Combined Lomustine Research Articles

309 - Lomustine in Combination with Etoposide and Cyclophosphamide in Conditioning Regimen for Lymphomas: A Phase 1 Study

309 - Lomustine in Combination with Etoposide and Cyclophosphamide in Conditioning Regimen for Lymphomas: A Phase 1 Study

The impact of bevacizumab on health-related quality of life in patients treated for recurrent glioblastoma: Results of the randomised controlled phase 2 BELOB trial

BackgroundThe BELOB study, a randomised controlled phase 2 trial comparing lomustine, bevacizumab and combined lomustine and bevacizumab in patients with recurrent glioblastoma, showed that the 9-month overall survival rate was most promising in the combination arm. Here we report the health-related quality of life (HRQoL) results, a secondary trial end-point. MethodsHRQoL was measured at baseline and every 6weeks until progression using the European Organisation for Research and Treatment of Cancer (EORTC) core questionnaire (QLQ-C30) and brain module (QLQ-BN20). HRQoL was assessed over time for five preselected scales (global health (GH), physical (PF) and social functioning (SF), motor dysfunction (MD) and communication deficit (CD)). Moreover, mean changes in HRQoL from baseline until progression were determined. Results138/148 patients with at least a baseline HRQoL assessment were analysed. Over time, HRQoL remained relatively stable in all treatment arms for all five scales, at least during the first three treatment cycles. More than half (54–61%) of the patients showed stable (<10 point change) or improved (⩾10 point change) HRQoL during their progression-free time, except for SF (43%), irrespective of treatment arm. Deterioration of mean HRQoL was most profound at disease progression for all scales except SF, which deteriorated earlier in disease course. Compared to baseline, 40% of patients had clinically relevant (⩾10 points) worse GH, PF and SF, while 44% and 31% had increased MD and CD at disease progression, irrespective of treatment arm. ConclusionsBevacizumab, whether or not in combination with lomustine, did not negatively affect HRQoL in patients treated for recurrent glioblastoma in this randomised study.

Tolerability of Lomustine in Combination with Cyclophosphamide in Dogs with Lymphoma

This retrospective study describes toxicity associated with a protocol of lomustine (CCNU) and cyclophosphamide (CTX) in dogs with lymphoma. CCNU was administered per os (PO) at a targeted dosage of 60 mg/m(2) body surface area on day 0, CTX was administered PO at a targeted dosage of 250 mg/m(2) divided over days 0 through 4, and all dogs received prophylactic antibiotics. Ninety treatments were given to the 57 dogs included in the study. Neutropenia was the principal toxic effect, and the overall frequency of grade 4 neutropenia after the first treatment of CCNU/CTX was 30% (95% confidence interval, 19-43%). The mean body weight of dogs with grade 4 neutropenia (19.7 kg ± 13.4 kg) was significantly less than the mean body weight of dogs that did not develop grade 4 neutropenia (31.7 kg ± 12.4 kg; P = .005). One dog (3%) developed hematologic changes suggestive of hepatotoxicity. No dogs had evidence of either renal toxicity or hemorrhagic cystitis. Adverse gastrointestinal effects were uncommon. On the basis of the findings reported herein, a dose of 60 mg/m(2) of CCNU combined with 250 mg/m(2) of CTX (divided over 5 days) q 4 wk is tolerable in tumor-bearing dogs.

Maximum Tolerated Dose of Lomustine in Combination with Etoposide, Cytarabine and Melphalan in a Short Conditioning Regimen in the Transplantation of Hematopoietic Stem Cells in Patients with Lymphoma

Maximum Tolerated Dose of Lomustine in Combination with Etoposide, Cytarabine and Melphalan in a Short Conditioning Regimen in the Transplantation of Hematopoietic Stem Cells in Patients with Lymphoma

Decreasing CD4/CD8 ratio during prolonged four-drug chemotherapy plus interferon treatment for metastatic melanoma.

A chemotherapy regimen consisting of dacarbazine, vincristine, bleomycin and lomustine in combination with natural leukocyte interferon (IFN)-alpha was administered to 48 metastatic melanoma patients with very favorable results. The frequencies of peripheral blood lymphocyte subsets during this treatment were monitored by flow cytometry in order to elucidate the underlying antitumor mechanism. Analysis of 467 peripheral blood samples revealed a significant decrease during treatment in absolute values of all lymphocyte subsets (CD4, CD8, CD56) as well as in total lymphocyte count. All the values returned to normal after discontinuation of treatment. Significant alterations in proportions of lymphocyte subsets were detected. Notably, the CD4+/CD8+ ratio showed changes related to response, treatment duration, and disease progression. Exceptionally high CD4+/CD8+ ratios (up to 14) were observed soon after the start of treatment in some of the patients later achieving a complete response. During the course of treatment, in 76% of the patients receiving at least a 2-month treatment, the CD4+/CD8+ ratio decreased to less than 1.0. Peculiarly, the nadir CD4+/CD8+ ratio was consistently observed 1-6 months before clinically detectable disease progression, suggesting a relation between CD4+/CD8+ ratio and tumor control.