A phase II study of everolimus (RAD001), an mTOR inhibitor plus CHOP for newly diagnosed peripheral T-cell lymphomas

S. J. Kim, D. Y. Shin, J. S. Kim, D. H. Yoon, W. S. Lee, H. Lee, Y. R. Do, H. J. Kang, H. S. Eom, Y. H. Ko, S. H. Lee, H. Y. Yoo, M. Hong, C. Suh, W. S. Kim

Research output: Contribution to journalArticlepeer-review

26 Scopus citations

Abstract

Background: Everolimus, an oral mTOR inhibitor, has single-agent activity against relapsed lymphomas. Thus, we carried out a phase II study of everolimus in combination with CHOP (cyclophosphamide, doxorubicin, vincristine, and prednisone) as a first-line treatment for patients with peripheral T-cell lymphoma (PTCL) based on our phase I study results. Patients and methods: Participants (n = 30) received CHOP with 5 mg everolimus per day from day 1 to 14 every 21 days for a total of six cycles. The primary end point was the overall response rate (ORR), which included complete response (CR) and partial response (PR) to this regimen. Immunohistochemistry was used to evaluate the expression of phosphatase and tensin homology (PTEN) and phosphorylated S6 kinase (pS6K) as a response. Results: The objective response rate was 90% with CR (n = 17) and PR (n = 10). The CR rate was different among subtypes; angioimmunoblastic T-cell lymphoma (AITL, n = 3) had a CR whereas PTCL-not-otherwise specified and ALKnegative anaplastic large-cell lymphoma (ALCL) patients showed 63% (12/19) and 29% (2/7) of CR rate, respectively. This difference in CR rate among subtypes was associated with PTEN loss because PTEN loss was not seen in AITL but 33% of ALCL patients. The most common toxicity was hematological, with 80% of patients experiencing at least one event of grade 3/4 neutropenia, and 60% of patients had grade 3/4 thrombocytopenia. Conclusion: The everolimus plus CHOP was effective for PTCL patients, and its efficacy might be related with the preservation of PTEN.

Original languageEnglish (US)
Pages (from-to)712-718
Number of pages7
JournalAnnals of Oncology
Volume27
Issue number4
DOIs
StatePublished - Apr 1 2016

Bibliographical note

Funding Information:
This research was supported by the research funding from Novartis and a grant of the Korea Health Technology R&D Project through the Korea Health Industry Development Institute (KHIDI), funded by the Ministry of Health & Welfare, Republic of Korea (grant number: HI14C2223).

Publisher Copyright:
© The Author 2016. Published by Oxford University Press on behalf of the European Society for Medical Oncology.

Keywords

  • CHOP
  • Everolimus
  • T-cell lymphoma

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