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Clinical Trial
. 2017 Dec;35(4):619-629.
doi: 10.1002/hon.2325. Epub 2016 Oct 10.

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

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Free PMC article
Clinical Trial

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

Rong Liang et al. Hematol Oncol. .
Free PMC article

Abstract

The nasal type of extranodal natural killer/T-cell lymphoma is a rare aggressive lymphoma with poor prognosis. To discover a successful treatment, we investigated the efficacy and safety of chemotherapy with methotrexate, etoposide, dexamethasone, and polyethylene glycol-asparaginase (MESA). Three cycles of MESA were administered to 46 patients with new or relapsed/refractory natural killer/T-cell lymphoma. Complete response after 3 treatment cycles was 43.5%, the overall response rate was 87%, and 2-year overall survival was 83.4%. Complete response was significantly better for newly diagnosed patients than for patients with relapsed/refractory disease. Patients with newly diagnosed disease had a significantly better overall response rate after 1, but not after 2 or 3 treatment cycles. Overall survival and progression-free survival did not differ over 2 years. Grade 1/2 toxicities were frequent, but MESA was associated with fewer grade 3/4 events or treatment-related deaths. These results will require confirmation in larger prospective trials.

Keywords: chemotherapy; clinical trial; extranodal NK/T-cell lymphoma; lymphoma; nasal type; non-Hodgkin; refractory; relapse.

Figures

Figure 1
Figure 1
Kaplan‐Meier curves of OS. A, OS of all patients. B, OS of patients by disease state. The log‐rank test found no difference between newly diagnosed patients and those who relapsed (P = .249). Abbreviations: OS, overall survival
Figure 2
Figure 2
Kaplan‐Meier curves of PFS. A, PFS of all patients. B, PFS of patients by disease state. The Breslow test found no difference between newly diagnosed patients and those who relapsed (P = .814). Abbreviations: PFS, progression‐free survival
Figure 3
Figure 3
Kaplan‐Meier curves of OS. A, OS by stage of disease; B, OS by IPI; C, OS by Ki‐67 expression. The Breslow test found no differences among the groups (P = .921 for stage, P = .861 for IPI, and P = .338 for Ki‐67 expression). Abbreviations: IPI, international prognostic index; OS, overall survival
Figure 4
Figure 4
Kaplan‐Meier curves of PFS. A, PFS by stage of disease; B, PFS by IPI; C, PFS by Ki‐67 expression. The Breslow test found no differences among the groups (P = .656 for stage, P = .160 for IPI, and P = .825 for Ki‐67 expression). Abbreviations: IPI, international prognostic index; PFS, progression‐free survival

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