1. Multicenter phase 1/2 study of forodesine in patients with relapsed peripheral T cell lymphoma.
- Author
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Maruyama, Dai, Tobinai, Kensei, Ando, Kiyoshi, Yoshida, Isao, Hidaka, Michihiro, Murayama, Tohru, Okitsu, Yoko, Tsukamoto, Norifumi, Taniwaki, Masafumi, Suzumiya, Junji, Tamura, Kazuo, Yamauchi, Takahiro, Tsukasaki, Kunihiro, Ueda, Ryuzo, Uchida, Toshiki, Maeda, Yoshinobu, Shibayama, Hirohiko, Nagai, Hirokazu, Kurosawa, Mitsutoshi, and Suehiro, Yoko
- Subjects
CLINICAL trials ,COMPARATIVE studies ,GLYCOSIDES ,HETEROCYCLIC compounds ,RESEARCH methodology ,MEDICAL cooperation ,NUCLEOSIDES ,ORAL drug administration ,RESEARCH ,DISEASE relapse ,EVALUATION research ,T-cell lymphoma - Abstract
Peripheral T cell lymphomas are an aggressive group of non-Hodgkin lymphomas with poor outcomes for most subtypes and no accepted standard of care for relapsed patients. This study evaluated the efficacy and safety of forodesine, a novel purine nucleoside phosphorylase inhibitor, in patients with relapsed peripheral T cell lymphomas. Patients with histologically confirmed disease, progression after ≥ 1 prior treatment, and an objective response to last treatment received oral forodesine 300 mg twice-daily. The primary endpoint was objective response rate (ORR). Secondary endpoints included duration of response, progression-free survival (PFS), overall survival (OS), and safety. Forty-eight patients (median age, 69.5 years; median of 2 prior treatments) received forodesine. In phase 1 (n = 3 evaluable), no dose-limiting toxicity was observed during the first 28 days of forodesine treatment. In phase 2 (n = 41 evaluable), the ORR for the primary and final analyses was 22% (90% CI 12-35%) and 25% (90% CI 14-38%), respectively, including four complete responses (10%). Median PFS and OS were 1.9 and 15.6 months, respectively. The most common grade 3/4 adverse events were lymphopenia (96%), leukopenia (42%), and neutropenia (35%). Dose reduction and discontinuation due to adverse events were uncommon. Secondary B cell lymphoma developed in five patients, of whom four were positive for Epstein-Barr virus. In conclusion, forodesine has single-agent activity within the range of approved therapies in relapsed peripheral T cell lymphomas, with a manageable safety profile, and may represent a viable treatment option for this difficult-to-treat population. [ABSTRACT FROM AUTHOR]
- Published
- 2019
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