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1994-08-09
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Document 1082
DOCN M9471082
TI Phase III trial of chemotherapy (CT) concomitantly with didanosine (DDI)
versus chemotherapy alone in patients (pts) with AIDS-non Hodgkin's
lymphoma (NHL) (Meeting abstract).
DT 9409
AU Ucar A; Harrington WJ; Cabral L; Hurley J; Cohen J; Lai S; Byrnes J;
Sylvester Comprehensive Cancer Center, Miami, FL
SO Proc Annu Meet Am Soc Clin Oncol; 13:A1265 1994. Unique Identifier :
AIDSLINE ICDB/94601261
AB This study was designed to explore the hypothesis that combined
antiretroviral and antitumor chemotherapy is feasible and more effective
in terms of response and survival. Eligibility criteria included: HIV
seropositivity; measurable Stage II-IV intermediate or high grade
lymphoma; no prior therapy; Karnofsky PS greater than or equal to 60%;
ANC greater than or equal to 1000/mm3, Hb greater than or equal to 8
mg/dl; platelet count greater than or equal to 50,000/mm3, SGOT less
than or equal to 2x upper limit of normal, CR less than or equal to 1.5.
30 pts were accrued, 16 pts were randomized to the DDI (+) arm and 14 to
the DDI (-) arm. The median absolute CD4 count was 73 (1-993) at
diagnosis. 50% of the pts had immunoblastic lymphoma, 45% diffuse large
cell lymphoma and 5% diffuse mixed cell lymphoma. IV chemotherapy was
delivered weekly over 12 wk. Pts received mitoxantrone (8 mg/m2) and
VP-16 (100 mg/m2) on odd weeks; cyclophosphamide 350 mg/m2 on wk 1, 5,
and 9; bleomycin (10 u/m2) and vincristine 2 mg on even weeks; and
methylprednisolone (1 g/m2) weekly. In addition, pts received daily oral
prophylaxis with Bactrim, difluconazole and acyclovir. 80% of the
planned CT dose was delivered; 88% in the DDI (+) arm and 77% in the DDI
(-) arm. The response rate was 84% (57% CR and 27% PR). The response
rate in the DDI (+) arm was 85% (61% CR and 25% PR) versus 71% (43% CR
and 28% PR) in the DDI (-) arm. The median duration of CR has been 50+
wk. 10 pts are alive (29-94 wk). With a median follow up of 6+ months no
statistically significant difference in survival has been detected, but
there is a trend in favor of the DDI (+) arm. DDI toxicities included:
pancreatitis, paresthesias, and diarrhea. Four pts in the DDI (+) arm
experienced episodes of febrile neutropenia versus 6 pts in the DDI (-)
arm. Concurrent CT and DDI is feasible and well tolerated. This
treatment program is delivered over a short period of time (12 wk), with
acceptable toxicity and a high response rate.
DE Antineoplastic Agents, Combined/ADVERSE EFFECTS/*THERAPEUTIC USE
Comparative Study Didanosine/*ADMINISTRATION & DOSAGE/ADVERSE EFFECTS
Feasibility Studies Follow-Up Studies Human Lymphoma,
AIDS-Related/*DRUG THERAPY/MORTALITY/PATHOLOGY Neoplasm Staging
Survival Rate MEETING ABSTRACT CLINICAL TRIAL, PHASE III CLINICAL
TRIAL RANDOMIZED CONTROLLED TRIAL
SOURCE: National Library of Medicine. NOTICE: This material may be
protected by Copyright Law (Title 17, U.S.Code).