The Effects of Unfractionated Heparin on Survival in Patients with Malignancy – A Systematic Review

1999 ◽  
Vol 82 (12) ◽  
pp. 1600-1604 ◽  
Author(s):  
Rohan Hettiarachchi ◽  
Roel Vink ◽  
Harry Büller ◽  
Susanne Smorenburg
Keyword(s):  
Unfractionated Heparin ◽  
Gastrointestinal Cancer ◽  
Small Cell Lung Carcinoma ◽  
Randomized Study ◽  
Experimental Studies ◽  
Convincing Evidence ◽  
Cell Lung Carcinoma ◽  
Level 2 ◽  
Methodological Strength ◽  
Heart Foundation

SummaryClinical and experimental studies have suggested that unfractionated heparin (UFH) effects malignancy progression. We reviewed all published clinical reports concerning the effects of UFH, as compared to no treatment on survival of cancer patients. Studies were classified on methodological strength and subdivided as to whether therapeutic or prophylactic dosages of UFH were used. Mortality rates after 3 years were extracted or calculated. One randomized study that evaluated the use of UFH in therapeutic dosages in patients with small cell lung carcinoma reported on an improved survival (odds ratio (OR) 0.64; 95% confidence interval (CI): 0.25 to 1.62). A detrimental effect was observed in 2 randomized studies which investigated the effects of intraportal UFH treatment in a prophylactic dose after surgery for gastrointestinal cancer (OR 1.66; 95% CI: 1.02 to 2.71). In contrast, level 2 studies in which either therapeutic or prophylactic dosages of UFH on mortality of patients with gastrointestinal cancer were evaluated, showed OR of 0.58 (95% CI; 0.11-3.13) and 0.65 (95% CI 0.51 to 0.84), respectively. We conclude that there is no convincing evidence of either positively or negatively effects of UFH on survival of patients with malignancy.Harry R. Büller is an Established Investigator of the Dutch Heart Foundation

scholarly journals Combination chemotherapy in small cell lung carcinoma: A randomized study of two intensive regimens

Cancer ◽  
1984 ◽  
Vol 54 (11) ◽  
pp. 2344-2350 ◽  
Author(s):  
Stanley Lowenbraun ◽  
Robert Birch ◽  
Rosalyn Buchanan ◽  
Stephen Krauss ◽  
John Durant ◽  
...  
Keyword(s):  
Lung Carcinoma ◽  
Combination Chemotherapy ◽  
Small Cell Lung Carcinoma ◽  
Randomized Study ◽  
Small Cell ◽  
Small Cell Lung ◽  
Cell Lung Carcinoma

Phase I study of irinotecan (Ir) and cisplatin (DDP) in combination with thoracic radiotherapy (RT), either twice daily (45 Gy) or once daily (70 Gy), in patients with limited (Ltd) small cell lung carcinoma (SCLC): Early analysis of RTOG 0241

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 7058-7058 ◽  
Author(s):  
C. J. Langer ◽  
S. Swann ◽  
M. Werner-Wasik ◽  
R. Lilenbaum ◽  
W. Curran ◽  
...  
Keyword(s):  
Survival Data ◽  
Small Cell Lung Carcinoma ◽  
Maximum Tolerated Dose ◽  
Early Analysis ◽  
Cell Lung Carcinoma ◽  
Once Daily ◽  
Level 3 ◽  
Extensive Stage ◽  
Level 1 ◽  
Level 2

7058 Background: Ir in combination with DDP has proven superior to DDP & VP-16 in extensive stage SCLC (Noda et al NEJM 1/02), with marked increase in 2 yr survival (19.5%, vs 5.2%). Hence, it is critical to determine if Ir can be safely & effectively integrated with concurrent RT and DDP in earlier stage, Ltd SCLC. Methods: 1° endpoint: Determine maximum tolerated dose (MTD) of Ir d 1 & 8 plus DDP 60 mg/m2 q 3 wks & either BID RT (45 Gy) or QD RT (70 Gy). Eligibility stipulated Tx-naïve patients (pts) with Ltd SCLC, PS 0–1, adequate heme (ANC ≤ 1500/mL; plts ≥ 120,000/mL) hepatic (bili ≤ 1.5/dL) & renal (creat ≤ 1.5gr/dL) function, & baseline FEV1 of ≥ 1 liter. Ir was escalated in sequential (seq) cohorts from 40 mg/m2 (level 1) to 50 mg/m2 (level 2) & then to 60 mg/m2 (level 3) d 1 & 8 q 3 wks during each cycle of treatment. Ir & DDP were given concurrently with RT for cycle 1 in seq A (45 Gy) & during cycles 1 & 2 in seq B (70 Gy). 36 pts were targeted for accrual. DLT was defined as gr 4 esophagitis, pneumonitis, or diarrhea; gr 4 neutropenic fever, or any attributable gr 5 toxicity Results: As of 12/05, 36 pts were accrued, (21 - seq A; 15 - seq B). Median age was 64 (range 49–79) Of 33 eval pts, 18 (55%) were female; 24 (73%) PS 0; 67% had ≤ 5% wt loss. Attributable DLT was not seen in seq A, but was observed in seq B (70 Gy) at 50 mg/m2 with 1 episode each of gr 4 diarrhea & esophagitis, necessitating hospitalization. In addition, 1 pt in seq B had non-attributable gr 4 cardiovascular AEs. There has been no acute gr 5 toxicity. 1 pt experienced late gr 3 pulm toxicity, another gr 3 constitutional toxicity, including wt loss. The overall incidence of gr 3 esophagitis was 34%. Conclusions: In Ltd SCLC, I at 60 mg/m2 d 1 & 8 is safe & feasible in combination with DDP 60 mg/m2 q 3 wks & BID RT (45 Gy). The MTD for I in combination with RT (70 Gy) & DDP 60 mg/m2 is 40 mg/m2 d 1 and 8. Response, progression, survival data remain immature. [Table: see text] [Table: see text]

