- Book学术

发布求助

文献互助智能选刊最新文献

IF 2 4区医学 Q3 ONCOLOGY

Oncology Research and Treatment Pub Date : 2025-04-03 DOI:10.1159/000545644

Jing Yang, Xingzhen Cheng, Guo Wei, Tingyu Chen, Yong Zhao

{"title":"Safety and efficacy of pharmacotherapy containing the second-generation INSTIs and chemotherapy drugs in AIDS-related diffuse large B-cell lymphoma: a single-center retrospective analysis.","authors":"Jing Yang, Xingzhen Cheng, Guo Wei, Tingyu Chen, Yong Zhao","doi":"10.1159/000545644","DOIUrl":null,"url":null,"abstract":"Background: Previous research indicates that combining antiviral and anti-tumor drugs may lead to compounded toxic side effects and risks of drug-drug interactions (DDIs). Our study aims to investigate the safety and effectiveness of pharmacotherapy combining second-generation integrase inhibitors (INSTIs) with chemotherapy drugs in patients with AIDS-related diffuse large B-cell lymphoma (AR-DLBCL).Methods: We conducted a retrospective cohort study of newly diagnosed AR-DLBCL patients at the Public Health Clinical Center of Chengdu from February 2020 to May 2023. All patients received a second-generation INSTI-based regimen alongside chemotherapy. Primary endpoints included the frequency and severity of adverse effects (AEs), while secondary endpoints encompassed CD4 count, CD4/CD8 ratio, HIV viral load, and complete response (CR), partial response (PR), and overall response rate (ORR)at the end of treatment (EOT). Evaluations were performed at each chemotherapy cycle, with AEs assessed using Common Terminology Criteria for Adverse Events, version 4.02.Results: We enrolled 96 AR-DLBCL patients with a median follow-up of 15.5 months (range: 5 to 33). Of these, 60 were treated with bictegravir (BIC)/tenofovir alafenamide (TAF)/emtricitabine (FTC) and 36 with dolutegravir (DTG)/lamivudine (3TC)/albuvirtide (ABT). 75 patients were treated with R+CHOP(rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone), and 21 with R+EPOCH(rituximab, etoposide, doxorubicin, vincristine, cyclophosphamide and prednisone) . The most common grade 3 or higher AEs during treatment were neutropenia (32.29%) and thrombocytopenia (20.83%). Seven patients experienced serious complications during treatment, including pulmonary tuberculosis(2), multiple organ dysfunction(1), intracranial infection(1), renal failure(1), and severe COVID-19(2), resulting in three deaths. CD4 count and CD4/CD8 ratio showed slight decreases from baseline (251.76 ± 188.53 cells/µl and 0.71 ± 0.69, respectively) to the 6th month (233.44 ± 140.53 cells/µl and 0.66 ± 0.55, respectively), with no statistical significance observed (p=0.375 and p=0.608). Viral load rebound was not observed. The objective response rate was 85.41%, with a CR rate of 51.04%. As of June 2024, 15 patients had died from severe infections or progressive disease.Conclusions: Second-generation INSTIs seem to be a safe and effective first-line treatment option for AR-DLBCL patients undergoing chemotherapy, regardless of the chemotherapy type.","PeriodicalId":19543,"journal":{"name":"Oncology Research and Treatment","volume":" ","pages":"1-19"},"PeriodicalIF":2.0000,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Oncology Research and Treatment","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1159/000545644","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"ONCOLOGY","Score":null,"Total":0}

引用次数: 0

摘要

背景：以往的研究表明，联合使用抗病毒药物和抗肿瘤药物可能会导致复合毒副作用和药物间相互作用（DDI）的风险。我们的研究旨在探讨艾滋病相关弥漫大 B 细胞淋巴瘤（AR-DLBCL）患者在接受第二代整合酶抑制剂（INSTIs）与化疗药物联合治疗时的安全性和有效性：我们对成都市公共卫生临床中心2020年2月至2023年5月新确诊的AR-DLBCL患者进行了一项回顾性队列研究。所有患者均在接受化疗的同时接受了基于第二代 INSTI 的治疗方案。主要终点包括不良反应（AE）的频率和严重程度，次要终点包括CD4计数、CD4/CD8比值、HIV病毒载量以及治疗结束时的完全应答（CR）、部分应答（PR）和总应答率（ORR）。在每个化疗周期进行评估，并使用《不良事件通用术语标准》（4.02版）评估AEs：我们共招募了96名AR-DLBCL患者，中位随访时间为15.5个月（5至33个月）。其中，60 名患者接受了比特拉韦（BIC）/替诺福韦-阿拉非酰胺（TAF）/恩曲他滨（FTC）治疗，36 名患者接受了多特拉韦（DTG）/拉米夫定（3TC）/阿巴韦肽（ABT）治疗。75名患者接受了R+CHOP（利妥昔单抗、环磷酰胺、多柔比星、长春新碱和泼尼松）治疗，21名患者接受了R+EPOCH（利妥昔单抗、依托泊苷、多柔比星、长春新碱、环磷酰胺和泼尼松）治疗。治疗期间最常见的 3 级或以上 AE 为中性粒细胞减少（32.29%）和血小板减少（20.83%）。七名患者在治疗期间出现严重并发症，包括肺结核（2 例）、多器官功能障碍（1 例）、颅内感染（1 例）、肾衰竭（1 例）和严重 COVID-19（2 例），导致三人死亡。从基线（分别为 251.76 ± 188.53 cells/µl 和 0.71 ± 0.69）到第 6 个月（分别为 233.44 ± 140.53 cells/µl 和 0.66 ± 0.55），CD4 细胞数和 CD4/CD8 比率略有下降，但未观察到统计学意义（p=0.375 和 p=0.608）。未观察到病毒载量反弹。客观反应率为 85.41%，CR 率为 51.04%。截至2024年6月，15名患者死于严重感染或疾病进展：第二代INSTIs似乎是接受化疗的AR-DLBCL患者安全有效的一线治疗选择，无论化疗类型如何。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

