Chlamydophila psittaci eradication with doxycycline as first-line targeted therapy for ocular adnexae lymphoma: final results of an international phase II trial

Ferreri, Andres J. M., Govi, Silvia, Pasini, Elisa, Mappa, Silvia, Bertoni, Francesco, Zaja, Francesco, Montalban, Carlos, Stelitano, Caterina, Cabrera, Maria Elena, Resti, Antonio Giordano, Politi, Letterio Salvatore, Doglioni, Claudio, Cavalli, Franco, Zucca, Emanuele, Ponzoni, Maurilio and Dolcetti, Riccardo (2012) Chlamydophila psittaci eradication with doxycycline as first-line targeted therapy for ocular adnexae lymphoma: final results of an international phase II trial. Journal of Clinical Oncology, 30 24: 2988-2994. doi:10.1200/JCO.2011.41.4466

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Author Ferreri, Andres J. M.
Govi, Silvia
Pasini, Elisa
Mappa, Silvia
Bertoni, Francesco
Zaja, Francesco
Montalban, Carlos
Stelitano, Caterina
Cabrera, Maria Elena
Resti, Antonio Giordano
Politi, Letterio Salvatore
Doglioni, Claudio
Cavalli, Franco
Zucca, Emanuele
Ponzoni, Maurilio
Dolcetti, Riccardo
Title Chlamydophila psittaci eradication with doxycycline as first-line targeted therapy for ocular adnexae lymphoma: final results of an international phase II trial
Formatted title
Chlamydophila psittaci eradication with doxycycline as first-line targeted therapy for ocular adnexae lymphoma: final results of an international phase II trial
Journal name Journal of Clinical Oncology   Check publisher's open access policy
ISSN 0732-183X
1527-7755
Publication date 2012-08-20
Year available 2012
Sub-type Article (original research)
DOI 10.1200/JCO.2011.41.4466
Open Access Status File (Publisher version)
Volume 30
Issue 24
Start page 2988
End page 2994
Total pages 7
Place of publication Alexandria, VA, United States
Publisher American Society of Clinical Oncology
Language eng
Formatted abstract
Purpose: The pathogenic association between Chlamydophila psittaci (Cp) and ocular adnexal marginal zone lymphoma (OAMZL) and the efficacy of doxycycline monotherapy have been investigated in retrospective series with variations in stage, management, and follow-up duration. To our knowledge, this is the first international phase II trial aimed at clarifying Cp prevalence and activity of first-line doxycycline in a homogeneous series of consecutive patients with newly diagnosed stage I OAMZL.

Patients and Methods: Forty-seven patients were registered. Tumor tissue, conjunctival swabs, and peripheral blood from 44 patients were assessed for seven Chlamydiaceae infections by three polymerase chain reaction protocols. Thirty-four patients with measurable or parametrable disease were treated with doxycycline and assessed for chlamydial eradication and lymphoma response (primary end point).

Results: Cp DNA was detected in biopsies of 39 patients (89%); no other Chlamydiaceae were detected. Twenty-nine patients had Cp DNA in baseline swabs and/or blood samples and were evaluable for chlamydial eradication, which was achieved in 14 patients (48%). Lymphoma regression was complete in six patients and partial in 16 (overall response rate, 65%; 95% CI, 49% to 81%); 11 had stable disease, and one had progressive disease. At a median follow-up of 37 months (range, 15 to 62 months), 20 patients remained relapse free (5-year progression-free survival [PFS] ± standard deviation, 55% ± 9%). Cp eradication was associated with improved response rate (86% v 47%; P = .02) and 5-year PFS (68% v 47%; P = .11).

Conclusion: Upfront doxycycline is a rational and active treatment for patients with stage I Cp-positive OAMZL. Lymphoma regression is consequent to Cp eradication, which can easily be monitored on conjunctival and blood samples. Prospective trials aimed at identifying more effective administration schedules for doxycycline are warranted.
Keyword Oncology
Oncology
ONCOLOGY
Q-Index Code C1
Q-Index Status Provisional Code
Grant ID ICP OCS-02062-03-2007
Institutional Status Non-UQ

Document type: Journal Article
Sub-type: Article (original research)
Collection: School of Medicine Publications
 
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