Pixantrone beyond monotherapy: a review

Research output: Contribution to journal/Conference contribution in journal/Contribution to newspaperReviewResearchpeer-review

  • Cristina Barrenetxea Lekue, Hospital Universitario Basurto
  • ,
  • Silvina Grasso Cicala, Medical Affairs Department
  • ,
  • Sirpa Leppä, Helsinki University Central Hospital
  • ,
  • Thomas Stauffer Larsen, Odense Universitetshospital
  • ,
  • Susana Herráez Rodríguez, Hospital Universitario Basurto
  • ,
  • Clara Alonso Caballero, Hospital Universitario Basurto
  • ,
  • Judit M. Jørgensen
  • ,
  • Helle Toldbod
  • Irene Leal Martínez, Hospital Universitario Basurto
  • ,
  • Francesco D’Amore

Outcomes for patients with non-Hodgkin’s lymphoma (NHL) that proves refractory to treatment remain poor. Treatment of such patients is individualized and can include enrolment in a clinical trial of novel agents or use of one of a wide array of drug regimens. Initial treatment with anthracyclines such as doxorubicin limits options at later stages of treatment because of anthracycline-related cumulative cardiotoxicity. The aza-anthracenedione pixantrone was developed to reduce the likelihood of cardiotoxicity without compromising efficacy and is currently conditionally approved for use as monotherapy in patients with multiply-relapsed or refractory aggressive B cell NHL. The use of pixantrone in combination therapy, often to replace doxorubicin or mitoxantrone, has or is currently being investigated in numerous studies in patients with aggressive or indolent NHL and is the focus of this review. These include the R-CPOP regimen (rituximab, cyclophosphamide, pixantrone, vincristine, prednisone) for aggressive NHL in the first-line setting, including a study in elderly patients with limited cardiac function, and for patients with relapsed NHL with prior anthracycline exposure; the PSHAP regimen (pixantrone, cytarabine, prednisone, cisplatin), also in the latter setting; the PREBen/PEBen regimen (pixantrone, bendamustine and etoposide with or without rituximab) as salvage therapy; and pixantrone in combination with fludarabine, dexamethasone, and rituximab (FPD-R) for relapsed indolent NHL.

Original languageEnglish
JournalAnnals of Hematology
Pages (from-to)2025-2033
Number of pages9
Publication statusPublished - 1 Jan 2019

    Research areas

  • Antineoplastic efficacy, Cardiotoxicity, Non-Hodgkin’s lymphoma, Pixantrone

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