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      Current Opinion on Pixantrone in the Treatment of Non-Hodgkin B-Cell Lymphoma

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          Abstract

          Not many treatment options exist for patients with relapsed or refractory (R/R) B-cell non-Hodgkin lymphoma (NHL) in whom first- and second-line therapies were unsuccessful. This is especially true for patients with aggressive lymphomas. The innovative agent pixantrone has shown some promising results in terms of disease-free and overall survival, both in monotherapy as well as in combinations. However, recent trials (Phase III and real-world studies) reported unsatisfactory results, thereby raising the question about the role of pixantrone in the current treatment of R/R aggressive lymphomas. Nonetheless, there might still be a potential position for this drug in combinations, for use as first-line treatment of patients with cardiac dysfunction. This article summarizes the definition, structure, mechanism of action and reduced cardiotoxicity of pixantrone as well as efficacy and toxicity both in monotherapy and in combinations, as treatment for aggressive and indolent non-Hodgkin lymphomas.

          Most cited references63

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          Axicabtagene Ciloleucel CAR T-Cell Therapy in Refractory Large B-Cell Lymphoma

          In a phase 1 trial, axicabtagene ciloleucel (axi-cel), an autologous anti-CD19 chimeric antigen receptor (CAR) T-cell therapy, showed efficacy in patients with refractory large B-cell lymphoma after the failure of conventional therapy.
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            Tisagenlecleucel in Adult Relapsed or Refractory Diffuse Large B-Cell Lymphoma

            Patients with diffuse large B-cell lymphoma that is refractory to primary and second-line therapies or that has relapsed after stem-cell transplantation have a poor prognosis. The chimeric antigen receptor (CAR) T-cell therapy tisagenlecleucel targets and eliminates CD19-expressing B cells and showed efficacy against B-cell lymphomas in a single-center, phase 2a study.
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              Chimeric antigen receptor T-cell therapy — assessment and management of toxicities

              Chimeric antigen receptor (CAR)-T-cell therapies are showing great promise in the treatment of cancer, particularly B-cell malignancies, but are associated with characteristic, potentially fatal toxicities, principally cytokine-release syndrome, CAR-T-cell-related encephalopathy syndrome, and haemophagocytic lymphohistiocytosis/macrophage-activation syndrome. Herein, the CAR-T-cell-therapy-associated TOXicity (CARTOX) Working Group, comprising multidisciplinary investigators from various institutions with clinical experience in the use of a range of CAR-T-cell platforms, review these acute toxicities and provide monitoring, grading, and management recommendations.
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                Author and article information

                Journal
                Ther Clin Risk Manag
                Ther Clin Risk Manag
                tcrm
                tcriskman
                Therapeutics and Clinical Risk Management
                Dove
                1176-6336
                1178-203X
                02 March 2021
                2021
                : 17
                : 183-192
                Affiliations
                [1 ]Division of Medical Oncology, Institute of Oncology Ljubljana , Ljubljana, 1000, Slovenia
                Author notes
                Correspondence: Barbara Jezeršek Novaković Division of Medical Oncology, Institute of Oncology Ljubljana , Zaloška 2, Ljubljana, 1000, SloveniaTel +38615879631Fax +38615879305 Email bjezersek@onko-i.si
                Author information
                http://orcid.org/0000-0002-5063-7072
                http://orcid.org/0000-0001-7280-1470
                http://orcid.org/0000-0002-8155-4173
                Article
                269324
                10.2147/TCRM.S269324
                7936695
                92ecddd9-221f-4ad7-b3c9-c62dee4b22e3
                © 2021 Jezeršek Novaković et al.

                This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License ( http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms ( https://www.dovepress.com/terms.php).

                History
                : 03 December 2020
                : 16 February 2021
                Page count
                Figures: 0, References: 67, Pages: 10
                Funding
                Funded by: no funding;
                There is no funding to report.
                Categories
                Review

                Medicine
                pixantrone,b-cell non-hodgkin lymphomas,efficacy,toxicity
                Medicine
                pixantrone, b-cell non-hodgkin lymphomas, efficacy, toxicity

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