1. Temsirolimus has activity in non-mantle cell non-Hodgkin's lymphoma subtypes: The University of Chicago phase II consortium.
- Author
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Smith SM, van Besien K, Karrison T, Dancey J, McLaughlin P, Younes A, Smith S, Stiff P, Lester E, Modi S, Doyle LA, Vokes EE, and Pro B
- Subjects
- Adult, Aged, Aged, 80 and over, Antineoplastic Agents administration & dosage, Antineoplastic Agents adverse effects, Bone Marrow drug effects, Chicago, Disease-Free Survival, Female, Humans, Intracellular Signaling Peptides and Proteins drug effects, Kaplan-Meier Estimate, Leukemia, Lymphocytic, Chronic, B-Cell drug therapy, Lymphoma, Follicular drug therapy, Lymphoma, Large B-Cell, Diffuse drug therapy, Lymphoma, Mantle-Cell drug therapy, Lymphoma, Non-Hodgkin metabolism, Male, Middle Aged, Mucositis chemically induced, Pneumonia chemically induced, Protein Kinase Inhibitors administration & dosage, Protein Kinase Inhibitors adverse effects, Protein Serine-Threonine Kinases drug effects, Remission Induction, Sirolimus administration & dosage, Sirolimus adverse effects, Sirolimus therapeutic use, TOR Serine-Threonine Kinases, Treatment Outcome, Antineoplastic Agents therapeutic use, Intracellular Signaling Peptides and Proteins metabolism, Lymphoma, Non-Hodgkin drug therapy, Protein Kinase Inhibitors therapeutic use, Protein Serine-Threonine Kinases metabolism, Sirolimus analogs & derivatives
- Abstract
Purpose: Despite high initial remission rates, most lymphomas relapse and require further therapy. The mammalian target of rapamycin (mTOR) pathway is a validated target in mantle cell lymphoma, but has not been extensively evaluated in other lymphomas., Patients and Methods: We performed a phase II trial of single-agent temsirolimus 25-mg weekly in patients with relapsed aggressive and indolent lymphomas. The primary objective was overall and complete response rate. Patients were stratified by histology: group A (diffuse large B-cell lymphoma, transformed follicular lymphoma), group B (follicular lymphoma), and group C (chronic lymphocytic leukemia/small lymphocytic lymphoma, and other indolent lymphomas)., Results: Eighty-nine patients were treated, with outcome strongly dependent on histology. Group A had an overall and complete response rate of 28.1% and 12.5%, respectively, and median progression-free survival (PFS) of 2.6 months and median overall survival (OS) of 7.2 months. Group B had overall and complete response rates of 53.8% and 25.6%, respectively, and median PFS of 12.7 months; median OS has not yet been reached. Group C had a partial response rate of 11% with no complete responders. Toxicity was mainly mild and/or reversible myelosuppression and mucositis; however, four patients developed pneumonitis., Conclusions: Single-agent temsirolimus has significant activity in both diffuse large B-cell lymphoma and follicular lymphoma, although the durability of responses and PFS are longer for patients with follicular lymphoma. This is the first report of substantial activity of temsirolimus in lymphomas other than mantle cell lymphoma, and supports further evaluation of mTOR as a target in these diseases.
- Published
- 2010
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