Radiochemotherapy for lung cancer with cisplatin and vinorelbine orally and shrinking field radiotherapy: Effectivity and feasibility in a nonselected patient collective.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. e17516-e17516
Author(s):  
Miriam Zagel ◽  
Anja Tobermann ◽  
Ludwig Fischer von Weikersthal ◽  
Antje Fahrig
Keyword(s):  
Side Effects ◽  
Tumor Response ◽  
No Reduction ◽  
Response Rates ◽  
Hematologic Toxicity ◽  
Median Dose ◽  
Stage Iiia ◽  
Adequate Dose ◽  
Simultaneous Radiochemotherapy ◽  
Acceptable Side

e17516 Background: To explore the side effects and effectivity of simultaneous radiochemotherapy (sim RCT) with cisplatin (Cis-DDP) and vinorelbine orally (VRBo) in pts. with NSCLC. Methods: From 2009 and 2011, a total of 20 pts. (5 female, 15 male) aged between 46 and 82 yrs. with NSCLC stage IIIA/B were irradiated with a median dose of 66.6 Gy to the primary and 45 Gy to the involved nodes as neoadjuvant or palliative treatment. Treatment volumes were adapted to tumor shrinkage after 19.8, 30.6, 45 and 59.4 Gy. Cis-DDP (20 mg/qm d1-4, d29-32) and VRBo (50 mg/qm d1,8,15,22,36,43) were administered simultaneously. Comorbidity was scored by the Charlson Index and nutritional status was monitored. Results: Toxicity rates: thrombopenia 3° 10%, 4° 0%, leucopenia 3° 15%, 4° 20%, haemoglobin 0% 3°/4°, esophagitis 3° 5%, 4° 0%, pneumonitis 3° 0%, 4° 5%. No reduction of planned RT-dose. Chx reduction was done due to hematologic toxicity in 35%. Response rates: CR 10%, PR 75%, SD 10%, PD 5%. 11pts. (55%) are alive after a median FU of 19 months. Conclusions: Sim RCT with Cis-DDP and VRBo results in good tumor response rates and is feasible with acceptable side effects. Shrinking treatment volumes allow adequate dose escalation without the risk for early locoregional recurrence.

Amifostine pretreatment for protection against cyclophosphamide-induced and cisplatin-induced toxicities: results of a randomized control trial in patients with advanced ovarian cancer.

1996 ◽  
Vol 14 (7) ◽  
pp. 2101-2112 ◽  
Author(s):  
G Kemp ◽  
P Rose ◽  
J Lurain ◽  
M Berman ◽  
A Manetta ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Tumor Response ◽  
No Reduction ◽  
Advanced Ovarian Cancer ◽  
Antitumor Efficacy ◽  
Hematologic Toxicity ◽  
Survival Times ◽  
Cytotoxic Effects ◽  
Randomized Control ◽  
To Receive

PURPOSE Serious cumulative toxicity is a well-recognized consequence of chemotherapy. Amifostine, an organic thiophosphate, has demonstrated the ability to protect selectively a broad range of normal, but not neoplastic, tissues from the cytotoxic effects of chemotherapy and radiotherapy. This study was designed to determine if amifostine could reduce the serious toxicities associated with cyclophosphamide and cisplatin (CP), without reducing antitumor efficacy in patients with ovarian cancer. PATIENTS AND METHODS Two hundred forty-two patients with advanced ovarian cancer were randomized to receive six cycles of cyclophosphamide (1,000 mg/m2) and cisplatin (100 mg/m2) with or without amifostine (910 mg/m2) every 3 weeks for six cycles. The occurrence of hematologic, renal, neurologic, and ototoxicity was evaluated. Antitumor efficacy was assessed by pathologic tumor response and survival. RESULTS Pretreatment with amifostine before each cycle of chemotherapy resulted in a reduction of cumulative toxicities. Hematologic toxicity consisted of grade 4 neutropenia associated with fever and/or infection that required antibiotic therapy (P = .005), days in hospital (P = .019), and days on antibiotics (P = .031). Platinum-specific toxicities consisted of protracted serum creatinine elevations (P = 0.004), > or = 40% reduction from baseline in creatinine clearance (P = .001), and severity of neurologic toxicity (P = .029). Twenty-four percent of CP patients compared with 9% of amifostine plus CP patients discontinued therapy because of protocol-specified toxicity (P = .002). Pathologic tumor response rates were 37% with amifostine and 28% in controls, with comparable median survival times of 31 months. Amifostine was generally well tolerated; the principal side effects were emesis and a transient decrease in blood pressure. CONCLUSION Pretreatment with amifostine reduces the cumulative hematologic, renal, and neurologic toxicities associated with the CP regimen, with no reduction in antitumor efficacy.

