Peng Yu, Liu Yue-E, Ren Xiao-Can, Chen Xue-Ji, Su Hui-Ling, Zong Jie, Feng Zeng-Li, Wang Dong-Ying, Lin Qiang, Gao Xian-Shu
Hebei North University, Zhangjiakou, Hebei 075000, P.R. China.
Department of Oncology, North China Petroleum Bureau General Hospital of Hebei Medical University, Renqiu, Hebei 062552, P.R. China.
Oncol Lett. 2015 Jan;9(1):67-74. doi: 10.3892/ol.2014.2675. Epub 2014 Nov 5.
In this study, the maximum tolerated dose (MTD) of lobaplatin (LBP) when it was combined with docetaxel (TXT) for the treatment of solid tumours that had progressed following chemotherapy was determined, and toxicities to this regimen were evaluated. A modified Fibonacci method was used for the dose escalation of LBP. The patients received TXT (at a fixed dose of 60 mg/m) on day one (d1) and LBP (at an initial tested dose of 30 mg/m) on day two (d2) of a treatment cycle that was repeated every 21 days. Each dose group consisted of at least three cases. In the absence of dose-limiting toxicity (DLT), we proceeded to the next dose group, with a dose increment of 5 mg/m between groups, until DLT occurred. The dose immediately below the dose that produced DLT was regarded as the MTD. The 17 patients examined in this study completed a total of 58 cycles of chemotherapy, and a total of three dose-escalation groups (30 mg/m LBP, 35 mg/m LBP, and 40 mg/m LBP) were established. The main adverse event that was observed was myelosuppression. DLT occurred in four patients, including three patients in the 40 mg/m LBP group and one patient in the 35 mg/m LBP group. In total, three out of the four patients in the 40 mg/m LBP group exhibited DLT. We determined that the treatment administered to the 35 mg/m LBP group represented the MTD. Thus, our phase I trial revealed that the MTD for the tested LBP combination regimen was 35 mg/m LBP and 60 mg/m TXT. This regimen resulted in mild adverse reactions and favourable patient tolerance. Therefore, we recommend the use of these dosages in phase II clinical trials.
在本研究中,确定了洛铂(LBP)与多西他赛(TXT)联合用于治疗化疗后进展的实体瘤时的最大耐受剂量(MTD),并评估了该方案的毒性。采用改良的斐波那契方法进行LBP的剂量递增。患者在每21天重复一次的治疗周期的第1天(d1)接受TXT(固定剂量60mg/m²),并在第2天(d2)接受LBP(初始测试剂量30mg/m²)。每个剂量组至少包含3例患者。在无剂量限制毒性(DLT)的情况下,我们进入下一个剂量组,组间剂量递增5mg/m²,直至出现DLT。产生DLT的剂量之下紧邻的那个剂量被视为MTD。本研究中接受检查的17例患者共完成了58个化疗周期,共建立了三个剂量递增组(30mg/m²LBP、35mg/m²LBP和40mg/m²LBP)。观察到的主要不良事件是骨髓抑制。4例患者出现DLT,包括40mg/m²LBP组的3例患者和35mg/m²LBP组的1例患者。40mg/m²LBP组的4例患者中共有3例出现DLT。我们确定给予35mg/m²LBP组的治疗代表MTD。因此,我们的I期试验表明,测试的LBP联合方案的MTD为35mg/m²LBP和60mg/m²TXT。该方案导致的不良反应较轻,患者耐受性良好。因此,我们建议在II期临床试验中使用这些剂量。