Comparison of first-line treatment with CHOP versus ICED in patients with peripheral T-cell lymphoma eligible for upfront autologous stem cell transplantation
IntroductionUpfront autologous stem cell transplantation (ASCT) has been recommended for patients who are newly diagnosed with peripheral T-cell lymphoma (PTCL), and CHOP (cyclophosphamide, doxorubicin, vincristine, and prednisone), an anthracycline-based chemotherapy has been the frontline chemothe...
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Frontiers Media S.A.
2023-08-01
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| Series: | Frontiers in Oncology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fonc.2023.1230629/full |
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| author | Seok Jin Kim Seok Jin Kim Jae-Cheol Jo Dok Hyun Yoon Deok-Hwan Yang Sang Eun Yoon Gyeong-Won Lee Jee Hyun Kong Jee Hyun Kong Yong Park Ka-Won Kang Ho-Sup Lee Sung Yong Oh Ho-Jin Shin Won Sik Lee Yoon Seok Choi Seong Hyun Jeong Min Kyoung Kim Hye Jin Kang Jun Ho Yi Sung-Nam Lim Ho-Young Yhim Young Rok Do Hwan Jung Yun Hyeon-Seok Eom Mark Hong Lee Cheolwon Suh Won Seog Kim Won Seog Kim |
| author_facet | Seok Jin Kim Seok Jin Kim Jae-Cheol Jo Dok Hyun Yoon Deok-Hwan Yang Sang Eun Yoon Gyeong-Won Lee Jee Hyun Kong Jee Hyun Kong Yong Park Ka-Won Kang Ho-Sup Lee Sung Yong Oh Ho-Jin Shin Won Sik Lee Yoon Seok Choi Seong Hyun Jeong Min Kyoung Kim Hye Jin Kang Jun Ho Yi Sung-Nam Lim Ho-Young Yhim Young Rok Do Hwan Jung Yun Hyeon-Seok Eom Mark Hong Lee Cheolwon Suh Won Seog Kim Won Seog Kim |
| author_sort | Seok Jin Kim |
| collection | DOAJ |
| description | IntroductionUpfront autologous stem cell transplantation (ASCT) has been recommended for patients who are newly diagnosed with peripheral T-cell lymphoma (PTCL), and CHOP (cyclophosphamide, doxorubicin, vincristine, and prednisone), an anthracycline-based chemotherapy has been the frontline chemotherapy for PTCL. However, it is not clear whether anthracycline-based chemotherapies such as CHOP could be standard induction therapy for PTCL.MethodsWe conducted a randomized phase II study to compare CHOP with fractionated ifosfamide, carboplatin, etoposide, and dexamethasone (ICED) for patients eligible for ASCT. The primary endpoint was progression-free survival (PFS) and secondary endpoints included objective response rate, overall survival (OS), and safety profiles.ResultsPatients were randomized into either CHOP (n = 69) or ICED (n = 66), and the characteristics of both arms were not different. PTCL-not otherwise specified (NOS, n = 60) and angioimmunoblastic T-cell lymphoma (AITL, n = 53) were dominant. The objective response rate was not different between CHOP (59.4%) and ICED (56.1%), and the 3-year PFS was not different between CHOP (36.7%) and ICED (33.1%). In AITL patients, CHOP was favored over ICED whereas ICED was associated with more cytopenia and reduced dose intensity. Patients who received upfront ASCT after achieving complete response to CHOP or ICED showed 80% of 3-year OS.DiscussionIn summary, our study showed no therapeutic difference between CHOP and ICED in terms of response and PFS. Thus, CHOP might remain the reference regimen especially for AITL based on its better outcome in AITL, and upfront ASCT could be recommended as a consolidation of complete response in patients with PTCL. |
| first_indexed | 2024-03-12T13:56:41Z |
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| last_indexed | 2024-03-12T13:56:41Z |
| publishDate | 2023-08-01 |
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| series | Frontiers in Oncology |
