Consolidation after upfront therapy

VIPD

Regimen

Preceding treatment

Chemotherapy

Glucocorticoid therapy

Supportive therapy

References

Relapsed or refractory

AspaMetDex

Regimen

Chemotherapy

Glucocorticoid therapy

Supportive therapy

Subsequent treatment

References

AspaMetDex (Erwinaze)

Regimen

Chemotherapy

Glucocorticoid therapy

Supportive therapy

Subsequent treatment

References