Gemcitabine, dexamethasone and cisplatin is an active and non-toxic chemotherapy regimen in relapsed or refractory Hodgkin’s disease: a phase II study by the National Cancer Institute of Canada Clinical Trials Group

• Published in: Annals of oncology Vol. 14; no. 12; pp. 1762 - 1767
• Main Authors: Baetz, T., Belch, A., Couban, S., Imrie, K., Yau, J., Myers, R., Ding, K., Paul, N., Shepherd, L., Iglesias, J., Meyer, R., Crump, M.
• Format: Journal Article
• Language: English
• Published: Oxford Oxford University Press 01.12.2003
• Subjects: Administration, Oral; Adult; Antineoplastic agents; Antineoplastic Combined Chemotherapy Protocols - administration & dosage; Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Biological and medical sciences; Chemotherapy; Cisplatin - administration & dosage; Deoxycytidine - administration & dosage; Deoxycytidine - analogs & derivatives; Dexamethasone - administration & dosage; Drug Resistance, Neoplasm; Female; Hodgkin Disease - drug therapy; Hodgkin Disease - pathology; Hodgkin’s disease; Humans; Infusions, Intravenous; Key words: gemcitabine; Male; Medical sciences; Middle Aged; Peripheral Blood Stem Cell Transplantation; Pharmacology. Drug treatments; salvage chemotherapy; Salvage Therapy; Treatment Outcome; Antineoplastic agent; Gemcitabine; Lymphoproliferative syndrome; Phase II trial; Pyrimidine nucleoside; Platinum II Complexes; Human; Corticosteroid; Drug combination; Dexamethasone; Steroid hormone; Hodgkin disease; Malignant hemopathy; Recurrent; Lymphoma; Cisplatin; Resistance; Alkylating agent; Chemotherapy; salvage chemotherapy; Treatment; Antimetabolic; Fluorine Organic compounds; Salvage treatment; Hodgkin's disease
• ISSN: 0923-7534; 1569-8041
• DOI: 10.1093/annonc/mdg496

Background: Gemcitabine (difluorodeoxycytidine) is active as a single agent in Hodgkin’s disease and has been used successfully in combination with cisplatin to treat a variety of solid tumors. Patients and methods: We evaluated the combination of gemcitabine/dexamethasone/cisplatin (GDP) as salvage chemotherapy in 23 patients with relapsed or refractory Hodgkin’s disease (median age 36 years, range 19–57). Treatment consisted of gemcitabine 1000 mg/m2 intravenously on days 1 and 8, dexamethasone 40 mg orally days 1–4 and cisplatin 75 mg/m2 on day 1, every 21 days as an outpatient. Response was assessed following two cycles of treatment. Results: There were four complete responses and 12 partial responses for a response rate of 69.5% (95% confidence interval 52% to 87%); the remaining seven patients had stable disease and no patient progressed on treatment. All patients had successful stem cell mobilization and underwent transplantation with a median 10.6 × 106 CD34+ cells/kg. Hematological toxicity from GDP was mild (grade 3 neutropenia 8.6%, grade 3 thrombocytopenia 13%). Conclusions: In summary, GDP is an active regimen for patients with relapsed or refractory Hodgkin’s disease. The response rate is similar to the rates of other current salvage regimens, it can be given to outpatients with tolerable toxicity and it does not inhibit the mobilization of autologous stem cells.