Sulpiride and Haloperidol in Schizophrenia: A Double-blind Cross-over Study of Therapeutic Effect, Side Effects and Plasma Concentrations

1985 ◽  
Vol 147 (3) ◽  
pp. 283-288 ◽  
Author(s):  
Jes Gerlach ◽  
Kirsten Behnke ◽  
Jon Heltberg ◽  
Ebbe Munk-Andersen ◽  
Henrik Nielsen
Keyword(s):  
Side Effects ◽  
Plasma Concentrations ◽  
Clinical Effects ◽  
Median Dose ◽  
Double Blind ◽  
Day Range ◽  
Daily Dose ◽  
Schizophrenic Patients ◽  
High Doses ◽  
Therapeutic Profile

SummaryIn a double-blind cross-over trial, 20 chronic schizophrenic patients were treated with sulpiride and haloperidol in two 12-week periods. The final median dose of sulpiride was 2000 mg/day (range 800–3200) and of haloperidol 12 mg/day (range 6–24). Sulpiride had an antipsychotic effect and therapeutic profile not significantly different from that of haloperidol. In spite of the high doses of sulpiride, extrapyramidal side-effects were seen less frequently during the first four weeks of the sulpiride period than during the corresponding haloperidol period (P < 0.05), whereas autonomic side-effects were equally rare for both drugs. A positive correlation was found between daily dose and plasma concentration of both sulpiride (P < 0.001) and haloperidol (P < 0.05), but no correlation could be established between clinical effects and plasma levels of either neuroleptic.

Drug combinations in the treatment of gastric adenocarcinoma: a randomized Southwest Oncology Group study.

1984 ◽  
Vol 2 (5) ◽  
pp. 420-424 ◽  
Author(s):  
F J Panettiere ◽  
C Haas ◽  
B McDonald ◽  
J J Costanzi ◽  
R W Talley ◽  
...  
Keyword(s):  
Gastric Adenocarcinoma ◽  
Statistical Significance ◽  
Randomized Study ◽  
Response Rates ◽  
Hematologic Toxicity ◽  
Oncology Group ◽  
Southwest Oncology Group ◽  
Medical Centers ◽  
Sequential Administration ◽  
Southwest Oncology Group Study

The FAM combination with the simultaneous administration of 5-fluorouracil, doxorubicin, and mitomycin C is considered standard chemotherapy for gastric adenocarcinoma. This study was initiated to determine whether a kinetically designed sequential administration of these three drugs would be superior and whether the presence or absence of easily measurable tumor would imply differences in survival. To do so, the Southwest Oncology Group tested two schedules in a randomized study of 239 patients. Independent judgments of response were made by two authors with the same results. Equivalent response rates (23% of all eligible sequential and 30% simultaneous) and median survival durations (22 and 23 weeks, respectively) were seen. Patients with and without readily measurable tumors each lived a median of 22 weeks. Higher degrees of hematologic toxicity were associated with prolonged survival (median 27 weeks versus 20 weeks, p = 0.04). Patients treated by community oncologists were described as having higher response rates than those treated in major medical centers (64% versus 31%, p = 0.03). The meaning of this is questionable in that there were no statistical differences in survival or toxicity. Those with prior exposure to 5-fluorouracil had only a tendency, without statistical significance, for a slightly inferior response and survival.

scholarly journals Resection of Locally Advanced Pancreatic Neoplasms after Neoadjuvant Chemotherapy with Nab-Paclitaxel and Gemcitabine following FOLFIRINOX Failure

2017 ◽  
Vol 11 (2) ◽  
pp. 422-427 ◽  
Author(s):  
Sarah Hahn ◽  
Ahmet Ayav ◽  
Anthony Lopez
Keyword(s):  
Pancreatic Cancer ◽  
Pancreatic Neoplasms ◽  
Locally Advanced ◽  
Advanced Pancreatic Cancer ◽  
Response Rates ◽  
Vascular Involvement ◽  
Hematologic Toxicity ◽  
First Line ◽  
The Past ◽  
Single Center Experience

The incidence of pancreatic cancer has dramatically increased over the past years, but the prognosis has not improved. Between 30 and 40% of tumors are considered locally advanced, essentially due to vascular involvement. In recent years, new chemotherapy protocols with high response rates have been developed. FOLFIRINOX seems to be an interesting option in this situation, but hematologic toxicity could be an obstacle to its prescription. Nab-paclitaxel and gemcitabine offer significant response rates with a reasonable safety profile. We report here a single-center experience of 2 cases with a locally advanced pancreatic cancer initially considered unresectable, progressive after first-line neoadjuvant FOLFIRINOX chemotherapy, and then treated with second-line nab-paclitaxel/gemcitabine chemotherapy.

