Paclitaxel in advanced non-small cell lung cancer - An alternative high-dose weekly schedule

被引:28
作者
Akerley, W [1 ]
机构
[1] Brown Univ, Oncol Grp, Providence, RI 02912 USA
关键词
dose intensity; maximum tolerated dose; non-small cell lung cancer; paclitaxel; platelets;
D O I
10.1378/chest.117.4_suppl_1.152S
中图分类号
R4 [临床医学];
学科分类号
1002 ; 100602 ;
摘要
Study objectives: Sequential phase I and phase II trials of paclitaxel using an extended weekly schedule were performed to explore its effect on tolerance, limits of dose intensity, and activity at maximum dose intensity in disseminated non-small cell lung cancer (NSCLC). Design: Patients with stage IIIB/IV NSCLC were eligible if they had a performance status of 0 to 2, no previous chemotherapy, and normal organ function. Paclitaxel was administered as a 3-h infusion weekly for 6 weeks of an 8-week cycle. Doses were modified for toxicity observed on the day of treatment. Measurements and results: Paclitaxel, 100 to 200 mg/m(2)/wk, was administered in the phase I trial. Dose escalation was limited primarily by neutropenia, and a relationship between dose and response was noted. A phase II trial of paclitaxel, 175 mg/m(2)/wk, the maximum tolerated dose, was initiated; data are available for the first 25 patients. Eighy-three, 75, 58, and 50% of intended doses were delivered during cycles one to four, respectively. Grade 2 or 3 neuropathy occurred in nine patients, but improved in all following dose reduction. Platelet counts rose by 17,000/mu L/wk. Partial responses occurred in 14 of 25 patients (56%; confidence interval, 46 to 66%), The duration of response was 6 months, and 1- and 2-year survival rates were 53% and 18%, respectively. Conclusion: Paclitaxel administered on a weekly schedule allows enhanced dose intensity, has a protective or stimulatory effect on platelets, and is active in NSCLC.
引用
收藏
页码:152S / 155S
页数:4
相关论文
共 15 条
[1]   Phase I trial of weekly paclitaxel in advanced lung cancer [J].
Akerley, W ;
Glantz, M ;
Choy, H ;
Rege, V ;
Sambandam, S ;
Joseph, P ;
Yee, L ;
Rodrigues, B ;
Wingate, P ;
Leone, L .
JOURNAL OF CLINICAL ONCOLOGY, 1998, 16 (01) :153-158
[2]  
ARBUCK SG, 1993, SEMIN ONCOL, V20, P31
[3]  
Bonomi P, 1996, P AN M AM SOC CLIN, V15, P382
[4]   PHASE-II STUDY OF TAXOL, MERBARONE, AND PIROXANTRONE IN STAGE-IV NON-SMALL-CELL LUNG-CANCER - THE EASTERN COOPERATIVE ONCOLOGY GROUP RESULTS [J].
CHANG, AY ;
KIM, K ;
GLICK, J ;
ANDERSON, T ;
KARP, D ;
JOHNSON, D .
JOURNAL OF THE NATIONAL CANCER INSTITUTE, 1993, 85 (05) :388-394
[5]   PHASE-I TRIAL OF OUTPATIENT WEEKLY PACLITAXEL AND CONCURRENT RADIATION-THERAPY FOR ADVANCED NON-SMALL-CELL LUNG-CANCER [J].
CHOY, H ;
AKERLEY, W ;
SAFRAN, H ;
CLARK, J ;
REGE, V ;
PAPA, A ;
GLANTZ, M ;
PUTHAWALA, Y ;
SODERBERG, C ;
LEONE, L .
JOURNAL OF CLINICAL ONCOLOGY, 1994, 12 (12) :2682-2686
[6]  
DONEHOWER RC, 1987, CANCER TREAT REP, V71, P1171
[7]   EUROPEAN-CANADIAN RANDOMIZED TRIAL OF PACLITAXEL IN RELAPSED OVARIAN-CANCER - HIGH-DOSE VERSUS LOW-DOSE AND LONG VERSUS SHORT INFUSION [J].
EISENHAUER, EA ;
HUININK, WWT ;
SWENERTON, KD ;
GIANNI, L ;
MYLES, J ;
VANDERBURG, MEL ;
KERR, I ;
VERMORKEN, JB ;
BUSER, K ;
COLOMBO, N ;
BACON, M ;
SANTABARBARA, P ;
ONETTO, N ;
WINOGRAD, B ;
CANETTA, R .
JOURNAL OF CLINICAL ONCOLOGY, 1994, 12 (12) :2654-2666
[8]   Phase I study of weekly outpatient paclitaxel and concurrent cranial irradiation in adults with astrocytomas [J].
Glantz, MJ ;
Choy, H ;
Kearns, CM ;
Cole, BF ;
Mills, P ;
Zuhowski, EG ;
Saris, S ;
Rhodes, CH ;
Stopa, E ;
Egorin, MJ .
JOURNAL OF CLINICAL ONCOLOGY, 1996, 14 (02) :600-609
[9]   PHASE-II TRIAL OF TAXOL, AN ACTIVE-DRUG IN THE TREATMENT OF METASTATIC BREAST-CANCER [J].
HOLMES, FA ;
WALTERS, RS ;
THERIAULT, RL ;
FORMAN, AD ;
NEWTON, LK ;
RABER, MN ;
BUZDAR, AU ;
FRYE, DK ;
HORTOBAGYI, GN .
JOURNAL OF THE NATIONAL CANCER INSTITUTE, 1991, 83 (24) :1797-1805
[10]  
Kearns Christine M., 1997, Seminars in Oncology, V24, P91