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Qian T, Huang XE. Study of Pemetrexed-based Chemotherapy for Patients with Locally Advanced or Metastatic Cancers. Asian Pac J Cancer Prev 2016; 16:4791-5. [PMID: 26107242 DOI: 10.7314/apjcp.2015.16.11.4791] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
PURPOSE This study was conducted to observe the efficacy and safety of pemetrexed based chemotherapy in treating patients with locally advanced or metastatic cancers as first-line, second-line or third-line therapy. MATERIALS AND METHODS From May 2011 to January 2015, we recruited 29 patients with advanced breast cancer, 19 patients with advanced ovary cancer, 17 patients with advanced esophageal cancer,5 patients with advanced gallbladder cancer,5 patients with advanced cervical cancer and 1 patient with advanced tongue cancer in Jiangsu Cancer Hospital and Research Institute.All of them were pathologically confirmed and treated with pemetrexed based chemotherapy. After two cycles of treatment,efficacy and safety can be evaluated. RESULTS For pemetrexed based regimens,including 76 patients with 6 kinds of advanced cancer were considered eligible for inclusion. Complete remission represents CR, partial remission represents PR, stable disease represents SD, progressive disease represents PD. Among 29 patients with advanced breast cancer, 4 patients chose pemetrexed based regimens as second-line treatment,1 of them was PR,the other 3 got SD. The last 25 patients made use of this chemotherapy as third-line treatment, except one patient could not be assessed, 2 of them got PR,6 of them got SD,the remaining 16 of them finally were PD.19 patients with advanced ovary cancer,5 patients used this regimens as second-line treatment, 3 of them got PD,the remaining patients got SD, respectively. The last 14 patients made use of pemetrexed based regimens as third-line treatment,. RR (CR+PR) was 28.5%. Among 17 patients with advanced esophageal cancer, 2 patients made use of pemetrexed based regimens as first-line treatment,both of them got PR.4 of them used this chemotherapy as second-line regimen, except 2 patients could not be assessed,the remaining 2 was PD at last. The last 11 patients was third-line users, RR (CR+PR) was 18.2%. Among 5 patients with advanced gallbladder cancer, pemetrexed based regimens was used in 1 patient as first- line treatment and 1 patient as second-line treatment. The curative effect was SD and PD, respectively. 3 patients accepted pemetrexed based regimens as third-line treatment, 2 of them got PD as results and another was SD. Among 5 patients with advanced cervical cancer, just 1 patient adopted pemetrexed based regimens as first-line treatment, whose curative effect was PR.2 patients chose this chemotherapy regimens as second-line treatment. Both of them got PD as their consequence. The last 2 patients made use of the regimens as third-line treatment, the effect of them was PD and SD, respectively. The one who with advanced tongue cancer, pemetrexed based regimens was used as second-line treatment, and the consequence was PD. About 71.1% patients experienced bone marrow suppression. Among them, 5 patients reached 4 grade. Other toxicity of pemetrexed were neurotoxicity, fatigue, diarrhea, dysphagia and vomiting. No treatment related death occurred with pemetrexed-based treatment. CONCLUSIONS Pemetrexed based chemotherapy has considerable effect in patients with advanced cancers such as breast cancer,esophageal cancer and ovary cancer. More randomly clinical trials are needed to verify the results.
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Affiliation(s)
- Ting Qian
- Department of Chemotherapy, the Affiliated Jiangsu Cancer Hospital of Nanjing Medical University and Jiangsu Institute of Cancer Research, Nanjing, China E-mail :
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Liang Z, Wang S, Lin Z, Feng S, Cheng Z, Yang Y, Kuang Y, Fidelis C, Ullah S, Li F. Phase I trial of nedaplatin chemotherapy concurrent with radiotherapy for untreated locoregionally advanced nasopharyngeal carcinoma. Cancer Chemother Pharmacol 2016; 77:643-51. [PMID: 26831498 DOI: 10.1007/s00280-016-2971-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2015] [Accepted: 01/14/2016] [Indexed: 02/07/2023]
Abstract
PURPOSE In this phase I study, single-agent chemotherapy was conducted in patients with locoregionally advanced nasopharyngeal carcinoma (NPC) using nedaplatin (NDP) and concomitant radiotherapy. The study sought to determine the maximum tolerated dose (MTD), recommended dose (RD) and the clinical efficacy of this treatment in locoregionally advanced NPC patients. EXPERIMENTAL DESIGN Twenty patients were enrolled. The eligibility criteria included local advanced NPC (stage III or IVa) without any previous treatment and an expected survival of ≥ 3 months. The regimen consisted of 1.8-2.0 Gy daily radiation for 5 days a week and NDP with dose escalation of 70-100 mg/m(2) on day 1. The cycles were repeated every 21 days (day 1, day 22 and day 43) until the completion of chemoradiation. Dose-limiting toxicities (DLTs) included: grade 4 anemia; grade 4 neutropenia lasting for ≥ 5 days; grades 3 and 4 febrile neutropenia; grade 4 thrombocytopenia; grades 3-4 non-hematological toxicity (with the exception of alopecia, nausea) and any of the grade 5 responses. RESULTS Ninety-five percent of the assessed patients experienced a treatment response. The median time to progression among all patients was 41.9 months. Two-year overall survival was 95%, while the progression-free survival was 85%. DLT included febrile neutropenia of grade 3. The RD of NDP was 90 mg/m(2) during cycles 1-3. CONCLUSION NDP combined with radiotherapy and administered every 21 days for three cycles was active in patients with locoregionally advanced NPC. The regimen resulted in mild adverse effects and good patient compliance. Based on the findings from the study, the RD of NDP for phase II trial was found to be 90 mg/m(2).
