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The only randomised trial run exclusively in the virus-driven adult T-cell leukaemia found an intensive Japanese regimen produced more complete remissions than standard chemotherapy, at considerable cost in toxicity.
A randomised controlled trial conducted exclusively in human T-lymphotropic virus type 1-associated adult T-cell leukaemia-lymphoma. Previously untreated patients with aggressive disease were assigned to six courses of VCAP-AMP-VECP every four weeks or eight courses of biweekly CHOP, both with granulocyte colony-stimulating factor support and intrathecal prophylaxis. 118 patients were enrolled.
The complete response rate was 40 per cent with VCAP-AMP-VECP against 25 per cent with biweekly CHOP (p = 0.020). One-year progression-free survival was 28 against 16 per cent (p = 0.100, two-sided p = 0.200) and three-year overall survival 24 against 13 per cent (p = 0.085, two-sided p = 0.169). Grade 4 neutropenia occurred in 98 against 83 per cent, grade 4 thrombocytopenia in 74 against 17 per cent and grade 3 or 4 infection in 32 against 15 per cent, with three toxic deaths in the VCAP-AMP-VECP arm.
The Japanese standard regimen for aggressive adult T-cell leukaemia/lymphoma rests on this trial. Three-year overall survival of 24 per cent with the better arm is the plainest statement of how much room remains, and is why allogeneic transplantation, mogamulizumab and antiviral approaches have all been pursued since.
Shares Complete response, Randomised evidence for the T-cell lymphomas, including the ones that are not in Europe or North America, Etoposide, Peripheral T-cell lymphomas (including cutaneous T-cell lymphoma) and the tag lymphoma-evidence.
Shares Complete response, Randomised evidence for the T-cell lymphomas, including the ones that are not in Europe or North America, Etoposide, Peripheral T-cell lymphomas (including cutaneous T-cell lymphoma) and the tag lymphoma-evidence.
Shares Prednisone, Vincristine, Etoposide, Lymphoma roadmap: from a jaw tumour in Uganda and the first human cancer virus to gene-expression subtypes, PET-adapted chemotherapy, CAR-T cells, bispecific antibodies and the genetics-directed trials now recruiting and the tag lymphoma-evidence.
Shares Prednisone, Vincristine, Peripheral T-cell lymphomas (including cutaneous T-cell lymphoma), Lymphoma roadmap: from a jaw tumour in Uganda and the first human cancer virus to gene-expression subtypes, PET-adapted chemotherapy, CAR-T cells, bispecific antibodies and the genetics-directed trials now recruiting and the tag lymphoma-evidence.
Shares Prednisone, Vincristine, Rare and paediatric cancers without markets, Lymphoma roadmap: from a jaw tumour in Uganda and the first human cancer virus to gene-expression subtypes, PET-adapted chemotherapy, CAR-T cells, bispecific antibodies and the genetics-directed trials now recruiting and the tag lymphoma-evidence.
Shares Prednisone, Vincristine, Etoposide, Lymphoma roadmap: from a jaw tumour in Uganda and the first human cancer virus to gene-expression subtypes, PET-adapted chemotherapy, CAR-T cells, bispecific antibodies and the genetics-directed trials now recruiting and the tag lymphoma-evidence.
Shares Prednisone, Vincristine, Lymphoma roadmap: from a jaw tumour in Uganda and the first human cancer virus to gene-expression subtypes, PET-adapted chemotherapy, CAR-T cells, bispecific antibodies and the genetics-directed trials now recruiting, Cyclophosphamide and the tag lymphoma-evidence.
Shares Prednisone, Vincristine, Lymphoma roadmap: from a jaw tumour in Uganda and the first human cancer virus to gene-expression subtypes, PET-adapted chemotherapy, CAR-T cells, bispecific antibodies and the genetics-directed trials now recruiting, Cyclophosphamide and the tag lymphoma-evidence.