DeMario M D, Ratain M J, Vogelzang N J, Mani S, Vokes E E, Fleming G F, Melton K, Johnson S, Benner S, Lebwohl D
Department of Medicine, The University of Chicago, Medical Center, IL 60637-1470, USA.
Cancer Chemother Pharmacol. 1999;43(5):385-8. doi: 10.1007/s002800050911.
To determine the feasibility, maximal tolerated doses, and response rates for a combined regimen of the platinum and 5-fluorouracil oral analogues bis-acetato-ammine-dichloro-cyclohexyl-amine platinum(IV) (JM-216) and uracil/ftorafur (UFT) coadministered as a 14 consecutive-day every 28-day schedule.
Of 20 patients enrolled in this investigation, 17 on the following dose escalation scheme were evaluable for toxicity and/or response: I UFT 300 mg/day, JM-216 5 mg/day (three patients), II UFT 300 mg/day, JM-216 10 mg/day (four patients), III UFT 300 mg/day, JM-216 20 mg/day (ten patients).
All 17 evaluable patients were evaluable for toxicity. At dose level III dose-limiting nausea and emesis were observed in one patient despite maximal antiemetic support. Importantly, neurotoxicity and nephrotoxicity were not observed at the JM-216 dose levels examined in this study. This observation is consistent with results seen with single agent JM-216.
For JM-216 and UFT administered at 20 mg/day and 300 mg/day over 14 days, nausea and emesis were observed as the principal dose-limiting toxicities. These doses are considerably below the maximally tolerated doses of single agent JM-216 and UFT. Shorter administration schedules should be explored in an attempt to increase the dose intensity and minimize the toxicity of this combination oral regimen.
确定铂类和5-氟尿嘧啶口服类似物双乙酸二氯环己胺铂(IV)(JM-216)与优福定(UFT)按每28天连续14天联合给药方案的可行性、最大耐受剂量及缓解率。
本研究纳入20例患者,其中17例按以下剂量递增方案给药,可评估毒性和/或疗效:I组,优福定300 mg/天,JM-216 5 mg/天(3例患者);II组,优福定300 mg/天,JM-216 10 mg/天(4例患者);III组,优福定300 mg/天,JM-216 20 mg/天(10例患者)。
所有17例可评估患者均评估了毒性。在III剂量水平,尽管给予了最大程度的止吐支持,但仍有1例患者出现剂量限制性恶心和呕吐。重要的是,本研究中所检测的JM-216剂量水平未观察到神经毒性和肾毒性。这一观察结果与单药JM-216的结果一致。
对于JM-216和优福定按20 mg/天和300 mg/天给药14天,恶心和呕吐是主要的剂量限制性毒性。这些剂量远低于单药JM-216和优福定的最大耐受剂量。应探索更短的给药方案,以提高剂量强度并尽量减少这种口服联合方案的毒性。