GALAXY-2 trial: A randomized phase III study of ganetespib in combination with docetaxel versus docetaxel alone in patients with advanced non-small cell lung adenocarcinoma.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. TPS8126-TPS8126
Author(s):  
Dean Anthony Fennell ◽  
Glenwood D. Goss ◽  
Mark A. Socinski ◽  
Kazuhiko Nakagawa ◽  
Joan H. Schiller ◽  
...  
Keyword(s):  
Advanced Nsclc ◽  
Small Cell Lung Carcinoma ◽  
Randomized Study ◽  
Single Agent ◽  
Small Cell ◽  
Phase Iii ◽  
Small Cell Lung ◽  
Good Tolerability ◽  
Cell Lung Carcinoma ◽  
Phase Iii Study

TPS8126 Background: Hsp90 is a molecular chaperone recognized as a key facilitator of cancer cell growth and survival. Ganetespib is a resorcinolic Hsp90 inhibitor that has shown single-agent activity in patients with lung, breast, and other cancers after progression on standard treatments. Ganetespib in combination with docetaxel induces synergistic efficacy in human non-small-cell lung carcinoma (NSCLC) tumor xenografts. Ganetespib is well tolerated and has not shown severe liver or common ocular toxicities reported for other Hsp90 inhibitors. Transient diarrhea is the most common adverse event, and is manageable with appropriate supportive care. A large randomized study of ganetespib in combination with docetaxel in advanced NSCLC patients (GALAXY-1 Trial) is ongoing. Preliminary results indicate good tolerability of the combination, and improvement in efficacy, including OS. Methods: GALAXY-2 is a randomized (1:1), international, open-label phase III study enrolling patients who received and progressed on one prior systemic therapy for advanced NSCLC of adenocarcinoma histology. Patients (N=500) are prospectively stratified for ECOG PS, total LDH, and best response to first-line therapy. The primary endpoint is OS. Key secondary endpoints include: OS in 3 subpopulations (mKRAS and elevated LDH and LDH5); PFS, ORR, DCR, DOT, and DOR. Patients in the control arm are treated with docetaxel 75 mg/m2 on Day 1 of a 3-week cycle. In the combination arm, ganetespib 150 mg/m2 is given on Day 1 with 75 mg/m2 docetaxel, and ganetespib 150 mg/m2 alone is given on Day 15 of each 3-week cycle. Two interim analyses for OS will be performed. Tumor tissue and blood samples will be collected for planned translational studies.

Astro plenary: Effect of chemotherapy on locally advanced non-small cell lung carcinoma: A randomized study of 353 patients

1991 ◽  
Vol 20 (6) ◽  
pp. 1183-1190 ◽  
Author(s):  
Rodrigo Arriagada ◽  
Thierry le Chevalier ◽  
Elizabeth Quoix ◽  
Pierre Ruffie ◽  
Hubert de Cremoux ◽  
...  
Keyword(s):  
Lung Carcinoma ◽  
Small Cell Lung Carcinoma ◽  
Randomized Study ◽  
Locally Advanced ◽  
Small Cell ◽  
Small Cell Lung ◽  
Cell Lung Carcinoma

A randomized study comparing a high and a standard dose of cisplatin in combination with etoposide in the treatment of advanced non-small-cell lung carcinoma.

1986 ◽  
Vol 4 (12) ◽  
pp. 1780-1786 ◽  
Author(s):  
J Klastersky ◽  
J P Sculier ◽  
P Ravez ◽  
P Libert ◽  
J Michel ◽  
...  
Keyword(s):  
Lung Carcinoma ◽  
Standard Dose ◽  
Small Cell Lung Carcinoma ◽  
Performance Status ◽  
Randomized Study ◽  
Objective Response ◽  
Small Cell ◽  
High Dose ◽  
Small Cell Lung ◽  
Cell Lung Carcinoma

We conducted a randomized trial comparing a high (120 mg/m2 day 1) v a standard (60 mg/m2 day 1) dose of cisplatin in combination with etoposide (120 mg/m2 days 3, 5, and 7) in advanced non-small-cell lung carcinoma (NSCLC). Two hundred forty-one patients were evaluable for survival and 207 for response. We obtained a 25% objective response rate in the standard-dose arm and 29% in the high-dose arm; this difference was not statistically significant. There was no significant improvement in the overall survival or survival of responders with the high-dose regimen. However, toxicity (mainly myelosuppression) was significantly increased in the patients receiving the higher dose of cisplatin. An analysis of prognostic factors showed that disease progression, loss of body weight, performance status, and prior therapy were predictive parameters of survival.

scholarly journals Cisplatin, etoposide, and ifosfamide in non-small cell lung carcinoma. A phase II randomized study with cisplatin and etoposide as the control arm

Cancer ◽  
1990 ◽  
Vol 65 (12) ◽  
pp. 2631-2634 ◽  
Author(s):  
Adriano Paccagnella ◽  
Adolfo Favaretto ◽  
Alba Brandes ◽  
Cristina Ghiotto ◽  
Driano Fornasiero ◽  
...  
Keyword(s):  
Phase Ii ◽  
Lung Carcinoma ◽  
Small Cell Lung Carcinoma ◽  
Randomized Study ◽  
Small Cell ◽  
Small Cell Lung ◽  
Cell Lung Carcinoma
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