Palliative first-line therapy with weekly high-dose 5-fluorouracil and sodium folinic acid as a 24-hour infusion (AIO regimen) combined with weekly irinotecan in patients with metastatic adenocarcinoma of the stomach or esophagogastric junction followed by secondary metastatic resection after downsizing

Objective: Platelet-associated immunoglobulin G (PA-IgG) refers to IgG attached to the surface of platelets, while the immature platelet fraction (IPF) reflects the state of platelet production in bone marrow. Since PA-IgG and IPF are increased in patients with immune thrombocytopenia (ITP), reflecting amounts of platelet antibodies and compensatory platelet production, respectively, we hypothesized that these laboratory findings may provide useful markers for predicting treatment response in patients with ITP. We therefore retrospectively investigated associations between levels of these markers at diagnosis and response to first-line therapy in patients with ITP. Methods: Forty-three patients diagnosed with ITP at Oita Kouseiren Tsurumi Hospital between May 2010 and November 2018 were included. Patients were divided into 2 groups based on response to corticosteroid as first-line therapy. Laboratory findings were compared between responders and nonresponders. Results: Median PA-IgG was 285 ng/107 cells (range, 45.5–18,200 ng/107 cells), and median IPF was 15.5% (range, 5.4–62.1%). Median levels were higher than the respective upper limits of normal range (PA-IgG, 0–46 ng/107 cells; IPF, 1.1–9.5%). First-line therapy was performed using standard-dose prednisolone (0.5–1.0 mg/kg/day) in 32 patients and high-dose dexamethasone (40 mg/day, 4 days) or methylprednisolone (125–1,000 mg/day, 3–4 days) in 11 patients. Twenty-four patients (55.8%) responded to first-line therapy. In univariate analysis, type of corticosteroid (p = 0.17) tended to differ between groups but did not differ significantly, and no difference in IPF level was apparent between responders (15.35%; range, 5.4–41.5%) and nonresponders (16.7%; range, 6.3–62.1%; p = 0.15). PA-IgG was significantly higher among nonresponders (430 ng/107 cells; range, 101–18,200 ng/107 cells) than among responders (254.5 ng/107 cells; range, 45.5–470 ng/107 cells; p = 0.004). Multivariate analysis revealed PA-IgG was independently associated with response to first-line therapy (odds ratio, 1.000; 95% confidence interval, 1.000–1.010; p = 0.029). Conclusion: Our data suggested that PA-IgG at diagnosis could offer a useful predictor of response to first-line corticosteroid therapy for ITP.

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A Phase I Study Of Docetaxel, Oxaliplatin, & Capecitabine (DOC) As First-Line Therapy of Patients With Locally Advanced or Metastatic Adenocarcinoma of Stomach and GE Junction

Cancer Investigation ◽

10.3109/07357901003630942 ◽

2010 ◽

Vol 28 (8) ◽

pp. 833-838 ◽

Cited By ~ 3

Author(s):

Imtiaz Malik ◽

Pedro Bernal ◽

Janet Byrd

Keyword(s):

Phase I ◽

Phase I Study ◽

Locally Advanced ◽

Metastatic Adenocarcinoma ◽

First Line ◽

First Line Therapy ◽

Line Therapy

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High-dose, single-agent irinotecan as first-line therapy in the treatment of metastatic colorectal cancer

Cancer Chemotherapy and Pharmacology ◽

10.1007/s00280-002-0506-7 ◽

2002 ◽

Vol 50 (5) ◽

pp. 383-391 ◽

Cited By ~ 34

Author(s):

Ychou M. ◽

Raoul J. ◽

Desseigne F. ◽

Borel C. ◽

Caroli-Bosc F. ◽

...

Keyword(s):

Colorectal Cancer ◽

Metastatic Colorectal Cancer ◽

Single Agent ◽

High Dose ◽

First Line ◽

First Line Therapy ◽

Line Therapy

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Comparative effectiveness study of single high-dose cisplatin with fractionated doses cisplatin in first-line therapy for treatment-naive Chinese patients with advanced non–small-cell lung cancer

Current Problems in Cancer ◽

10.1016/j.currproblcancer.2019.01.007 ◽

2019 ◽

Vol 43 (6) ◽

pp. 100466 ◽

Cited By ~ 4

Author(s):

Xiaoyou Li ◽

Xia Zhao ◽

Muhammad Abbas ◽

Li Wang ◽

Chenchen Li ◽

...

Keyword(s):

Comparative Effectiveness ◽

Small Cell ◽

Chinese Patients ◽

High Dose ◽

Small Cell Lung ◽

First Line ◽

First Line Therapy ◽

Line Therapy ◽

Comparative Effectiveness Study ◽

Treatment Naïve

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A randomized phase 3 trial of auto vs. allo transplantation as part of first-line therapy in poor-risk peripheral T-NHL

Blood ◽

10.1182/blood.2020008825 ◽

2020 ◽

Author(s):

Norbert Schmitz ◽

Lorenz H Truemper ◽

Krimo Bouabdallah ◽

Marita Ziepert ◽

Mathieu Leclerc ◽

...

