Difference between revisions of "Staging page"

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<div class="noprint" style="background-color:LightGray; position:fixed; bottom:2%; right:0.25%; padding-left:5px; padding-right:5px; margin: 15px; opacity:0.8; border-style: solid; border-color:DarkGray; border-width: 1px">
 
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[[#top|Back to Top]]
 
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</div>
 
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{{#lst:Section editor transclusions|peds}}
 
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<big>''This page contains studies that were specific to pediatric populations. For the more general ALCL page, follow [[Anaplastic large cell lymphoma|this link]].</big>
 
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{| class="wikitable" style="float:right; margin-right: 5px;"
 
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|-
 
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|<div style="background-color: #fee0d1; border: 1px solid #808000; padding: 5px; {{border-radius|16px}}" align="right"><font size="4"><b>{{#ask: [[-Has subobject::{{FULLPAGENAME}}]] |?Regimen |limit=10000|format=sum}} [[Tutorial#Regimens|regimens]] on this page</b></font></div>
 
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<div style="background-color: #deebf6; border: 1px solid #808000; padding: 5px; {{border-radius|16px}}"><font size="4"><b>{{#ask: [[-Has subobject::{{FULLPAGENAME}}]] |?Variant |limit=10000|format=sum}} [[Tutorial#Variants|variants]] on this page</b></font></div>
 
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|}
 
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{{TOC limit|limit=3}}
 
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=Untreated=
 
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==COG ANHL12P1 protocol {{#subobject:69ug1e|Regimen=1}}==
 
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<div class="toccolours" style="background-color:#eeeeee">
 
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===Pre-phase {{#subobject:1yxa91|Variant=1}}===
 
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{| class="wikitable sortable" style="width: 60%; text-align:center;"
 
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!style="width: 33%"|Study
 
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!style="width: 33%"|Years of enrollment
 
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!style="width: 33%"|[[Levels_of_Evidence#Evidence|Evidence]]
 
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|-
 
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|[https://www.ncbi.nlm.nih.gov/pmc/articles/pmc8462406/ Lowe et al. 2021 (COG ANHL12P1)]
 
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|2013-2017
 
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| style="background-color:#91cf61" |Randomized Phase 2
 
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|-
 
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|}
 
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''Note: there appear to be several dosing errors in Table 2; the authors have been contacted for clarification.''
 
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<div class="toccolours" style="background-color:#b3e2cd">
 
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====Chemotherapy====
 
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*[[Cyclophosphamide (Cytoxan)]] 200 mg/m<sup>2</sup> IV once per day on days 1 & 2
 
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====Glucocorticoid therapy====
 
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*[[Dexamethasone (Decadron)]] 5 mg/m<sup>2</sup>/day PO on days 1 & 2, then 10 mg/m<sup>2</sup>/day PO on days 3 to 5
 
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====CNS therapy, prophylaxis====
 
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*[[Methotrexate (MTX)]] age-based IT once on day 1
 
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'''5-day course'''
 
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</div></div><br>
 
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<div class="toccolours" style="background-color:#eeeeee">
 
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===Induction {{#subobject:1yxa92|Variant=1}}===
 
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====Antibody-drug conjugate therapy====
 
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*[[Brentuximab vedotin (Adcetris)]] 1.8 mg/kg (maximum dose of 180 mg) IV over 30 minutes once on day 1
 
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====Chemotherapy====
 
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*[[Methotrexate (MTX)]] 3000 mg/m<sup>2</sup> IV over 3 hours once on day 1
 
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*[[Ifosfamide (Ifex)]] as follows:
 
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**Cycles 1, 3, 5: 800 mg/m<sup>2</sup> IV once per day on days 1 to 5
 
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*[[Etoposide (Vepesid)]] as follows:
 
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**Cycles 1, 3, 5: 100 mg/m<sup>2</sup> IV once per day on days 4 & 5
 
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*[[Cytarabine (Ara-C)]] as follows:
 
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**Cycles 1, 3, 5: 150 mg/m<sup>2</sup> IV every 12 hours on days 4 & 5 (total dose per cycle: 600 mg/m<sup>2</sup>)
 
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*[[Cyclophosphamide (Cytoxan)]] as follows:
 
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**Cycles 2, 4, 6: 200 mg/m<sup>2</sup> IV once per day on days 1 to 5
 
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*[[Doxorubicin (Adriamycin)]] as follows:
 
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**Cycles 2, 4, 6: 25 mg/m<sup>2</sup> IV once per day on days 4 & 5
 
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====Glucocorticoid therapy====
 
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*[[Dexamethasone (Decadron)]] 10 mg/m<sup>2</sup>/day PO on days 1 to 5
 
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'''21-day cycle for 6 cycles'''
 
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</div></div>
 
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===References===
 
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#'''COG ANHL12P1:''' Lowe EJ, Reilly AF, Lim MS, Gross TG, Saguilig L, Barkauskas DA, Wu R, Alexander S, Bollard CM. Brentuximab vedotin in combination with chemotherapy for pediatric patients with ALK+ ALCL: results of COG trial ANHL12P1. Blood. 2021 Jul 1;137(26):3595-3603. [https://doi.org/10.1182/blood.2020009806 link to original article] '''contains dosing details in manuscript''' [https://www.ncbi.nlm.nih.gov/pmc/articles/pmc8462406/ link to PMC article] [https://pubmed.ncbi.nlm.nih.gov/33684925/ PubMed] NCT01979536
 
