Dose-intensive therapy for small cell lung cancer
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Abstracts/Lung Gzncer I3 (1995) 185-232 215 WI, 19%-520/o). The median response time was 6 months (range, 3-13 months). The median survival time was 11 months (range, 4-27+ months) for Stage III and 8 months (range, 2-22 months) for Stage IV This chemotherapy regimen was well tolerated. The hematologic toxicities, such as leukopenia and thrombocytopenia of grades 3 and 4, occurred in only 2 of 3 1 (6%) patients. Nonhematologic toxicities of grades 3 or 4 were not observed. Conclusions. Oral LIFT plus cisplatin administration demonstrated an activity comparable with that of other effects. These observations suggest that this chemotherapy regimen is worthy of further investigation in a multi-institutional trial to deter- mine the antitumor effect and the quality of life of patients. Cognitive deficits in patients with small cell lung cancer before and atter chemotherapy Meyers CA, Byrne KS, Komaki R. Department of Neum-Oncology, Box 100, Universi@ of Texas, M.D. Anderson Cancer Cente,: 151s Holcombe Boulevard Houston, Ix 77030-4095. Lung Cancer (Ireland) 1995;12:231-5. We conducted a prospective study of cognitive function in patients with small cdl lung cancer (SCLC). A previous study had shown SCLC patients to have deficits in memory, frontal lobe executive functioning, and motor skills before they received prophylactic cranial irradiation (PCI). This study was performed to determine whether these deficits were related to chemoradiation treatment. We evaluated two groups of patients: one newly diagnosed and untreated, the other post- chemoradiation and before PCI. Strict eligibility criteria were used to minimize any preexisting factors that might influence cognitive functioning. Results showed that patients with SCLC have cognitive deficits before receiving chemoradiation, specifically on tests of verbal memory, frontal lobe executive hmctions, and motor coordination. There was no difference between the treated and untreated patients on any test. Etiologic considerations currently under study include paraneoplastic phenomena. Phase I study of vinorelbine and carboplatin in advanced non- small cell lung cancer Jacotdet P, Breton J-L, Westeel V, Mercier M, Gamier G, Depierre A. Service de Pneumologie, Hopital Saint-Jacques, Chest Disease Department, 25OOOBesancon. Lung Cancer (Ireland) 1995;12:247-57. Thirty+ne patients with previously untreated advanced non-small cell lung CBllcer were included in a Phase I study to determine the optimal dose of CarbopIatin (CBDCA) which preserves the best Navelbine (NVB) dose-intensity. NVB was administered at a 30-mglmz fixeddose on days 1-8/q 3 weeks, whereas CBDCA doses were planned to be escalated from 275 to 400 mg/m’ on day l/q 3 weeks for six successive groups of patients. The toxicity limiting dose of CBDCA in the combination was 350 mg/m* on day I/q 3 weeks because of repetitive Grade IV neutropenia, and the optimal dose of CBDCA was 325 mg/mz on day 11 q 3 weeks, offering a 86.4% NVB and a 92.6% CBDCA relative dose- intensity for the first 9 weeks. Responses were observed at each step. This study demonstrates the feasibility and the efficacy of the NVB- CBDCA combination. It suggests that dose-intensity calculation can be helpful to determine the recommended dose for phase II studies of new drug combinations. Phase II trial of carboplatin in combination with etoposide in locally advauced large cell carcinoma and adenocarcinoma of the lung Fuentes R, Dorca J, Canals E, Izquierdo A, Beltran M, Viladiu I? Oncology Service, Windre Hospital, Cat&8 Lung Cancer (Ireland) 1995;12:259-62. A total of 18 patients with locally advanced (Stage III) adeno- carcinoma and large cell undifferentiated carcinoma of the lung, previously untreated, were enrolled in a phase II trial. Treatment consisted of carhoplatin 325 mg/mz, day 1 and etoposide 100 mg/m’ on days 2 and 3. All patients were evduable for response. Of these, one patient had a partial response (5.5%; confidence interval O-24%). Toxicity comprised mainly leukopenia and anaemia. Other toxicities were mild. This phase II study evidenced a poor response rate for these regimes on adenocarcinoma and large cell undifferentiated carcinoma of the lung. New chemotherapeutic agents for non-small cell lung cancer Miller VA, Rigas JR, Grant SC, Pisters KMW, Kris MG. 1275 York Ave., New yo& NJ’10021. Chest 1995;107:6 Suppl:306S-11s. The identification of new chemotherapeutic agents for the treatment of non-small cell lung cancer should proceed in a structured, logical fashion. Agents should be