| Autor: |
Mirjam, Crul, Nadja E, Schoemaker, Dick, Pluim, Marc, Maliepaard, René W M, Underberg, Margaret, Schot, Rolf W, Sparidans, Paul, Baas, Jos H, Beijnen, Nico, Van Zandwijk, Jan H M, Schellens |
| Rok vydání: |
2003 |
| Předmět: |
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| Zdroj: |
Clinical cancer research : an official journal of the American Association for Cancer Research. 9(10 Pt 1) |
| ISSN: |
1078-0432 |
| Popis: |
To establish the maximum dose intensity of cisplatin plus gemcitabine on a weekly or two-weekly schedule in patients with advanced non-small cell lung cancer (NSCLC).Patients with NSCLC stage IIIB or IV were randomized to receive weekly or two-weekly courses of gemcitabine on day 1 and cisplatin on day 2. An interpatient dose escalation scheme was used, and pharmacokinetics were determined for both agents in plasma and WBCs.Seventy-three patients were included, 32 on the weekly schedule and 41 on the two-weekly schedule. Fifty patients received all planned courses. Dose-limiting toxicities were leukocytopenia, neutropenia, and trombocytopenia on the weekly schedule and ototoxicity on the two-weekly schedule. Most common nonhematological toxicities consisted of nausea, vomiting, and fatigue. The highest dose intensity of cisplatin could be achieved on the two-weekly schedule, and therefore, further development of the weekly schedule was abandoned. The maximum tolerated dose was established at 1500 mg/m(2) gemcitabine in combination with cisplatin 90 mg/m(2). More than half (53%) of patients achieved an objective response on the two-weekly schedule, versus 23% in the weekly treatment arm. The pharmacokinetic studies revealed a significant interaction: gemcitabine reduced both GG and AG platinum-DNA intrastrand adducts in WBCs.The combination of gemcitabine (1500 mg/m(2)) with cisplatin at a dose intensity of 50 mg/m(2)/week is feasible on a two-weekly administration scheme in NSCLC patients. |
| Databáze: |
OpenAIRE |
| Externí odkaz: |
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