查看原文本刊更多论文

Safety and efficacy of pharmacotherapy containing the second-generation INSTIs and chemotherapy drugs in AIDS-related diffuse large B-cell lymphoma: a single-center retrospective analysis.

Background: Previous research indicates that combining antiviral and anti-tumor drugs may lead to compounded toxic side effects and risks of drug-drug interactions (DDIs). Our study aims to investigate the safety and effectiveness of pharmacotherapy combining second-generation integrase inhibitors (INSTIs) with chemotherapy drugs in patients with AIDS-related diffuse large B-cell lymphoma (AR-DLBCL).

Methods: We conducted a retrospective cohort study of newly diagnosed AR-DLBCL patients at the Public Health Clinical Center of Chengdu from February 2020 to May 2023. All patients received a second-generation INSTI-based regimen alongside chemotherapy. Primary endpoints included the frequency and severity of adverse effects (AEs), while secondary endpoints encompassed CD4 count, CD4/CD8 ratio, HIV viral load, and complete response (CR), partial response (PR), and overall response rate (ORR)at the end of treatment (EOT). Evaluations were performed at each chemotherapy cycle, with AEs assessed using Common Terminology Criteria for Adverse Events, version 4.02.

Results: We enrolled 96 AR-DLBCL patients with a median follow-up of 15.5 months (range: 5 to 33). Of these, 60 were treated with bictegravir (BIC)/tenofovir alafenamide (TAF)/emtricitabine (FTC) and 36 with dolutegravir (DTG)/lamivudine (3TC)/albuvirtide (ABT). 75 patients were treated with R+CHOP(rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone), and 21 with R+EPOCH(rituximab, etoposide, doxorubicin, vincristine, cyclophosphamide and prednisone) . The most common grade 3 or higher AEs during treatment were neutropenia (32.29%) and thrombocytopenia (20.83%). Seven patients experienced serious complications during treatment, including pulmonary tuberculosis(2), multiple organ dysfunction(1), intracranial infection(1), renal failure(1), and severe COVID-19(2), resulting in three deaths. CD4 count and CD4/CD8 ratio showed slight decreases from baseline (251.76 ± 188.53 cells/µl and 0.71 ± 0.69, respectively) to the 6th month (233.44 ± 140.53 cells/µl and 0.66 ± 0.55, respectively), with no statistical significance observed (p=0.375 and p=0.608). Viral load rebound was not observed. The objective response rate was 85.41%, with a CR rate of 51.04%. As of June 2024, 15 patients had died from severe infections or progressive disease.

Conclusions: Second-generation INSTIs seem to be a safe and effective first-line treatment option for AR-DLBCL patients undergoing chemotherapy, regardless of the chemotherapy type.

求助全文

通过发布文献求助，成功后即可免费获取论文全文。去求助

来源期刊

Oncology Research and Treatment ONCOLOGY-

CiteScore

3.20

自引率

0.00%

发文量

期刊介绍： With the first issue in 2014, the journal ''Onkologie'' has changed its title to ''Oncology Research and Treatment''. By this change, publisher and editor set the scene for the further development of this interdisciplinary journal. The English title makes it clear that the articles are published in English – a logical step for the journal, which is listed in all relevant international databases. For excellent manuscripts, a ''Fast Track'' was introduced: The review is carried out within 2 weeks; after acceptance the papers are published online within 14 days and immediately released as ''Editor’s Choice'' to provide the authors with maximum visibility of their results. Interesting case reports are published in the section ''Novel Insights from Clinical Practice'' which clearly highlights the scientific advances which the report presents.