Seminars in oncology
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Seminars in oncology · Aug 1997
Clinical TrialThe development of docetaxel (Taxotere) in non-small cell lung cancer--docetaxel in new combinations and new schedules: an overview of ongoing and future developments.
Non-small cell lung cancer is the most common cause of cancer death in the western world. Non-small cell lung cancer is modestly sensitive to chemotherapy with a small survival benefit in locally advanced and metastatic disease. Newer agents such as docetaxel are yielding encouraging response rates both as single agents and in combination. ⋯ These preliminary results suggest that the combination of docetaxel, ifosfamide, and cisplatin, with lenograstim support, is well tolerated in the doses evaluated. Preliminary efficacy results show a response rate of 67% (six of nine patients). The study continues to determine the maximum tolerated dose of this regimen in preparation for a phase II evaluation.
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Seminars in oncology · Aug 1997
Clinical TrialWeekly paclitaxel in patients with advanced lung cancer: preliminary data from a phase II trial.
We conducted a phase II trial in chemotherapy-naive patients with advanced non-small cell lung cancer to determine the efficacy of paclitaxel (Taxol; Bristol-Myers Squibb Company, Princeton, NJ) delivered at a maximum tolerated dose of 175 mg/m2 on an extended weekly schedule. Patients with stage IIIB/IV non-small cell lung cancer were eligible if they had an Eastern Cooperative Oncology Group performance status of 0 to 2, had received no previous chemotherapy, demonstrated normal hematologic and hepatic function, and could provide informed consent. Paclitaxel 175 mg/m2 was administered as an intravenous infusion weekly over 3 hours with standard premedication, for 6 weeks of an 8-week cycle. ⋯ Median duration of response was 6.5 months, and the 1-year survival rate was 53%. The extended weekly paclitaxel schedule results in enhanced dose intensity, marked activity, and acceptable toxicity. Paclitaxel given weekly at maximum dose intensity may be more effective than conventional paclitaxel administration schedules.
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Seminars in oncology · Aug 1997
Clinical TrialPreliminary results of neoadjuvant paclitaxel and carboplatin in the treatment of early stage non-small cell lung cancer.
The purpose of this study is to determine the feasibility of delivering neoadjuvant paclitaxel (Taxol; Bristol-Myers Squibb Company, Princeton, NJ) and carboplatin to patients with clinical early stage (stage I and II) non-small cell lung cancer. Although neoadjuvant chemotherapy appears to prolong survival in patients with stage IIIA non-small cell lung cancer, several studies have demonstrated an increase in perioperative mortality associated with this approach. This study is designed to address whether three cycles of paclitaxel (200 mg/m2/3 hour, day 1) and carboplatin (area under the concentration-time curve 5, day 2) can be given preoperatively to patients with clinical stage I and II non-small cell lung cancer and to assess the associated toxicities, pathologic response rate, disease-free survival, and overall survival of this group of patients. ⋯ Three have successfully undergone resection, with no perioperative complications noted. One patient had a pathologic complete remission and two had pathologic partial remissions. Preliminary results indicate that this approach is well tolerated and results in major tumor response.
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Seminars in oncology · Aug 1997
Combination treatment with docetaxel (Taxotere) and platinum compounds for non-small cell lung cancer.
There is a strong rationale for combining docetaxel (Taxotere; Rhône-Poulenc Rorer, Antony, France) and platinum compounds for use in the treatment of non-small cell lung cancer (NSCLC). The compounds are active as single agents and have no overlapping toxicity profiles. The first dose-finding study reported a response rate of 46%, and recommended doses of 75 mg/m2 for docetaxel and 75 to 100 mg/m2 for cisplatin, given concomitantly every 3 weeks. ⋯ Compared with monotherapy, docetaxel/platinum combinations appear to offer the potential for improved response rates in patients with NSCLC. The use of alternating schedules offers the further possible advantage of improving tolerability while retaining effective doses. Further studies are in progress or planned to elucidate optimal doses and schedules.
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Seminars in oncology · Apr 1997
Randomized Controlled Trial Clinical TrialAdjuvant chemotherapy with epirubicin and carmofur after radical resection of hepatocellular carcinoma: a prospective randomized study.
The intrahepatic recurrence rate is extremely high, even after radical resection of hepatocellular carcinoma (HCC). One report showed intra-arterial administration of epirubicin to be effective in the treatment of nonresectable HCC. We evaluated the effect of postoperative adjuvant chemotherapy including this drug. ⋯ The mean total doses were 128 +/- 114 mg for epirubicin and 144 +/- 84 g for HCFU. The cumulative overall and disease-free survival rates for 5 years were not significantly different between the two groups. The results of this prospective randomized study suggest that this adjuvant chemotherapy protocol with epirubicin and HCFU after radical resection of HCC was not effective.