  
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==EICNHL ALCL99 protocol {{#subobject:69ug1e|Regimen=1}}==
 
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<div class="toccolours" style="background-color:#eeeeee">
 
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===Pre-phase {{#subobject:1yxa91|Variant=1}}===
 
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{| class="wikitable sortable" style="width: 100%; text-align:center;"
 
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!style="width: 17%"|Study
 
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!style="width: 15%"|Years of enrollment
 
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!style="width: 17%"|[[Levels_of_Evidence#Evidence|Evidence]]
 
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!style="width: 17%"|Comparator
 
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!style="width: 17%"|[[Levels_of_Evidence#Comparative_efficacy|Comparative Efficacy]]
 
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!style="width: 17%"|[[Levels_of_Evidence#Toxicity|Comparative Toxicity]]
 
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|-
 
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|[https://doi.org/10.1200/jco.2008.18.1487 Brugières et al. 2009 (EICNHL ALCL99)]
 
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|1999-2005
 
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| style="background-color:#1a9851" |Randomized (E-switch-ic)
 
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|[[#EICNHL_ALCL99_protocol|EICHNL ALCL99]]; alternate MTX dosing
 
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| style="background-color:#ffffbf" |Inconclusive whether non-inferior EFS
 
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| style="background-color:#1a9850" |Less toxic
 
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|-
 
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|}
 
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''Note: the intrathecal component is only described as "triple therapy" in the manuscript.''
 
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<div class="toccolours" style="background-color:#b3e2cd">
 
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====Chemotherapy====
 
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*[[Cyclophosphamide (Cytoxan)]] 200 mg/m<sup>2</sup> IV once per day on days 1 & 2
 
−
====Glucocorticoid therapy====
 
−
*[[Dexamethasone (Decadron)]] 5 mg/m<sup>2</sup>/day PO on days 1 & 2, then 10 mg/m<sup>2</sup>/day PO on days 3 to 5
 
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====CNS therapy, prophylaxis====
 
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*[[Methotrexate (MTX)]] (dose not specified) IT once on day 1
 
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*[[Cytarabine (Ara-C)]] (dose not specified) IT once on day 1
 
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*[[Hydrocortisone (Cortef)]] (dose not specified) IT once on day 1
 
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'''5-day course'''
 
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<div class="toccolours" style="background-color:#eeeeee">
 
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===Induction {{#subobject:1yjxo1|Variant=1}}===
 
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====Chemotherapy====
 
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*[[Methotrexate (MTX)]] 3000 mg/m<sup>2</sup> IV over 3 hours once on day 1
 
−
*[[Ifosfamide (Ifex)]] as follows:
 
−
**Cycles 1, 3, 5: 800 mg/m<sup>2</sup> IV once per day on days 1 to 5
 
−
*[[Etoposide (Vepesid)]] as follows:
 
−
**Cycles 1, 3, 5: 100 mg/m<sup>2</sup> IV once per day on days 4 & 5
 
−
*[[Cytarabine (Ara-C)]] as follows:
 
−
**Cycles 1, 3, 5: 150 mg/m<sup>2</sup> IV every 12 hours on days 4 & 5 (total dose per cycle: 600 mg/m<sup>2</sup>)
 
−
*[[Cyclophosphamide (Cytoxan)]] as follows:
 
−
**Cycles 2, 4, 6: 200 mg/m<sup>2</sup> IV once per day on days 1 to 5
 
−
*[[Doxorubicin (Adriamycin)]] as follows:
 
−
**Cycles 2, 4, 6: 25 mg/m<sup>2</sup> IV once per day on days 4 & 5
 
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====Glucocorticoid therapy====
 
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*[[Dexamethasone (Decadron)]] 10 mg/m<sup>2</sup>/day PO on days 1 to 5
 
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'''21-day cycle for 6 cycles'''
 
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</div></div>
 
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===References===
 
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#'''EICNHL ALCL99:''' Brugières L, Le Deley MC, Rosolen A, Williams D, Horibe K, Wrobel G, Mann G, Zsiros J, Uyttebroeck A, Marky I, Lamant L, Reiter A. Impact of the methotrexate administration dose on the need for intrathecal treatment in children and adolescents with anaplastic large-cell lymphoma: results of a randomized trial of the EICNHL Group. J Clin Oncol. 2009 Feb 20;27(6):897-903. Epub 2009 Jan 12. [https://doi.org/10.1200/jco.2008.18.1487 link to original article] '''contains dosing details in manuscript''' [https://pubmed.ncbi.nlm.nih.gov/19139435/ PubMed] NCT00006455
 
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==APO{{#subobject:6964de|Regimen=1}}==
 
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APO: '''<u>A</u>'''driamycin (Doxorubicin), '''<u>P</u>'''rednisone, '''<u>O</u>'''ncovin (Vincristine)
 