| spelling | doaj.art-3ac432a63fad4f94935c09078e6069be2023-08-22T12:41:03ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2023-08-011310.3389/fonc.2023.12306291230629Comparison of first-line treatment with CHOP versus ICED in patients with peripheral T-cell lymphoma eligible for upfront autologous stem cell transplantationSeok Jin Kim0Seok Jin Kim1Jae-Cheol Jo2Dok Hyun Yoon3Deok-Hwan Yang4Sang Eun Yoon5Gyeong-Won Lee6Jee Hyun Kong7Jee Hyun Kong8Yong Park9Ka-Won Kang10Ho-Sup Lee11Sung Yong Oh12Ho-Jin Shin13Won Sik Lee14Yoon Seok Choi15Seong Hyun Jeong16Min Kyoung Kim17Hye Jin Kang18Jun Ho Yi19Sung-Nam Lim20Ho-Young Yhim21Young Rok Do22Hwan Jung Yun23Hyeon-Seok Eom24Mark Hong Lee25Cheolwon Suh26Won Seog Kim27Won Seog Kim28Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of KoreaDepartment of Health Sciences and Technology, Samsung Advanced Institute for Health Sciences and Technology, Sungkyunkwan University School of Medicine, Seoul, Republic of KoreaDepartment of Hematology and Oncology, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Republic of KoreaDepartment of Oncology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of KoreaDepartment of Internal Medicine, Chonnam National University Hwasun Hospital, Chonnam National University Medical School, Gwangju, Republic of KoreaDivision of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of KoreaDivision of Hematology and Oncology, Department of Internal Medicine, Gyeongsang National University Hospital, Gyeongsang National University College of Medicine, Changwon, Republic of KoreaDepartment of Hematology-oncology, Division of Internal Medicine, Wonju Severance Christian Hospital, Yonsei University Wonju College of Medicine, Wonju, Republic of KoreaCancer of Evidence Based Medicine, Institute of Convergence Science, Yonsei University, Seoul, Republic of KoreaDepartment of Internal Medicine, Korea University College of Medicine, Korea University Anam Hospital, Seoul, Republic of KoreaDepartment of Internal Medicine, Korea University College of Medicine, Korea University Anam Hospital, Seoul, Republic of Korea0Department of Internal Medicine, Kosin University Gospel Hospital, Busan, Republic of Korea1Department of Internal Medicine, Dong-A University Medical Center, Busan, Republic of Korea2Department of Internal Medicine, Pusan National University Hospital, Busan, Republic of Korea3Department of Internal Medicine, Inje University Busan Paik Hospital, Busan, Republic of Korea4Division of Hematology-Oncology, Department of Internal Medicine, Ajou University School of Medicine, Suwon, Republic of Korea4Division of Hematology-Oncology, Department of Internal Medicine, Ajou University School of Medicine, Suwon, Republic of Korea5Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, Republic of Korea6Department of Internal Medicine, Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, Seoul, Republic of Korea7Department Internal Medicine, Chung-Ang University Hospital, Seoul, Republic of Korea8Department of Internal Medicine, Haeundae Baek Hospital, Busan, Republic of Korea9Department of Internal Medicine, Jeonbuk National University Medical School, Research Institute of Clinical Medicine of Jeonbuk National University-Biomedical Research Institute of Jeonbuk National University Hospital, Jeonju, Republic of Korea0Department of Internal Medicine, Dongsan Medical Center, Daegu, Republic of Korea1Department of Internal Medicine, Chungnam National University Hospital, Daejeon, Republic of Korea2Hematology-Oncology Clinic, National Cancer Center, Go-Yang, Republic of Korea3Division of Hematology-Oncology, Department of Internal Medicine, Konkuk University Medical Center, Seoul, Republic of KoreaDepartment of Oncology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of KoreaDivision of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of KoreaDepartment of Health Sciences and Technology, Samsung Advanced Institute for Health Sciences and Technology, Sungkyunkwan University School of Medicine, Seoul, Republic of KoreaIntroductionUpfront