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顺铂联合每周一次紫杉醇治疗晚期非小细胞肺癌的I/II期研究

Phase I/II study of cisplatin combined with weekly paclitaxel in patients with advanced non-small-cell lung cancer.

作者信息

Yoshimura N, Kudoh S, Mukohara T, Yamauchi S, Yamada M, Kawaguchi T, Nakaoka Y, Hirata K, Yoshikawa J

机构信息

Department of Respiratory Medicine, Graduate School of Medicine, Osaka City University, 1-4-3, Asahi-machi, Abeno-ku, Osaka 545-8585, Japan.

出版信息

Br J Cancer. 2004 Mar 22;90(6):1184-9. doi: 10.1038/sj.bjc.6601672.

Abstract

To determine the maximum-tolerated dose (MTD) and the recommended dose (RD) of paclitaxel administered weekly with a fixed dose of cisplatin, and to assess the toxicity and activity of this combination, we conducted a phase I/II trial in patients with advanced non-small-cell lung cancer (NSCLC). In this study, patients with stage IIIB/IV NSCLC were eligible. Paclitaxel, at a starting dose of 40 mg x m(-2) week(-1) on days 1, 8, and 15, was combined with a fixed dose of cisplatin 80 mg x m(-2) on day 1. Chemotherapy was given in a 4-week cycle. In this phase I/II study, 38 patients were enrolled. Dose-limiting toxicities (DLT) were neutropenia, fatigue, and omission of treatment due to leucopenia, thrombocytopenia, or febrile neutropenia. The MTD and RD were estimated to be 70 mg x m(-2). Of the 37 assessable patients, 23 had a partial response and one had a complete response. Overall response rate was 62.1% (95% confidence interval (CI): 46.5-77.7%). The progression-free survival, the median survival time, and the 1-year survival rate were 5.5 months, 13.7 months, and 56.9%, respectively. This regimen is tolerable and very active against advanced NSCLC, and its efficacy should be confirmed in a phase III study.

摘要

为确定每周给予固定剂量顺铂时紫杉醇的最大耐受剂量(MTD)和推荐剂量(RD),并评估该联合方案的毒性和活性,我们对晚期非小细胞肺癌(NSCLC)患者进行了一项I/II期试验。在本研究中,IIIB/IV期NSCLC患者符合条件。紫杉醇起始剂量为40mg×m⁻²每周一次,于第1、8和15天给药,与第1天固定剂量的顺铂80mg×m⁻²联合使用。化疗以4周为一个周期。在这项I/II期研究中,共纳入38例患者。剂量限制性毒性(DLT)为中性粒细胞减少、疲劳以及因白细胞减少、血小板减少或发热性中性粒细胞减少而导致的治疗中断。MTD和RD估计为70mg×m⁻²。在37例可评估患者中,23例部分缓解,1例完全缓解。总缓解率为62.1%(95%置信区间(CI):46.5 - 77.7%)。无进展生存期、中位生存期和1年生存率分别为5.5个月、13.7个月和56.9%。该方案耐受性良好且对晚期NSCLC活性很强,其疗效应在III期研究中得到证实。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0ffb/2409643/01b5138a337c/90-6601672f1.jpg

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