Table 2.
Summaries of the therapeutic efficacies of immunomodulatory drugs in relapsed or refractory MALT lymphoma.
| Authors | Drugs | Number | Age Median (Range) |
Lesions | Previous Treatment |
ORR | Most Common Side Effects |
PFS | Ref |
|---|---|---|---|---|---|---|---|---|---|
| Govi et al. | A regimen *: Clarithromycin 500 mg twice/D for 6 m |
13 M/F = 7/6 |
57 (36–80) | Conjunctival/ ocular+: 11 Gastric: 1 Breast: 1 |
Relapsed or refractory | 38.5% CR: 2 PR: 3 |
Nausea | 3-year 58% |
[113] |
| Ferreri et al. | B regimen *: Clarithromycin 2g/D, D1–14 every 21 D, 4 courses |
23 M/F = 5/18 |
70 (47–88) | Gastric: 3 Extra-gastric or multiple: 20 |
Relapsed or refractory | 52.0% CR: 6 PR: 6 |
Nausea | 2-year 56% |
[24] |
| Ferreri et al. | Clarithromycin 1 g (A regimen * or 500 mg twice daily D 1–21, every 35 D for 3 courses 2 g (B regimen *) |
55 M/F = 31/24 |
65 (30–88) | Gastric: 9 Extra-gastric: 46 Stage I: 40 Stage IV: 15 |
Tx: naïve N = 8 Previous Tx: N = 47 |
47.3% CR: 13 PR: 13 1 g vs. 2 g 57% vs. 41% p = 0.28 |
Nausea 1 g vs. 2 g 25% vs. 52% p = 0.03 |
3-year 52% 1 g vs. 2 g 78% vs. 41% p = 0.04 |
[114] |
| Lagler et al. | Azithromycin 1500 mg once Weekly 4 time/per m 3 to 6 m |
16 M/F = 6/10 |
68 (47–88) | 2 Gastric 14 Extra-gastric |
Tx: naïve N = 12 Previous Tx: N = 4 |
25% CR: 2 PR: 2 |
Nausea Diarrhea |
No Report |
[116] |
| Troch et al. | Thalidomide 100 mg D initially 200 mg after 4 weeks |
8 M/F = 6/2 |
60 (36–73) | Gastric: 5 Extra-gastric: 3 |
HPE, fail; or stage IV disease |
Initial: 0% 25.0% ** (after Tx) CR, 16.5 m CR, 22.5 m |
Neuropathy | No Report |
[124,126] |
| Kuo et al. | Thalidomide 100 mg-200 mg D, for 6 m |
10 M/F = 6/2 |
62 (48–78) | Gastric: 10 I/IIE1: 3 IV: 7 |
HPE or C/T: failed |
50.0% CR: 2 PR: 3 |
Dizziness | 3-year EFS; 38% | [125] |
| Kiese- wetter et al. |
Lenalidomide 25 mg/D D1–21, every 28 D Maximal: 6 cycles |
M/F = 8/10 | 60 (41–79) | Gastric: 5 Extra-gastric: 13 |
Previous tx: 7 None: 11 |
61.1% CR: 6 PR: 5 |
Pruritis | Median FU: 20.3 months 17 pts: alive |
[127] |
| Kiese- wetter et al. |
Lenalidomide (Len) 25 mg D, D1–21, every 28 D Maximal: 6 cycles Rituximab (Rit) + Len Len: 20 mg D D1–21 Rit: 375 mg/m2. D1 every 28 D Maximal: 8 cycles |
Len: 16 R + Len 34 M/F = 19/31 |
67 (33–85) | Gastric: 16 Extra-gastric: 34 I–II: 33 III–IV: 17 |
Previous Tx : 24 |
72.0% CR: 24 PR: 12 |
Pruritis | 54% free-off relapse Median PFS: 72.3 months 5-year OS: 92% |
[128] |
Abbreviation: ORR, overall response rate; PFS, progression-free survival; Ref, reference; D, daily; m, months; M, male; F, female; Tx, treatment; N, number; CR, complete remission; PR, partial remission; HPE, Helicobacter pylori eradication; EFS, event-free survival; FU, follow-up; OS, overall survival. * Clarithromycin regimen; ** 2 (25%) of 8 patients with thalidomide achieved CR at 16.5 m, and 22.5 m after starting treatment.