In Vitro Tumor Response Rates and Population Treatment Response Rates for Non–Small-Cell Lung Cancer

2009 ◽  
Vol 10 (5) ◽  
pp. E13
Author(s):  
Rodney J. Landreneau ◽  
Robert J. Cerfolio ◽  
Robert J. McKenna ◽  
Matthew J. Schuchert ◽  
Daniel L. Miller ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Small Cell Lung Cancer ◽  
Treatment Response ◽  
Cell Lung Cancer ◽  
Tumor Response ◽  
Response Rates ◽  
Small Cell ◽  
Small Cell Lung ◽  
Population Treatment

Subcutaneous Low-Dose Interleukin-2 plus Alpha Interferon in Advanced Malignant Melanoma

1993 ◽  
Vol 79 (3) ◽  
pp. 187-190 ◽  
Author(s):  
Filippo de Braud ◽  
Laura Biganzoli ◽  
Emilio Bajetta ◽  
Marco Colleoni ◽  
M. Giulia Zampino
Keyword(s):  
Side Effects ◽  
Malignant Melanoma ◽  
Patient Compliance ◽  
Low Dose ◽  
Interleukin 2 ◽  
Subcutaneous Administration ◽  
Hematologic Toxicity ◽  
Weekly Dose ◽  
Who Grade ◽  
Heavily Pretreated

Aims and Background Interferon (IFN) and interleukin-2 (IL-2) have been proven to be active agents in the treatment of malignant melanoma, but the most effective doses of these cytokines were often associated to important side effects and poor patient compliance. Recently, the subcutaneous administration of low-dose IL-2 was found to be a well-tolerated and effective treatment for renal cancer. Since the combination of low doses of IL-2 and IFN has been hypothesized to have synergistic biologic and cytotoxic effects, we evaluated feasibility and patient compliance of a scheme that combined recombinant IFN-alpha (rIFN-α) (3 million units by intramuscular injection, 3 times a week) plus low-dose IL-2 (9 million IU, 3 to 5 times a week) administered subcutaneously for 2 weeks every 28 days. Results Fifteen patients with disseminated malignant melanoma previously treated with chemotherapy entered the study. All but the first 2 self-administered the therapy at home and were followed in an out-patient setting. None of them required in-patient care for toxicity. No WHO grade 4 side effects were detected; the only grade 3 side effects were fever and asthenia in 5 % of the cycles. Mild hematologic toxicity (grade 2) was observed at the highest weekly dose of IL-2. No major responses were observed in this subset of heavily pretreated patients. Conclusions We conclude that the regimen studied is feasible and well tolerated in an out-patient setting, but it is unlikely to be effective. The good patient compliance makes this schedule eligible to evaluate whether IL-2 plus rIFN-α can enhance the results of chemotherapy in this disease.

Pharmacogenetic Assessment of Toxicity and Outcome in Patients With Metastatic Colorectal Cancer Treated With LV5FU2, FOLFOX, and FOLFIRI: FFCD 2000-05

2010 ◽  
Vol 28 (15) ◽  
pp. 2556-2564 ◽  
Author(s):  
Valérie Boige ◽  
Jean Mendiboure ◽  
Jean-Pierre Pignon ◽  
Marie-Anne Loriot ◽  
Marine Castaing ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Metastatic Colorectal Cancer ◽  
Tumor Response ◽  
Progression Free Survival ◽  
Hematologic Toxicity ◽  
First Line ◽  
Free Survival ◽  
Increased Risk ◽  
Grade 3 ◽  
Cancérologie Digestive

Purpose The aim was to investigate whether germline polymorphisms within candidate genes known or suspected to be involved in fluorouracil (FU), oxaliplatin, and irinotecan pathways were associated with toxicity and clinical outcome in patients with metastatic colorectal cancer (mCRC). Patients and Methods Blood samples from 349 patients included in the Fédération Francophone de Cancérologie Digestive 2000-05 randomized trial, which compared FU plus leucovorin (LV5FU2) followed by FU, leucovorin, and oxaliplatin (FOLFOX) followed by FU, leucovorin, and irinotecan (FOLFIRI; sequential arm) with FOLFOX followed by FOLFIRI (combination arm) in terms of progression-free survival (PFS) and overall survival, were collected. Twenty polymorphisms within the DPD, TS, MTHFR, ERCC1, ERCC2, GSTP1, GSTM1, GSTT1, and UGT1A1 genes were genotyped. Results The ERCC2-K751QC allele was independently associated with an increased risk of FOLFOX-induced grade 3 or 4 hematologic toxicity (P = .01). In the sequential arm, TS-5′UTR3RG and GSTT1 alleles were independently associated with response to LV5FU2 (P = .009) and FOLFOX (P = .01), respectively. The effect of oxaliplatin on tumor response increased with the number of MTHFR-1298C alleles (test for trend, P = .008). The PFS benefit from first-line FOLFOX was restricted to patients with 2R/2R (hazard ratio [HR] = 0.39; 95% CI, 0.23 to 0.68) or 2R/3R (HR = 0.59; 95% CI, 0.42 to 0.82) TS-5′UTR genotypes, respectively. Conversely, patients with the TS-5′UTR 3R/3R genotype did not seem to benefit from the adjunction of oxaliplatin (HR = 0.96; 95% CI, 0.66 to 1.40; trend between the three HRs, P = .006). Conclusion A pharmacogenetic approach may be a useful strategy for personalizing and optimizing chemotherapy in mCRC patients and deserves confirmation in additional prospective studies.

