Seminars in oncology
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Seminars in oncology · Feb 2003
Review Randomized Controlled Trial Clinical TrialDose-comparative monotherapy trials of ZD1839 in previously treated non-small cell lung cancer patients.
Patients with non-small cell lung cancer (NSCLC) frequently present, or relapse, with unresectable disease that is resistant to standard chemotherapy. There is, therefore, an urgent need for new treatments for NSCLC and other solid tumors. ZD1839 (Iressa; AstraZeneca Pharmaceuticals LP, Wilmington, DE), an orally active, selective epidermal growth factor receptor-tyrosine kinase inhibitor, has shown promising antitumor responses in phase I clinical trials in heavily pretreated patients with advanced NSCLC and other solid tumors. ⋯ Symptom improvement rates (increase of at least two points on the Lung Cancer Subscale) were 43% and 35%, respectively. Both doses of ZD1839 were well tolerated in this trial. The results of IDEAL-1 and IDEAL-2 indicate that ZD1839 monotherapy may offer a single-agent alternative for patients with advanced solid tumors who have received and progressed on prior chemotherapy, many of whom have exhausted their therapy options.
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Seminars in oncology · Feb 2003
ReviewFirst-line and maintenance treatment with rituximab for patients with indolent non-Hodgkin's lymphoma.
The chimeric human-mouse anti-CD20 monoclonal antibody rituximab has durable single-agent activity in patients with relapsed and refractory indolent non-Hodgkin's lymphoma. The focus of this report is a phase II trial evaluating the efficacy of single-agent rituximab as first-line therapy in patients with indolent lymphoma and scheduled maintenance treatment in prolonging duration of remission. Patients received a 4-week course of standard rituximab (375 mg/m(2) intravenously weekly x 4). ⋯ In summary, rituximab appears highly active as first-line single-agent therapy for indolent non-Hodgkin's lymphoma and responses may be improved with maintenance courses of rituximab. Results suggest a higher response rate to rituximab when used as first-line compared with second/third-line treatment, particularly in the subset of patients with SLL and chronic lymphocytic leukemia. Further follow-up will provide important information regarding the impact of first-line and maintenance rituximab on progression-free survival in patients with indolent non-Hodgkin's lymphoma.
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Seminars in oncology · Feb 2003
Impact of ZD1839 on non-small cell lung cancer-related symptoms as measured by the functional assessment of cancer therapy-lung scale.
The majority of patients with non-small cell lung cancer (NSCLC) present with advanced disease, which is associated with a poor prognosis and symptoms such as pain, coughing, and shortness of breath. In patients who present at an earlier stage, the progressive nature of NSCLC and its resistance to treatment often result in recurrence, with the associated symptoms of advanced disease. These symptoms negatively affect patient quality of life and performance status rating, both of which are predictive of treatment response and survival. ⋯ In IDEAL-1 and IDEAL-2, improvements in NSCLC-related symptoms and quality of life, as measured by FACT-L, correlated with tumor response, and improvements in symptoms also correlated with progression-free and overall survival. Although symptom response is correlated with tumor response, it is also uniquely predictive of progression-free and overall survival. The FACT-L questionnaire has also been included in phase III trials of ZD1839 treatment in combination with chemotherapy regimens.