According to an article published in the British Journal of Haematology, the use of oxaliplatin (Eloxatin®) in place of Platinol® (cisplatin) in the chemotherapy regimen referred to as DHAP may reduce side effects while maintaining efficacy.
NHL is a form of cancer that begins in the cells of the lymph system. The lymph system includes the spleen, thymus, tonsils, bone marrow, lymph nodes and circulating immune cells. The main cells in the lymph system are lymphocytes, of which there are two types: B and T-cells. Each of these cells has a very specific function in aiding the body to fight infection. NHL is characterized by the excessive accumulation of atypical (cancerous) lymphocytes. These lymphocytes can crowd the lymph system and suppress the formation and function of other immune and blood cells. While NHL is categorized by the type of lymphocyte it involves, it is also further defined by the rate at which the cancer grows, based on the appearance of the cells under a microscope. High-grade or aggressive NHL is the fastest growing and low-grade or indolent lymphoma is the slowest growing.
Patients who have NHL that has returned following initial therapy are often treated with a regimen referred to as DHAP, which includes dexamethasone, cytarabine (Cytosar-U®) and Platinol®. However, Platinol® is associated with side effects, particularly to the kidney, that could compromise the success of subsequent intensive therapy. In order to reduce kidney toxicity, researchers from the Royal Marsden Hospital in London, England recently conducted a study to determine the safety and effectiveness of replacing Platinol® with Eloxatin® for patients with recurrent NHL. Eloxatin® is a platinum-compound and is in the same class of chemotherapeutics as Platinol®. Eloxatin® has recently been approved by the Food and Drug Administration (FDA) for the treatment of recurrent colorectal cancer.
The study included 24 patients with recurrent intermediate or high-grade NHL who were treated with dexamethasone, Eloxatin® and cytarabine. Four patients achieved a complete disappearance of detectable cancer and 8 patients achieved at least a 50% reduction in their cancer. The overall anti-cancer response rate for patients who were in their first recurrence was 77%, compared to 29% for patients in subsequent recurrences. The average survival was approximately 11 months and progression-free survival and overall survival at one year following therapy was 47% and 50%, respectively. Side effects were mainly hematologic (blood related) with no severe non-hematologic side effects noted.
These researchers concluded that Eloxatin® in place of Platinol® in the treatment combination including dexamethasone and cytarabine® appear just as effective with fewer side effects that could compromise subsequent intensive therapies for patients with recurrent NHL. Patients with NHL may wish to speak with their physician about the results of this trial or the participation in a clinical trial evaluating this or other novel therapeutic approaches. Two sources of information regarding ongoing clinical trials include the National Cancer Institute (cancer.gov) and www.eCancerTrials.com. eCancerTrials.com also provides personalized clinical trial searches on behalf of patients.
Reference: Webb A, Cunningham D, Hill M, et al. An oxaliplatin-based chemotherapy in patients with relapsed or refractory intermediate and high-grade non-Hodgkin's lymphoma.
British Journal of Haematology. 2001;115:786-792.
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