Preliminary results on the activity of oxaliplatin (L-OHP) in refractory recurrent non-Hodgkin's lymphoma patients

Background: Many patients with advanced NHL ultimately relapse and require salvage treatment. Oxaliplatin, a diamino-cyclohexane (DACH) platinum, has shown a differential spectrum of cytotoxicity with cisplatin, with activity in primary or secondary cisplatin-resistant solid tumors (colon and ovaria n cancer). We report the tolerance/activity of this platinum derivate in pr eviously-treated NHL patients. Patients and methods: From July 1988 to February 1994, 22 patients (11 men, 11 women) with recurrent NHL received single-agent oxaliplatin (100-130 mg /m(2) i.v. over two hours with antiemetic premedication, q three weeks). Al l had been previously treated (median number of prior chemotherapy regimens 2, range 1-7) greater than or equal to 1 alkylating agent: 22 patients, an thracyclines: 18 patients, cisplatin: four patients, and radiation: 11 pati ents. Fourteen patients (63%) had progressive disease as best response to t heir last chemotherapy, and were considered treatment-refractory. All histo logies were centrally reviewed in accord with the R.E.A.L. Classification; they were: eight follicular, five MCL, three diffuse large cell, two MALT, one lymphoplasmocytoid, and three other. Results. A total of 144 cycles were administered for a median number of 6 ( range 1-30) per patient. The objective response rate was 40% (95% CI: 21-64 ), including one CR (MCL) and eight PRs (four follicular, two MCL, two MALT ). The median response duration was 27 months (range 5-44). Treatment-relat ed toxicity was limited to grade 1-2 nausea/vomiting and reversible grade 1 -2 peripheral neuropathy in most of the patients. Conclusion: Oxaliplatin is an active agent in relapsed/refractory NHL, incl uding the MCL type. Its safety profile makes this agent a good candidate fo r the development of combined salvage regimens. Further phase II studies ar e needed to confirm these preliminary results.