Frequency and Determining Factors of Empiric Chemotherapy Dose Reduction in Patients with Non-Small Cell Lung Cancer

Crizotinib, the first clinically available inhibitor of anaplastic lymphoma kinase (ALK) gene rearrangement, is generally well tolerated. In contrast, neutropenia induced by crizotinib is a commonly reported grade 3 or 4 adverse event. In such cases, interruption and dose reduction of crizotinib might be necessary for some patients with severe neutropenia. However, information concerning clinical experience and management of severe neutropenia is currently limited. In this report, the successful management of crizotinib-induced neutropenia by dose reduction of crizotinib in a patient with ALK-positive non-small cell lung cancer is described.

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Chemotherapy dose intensity in small cell lung cancer

Lung Cancer ◽

10.1016/0169-5002(94)91680-2 ◽

1994 ◽

Vol 10 ◽

pp. S175-S185 ◽

Cited By ~ 3

Author(s):

R SOUHAMI ◽

M DEELVIRA

Keyword(s):

Lung Cancer ◽

Small Cell Lung Cancer ◽

Cell Lung Cancer ◽

Dose Intensity ◽

Small Cell ◽

Small Cell Lung ◽

Chemotherapy Dose ◽

Chemotherapy Dose Intensity

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Increasing Chemotherapy Dose Density and Intensity: Phase I Trials in Non‐Small Cell Lung Cancer and Non‐Hodgkin's Lymphoma

The Oncologist ◽

10.1634/theoncologist.10-2-138 ◽

2005 ◽

Vol 10 (2) ◽

pp. 138-149 ◽

Cited By ~ 17

Author(s):

Douglas W. Blayney ◽

Brian W. McGuire ◽

Scott E. Cruickshank ◽

David H. Johnson

Keyword(s):

Lung Cancer ◽

Phase I ◽

Small Cell Lung Cancer ◽

Cell Lung Cancer ◽

Small Cell ◽

Hodgkin's Lymphoma ◽

Phase I Trials ◽

Small Cell Lung ◽

Non Hodgkin's Lymphoma ◽

Chemotherapy Dose

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Effects of brain irradiation and chemotherapy on myelosuppression in small-cell lung cancer.

Journal of Clinical Oncology ◽

10.1200/jco.1986.4.11.1615 ◽

1986 ◽

Vol 4 (11) ◽

pp. 1615-1619 ◽

Cited By ~ 9

Author(s):

J S Lee ◽

T Umsawasdi ◽

H M Dhingra ◽

H T Barkley ◽

W K Murphy

Keyword(s):

Lung Cancer ◽

Small Cell Lung Cancer ◽

Cell Lung Cancer ◽

Infectious Complications ◽

Small Cell ◽

Close Monitoring ◽

Small Cell Lung ◽

Brain Irradiation ◽

Chemotherapy Dose ◽

Dose Reductions

The effect of brain irradiation on myelosuppression was studied in patients with untreated small-cell lung cancer (SCLC) by comparing 24 patients who received brain irradiation for brain metastasis at presentation (irradiated patients) with 24 control patients who were selected by matching ages and non-CNS metastatic sites with those of irradiated patients. All patients were evaluated during the first three courses of chemotherapy. More irradiated patients than control patients had chemotherapy dose reductions from the starting dose level for the second (nine of 22 v two of 24; P = .03) and the third (nine of 18 v three of 20; P = .05) courses of chemotherapy. Overall, more irradiated patients had chemotherapy dose reductions than did control patients (11 of 22 v three of 24; P = .01). The difference was highly significant even after other variables were considered in a multivariate analysis (P less than .001). Myelosuppression was more severe in irradiated patients for WBCs (P = .01) and for platelets (P = .05). When the second course of chemotherapy was administered at the same dose levels as in the first course, irradiated patients had greater decreases in nadir counts after the second course compared with the first course than did control patients. Irradiated patients had a higher incidence of infectious complications than did control patients (14 of 24 v six of 24; P = .02), particularly after the second course of chemotherapy (seven of 22 v one of 24; P = .04). There were four treatment-related deaths due to sepsis in irradiated patients. Following brain irradiation given concurrently with intensive chemotherapy, close monitoring of myelosuppression and adjustments of chemotherapy doses are advised.

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