The first 3 authors contributed equally to this work.
Phase 2 trial of “Sandwich” L-asparaginase, vincristine, and prednisone chemotherapy with radiotherapy in newly diagnosed, stage IE to IIE, nasal type, extranodal natural killer/T-cell lymphoma
Article first published online: 2 DEC 2011
Copyright © 2011 American Cancer Society
Volume 118, Issue 13, pages 3294–3301, 1 July 2012
How to Cite
Jiang, M., Zhang, H., Jiang, Y., Yang, Q., Xie, L., Liu, W., Zhang, W., Ji, X., Li, P., Chen, N., Zhao, S., Wang, F. and Zou, L. (2012), Phase 2 trial of “Sandwich” L-asparaginase, vincristine, and prednisone chemotherapy with radiotherapy in newly diagnosed, stage IE to IIE, nasal type, extranodal natural killer/T-cell lymphoma. Cancer, 118: 3294–3301. doi: 10.1002/cncr.26629
- Issue published online: 18 JUN 2012
- Article first published online: 2 DEC 2011
- Manuscript Accepted: 14 SEP 2011
- Manuscript Revised: 8 AUG 2011
- Manuscript Received: 18 JUN 2011
- extranodal natural killer/T-cell lymphoma;
- LVP (L-asparaginase, vincristine, prednisone);
Extranodal natural killer/T-cell lymphoma (ENKTL), nasal-type, is a distinct entity of lymphoid tissue. ENKTL is sensitive to radiotherapy (RT), but the prognosis is poorer than for other types of early lymphoma. The treatment schedule is controversial.
A phase 2 study was conducted of “sandwich” protocols, with earlier RT after an initial 2 to 3 cycles of LVP (L-asparaginase, vincristine, and prednisone), followed by further “consolidation” cycles. Patients aged 18 years and older who had previously untreated ENKTL and localized lesions in the upper aerodigestive tract were enrolled. The primary endpoints were objective response rate and complete remission rate. The secondary endpoints were 2-year overall survival, 2-year progression-free survival, and toxicity. This study is registered with www.Chictr.org, number ChicTR-TNC-00000394, and is ongoing for long-term follow-up.
Twenty-six patients completed total therapy, which resulted in 88.5% response that included 21 patients (80.8%) with complete response (CR) and 2 patients (7.7%) with partial response. Three (11.5%) of 26 patients progressed during therapy. With a median follow-up of 27 months (range, 4-35 months), the 2-year overall survival was 88.5%, and the 2-year progression-free survival was 80.6%. Patients with CR had better prognosis than patients without CR. Only 2 patients (7.7%) experienced grade 3 leukocytopenia. No grade 4 toxicity or treatment-related deaths were observed.
The research showed that the “sandwich” protocol of LVP combined with RT was a safe and effective treatment for localized nasal natural killer/T-cell lymphoma, and the results warrant further investigation into this protocol. Cancer 2011. © 2011 American Cancer Society.