autologous stem cell transplantation (ASCT) has been recommended for patients who are newly diagnosed with peripheral T-cell lymphoma (PTCL), and CHOP (cyclophosphamide, doxorubicin, vincristine, and prednisone), an anthracycline-based chemotherapy has been the frontline chemotherapy for PTCL. However, it is not clear whether anthracycline-based chemotherapies such as CHOP could be standard induction therapy for PTCL.MethodsWe conducted a randomized phase II study to compare CHOP with fractionated ifosfamide, carboplatin, etoposide, and dexamethasone (ICED) for patients eligible for ASCT. The primary endpoint was progression-free survival (PFS) and secondary endpoints included objective response rate, overall survival (OS), and safety profiles.ResultsPatients were randomized into either CHOP (n = 69) or ICED (n = 66), and the characteristics of both arms were not different. PTCL-not otherwise specified (NOS, n = 60) and angioimmunoblastic T-cell lymphoma (AITL, n = 53) were dominant. The objective response rate was not different between CHOP (59.4%) and ICED (56.1%), and the 3-year PFS was not different between CHOP (36.7%) and ICED (33.1%). In AITL patients, CHOP was favored over ICED whereas ICED was associated with more cytopenia and reduced dose intensity. Patients who received upfront ASCT after achieving complete response to CHOP or ICED showed 80% of 3-year OS.DiscussionIn summary, our study showed no therapeutic difference between CHOP and ICED in terms of response and PFS. Thus, CHOP might remain the reference regimen especially for AITL based on its better outcome in AITL, and upfront ASCT could be recommended as a consolidation of complete response in patients with PTCL.https://www.frontiersin.org/articles/10.3389/fonc.2023.1230629/fullT-celllymphomachemotherapyautologous stem cell transplantationprogression-free survival |
| spellingShingle | Seok Jin Kim Seok Jin Kim Jae-Cheol Jo Dok Hyun Yoon Deok-Hwan Yang Sang Eun Yoon Gyeong-Won Lee Jee Hyun Kong Jee Hyun Kong Yong Park Ka-Won Kang Ho-Sup Lee Sung Yong Oh Ho-Jin Shin Won Sik Lee Yoon Seok Choi Seong Hyun Jeong Min Kyoung Kim Hye Jin Kang Jun Ho Yi Sung-Nam Lim Ho-Young Yhim Young Rok Do Hwan Jung Yun Hyeon-Seok Eom Mark Hong Lee Cheolwon Suh Won Seog Kim Won Seog Kim Comparison of first-line treatment with CHOP versus ICED in patients with peripheral T-cell lymphoma eligible for upfront autologous stem cell transplantation Frontiers in Oncology T-cell lymphoma chemotherapy autologous stem cell transplantation progression-free survival |
| title | Comparison of first-line treatment with CHOP versus ICED in patients with peripheral T-cell lymphoma eligible for upfront autologous stem cell transplantation |
| title_full | Comparison of first-line treatment with CHOP versus ICED in patients with peripheral T-cell lymphoma eligible for upfront autologous stem cell transplantation |
| title_fullStr | Comparison of first-line treatment with CHOP versus ICED in patients with peripheral T-cell lymphoma eligible for upfront autologous stem cell transplantation |
| title_full_unstemmed | Comparison of first-line treatment with CHOP versus ICED in patients with peripheral T-cell lymphoma eligible for upfront autologous stem cell transplantation |
| title_short | Comparison of first-line treatment with CHOP versus ICED in patients with peripheral T-cell lymphoma eligible for upfront autologous stem cell transplantation |
| title_sort | comparison of first line treatment with chop versus iced in patients with peripheral t cell lymphoma eligible for upfront autologous stem cell transplantation |
| topic | T-cell lymphoma chemotherapy autologous stem cell transplantation progression-free survival |
| url | https://www.frontiersin.org/articles/10.3389/fonc.2023.1230629/full |
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