Pazdur R, Lassere Y, Soh L T, Ajani J A, Bready B, Soo E, Sugarman S, Patt Y, Abbruzzese J L, Levin B
Division of Medicine, University of Texas M.D. Anderson Cancer Center, Houston.
Ann Oncol. 1994 May;5(5):468-70. doi: 10.1093/oxfordjournals.annonc.a058883.
Docetaxel (Taxotere) is prepared from a noncytotoxic precursor extracted from the needles of the Taxus baccata. Preclinical investigations have demonstrated that docetaxel is very active in colon adenocarcinoma murine models. Phase I studies revealed granulocytopenia to be the dose-limiting toxicity. Initial clinical trials also demonstrated docetaxel's activity in ovarian, breast, and non-small cell lung cancer. Because of this encouraging preclinical and clinical activity, we initiated a phase II study of docetaxel in patients with metastatic colorectal carcinoma.
Docetaxel, 100 mg/m2, was administered as a 1-hour intravenous infusion every 21 days. Nineteen patients were entered on the trial. All patients had measurable disease and had not received prior chemotherapy for metastatic disease.
No complete or partial responses were observed. Granulocytopenia was the dose-limiting toxic effect. Seventeen patients had grade 4 granulocytopenia; 8 of these patients received antibiotics for neutropenic fevers. Twelve patients experienced hypersensitivity reactions, and 15 patients experienced cutaneous toxic reactions. One patient demonstrated evidence of fluid retention.
Administered at the stated dose and schedule, docetaxel has little activity against metastatic colorectal carcinomas. The toxicity profile, consisting of granulocytopenia, hypersensitivity reactions, cutaneous reactions, and edema, has been previously described in patients receiving docetaxel.
多西他赛(泰索帝)由从欧洲红豆杉针叶中提取的一种无细胞毒性前体物质制备而成。临床前研究表明,多西他赛在结肠腺癌小鼠模型中具有很高的活性。I期研究显示粒细胞减少是剂量限制性毒性。最初的临床试验也证明了多西他赛在卵巢癌、乳腺癌和非小细胞肺癌中的活性。鉴于这种令人鼓舞的临床前和临床活性,我们开展了一项多西他赛治疗转移性结直肠癌患者的II期研究。
多西他赛,100mg/m²,每21天静脉输注1小时给药。19例患者进入该试验。所有患者均有可测量的病灶,且未接受过针对转移性疾病的先前化疗。
未观察到完全缓解或部分缓解。粒细胞减少是剂量限制性毒性效应。17例患者出现4级粒细胞减少;其中8例患者因中性粒细胞减少性发热接受了抗生素治疗。12例患者出现过敏反应,15例患者出现皮肤毒性反应。1例患者有液体潴留的证据。
按照规定的剂量和方案给药,多西他赛对转移性结直肠癌几乎没有活性。由粒细胞减少、过敏反应、皮肤反应和水肿组成的毒性特征在接受多西他赛治疗的患者中已有描述。