Optimization of rituximab for the treatment of DLBCL: increasing the dose for elderly male patients.
GLA - German Lymphoma Alliance

Abstract (Expand)

Male sex is associated with unfavourable pharmacokinetics and prognosis in elderly patients with diffuse large B-cell lymphoma (DLBCL). We investigated higher rituximab doses for elderly male DLBCL … patients. Elderly patients (61-80 years) received 6 cycles CHOP-14 (cyclophosphamide, doxorubicin, vincristine and prednisone at 14-day intervals) and were randomized to 8 cycles rituximab (males 500 mg/m(2) , females 375 mg/m(2) ) every 2 weeks or according to an upfront dose-dense schedule. In 268 (120 females, 148 males) no difference between the standard and the upfront dose-dense rituximab schedule was found (3-year PFS 72% vs. 74%; OS 74% vs. 77%; P = 0.651). The 500 mg/m(2) dose of rituximab for male patients was associated with serum levels and exposure times slightly better than in females and a male/female hazard ratio of 0.9 for progression-free survival (PFS) and 0.8 for overall survival. For elderly males, 500 mg/m(2) was not more toxic than 375 mg/m(2) rituximab, but improved PFS by 32.5% (P = 0.039), with a trend for a (30%) better overall survival (P = 0.076) in a planned subgroup analysis adjusting for International Prognostic Index risk factors. We conclude that the higher rituximab dose for elderly male patients abrogated the adverse prognosis of male sex without increasing toxicity. In the era of personalized medicine, sex-specific pharmacokinetics and toxicities should be investigated for all drugs where these parameters impact on outcome.

Authors: M. Pfreundschuh, N. Murawski, S. Zeynalova, M. Ziepert, M. Loeffler, M. Hanel, J. Dierlamm, U. Keller, M. Dreyling, L. Truemper, N. Frickhofen, A. N. Hunerliturkoglu, N. Schmitz, V. Poschel, T. Rixecker, C. Berdel, C. Rube, G. Held, C. Zwick

Date Published: 11th Oct 2017

Publication Type: Not specified

Human Diseases: non-Hodgkin lymphoma, diffuse large B-cell lymphoma

Neural processing of negative emotional stimuli and the influence of age, sex and task-related characteristics.
LIFE Adult

Abstract (Expand)

Negative emotional stimuli are particularly salient events that receive privileged access to neurocognitive resources. At the neural level, the processing of negative stimuli relies on a set of sensory, … limbic, and prefrontal areas. However, controversies exist on how demographic and task-related characteristics modulate this brain pattern. Here, we used activation likelihood estimation (ALE) meta-analysis and replicator dynamics to investigate the processing of negative visual stimuli in healthy adults. Our findings endorse the central role of the amygdala. This result might reflect how this structure modulates perceptual and attentional mechanisms in response to emotional stimuli. Additionally, we characterize how the neural processing of negative visual stimuli is influenced by the demographic factors of age and sex as well as by task-related characteristics like stimulus type, emotion category, and task instruction, with the amygdala showing comparable engagement across different sexes, stimulus types, and task instructions. Our findings practically inform experimentation in the affective neurosciences but also suggest brain circuits for neurobiological investigations of affective symptomatology.

Authors: I. Garcia-Garcia, J. Kube, M. Gaebler, A. Horstmann, A. Villringer, J. Neumann

Date Published: 12th May 2016

Publication Type: Not specified

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