Difference between revisions of "Mediastinal gray-zone lymphoma"

From HemOnc.org - A Hematology Oncology Wiki
Jump to navigation Jump to search
m (Text replacement - "clinicaltrials.gov/ct2/show" to "clinicaltrials.gov/study")
m
 
(7 intermediate revisions by 2 users not shown)
Line 3: Line 3:
 
[[#top|Back to Top]]
 
[[#top|Back to Top]]
 
</div>
 
</div>
−
{{#lst:Section editor transclusions|anhl}}
+
{{#lst:Editorial board transclusions|anhl}}
 
{| class="wikitable" style="float:right; margin-right: 5px;"
 
{| class="wikitable" style="float:right; margin-right: 5px;"
 
|-
 
|-
Line 17: Line 17:
 
<div class="toccolours" style="background-color:#eeeeee">
 
<div class="toccolours" style="background-color:#eeeeee">
 
===Regimen {{#subobject:3202d4|Variant=1}}===
 
===Regimen {{#subobject:3202d4|Variant=1}}===
−
{| class="wikitable" style="width: 40%; text-align:center;"  
+
{| class="wikitable sortable" style="width: 60%; text-align:center;"  
−
!style="width: 25%"|Study
+
!style="width: 33%"|Study
−
!style="width: 25%"|[[Levels_of_Evidence#Evidence|Evidence]]
+
!style="width: 33%"|Dates of enrollment
 +
!style="width: 33%"|[[Levels_of_Evidence#Evidence|Evidence]]
 
|-
 
|-
 
|[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4155269/ Wilson et al. 2014 (NCI 93-C-0133<sub>MGZL</sub>)]
 
|[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4155269/ Wilson et al. 2014 (NCI 93-C-0133<sub>MGZL</sub>)]
 +
|NR
 
|style="background-color:#91cf61"|Phase 2
 
|style="background-color:#91cf61"|Phase 2
 
|-
 
|-
Line 47: Line 49:
 
</div>
 
</div>
 
<div class="toccolours" style="background-color:#fff2ae">
 
<div class="toccolours" style="background-color:#fff2ae">
−
====Dose modifications====
+
====Dose and schedule modifications====
 
*Start cycle 1 as described above.
 
*Start cycle 1 as described above.
 
*Obtain CBCs twice per week for nadir measurements.
 
*Obtain CBCs twice per week for nadir measurements.
Line 58: Line 60:
 
</div></div>
 
</div></div>
 
===References===
 
===References===
−
# '''NCI 93-C-0133:''' Wilson WH, Pittaluga S, Nicolae A, Camphausen K, Shovlin M, Steinberg SM, Roschewski M, Staudt LM, Jaffe ES, Dunleavy K. A prospective study of mediastinal gray-zone lymphoma. Blood. 2014 Sep 4;124(10):1563-9. Epub 2014 Jul 14. [http://www.bloodjournal.org/content/124/10/1563.long link to original article] '''contains dosing details in abstract''' [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4155269/ link to PMC article] [https://pubmed.ncbi.nlm.nih.gov/25024303/ PubMed]
+
# '''NCI 93-C-0133<sub>MGZL</sub>:''' Wilson WH, Pittaluga S, Nicolae A, Camphausen K, Shovlin M, Steinberg SM, Roschewski M, Staudt LM, Jaffe ES, Dunleavy K. A prospective study of mediastinal gray-zone lymphoma. Blood. 2014 Sep 4;124(10):1563-9. Epub 2014 Jul 14. [http://www.bloodjournal.org/content/124/10/1563.long link to original article] '''contains dosing details in abstract''' [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4155269/ link to PMC article] [https://pubmed.ncbi.nlm.nih.gov/25024303/ PubMed]
 