evaluated on the basis of multiple objective and subjective end points. A 15% or greater major objective response rate, demonstrated in multiple single-agent phase II trials, is considered the lower limit for an agent to be deemed clinically active in this disease. A number of drugs previously have been identified in this category, including cisplatin, ifosfamide, mitomycin, paclitaxel, and the vinca alkaloids vinblastine and vindesine. Most of these conventional agents have been explored alone, in a variety of doses and schedules, and in combinstion. In the last several years clinical development has produced new agents, including chloroquinoxaline sulfonamide, docetaxel, edatrexate, gemcitabine, irinotecan, topotecan, and vinorelbine, which hold promise for more successful treatment of this lethal disease. Dose-intensive therapy for small cell lung cancer Elias AD. Dana-Farber Cancer Institute. Harvard Medical School, Boston, u4. Chest 1995;107:Suppl:261S6S. Enhancement of dose and dose intensity increases tumor response and may enhance long-term progression-free survival in patients with small cell lung cancer, Several strategies are identified to intensity therapy safely: a traditional induction/intensification mode, in which high-dose therapy with hematopoietic stem cell support is used to treat patients responding to conventional-dose therapy; and muhicycle dose- intensive approaches, in which higberdose therapy is administered over multiple cycles at initiation of therapy. Tbis paper reviews some of the recently completed and activated trials (particularly those developed at the Dana-Farber Cancer Institute) exploring these concepts. Efficacy and toxicity of vinorelbine-carboplatin combination in the treatment of advanced adenocarcinoma or large-cell carcinoma of the lung Masotti A, Borzellino G, Zannini G, Laterza E, Ricci F, Morandini G. Division of Pneumology, Ospedale Maggiow, Borg0 Tmnto, Pie A. Stefani 1. 37126 Venma. Tumori 1995;81:112-6. Aimsand backgnxmd: The aim of the study was to assess the activity and toxicity of the vinorelbine-carboplatin combination in advanced adenocarcinoma or large-cell carcinoma of the lung. The new vinca derivative, vinorelbine, shows promising activity when combined with
Transcript of Dose-intensive therapy for small cell lung cancer
Abstracts/Lung Gzncer I3 (1995) 185-232 215
WI, 19%-520/o). The median response time was 6 months (range, 3-13 months). The median survival time was 11 months (range, 4-27+ months) for Stage III and 8 months (range, 2-22 months) for Stage IV This chemotherapy regimen was well tolerated. The hematologic toxicities, such as leukopenia and thrombocytopenia of grades 3 and 4, occurred in only 2 of 3 1 (6%) patients. Nonhematologic toxicities of grades 3 or 4 were not observed. Conclusions. Oral LIFT plus cisplatin administration demonstrated an activity comparable with that of other
effects. These observations suggest that this chemotherapy regimen is worthy of further investigation in a multi-institutional trial to deter- mine the antitumor effect and the quality of life of patients.
Cognitive deficits in patients with small cell lung cancer before and atter chemotherapy Meyers CA, Byrne KS, Komaki R. Department of Neum-Oncology, Box 100, Universi@ of Texas, M.D. Anderson Cancer Cente,: 151s Holcombe Boulevard Houston, Ix 77030-4095. Lung Cancer (Ireland) 1995;12:231-5.
We conducted a prospective study of cognitive function in patients with small cdl lung cancer (SCLC). A previous study had shown SCLC patients to have deficits in memory, frontal lobe executive functioning, and motor skills before they received prophylactic cranial irradiation (PCI). This study was performed to determine whether these deficits were related to chemoradiation treatment. We evaluated two groups of patients: one newly diagnosed and untreated, the other post- chemoradiation and before PCI. Strict eligibility criteria were used to minimize any preexisting factors that might influence cognitive functioning. Results showed that patients with SCLC have cognitive deficits before receiving chemoradiation, specifically on tests of verbal memory, frontal lobe executive hmctions, and motor coordination. There was no difference between the treated and untreated patients on any test. Etiologic considerations currently under study include paraneoplastic phenomena.
Phase I study of vinorelbine and carboplatin in advanced non- small cell lung cancer Jacotdet P, Breton J-L, Westeel V, Mercier M, Gamier G, Depierre A. Service de Pneumologie, Hopital Saint-Jacques, Chest Disease Department, 25OOOBesancon. Lung Cancer (Ireland) 1995;12:247-57.