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Affiliation(s)
- Zibin Liang
- Department of Anatomy and Neurobiology, Sun Yat-sen University, Guangzhou, 510080, China
- Department of Radiation Oncology, The Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, 519020, China
| | - Siyang Wang
- Department of Radiation Oncology, The Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, 519020, China
| | - Zhong Lin
- Department of Medical Oncology, The Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, 519020, China
| | - Shaoyan Feng
- Department of Otolaryngology, The Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, 519020, China
| | - Zhibin Cheng
- Department of Radiation Oncology, The Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, 519020, China
| | - Yaqi Yang
- Department of Anatomy and Neurobiology, Sun Yat-sen University, Guangzhou, 510080, China
| | - Ying Kuang
- Department of Anatomy and Neurobiology, Sun Yat-sen University, Guangzhou, 510080, China
| | - Chibhabha Fidelis
- Department of Anatomy and Neurobiology, Sun Yat-sen University, Guangzhou, 510080, China
| | - Shahid Ullah
- Department of Anatomy and Neurobiology, Sun Yat-sen University, Guangzhou, 510080, China
| | - Feng Li
- Department of Anatomy and Neurobiology, Sun Yat-sen University, Guangzhou, 510080, China.
- Guangdong Provincial Key Laboratory of Brain Function and Disease, Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, 510080, China.
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Miyazaki T, Ojima H, Fukuchi M, Sakai M, Sohda M, Tanaka N, Suzuki S, Ieta K, Saito K, Sano A, Yokobori T, Inose T, Nakajima M, Kato H, Kuwano H. Phase II Study of Docetaxel, Nedaplatin, and 5-Fluorouracil Combined Chemotherapy for Advanced Esophageal Cancer. Ann Surg Oncol 2015; 22:3653-8. [PMID: 25691281 DOI: 10.1245/s10434-015-4440-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2014] [Indexed: 11/18/2022]
Abstract
BACKGROUND We performed a prospective, multi-institutional, phase-II, clinical trial of a docetaxel, nedaplatin, and 5-fluorouracil (DNF) regimen in patients with unresectable esophageal cancer. Our goal was to determine the efficacy and feasibility of this DNF protocol. METHODS Thirty-four patients with unresectable esophageal cancer were enrolled and received DNF therapy. The DNF regimen was repeated every 4 weeks for up to 8 weeks, based on the following recommended doses: docetaxel, 60 mg/m(2) (day 1); nedaplatin, 70 mg/m(2) (day 1); and 5-fluorouracil, 700 mg/m(2) (days 1-5). The primary endpoint was the response rate. The secondary endpoints were overall survival and chemotherapy toxicities. RESULTS The complete response rate and response rate were 5.9 and 47.1 %, respectively. The 2-year overall survival rate and progression-free survival rate were 44.3 and 27.3 %, respectively. The median survival time was 594 days. The median progression-free time was 277 days. No treatment-related deaths occurred. Thirty patients (30/34) with grade 3, 4 neutropenia improved relatively quickly with administration of granulocyte colony-stimulating factor. CONCLUSIONS DNF combination chemotherapy is a useful regimen with relatively minor adverse events and may serve as an effective protocol in patients with unresectable esophageal cancer.