=Relapsed or refractory=
 
=Relapsed or refractory=
 
==Brentuximab vedotin monotherapy {{#subobject:148648|Regimen=1}}==
 
==Brentuximab vedotin monotherapy {{#subobject:148648|Regimen=1}}==
 
<div class="toccolours" style="background-color:#eeeeee">
 
<div class="toccolours" style="background-color:#eeeeee">
 
===Regimen {{#subobject:bb7dfb|Variant=1}}===
 
===Regimen {{#subobject:bb7dfb|Variant=1}}===
−
{| class="wikitable" style="width: 40%; text-align:center;"  
+
{| class="wikitable sortable" style="width: 60%; text-align:center;"  
−
!style="width: 25%"|Study
+
!style="width: 33%"|Study
−
!style="width: 25%"|[[Levels_of_Evidence#Evidence|Evidence]]
+
!style="width: 33%"|Dates of enrollment
 +
!style="width: 33%"|[[Levels_of_Evidence#Evidence|Evidence]]
 
|-
 
|-
−
|[http://www.bloodjournal.org/content/125/9/1394 Jacobsen et al. 2015 (SGN35-012)]
+
|[http://www.bloodjournal.org/content/125/9/1394 Jacobsen et al. 2015 (SGN35-012<sub>CD30+B-NHL</sub>)]
−
|style="background-color:#ffffbe"|Phase 2, <20 pts in this subgroup
+
|2011-08 to 2013-08
 +
|style="background-color:#ffffbe"|Phase 2, fewer than 20 pts in this subgroup
 
|-
 
|-
 
|}
 
|}
Line 79: Line 83:
 
===References===
 
===References===
 
<!-- '''Abstract:''' Nancy L. Bartlett, MD, Jeff P. Sharman, MD, Yasuhiro Oki, MD, Ranjana H. Advani, MD, Celeste M. Bello, MD, Jane N. Winter, MD, Yin Yang, MS, Dana A. Kennedy, PharmD and Eric D. Jacobsen, MD. A Phase 2 Study Of Brentuximab Vedotin In Patients With Relapsed Or Refractory CD30-Positive Non-Hodgkin Lymphomas: Interim Results In Patients With DLBCL and Other B-Cell Lymphomas. ASH Abstract 848. [https://ash.confex.com/ash/2013/webprogram/Paper59695.html link to abstract] -->
 
<!-- '''Abstract:''' Nancy L. Bartlett, MD, Jeff P. Sharman, MD, Yasuhiro Oki, MD, Ranjana H. Advani, MD, Celeste M. Bello, MD, Jane N. Winter, MD, Yin Yang, MS, Dana A. Kennedy, PharmD and Eric D. Jacobsen, MD. A Phase 2 Study Of Brentuximab Vedotin In Patients With Relapsed Or Refractory CD30-Positive Non-Hodgkin Lymphomas: Interim Results In Patients With DLBCL and Other B-Cell Lymphomas. ASH Abstract 848. [https://ash.confex.com/ash/2013/webprogram/Paper59695.html link to abstract] -->
−
# '''SGN35-012:''' Jacobsen ED, Sharman JP, Oki Y, Advani RH, Winter JN, Bello CM, Spitzer G, Palanca-Wessels MC, Kennedy DA, Levine P, Yang J, Bartlett NL. Brentuximab vedotin demonstrates objective responses in a phase 2 study of relapsed/refractory DLBCL with variable CD30 expression. Blood. 2015 Feb 26;125(9):1394-402. Epub 2015 Jan 8. [http://www.bloodjournal.org/content/125/9/1394 link to original article] '''contains dosing details in manuscript''' [https://pubmed.ncbi.nlm.nih.gov/25573987/ PubMed] [https://clinicaltrials.gov/study/NCT01421667 Clinical Trial Registry]
+
# '''SGN35-012<sub>CD30+B-NHL</sub>:''' Jacobsen ED, Sharman JP, Oki Y, Advani RH, Winter JN, Bello CM, Spitzer G, Palanca-Wessels MC, Kennedy DA, Levine P, Yang J, Bartlett NL. Brentuximab vedotin demonstrates objective responses in a phase 2 study of relapsed/refractory DLBCL with variable CD30 expression. Blood. 2015 Feb 26;125(9):1394-402. Epub 2015 Jan 8. [http://www.bloodjournal.org/content/125/9/1394 link to original article] '''contains dosing details in manuscript''' [https://pubmed.ncbi.nlm.nih.gov/25573987/ PubMed] [https://clinicaltrials.gov/study/NCT01421667 NCT01421667]
 
[[Category:Mediastinal gray-zone lymphoma regimens]]
 
[[Category:Mediastinal gray-zone lymphoma regimens]]
 
[[Category:Disease-specific pages]]
 