Tositumomab and Iodine I 131 Tositumomab (the BEXXAR® Therapeutic Regimen) Shows Efficacy in Elderly Patients (pts) with Relapsed/Refractory Low-Grade (LG), Follicular, and Transformed Non-Hodgkin’s Lymphoma (NHL).

Blood ◽  
2004 ◽  
Vol 104 (11) ◽  
pp. 2630-2630
Author(s):  
Stephanie A. Gregory ◽  
Andrew Zelenetz ◽  
Susan J. Knox ◽  
Julie Vose ◽  
John P. Leonard ◽  
...  
Keyword(s):  
Bone Marrow Involvement ◽  
Response Rates ◽  
Hematologic Toxicity ◽  
Low Grade ◽  
Age Group ◽  
Prognostic Features ◽  
Prior Therapy ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

Abstract Objective: Pts are first diagnosed with NHL at a median age of 60 yrs. There is increasing support for the idea that physicians should evaluate older pts for cancer treatment on the basis of their health status and cognitive function rather than on chronologic age. Five core clinical trials and an expanded-access program included 995 pts with relapsed/refractory LG follicular or transformed NHL treated with BEXXAR. Data were analyzed to establish the efficacy and safety of BEXXAR as a function of age. Safety data have been presented previously (Gregory et al. Blood. 2003;102. Abstract 1485). Overall toxicity and acute hematologic toxicity associated with BEXXAR in older pts is similar to that observed in pts ≤60 yrs. Methods: BEXXAR efficacy was analyzed by age: group 1 pts, ≤60 yrs (n=586); group 2 pts, >60–≤70 yrs (n=250); group 3 pts, >70 yrs (n=159). Median age at time of BEXXAR was 58 yrs (range, 21–88 yrs). Inclusion criteria included KPS ≥60, platelet count ≥100,000/mm3, ANC ≥1,500 cells/mm3, bone marrow involvement ≤25%, and no impaired renal, hepatic, or cardiac function. Results: All 3 pt groups had received multiple therapies for NHL before receiving BEXXAR (1–3 prior treatments, 63%–65%; ≥4 prior treatments, 34%–37%). In addition to the known poorer prognosis with older age, pts in groups 2 and 3 more frequently had other poor prognostic features, ie, transformed histology and prior radiotherapy (P <.001). Complete response rates (CR+CCR) to the most recent pre-BEXXAR therapy decreased with increasing age (group 1, 21%; group 2, 12%; group 3, 7%), and progressive disease as the initial “response” to prior therapy increased with age (group 1, 20%; group 2, 29%; group 3, 33%). Table 1 shows response rates and CR post- BEXXAR for the 3 groups. Post-BEXXAR CR+CCR rates were higher for pts in every age group compared with CR rates to prior therapy. These rates were nearly doubled for pts >60–≤70 yrs (23% vs 12%) and tripled for pts >70 yrs (23% vs 7%). Conclusions: Of all previously treated pts >60 yrs, ≥50% achieved a response post-BEXXAR. Nearly 25% of pts >60 yrs achieved a CR, with a median duration of CR of 32.3 mos. Response rates and durations of response are somewhat better in younger pts than in pts >60 yrs, but pts >60 yrs presented with poorer prognostic features (as above). Overall toxicity and acute hematologic toxicity associated with BEXXAR in older pts is similar to that observed in pts ≤60 yrs (Gregory et al. Blood. 2003;102. Abstract 1485). BEXXAR can be administered safely and effectively to older pts with low-grade follicular or transformed NHL. Table 1 Response results to BEXXAR by age, N = 995 Age groups Overall response, % CR, % Median CR duration, mos ≤ 60 66 37 59.1 (n=586) 95% CI = 45.8, NR) 60 to ≤70 N = 250 50 23 21.8 (n=250) (95% CI = 15.7, 69.1) >70 54 23 36.4 (n=159) (95% CI = 22.6, NR)

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