Keyword(s):

T Cell ◽

Cell Lymphoma ◽

Allogeneic Transplantation ◽

T Cell Lymphoma ◽

High Dose ◽

First Line ◽

High Dose Therapy ◽

Peripheral T Cell Lymphoma ◽

First Line Therapy ◽

Line Therapy

Standard first-line therapy for younger patients with peripheral T-cell lymphoma consists of six courses of CHOP or CHOEP consolidated by high-dose therapy and autologous stem cell transplantation (AutoSCT). We hypothesized that consolidative allogeneic transplantation (AlloSCT) could improve outcome. 104 patients with nodal peripheral T-cell lymphoma except ALK+ ALCL, 18 to 60 years of age, all stages and IPI scores except stage 1 and aaIPI 0, were randomized to receive 4 x CHOEP and 1 x DHAP followed by high-dose therapy and AutoSCT or myeloablative conditioning and AlloSCT. The primary endpoint was event-free survival (EFS) at three years. After a median follow-up of 42 months, 3-year EFS of patients undergoing AlloSCT was 43% (95% confidence interval [CI]: 29%; 57%) as compared to 38% (95% CI: 25%; 52%) after AutoSCT. Overall survival at 3 years was 57% (95% CI: 43%; 71%) versus 70% (95% CI: 57%; 82%) after AlloSCT or AutoSCT, without significant differences between treatment arms. None of 21 responding patients proceeding to AlloSCT as opposed to 13 of 36 patients (36%) proceeding to AutoSCT relapsed. Eight of 26 patients (31%) and none of 41 patients died due to transplant-related toxicity after allogeneic and autologous transplantation, respectively. In younger patients with T-cell lymphoma standard chemotherapy consolidated by autologous or allogeneic transplantation results in comparable survival. The strong graft-versus-lymphoma effect after AlloSCT was counterbalanced by transplant-related mortality. CHO(E)P followed by AutoSCT remains the preferred treatment option for transplant-eligible patients. AlloSCT is the treatment of choice for relapsing patients also after AutoSCT.

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Reversal of Resistance to Doxifluridine and Fluorouracil in Metastatic Colorectal Cancer: The Role of High-Dose Folinic Acid

Tumori Journal ◽

10.1177/030089169207800409 ◽

1992 ◽

Vol 78 (4) ◽

pp. 258-261 ◽

Cited By ~ 1

Author(s):

Marco Colleoni ◽

Emilio Bajetta ◽

Filippo de Braud ◽

Nicoletta Zilembo ◽

Franco Noiè ◽

...

Keyword(s):

Colorectal Cancer ◽

Folinic Acid ◽

Performance Status ◽

Objective Response ◽

High Dose ◽

Severe Toxicity ◽

First Line ◽

First Line Therapy ◽

Colon And Rectum

The benefits from medical treatment in colorectal cancer are limited. Fluorouracil remains the only recognized drug, and how to treat unresponsive patients is still debated. To evaluate the role of folinic acid (FA) in circumvence resistance in colorectal cancer, 28 patients pretreated with fluoropyrimidine were candidated to receive one of the following schedules: fluorouracil (600 mg/m2) associated with FA (500 mg/m2) weekly for 6 weeks (Regimen A: 21 cases), or fluorouracil (370 mg/m2) plus FA (200 mg/m2) dally for 5 days every 4 weeks (Regimen B: 7 cases). Fourteen patients were pretreated with doxifluridlne, a new fluoropyrimldine derivative with a peculiar mechanism of action, and the remaining 14 patients with fluorouracil. All but 2 patients were unresponsive to first-line treatments. When the treatment began, the median age of the patients was 60 years (range, 30-68). The performance status (ECOG) was 0/1 in 25 of them, and the primary tumor was in the colon and rectum in 19 and 9 patients, respectively. Sites of disease were liver (64 %), lung (35 %), local recurrence (10 %) and peritoneum (10 %). A median of 3 cycles (range, 1-7) was delivered, and no objective response was observed in the group of patients pretreated with doxlfluridine or in the group pretreated with fluorouracil. In 5 cases a significant decrease in baseline CEA values was observed. Therapy was well tolerated, and no grade 4 toxicity was encountered. Severe toxicity was limited and included diarrhea (7 patients), stomatitis (1 patient) and nausea/vomiting (1 patient). High-dose FA has no role in reversing resistance to fluoropyrimidine, and other mechanisms of refractoriness are surely involved. FA should be associated with fluoropyrimidine as first-line therapy together with other biochemical modulators. Further rescue therapies need to be developed.

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