Response-based modification of CHOP chemotherapy for canine B-cell lymphoma.

Autor: Benjamin SE; Department of Clinical Science & Advanced Medicine, University of Pennsylvania School of Veterinary Medicine, Philadelphia, Pennsylvania, USA., Sorenmo KU; Department of Biomedical Sciences, University of Pennsylvania School of Veterinary Medicine, Philadelphia, Pennsylvania, USA., Krick EL; Department of Oncology, Mount Laurel Animal Hospital, Mt Laurel Township, New Jersey, USA., Salah P; Department of Clinical Science & Advanced Medicine, University of Pennsylvania School of Veterinary Medicine, Philadelphia, Pennsylvania, USA., Walsh KA; Department of Clinical Science & Advanced Medicine, University of Pennsylvania School of Veterinary Medicine, Philadelphia, Pennsylvania, USA., Weinstein NM; Department of Clinical Science & Advanced Medicine, University of Pennsylvania School of Veterinary Medicine, Philadelphia, Pennsylvania, USA., Keuler NS; Department of Statistics, University of Wisconsin-Madison, Madison, Wisconsin, USA., Avery AC; Department of Microbiology, Immunology & Pathology, Colorado State University College of Veterinary Medicine & Biomedical Sciences, Fort Collins, Colorado, USA., Atherton MJ; Department of Biomedical Sciences, University of Pennsylvania School of Veterinary Medicine, Philadelphia, Pennsylvania, USA., Lenz JA; Department of Clinical Science & Advanced Medicine, University of Pennsylvania School of Veterinary Medicine, Philadelphia, Pennsylvania, USA.
Jazyk: angličtina
Zdroj: Veterinary and comparative oncology [Vet Comp Oncol] 2021 Sep; Vol. 19 (3), pp. 541-550. Date of Electronic Publication: 2021 Mar 26.
DOI: 10.1111/vco.12693
Abstrakt: Despite high initial response rates, a subset of dogs with B-cell lymphoma responds less robustly to CHOP-based chemotherapy and experiences shorter survival. One hundred and four dogs with nodal B-cell lymphoma were treated with a response-based CHOP (RBCHOP) protocol modified based on response to individual drugs during the first chemotherapy cycle. Dogs achieving complete (CR) or partial response (PR) at week 3, following treatment with vincristine and cyclophosphamide, received RBCHOP 1 (n = 72), a protocol sequentially rotating vincristine, cyclophosphamide, and doxorubicin. Dogs without a detectable response at week 3 that subsequently achieved CR or PR following treatment with doxorubicin received RBCHOP 2 (n = 14), in which four doses of doxorubicin were given consecutively followed by vincristine and cyclophosphamide. Dogs that failed to respond at week 3 and then to doxorubicin at week 5 assessment were offered rescue chemotherapy (RBCHOP 3, n = 18). Median progression free survival (PFS) and overall survival time (OST) were similar between RBCHOP 1 (PFS 210 days, OST 354 days) and RBCHOP 2 (PFS 220 days, OST 456 days), but significantly shorter for RBCHOP 3 (PFS 34 days, OST 80.5 days, P < 0.001). No presenting signalment nor hematologic variable differentiated patient cohort, however, dogs in RBCHOP 2 and RBCHOP 3 were more likely to have a lymphocytosis at diagnosis (P = 0.02 and 0.04, respectively). Protocol modification based on response during the first cycle resulted in similar toxicity profiles and outcomes to previously published variants of CHOP, and prognosis remained poor for dogs failing to respond during the first treatment cycle.
(© 2021 John Wiley & Sons Ltd.)
Databáze: MEDLINE
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