Miller V A
Memorial Sloan-Kettering Cancer Center, Department of Medicine, Division of Solid Tumor Oncology, New York, NY 10021, USA.
Semin Oncol. 1998 Jun;25(3 Suppl 8):15-9.
Following encouraging phase I trials in non-small cell lung cancer, the semisynthetic taxoid docetaxel has been extensively studied in the phase 11 setting, most commonly using a dose of 100 mg/m2 every 3 weeks. Major objective response rates range from 21% to 38% in previously untreated patients. The pooled response rate is 29% and median survival is nearly 11 months. In combination with cisplatin, docetaxel achieves a pooled response rate of approximately 40%, with neutropenia the dose-limiting toxicity. However, the median survival durations achieved do not clearly exceed those with docetaxel monotherapy. Based on preclinical evidence of synergy, docetaxel also has been combined with vinorelbine and, using prophylactic granulocyte colony-stimulating factor, it has been possible to escalate the doses of both drugs to single-agent phase II dose intensity.
在非小细胞肺癌的I期试验取得令人鼓舞的结果后,半合成紫杉烷多西他赛已在II期试验中得到广泛研究,最常用的给药方案是每3周100mg/m²。在既往未接受过治疗的患者中,主要客观缓解率在21%至38%之间。汇总缓解率为29%,中位生存期接近11个月。多西他赛与顺铂联合使用时,汇总缓解率约为40%,中性粒细胞减少是剂量限制性毒性。然而,所达到的中位生存期并未明显超过多西他赛单药治疗的生存期。基于协同作用的临床前证据,多西他赛也已与长春瑞滨联合使用,并且通过使用预防性粒细胞集落刺激因子,有可能将两种药物的剂量提升至单药II期剂量强度。