Role of gemcitabine, oxaliplatin and prednisolone combination as first-line chemotherapy in non-Hodgkin's Lymphoma

ABSTRACT

Non-Hodgkin's lymphomas [NHL] are commonly treated with cyclophosphamide, doxorubicin, vincristine and prednisolone [CHOP]. The objective of the current study was to evaluate the efficacy and safety of gemcitabine, oxaliplatin and corticosteroids [GEMOX-P] as first-line treatment for patients with intermediate-high grade non-Hodgkin's lymphoma [NHL]. Thirty-three patients with intermediate/high grade NHL were randomized into two groups. First group received standard [CHOP] with prednisolone tablets 40 mg/m2/day for five days. The second group received gemcitabine 1000 mg/m2 D1, 8, then oxaliplatin 80 mg/m2 D1 and prednisolone tablets 40 mg/m2/day for five days with recycling every 21 days. The primary end point was response rate. The secondary end points were disease-free survival and overall survival. From the results of this study, it was concluded that the regimen of [GEMOX-P] had beneficial effects over [CHOP] regimen, that included higher complete response rate in high-risk cases and lower cardiac and hepatic toxicity, but there was no difference after 18 months in disease free or overall survival between both treatment arms. Selection of cases that may benefit from chemotherapy treatment either [CHOP] or [GEMOX-P] is needed balance between anticipated toxicities, treatment outcome and cost benefit aspect