SMILE regimen effective against rare T-cell subtype

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According to a study by Japanese researchers, the SMILE combination chemotherapy protocol is effective against extranodal natural killer/T-cell lymphoma, nasal type (ENKL), a subtype with a typically poor prognosis.

The Phase II study involved 38 patients with the following diagnoses:

- Newly diagnosed stage IV disease: 20
- First relapse: 14
- Primary refractory disease: 4

Following two cycles, the overall response rate was 79% and the complete response rate was 45%. Despite this, researchers warned that the regimen is "potentially toxic, and careful patient monitoring is needed."

SMILE is composed of the following chemotherapeutic drugs:

- Dexamethasone
- Methotrexate
- Ifosfamide
- L-asparaginase
- Etoposide

The disease is more prevalent in Japan and other Asian countries than it is in the West. According to researchers, the diagnosis is made in about 600 Japanese citizens annually, against just 200 US citizens annually.

Source

Yamaguchi M et al. Phase II Study of SMILE Chemotherapy for Newly Diagnosed Stage IV, Relapsed, or Refractory Extranodal Natural Killer (NK)/T-Cell Lymphoma, Nasal Type: The NK-Cell Tumor Study Group Study. JCO. 2011.35.6287

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