Atagi Shinji, Kawahara Masaaki, Kusunoki Yoko, Takada Minoru, Kawaguchi Tomoya, Okishio Kyoiti, Kubo Akihito, Uehira Kazutaka, Yumine Katsuyuki, Tomizawa Yoshio, Saito Ryusei, Fukai Shimao, Komatsu Hikotaro
National Hospital Organization Kinki-Chuo Chest Medical Center, 1180 Nagasone, Sakai, Osaka, 591-8555, Japan.
J Thorac Oncol. 2008 Sep;3(9):1012-7. doi: 10.1097/JTO.0b013e318183f8ed.
The aim of this study was to determine and evaluate the recommended dose of docetaxel in combination with a novel oral 5-fluorouracil analogue S-1 and evaluate the efficacy and safety in patients with previously treated non-small cell lung cancer.
In phase I, patients with previously treated non-small cell lung cancer were treated with docetaxel (starting dose 40 mg/m) intravenously on day 1 and oral administration of S-1 at a fixed dose of 80 mg/m on days 1 to14 every 3 weeks. The recommended dose was the dose level preceding the maximum tolerated dose; once determined, patients were enrolled in phase II.
The recommended dose of docetaxel was 40 mg/m in combination with S-1 80 mg/m/d. Of 30 patients enrolled in phase II part, 29 patients were eligible and analyzed. No complete response and 7 (24.1%) partial responses were observed, for an overall response rate of 24.1% (95% confidence interval, 10.3-43.5%). Median overall survival was 11.8 months. The 1-year survival rate was 42%. The grade 3 to 4 hematologic toxicities were neutropenia (34.5%), leukopenia (20.6%), and anemia (10.3%). The grade 3 to 4 nonhematological toxicities included fever 2 (6.9%), diarrhea 1 (3.4%), stomatitis 1 (3.4%), cerebral infarction 1 (3.4%), and pneumonitis 1 (3.4%). There was one treatment-related death due to relapse of drug induced pneumonitis.
This combination chemotherapy is highly active and well tolerated in previously treated patients with non-small cell lung cancer. These results are encouraging and warrant additional investigation.
本研究的目的是确定并评估多西他赛与新型口服5-氟尿嘧啶类似物S-1联合使用的推荐剂量,并评估其在既往接受过治疗的非小细胞肺癌患者中的疗效和安全性。
在I期试验中,既往接受过治疗的非小细胞肺癌患者在第1天静脉注射多西他赛(起始剂量40mg/m²),并在第1至14天口服固定剂量80mg/m²的S-1,每3周重复一次。推荐剂量为最大耐受剂量之前的剂量水平;一旦确定,患者进入II期试验。
多西他赛的推荐剂量为40mg/m²,联合S-1 80mg/m²/天。在II期试验部分入组的30例患者中,29例符合条件并进行了分析。未观察到完全缓解,观察到7例(24.1%)部分缓解,总缓解率为24.1%(95%置信区间,10.3-43.5%)。中位总生存期为11.8个月。1年生存率为42%。3-4级血液学毒性包括中性粒细胞减少(34.5%)、白细胞减少(20.6%)和贫血(10.3%)。3-4级非血液学毒性包括发热2例(6.9%)、腹泻1例(3.4%)、口腔炎1例(3.4%)、脑梗死1例(3.4%)和肺炎1例(3.4%)。有1例与治疗相关的死亡,原因是药物性肺炎复发。
这种联合化疗在既往接受过治疗的非小细胞肺癌患者中具有高活性且耐受性良好。这些结果令人鼓舞,值得进一步研究。