Efficacy of combined gemcitabine, oxaliplatin and pegaspargase (P-gemox regimen) in patients with newly diagnosed advanced-stage or relapsed/refractory extranodal NK/T-cell lymphoma

// Jing-hua Wang 1, 2, 3, * , Liang Wang 1, 2, 3, * , Cheng-cheng Liu 1, 2, 3, * , Zhong-jun Xia 1, 2, 3 , Hui-qiang Huang 2, 3, 4 , Tong-yu Lin 2, 3, 4 , Wen-qi Jiang 2, 3, 4 , Yue Lu 1, 2, 3 1 Department of Hematologic Oncology, Sun Yat-Sen University Cancer Center, Guangzhou, 510060, People’s Republic of China 2 State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, 510060, People’s Republic of China 3 Collaborative Innovation Center for Cancer Medicine, Guangzhou, 510060, People’s Republic of China 4 Department of Medical Oncology, Sun Yat-Sen University Cancer Center, Guangzhou, 510060, People’s Republic of China * These authors contributed equally to this work Correspondence to: Yue Lu, email: yuelv304@yahoo.com Keywords: extranodal NK/T-cell lymphoma, gemcitabine, oxaliplatin, pegaspargase, adverse effects Received: November 02, 2015 Accepted: March 18, 2016 Published: April 08, 2016 ABSTRACT Extranodal natural killer/T-cell lymphoma (ENKTL) is an aggressive neoplasm with a poor outcome. Asparaginase-based regimens are recommended for patients with advanced-stage or relapsed/refractory ENKTL. We retrospectively investigated the efficacy and toxicity of combined gemcitabine, oxaliplatin, and pegaspargase (P-gemox) in these patients. A total of 35 patients with newly diagnosed stage III–IV, relapsed or refractory ENKTL were treated with 2 to 8 cycles of P-gemox: gemcitabine (1250 mg/m 2 ) and oxaliplatin (85 mg/m 2 ) injected intravenously and pegaspargase (2500 IU/m 2 ) injected intramuscularly on day 1 and repeated every 2 weeks. Upon completion of treatment, the overall response rate was 80.0%, with a complete response in 51.4% of patients. The 1-, 2- and 3- year progression-free survival rates were 45.0%, 38.6% and 38.6%, and overall survival rates were 76.8%, 64.7% and 64.7%, respectively. Patients who attained a complete response showed better progression-free survival than those without a complete response ( p = 0.01). The major adverse effects were hematologic toxicity and liver dysfunction. Grade 3/4 leucopenia and neutropenia occurred in 40.0% of patients. No treatment-related deaths occurred. These results indicate the P-gemox regimen is a safe and effective treatment for patients with newly diagnosed advanced-stage or relapsed/refractory ENKTL. We anticipate future prospective trials will confirm the efficacy.