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卡铂在荷瘤猫中的I期临床评估:一项兽医肿瘤协作组研究。

Phase I clinical evaluation of carboplatin in tumor-bearing cats: a Veterinary Cooperative Oncology Group study.

作者信息

Kisseberth W C, Vail D M, Yaissle J, Jeglum K A, Couto C G, Ward H, Khanna C, Obradovich J E

机构信息

Department of Medical Sciences, School of Veterinary Medicine, University of Wisconsin, Madison, WI, USA.

出版信息

J Vet Intern Med. 2008 Jan-Feb;22(1):83-8. doi: 10.1111/j.1939-1676.2007.0017.x.

Abstract

BACKGROUND

The dosage of carboplatin in cats has been reported anecdotally and experimentally in non-tumor-bearing cats, but the dosage for carboplatin treatment in tumor-bearing cats has yet to be defined in a prospective clinical trial.

PURPOSE

To determine the maximally tolerated dose (MTD) and dose-limiting toxicosis (DLT) of carboplatin in tumor-bearing cats. CATS: Fifty-nine cats with measurable solid tumors.

METHODS

The starting dose of carboplatin was 160 mg/m(2) of body surface area IV. Doses were increased by 20 mg/m(2) in cohorts of 3-14 cats until the MTD was reached.

RESULTS

The 59 cats entered into this multi-institutional phase I study received 1 or more doses of carboplatin at various dosages and were evaluated for toxicity, response to treatment, or both. The MTD was 240 mg/m(2) and neutropenia was the DLT. For the 1st cycle of treatment in 44 cats evaluated for neutropenia, 6 episodes of grade 3 or greater neutropenia occurred on days 7 (n=1), 14 (n=4), and 21 (n=1). There was no evidence of drug-induced nephrotoxicosis or pulmonary edema. Preliminary evidence of antitumor activity was observed in 7 of 59 (11.9%; 95% CI, 5.6-22.8%) cats evaluated for response to treatment. There was 1 complete response (cutaneous hemangiosarcoma) and 6 partial responses (4 injection site sarcomas, 1 oral squamous cell carcinoma, 1 lymphoma). Responses were of short duration (median, 42 days; range, 7-168 days).

CONCLUSIONS AND CLINICAL IMPORTANCE

The dose of carboplatin recommended to treat tumor-bearing cats is 240 mg/m(2) IV every 3-4 weeks.

摘要

背景

关于卡铂在猫体内的剂量,已有在非荷瘤猫身上的轶事性报道和实验研究,但在荷瘤猫中卡铂治疗的剂量尚未在前瞻性临床试验中确定。

目的

确定卡铂在荷瘤猫中的最大耐受剂量(MTD)和剂量限制性毒性(DLT)。

59只患有可测量实体瘤的猫。

方法

卡铂的起始剂量为160mg/m²体表面积静脉注射。剂量以20mg/m²的幅度在每组3 - 14只猫中递增,直至达到MTD。

结果

这59只进入这项多机构I期研究的猫接受了1次或多次不同剂量的卡铂治疗,并对毒性、治疗反应或两者进行评估。MTD为240mg/m²,中性粒细胞减少是DLT。在44只接受中性粒细胞减少评估的猫的第1周期治疗中,在第7天(n = 1)、14天(n = 4)和21天(n = 1)出现了6次3级或更高级别的中性粒细胞减少发作。没有药物诱导的肾毒性或肺水肿的证据。在59只接受治疗反应评估的猫中,有7只(11.9%;95%CI,5.6 - 22.8%)观察到了抗肿瘤活性的初步证据。有1例完全缓解(皮肤血管肉瘤)和6例部分缓解(4例注射部位肉瘤、1例口腔鳞状细胞癌、1例淋巴瘤)。缓解持续时间较短(中位数,42天;范围,7 - 168天)。

结论及临床意义

推荐用于治疗荷瘤猫的卡铂剂量为每3 - 4周静脉注射240mg/m²。

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