Istituto Oncologico della Svizzera Italiana, Bellinzona, Switzerland.
Acta Oncol. 2011 Oct;50(7):1105-10. doi: 10.3109/0284186X.2010.543697. Epub 2010 Dec 27.
The broad spectrum of antitumor activity of both the oral platinum analogue satraplatin (S) and capecitabine (C), along with the advantage of their oral administration, prompted a clinical study aimed to define the maximum tolerated dose (MTD) of the combination.
Four dose levels of S (mg/m(2)/day) and C (mg/m(2)/day) were evaluated in adult patients with advanced solid tumors: 60/1650, 80/1650, 60/2000, 70/2000; a course consisted of 28 days with sequential administration of S (days 1-5) and C (days 8-21) followed by one week rest.
Thirty-seven patients were treated, 24 in the dose escalation and 13 in the expansion phase; at the MTD, defined at S 70/C 2000, two patients presented dose limiting toxicities: lack of recovery of neutropenia by day 42 and nausea with dose skip of C. Most frequent toxicities were nausea (57%), diarrhea (51%), neutropenia (46%), anorexia, fatigue, vomiting (38% each). Two partial responses were observed in platinum sensitive ovarian cancer and one in prostate cancer.
At S 70/C 2000 the combination of sequential S and C is tolerated with manageable toxicities; its evaluation in platinum and fluorouracil sensitive tumor types is worthwhile because of the easier administration and lack of nephro- and neurotoxicity as compared to parent compounds.
口服铂类似物司他拉宾(S)和卡培他滨(C)具有广谱抗肿瘤活性,且具有口服给药的优势,这促使我们进行了一项临床研究,旨在确定该联合用药的最大耐受剂量(MTD)。
我们在 37 名晚期实体瘤成年患者中评估了 S(mg/m(2)/天)和 C(mg/m(2)/天)的四个剂量水平:60/1650、80/1650、60/2000、70/2000;一个疗程为 28 天,连续给予 S(第 1-5 天)和 C(第 8-21 天),然后休息一周。
24 名患者在剂量递增阶段,13 名患者在扩展阶段接受了治疗;在最大耐受剂量(MTD)定义为 S 70/C 2000 时,两名患者出现剂量限制毒性:中性粒细胞减少症第 42 天未恢复,C 剂量跳过出现恶心。最常见的毒性反应为恶心(57%)、腹泻(51%)、中性粒细胞减少(46%)、厌食、疲劳、呕吐(各 38%)。两名卵巢癌铂类敏感患者和一名前列腺癌患者观察到部分缓解。
S 70/C 2000 时,S 和 C 的序贯联合用药可耐受且毒性反应可管理;与母体化合物相比,该联合用药具有更容易给药和无肾毒性和神经毒性的优势,因此值得在铂类和氟尿嘧啶敏感肿瘤类型中进行评估。