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Affiliation(s)
- Tatsuya Miyazaki
- Department of General Surgical Science (Surgery 1), Gunma University Graduate School, Maebashi, Gunma, Japan.
| | - Hitoshi Ojima
- Department of General Surgical Science (Surgery 1), Gunma University Graduate School, Maebashi, Gunma, Japan.,Department of Gastroenterological Surgery, Gunma Prefectural Cancer Center, Ota, Japan
| | - Minoru Fukuchi
- Department of General Surgical Science (Surgery 1), Gunma University Graduate School, Maebashi, Gunma, Japan.,Department of Surgery, Gunma Chuo Hospital, Maebashi, Gunma, Japan
| | - Makoto Sakai
- Department of General Surgical Science (Surgery 1), Gunma University Graduate School, Maebashi, Gunma, Japan.,Department of Surgery, Isesaki Municipal Hospital, Isesaki, Gunma, Japan
| | - Makoto Sohda
- Department of General Surgical Science (Surgery 1), Gunma University Graduate School, Maebashi, Gunma, Japan
| | - Naritaka Tanaka
- Department of General Surgical Science (Surgery 1), Gunma University Graduate School, Maebashi, Gunma, Japan
| | - Shigemasa Suzuki
- Department of General Surgical Science (Surgery 1), Gunma University Graduate School, Maebashi, Gunma, Japan
| | - Keisuke Ieta
- Department of General Surgical Science (Surgery 1), Gunma University Graduate School, Maebashi, Gunma, Japan.,Department of Surgery, Isesaki Municipal Hospital, Isesaki, Gunma, Japan
| | - Kana Saito
- Department of General Surgical Science (Surgery 1), Gunma University Graduate School, Maebashi, Gunma, Japan.,Department of Surgery, Gunma Chuo Hospital, Maebashi, Gunma, Japan.,Department of Surgery, Isesaki Municipal Hospital, Isesaki, Gunma, Japan
| | - Akihiko Sano
- Department of General Surgical Science (Surgery 1), Gunma University Graduate School, Maebashi, Gunma, Japan.,Department of Gastroenterological Surgery, Gunma Prefectural Cancer Center, Ota, Japan
| | - Takehiko Yokobori
- Department of General Surgical Science (Surgery 1), Gunma University Graduate School, Maebashi, Gunma, Japan
| | - Takanori Inose
- Department of General Surgical Science (Surgery 1), Gunma University Graduate School, Maebashi, Gunma, Japan
| | - Masanobu Nakajima
- Department of Surgery I, Dokkyo Medical University, Tsuga-gun, Tochigi, Japan
| | - Hiroyuki Kato
- Department of Surgery I, Dokkyo Medical University, Tsuga-gun, Tochigi, Japan
| | - Hiroyuki Kuwano
- Department of General Surgical Science (Surgery 1), Gunma University Graduate School, Maebashi, Gunma, Japan
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Phase I/II study of docetaxel, cisplatin, and 5-fluorouracil combination chemoradiotherapy in patients with advanced esophageal cancer. Cancer Chemother Pharmacol 2014; 75:449-55. [PMID: 25544126 DOI: 10.1007/s00280-014-2659-6] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2014] [Accepted: 12/22/2014] [Indexed: 01/17/2023]
Abstract
PURPOSE This phase I/II study was aimed to determine the recommended dose (RD) of docetaxel, cisplatin, and 5-fluorouracil as combination chemoradiotherapy (DCF-RT) for patients with esophageal cancer and to evaluate the efficacy and safety of this protocol. METHODS Fourteen patients with esophageal cancer enrolled in this dose escalation study to determine the RD for a phase III trial. Efficacy and toxicity in DCF-RT of RD were evaluated in 37 patients with esophageal cancer. RESULTS The RD for DCF-RT for esophageal cancer in the present study was 50 mg/m(2) docetaxel plus 60 mg/m(2) cisplatin on day 1 and day 29 plus 600 mg/m(2) 5-FU on days 1-4 and days 29-32 and concurrent radiation of 60 Gy/30 fractions/6 weeks. The main toxicities were myelotoxicity and radiation esophagitis. In this phase I/II study, we could have safety and feasibility by RD, because there was low mortality and most toxicities were manageable level. The complete response (CR) rate and response rate were 54.1 and 83.8 %, respectively, in the phase II study. In patients with a classification of clinical T4, the CR rate and response rate were 47.6 and 85.7 %, respectively. The 2-year overall survival rate, 2-year progression-free survival rate, and median survival time (MST) were 52.9, 50.0 %, and 24.7 months, respectively. In patients with clinical T4 classification, the 2-year overall survival rate, 2-year progression-free survival rate, and MST were 43.5, 44.9 %, and 21.6 months respectively. CONCLUSIONS DCF-RT keeps safety and feasibility by management of myelotoxicity adequately in RD. This protocol might produce a high CR rate and favorable prognosis compared with standard chemoradiotherapy for advanced esophageal cancer.
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