Lara Primo N, Koczywas Mariana, Quinn David I, Lenz Heinz Josef, Davies Angela M, Lau Derick H M, Gumerlock Paul H, Longmate Jeff, Doroshow James H, Schenkein David, Kashala Oscar, Gandara David R
University of California, Davis Cancer Center, Sacramento, California 95817, USA.
J Thorac Oncol. 2006 Feb;1(2):126-34.
This phase I study was performed to determine the dose-limiting toxicity and maximum tolerated dose (MTD) of docetaxel in combination with bortezomib in patients with advanced non-small cell lung cancer (NSCLC) or other solid tumors.
Patients were enrolled in cohorts of three over six dose levels. Each treatment cycle was 3 weeks long and consisted of one docetaxel infusion (day 1) and four bortezomib injections (days 1, 4, 8, and 11). Dose escalation and MTD determination were based on the occurrence of dose-limiting toxicities in cycle 1 only.
A total of 36 patients were enrolled, 26 of whom had NSCLC. All patients received at least one dose of study drug at one of five dose levels. The MTD of the combined regimen was determined to be 1.0/75 mg/m bortezomib/docetaxel. The combination was generally well tolerated. Toxicities were manageable, and no additive toxicities were observed. The most common adverse events were fatigue (67% of patients), nausea (50%), diarrhea (39%), and neutropenia (39%). Two patients with NSCLC achieved a partial response, and seven (19%) patients achieved stable disease (including six patients with NSCLC).
The combination of bortezomib and docetaxel was feasible and well tolerated in patients with advanced NSCLC or other solid tumors. The recommended phase II dose is bortezomib 1.0 mg/m on days 1, 4, 8, and 11 plus docetaxel 75 mg/m on day 1, cycled every 21 days. Therapeutic doses of docetaxel and bortezomib are achievable for this combination.
本I期研究旨在确定多西他赛联合硼替佐米对晚期非小细胞肺癌(NSCLC)或其他实体瘤患者的剂量限制性毒性和最大耐受剂量(MTD)。
患者按六个剂量水平分三组入组。每个治疗周期为3周,包括一次多西他赛输注(第1天)和四次硼替佐米注射(第1、4、8和11天)。剂量递增和MTD确定仅基于第1周期中剂量限制性毒性的发生情况。
共入组36例患者,其中26例患有NSCLC。所有患者均在五个剂量水平之一接受了至少一剂研究药物。联合方案的MTD确定为硼替佐米/多西他赛1.0/75mg/m²。该联合方案总体耐受性良好。毒性易于管理,未观察到叠加毒性。最常见的不良事件为疲劳(67%的患者)、恶心(50%)、腹泻(39%)和中性粒细胞减少(39%)。两名NSCLC患者获得部分缓解,7例(19%)患者病情稳定(包括6例NSCLC患者)。
硼替佐米和多西他赛联合方案对晚期NSCLC或其他实体瘤患者可行且耐受性良好。推荐的II期剂量为第1、4、8和11天硼替佐米1.0mg/m²加第1天多西他赛75mg/m²,每21天为一个周期。该联合方案可达到多西他赛和硼替佐米的治疗剂量。