[[Category:Disease-specific pages]]
−
[[Category:Aggressive lymphomas]]
+
[[Category:Aggressive non-Hodgkin lymphomas]]
 
[[Category:B-cell lymphomas]]
 
[[Category:B-cell lymphomas]]

Latest revision as of 12:26, 1 March 2024

Back to Top

Section editor
TarsheenSethi.jpg
 Tarsheen Sethi, MD, MSCI
Yale University
New Haven, CT, USA
LinkedIn
2 regimens on this page
2 variants on this page


Note: Mediastinal gray-zone lymphome (MGZL) is considered intermediate between primary mediastinal B-cell lymphoma (PMBL) and nodular sclerosis Hodgkin lymphoma (NSHL). Given that it is treated more similarly to the non-Hodgkin lymphoma, it is included here.

Untreated

DA-R-EPOCH

DA-R-EPOCH: Dose Adjusted Rituximab, Etoposide, Prednisone, Oncovin (Vincristine), Cyclophosphamide, Hydroxydaunorubicin (Doxorubicin)
DA-EPOCH-R

Regimen

Study Dates of enrollment Evidence
Wilson et al. 2014 (NCI 93-C-0133MGZL) NR Phase 2

Note: this should be considered a substudy under the master protocol NCI 93-C-0133.

Targeted therapy

  • Rituximab (Rituxan) 375 mg/m2 IV once per cycle or 1 day before the start of EPOCH (depending on reference)

Chemotherapy

Glucocorticoid therapy

Supportive therapy

21-day cycle for 6 to 8 cycles

Dose and schedule modifications

  • Start cycle 1 as described above.
  • Obtain CBCs twice per week for nadir measurements.
  • If nadir ANC greater than 500/μL, increase etoposide, doxorubicin, and cyclophosphamide by 20% compared to previous cycle.
  • If nadir ANC less than 500/μL on 1 or 2 measurements, use same doses as last cycle.
  • If nadir ANC less than 500/μL on at least 3 measurements, decrease etoposide, doxorubicin, and cyclophosphamide by 20% compared to previous cycle.
  • And/or if nadir platelet count less than 25 x 109/L on at least 1 measurement, decrease etoposide, doxorubicin, and cyclophosphamide by 20% compared to previous cycle.
  • Dose adjustments below the cycle 1 starting dose only applies to cyclophosphamide. The lowest etoposide and doxorubicin would be dosed at is the original cycle 1 dose.
  • Can start new cycle every 21 days if ANC greater than 1000/μL and platelets greater than 100 x 109/L. If counts are below those levels, check daily CBC and continue growth factor support until counts are adequate and next cycle can start.

References

  1. NCI 93-C-0133MGZL: Wilson WH, Pittaluga S, Nicolae A, Camphausen K, Shovlin M, Steinberg SM, Roschewski M, Staudt LM, Jaffe ES, Dunleavy K. A prospective study of mediastinal gray-zone lymphoma. Blood. 2014 Sep 4;124(10):1563-9. Epub 2014 Jul 14. link to original article contains dosing details in abstract link to PMC article PubMed

Relapsed or refractory

Brentuximab vedotin monotherapy

Regimen

Study Dates of enrollment Evidence
Jacobsen et al. 2015 (SGN35-012CD30+B-NHL) 2011-08 to 2013-08 Phase 2, fewer than 20 pts in this subgroup

Note: This regimen was evaluated in patients with CD30+ non-Hodgkin lymphoma, as determined by immunohistochemistry.

Antibody-drug conjugate therapy

21-day cycles

References

  1. SGN35-012CD30+B-NHL: Jacobsen ED, Sharman JP, Oki Y, Advani RH, Winter JN, Bello CM, Spitzer G, Palanca-Wessels MC, Kennedy DA, Levine P, Yang J, Bartlett NL. Brentuximab vedotin demonstrates objective responses in a phase 2 study of relapsed/refractory DLBCL with variable CD30 expression. Blood. 2015 Feb 26;125(9):1394-402. Epub 2015 Jan 8. link to original article contains dosing details in manuscript PubMed NCT01421667
Retrieved from "https://hemonc.org/w/index.php?title=Mediastinal_gray-zone_lymphoma&oldid=84102"