Thirty+ne patients with previously untreated advanced non-small cell lung CBllcer were included in a Phase I study to determine the optimal dose of CarbopIatin (CBDCA) which preserves the best Navelbine (NVB) dose-intensity. NVB was administered at a 30-mglmz fixeddose on days 1-8/q 3 weeks, whereas CBDCA doses were planned to be escalated from 275 to 400 mg/m’ on day l/q 3 weeks for six successive groups of patients. The toxicity limiting dose of CBDCA in the combination was 350 mg/m* on day I/q 3 weeks because of repetitive Grade IV neutropenia, and the optimal dose of CBDCA was 325 mg/mz on day 11 q 3 weeks, offering a 86.4% NVB and a 92.6% CBDCA relative dose- intensity for the first 9 weeks. Responses were observed at each step. This study demonstrates the feasibility and the efficacy of the NVB- CBDCA combination. It suggests that dose-intensity calculation can be helpful to determine the recommended dose for phase II studies of new drug combinations.
Phase II trial of carboplatin in combination with etoposide in locally advauced large cell carcinoma and adenocarcinoma of the lung Fuentes R, Dorca J, Canals E, Izquierdo A, Beltran M, Viladiu I? Oncology Service, Windre Hospital, Cat&8 Lung Cancer (Ireland) 1995;12:259-62.
A total of 18 patients with locally advanced (Stage III) adeno- carcinoma and large cell undifferentiated carcinoma of the lung, previously untreated, were enrolled in a phase II trial. Treatment consisted of carhoplatin 325 mg/mz, day 1 and etoposide 100 mg/m’ on days 2 and 3. All patients were evduable for response. Of these, one patient had a partial response (5.5%; confidence interval O-24%). Toxicity comprised mainly leukopenia and anaemia. Other toxicities were mild. This phase II study evidenced a poor response rate for these regimes on adenocarcinoma and large cell undifferentiated carcinoma of the lung.
New chemotherapeutic agents for non-small cell lung cancer Miller VA, Rigas JR, Grant SC, Pisters KMW, Kris MG. 1275 York Ave., New yo& NJ’10021. Chest 1995;107:6 Suppl:306S-11s.
The identification of new chemotherapeutic agents for the treatment of non-small cell lung cancer should proceed in a structured, logical fashion. Agents should be evaluated on the basis of multiple objective and subjective end points. A 15% or greater major objective response rate, demonstrated in multiple single-agent phase II trials, is considered the lower limit for an agent to be deemed clinically active in this disease. A number of drugs previously have been identified in this category, including cisplatin, ifosfamide, mitomycin, paclitaxel, and the vinca alkaloids vinblastine and vindesine. Most of these conventional agents have been explored alone, in a variety of doses and schedules, and in combinstion. In the last several years clinical development has produced new agents, including chloroquinoxaline sulfonamide, docetaxel, edatrexate, gemcitabine, irinotecan, topotecan, and vinorelbine, which hold promise for more successful treatment of this lethal disease.
Dose-intensive therapy for small cell lung cancer Elias AD. Dana-Farber Cancer Institute. Harvard Medical School, Boston, u4. Chest 1995;107:Suppl:261S6S.
Enhancement of dose and dose intensity increases tumor response and may enhance long-term progression-free survival in patients with small cell lung cancer, Several strategies are identified to intensity therapy safely: a traditional induction/intensification mode, in which high-dose therapy with hematopoietic stem cell support is used to treat patients responding to conventional-dose therapy; and muhicycle dose- intensive approaches, in which higberdose therapy is administered over multiple cycles at initiation of therapy. Tbis paper reviews some of the recently completed and activated trials (particularly those developed at the Dana-Farber Cancer Institute) exploring these concepts.
Efficacy and toxicity of vinorelbine-carboplatin combination in the treatment of advanced adenocarcinoma or large-cell carcinoma of the lung Masotti A, Borzellino G, Zannini G, Laterza E, Ricci F, Morandini G. Division of Pneumology, Ospedale Maggiow, Borg0 Tmnto, Pie A. Stefani 1. 37126 Venma. Tumori 1995;81:112-6.
Aimsand backgnxmd: The aim of the study was to assess the activity and toxicity of the vinorelbine-carboplatin combination in advanced adenocarcinoma or large-cell carcinoma of the lung. The new vinca derivative, vinorelbine, shows promising activity when combined with
