Gemzar and Navelbine salvage for lympnoma – pro
Gemcitabine, vinorelbine and prednisone or otehr drugs are being investigated to treat refractory or relapsed aggressive non-Hodgkin lymphomas (NHL).
Lay Summary: Gemcitabine and vinorelbine are somewhat effective but toxic when few options remain, but more investigation is needed.
The optimum therapy for patients with relapsed or refractory aggressive NHL not qualifying for platinum-based and/or high-dose chemotherapy is not known. In one prospective phase II study evaluating a regimen consisting of gemcitabine (1 g/m2, days 1 and 8), vinorelbine (30 mg/m2, days 1 and 8) and prednisone (100 mg/day, days 1-8) (GVP) given every 21 days, there was substantial activity in poor prognosis relapsed or refractory aggressive lymphomas. It was generally well tolerated, but haematological toxicity is dose limiting. Several other studies yilded similar results.
One has to conclude that despite these results the treatment is still experimental as it is being studies in various studies with otehr agents added and a prospective phase III trial is necessary.
Efstathios S. Papageorgiou, Panagiotis Tsirigotis, Meletios Dimopoulos, Nikolaos Pavlidis, George Fountzilas, Sotirios Papageorgiou, Theofanis Economopoulos (2005) Combination chemotherapy with gemcitabine and vinorelbine in the treatment of relapsed or refractory diffuse large B-cell lymphoma: a phase-II trial by the Hellenic Cooperative Oncology Group European Journal of Haematology 75 (2), 124–129.
A. Spencer, K. Reed and C. Arthur. (2007) Pilot study of an outpatient-based approach for advanced lymphoma using vinorelbine, gemcitabine and filgrastim. Internal Medicine Journal 37:11, 760–766
Fatih M. Uckun, Sanda Morar and Sanjive Qazi. (2006) Vinorelbine-based salvage chemotherapy for therapy-refractory aggressive leukaemias. British Journal of Haematology 135:4, 500–508