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HOP: '''<u>H</u>'''ydroxydaunorubicin (Doxorubicin), '''<u>O</u>'''ncovin (Vincristine), '''<u>P</u>'''rednisone
 
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<br>
 
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<div class="toccolours" style="background-color:#eeeeee">
 
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===Regimen {{#subobject:985a91|Variant=1}}===
 
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{| class="wikitable sortable" style="width: 60%; text-align:center;"
 
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!style="width: 33%"|Study
 
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!style="width: 33%"|Years of enrollment
 
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!style="width: 33%"|[[Levels_of_Evidence#Evidence|Evidence]]
 
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|-
 
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|[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4682366/ Alexander et al. 2014 (COG ANHL0131)]
 
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|2004-2008
 
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| style="background-color:#91cf61" |Non-randomized portion of phase 3 RCT
 
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|-
 
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|}
 
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<div class="toccolours" style="background-color:#b3e2cd">
 
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====Chemotherapy====
 
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*[[Doxorubicin (Adriamycin)]] 75 mg/m<sup>2</sup> IV once per day on days 1 & 22
 
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*[[Vincristine (Oncovin)]] 1.5 mg/m<sup>2</sup> (maximum dose of 2 mg) IV once per day on days 1, 8, 15, 22, 29
 
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====Glucocorticoid therapy====
 
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*[[Prednisone (Sterapred)]] 40 mg/m<sup>2</sup>/day PO on days 1 to 28
 
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====CNS therapy, prophylaxis====
 
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*[[Methotrexate (MTX)]] age-adjusted IT once per day on days 1, 8, 22
 
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'''6-week course'''
 
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</div>
 
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<div class="toccolours" style="background-color:#cbd5e7">
 
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====Subsequent treatment====
 
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*APO versus APV maintenance
 
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</div></div>
 
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===References===
 
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# '''COG ANHL0131:''' Alexander S, Kraveka JM, Weitzman S, Lowe E, Smith L, Lynch JC, Chang M, Kinney MC, Perkins SL, Laver J, Gross TG, Weinstein H. Advanced stage anaplastic large cell lymphoma in children and adolescents: results of ANHL0131, a randomized phase III trial of APO versus a modified regimen with vinblastine: a report from the children's oncology group. Pediatr Blood Cancer. 2014 Dec;61(12):2236-42. Epub 2014 Aug 23. [https://doi.org/10.1002/pbc.25187 link to original article] [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4682366/ link to PMC article] '''contains dosing details in manuscript''' [https://pubmed.ncbi.nlm.nih.gov/25156886 PubMed] NCT00059839
 
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=Relapsed or refractory, subsequent lines of therapy=
 
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==Crizotinib monotherapy {{#subobject:be5391|Regimen=1}}==
 
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<div class="toccolours" style="background-color:#eeeeee">
 
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===Regimen {{#subobject:e9c195|Variant=1}}===
 
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{| class="wikitable" style="color:white; background-color:#404040"
 
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|<small>'''FDA-recommended dose'''</small>
 
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|-
 
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|}
 
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{| class="wikitable sortable" style="width: 60%; text-align:center;"
 
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!style="width: 33%"|Study
 
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!style="width: 33%"|Years of enrollment
 
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!style="width: 33%"|[[Levels_of_Evidence#Evidence|Evidence]]
 
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|-
 
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|[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3730818/ Mossé et al. 2013 (COG ADVL0912)]
 
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|2009-2012
 
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| style="background-color:#91cf61" |Phase 1/2 (RT)
 
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|-
 
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|}
 
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''Note: this was an expansion cohort of a phase 1/2 study.''
 
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<div class="toccolours" style="background-color:#fdcdac">
 
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====Biomarker eligibility criteria====
 
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*ALK rearrangement
 
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</div>
 
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<div class="toccolours" style="background-color:#b3e2cd">
 
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====Targeted therapy====
 
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*[[Crizotinib (Xalkori)]] 280 mg/m<sup>2</sup> PO twice per day
 
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'''28-day cycles'''
 
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</div></div>
 
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===References===
 
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# '''COG ADVL0912:''' Mossé YP, Lim MS, Voss SD, Wilner K, Ruffner K, Laliberte J, Rolland D, Balis FM, Maris JM, Weigel BJ, Ingle AM, Ahern C, Adamson PC, Blaney SM. Safety and activity of crizotinib for paediatric patients with refractory solid tumours or anaplastic large-cell lymphoma: a Children's Oncology Group phase 1 consortium study. Lancet Oncol. 2013 May;14(6):472-80. Epub 2013 Apr 16. [https://doi.org/10.1016/s1470-2045(13)70095-0 link to original article] [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3730818/ link to PMC article] '''contains dosing details in manuscript''' [https://pubmed.ncbi.nlm.nih.gov/23598171 PubMed] NCT00939770
 
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[[Category:Anaplastic large cell lymphoma regimens]]
 
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[[Category:Disease-specific pages]]
 
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[[Category:T-cell lymphomas]]
 
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[[Category:Pediatric hematologic neoplasms]]
 

Latest revision as of 00:13, 18 June 2023

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